Welcome to our Spring newsletter. In this issue, in addition to general updates, we focus on:
- Our new Strategic Plan 2023 to 2026
- Updated expectations/new Standard for both regulators and Accredited Registers with a stronger focus on equality, diversity and inclusion
- Regulatory reform
- Safer care for all
Strategic Plan: our goals for the next three years
We have just published our strategic plan. We have set ourselves some ambitious aims over the next three years:
- To protect the public by delivering highly effective oversight of regulation and registration
- To make regulation fairer and better
- To promote and support safer care for all.
Our top priority is to continue to deliver our statutory role – overseeing the 10 health and social care regulators and the Accredited Registers programme. This means continuing the work already underway to make our performance review process more proportionate and timelier; and continuing to raise awareness of the Accredited Registers programme and how it can contribute to alleviating workforce pressures and ensuring greater public confidence when choosing practitioners who are not subject to statutory regulation.
We approached our strategic planning differently this year – asking for feedback on the plan by consulting on our draft aims as well as how we can prioritise the recommendations set out in our report Safer care for all.
In addition to the three-year Strategic Plan, we will also publish a yearly business plan setting out in more detail the activities and actions planned under each strategic aim.
Find out more:
Better and fairer
Equality, diversity and inclusion are interweaved throughout our three aims, but are the main focus of strategic aim 2. We started thinking about how we can contribute to making regulation and registration better and fairer under our first EDI action plan. The result of this work is the decision to update our expectations of what regulators need to do to meet Standard 3 of our Standards for Good Regulation; and introducing a new EDI Standard for the Accredited Registers.
Updating our approach to assessing equality, diversity and inclusion
As part of our organisational equality, diversity and inclusion (EDI) action plan, we have been looking at how we assess regulators against Standard 3 of our Standards of Good Regulation: ‘The regulator understands the diversity of its registrants and their patients and service users and of others who interact with the regulator and ensures that its processes do not impose inappropriate barriers or otherwise disadvantage people with protected characteristics.’
We have been working towards developing our expectations since early 2022 and have recently been engaging with the regulators on the final wording of our updated evidence matrix and associated guidance. We wanted to increase our expectations of regulators’ performance against this Standard, partly as we have seen improvements across regulators from when we introduced the Standard in 2019. The first year we assessed regulators against Standard 3, six of the 10 met it; in the most recent cycle of reviews, all regulators met Standard 3. We welcome this progress and recognise the hard work and commitment that lies behind that improvement. We know that EDI is a key focus for the regulators we oversee, and we want to ensure we continue to push and support them in their improvement work. We also want to ensure we are doing what we can to identify and share learning and good practice.
We have now published the evidence matrix and guidance for regulations. The evidence matrix describes four outcomes relating to the regulators’ work in EDI, each one is broken down into a number of indicators. The outcomes and indicators show our expectations of regulators for the next three years. This work represents a shift in our focus in our assessments against our EDI Standard – from process to demonstrating impact. The matrix and supporting guidance will also help regulators understand what we expect them to do to meet the Standard. We will begin assessing regulators against the new evidence matrix at the end of their 2023/24 review periods.
Find out more
Introducing a new EDI Standard for Accredited Registers
We thought there was more we could do to strengthen our approach to EDI within the Accredited Registers programme and had committed to explore the possibility of this as part of our EDI action plan. At the tail-end of 2022, we consulted on the possibility of introducing a new EDI-focused Standard to our Standards for Accredited Registers. We received a wide range of responses supporting the proposal. We analysed all the responses and published our report on the outcome of the consultation on 5 May. We have now published the new Standards as well as the evidence framework and guidance for registers. The new EDI Standard will be introduced over the coming months and will look at how organisations holding a Register demonstrate their commitment to EDI. The information gained through our assessment of the EDI Standard in 2023/24 will be used to inform the development of a Good Practice Guide on EDI.
Find out more
Watch this space: we will be publishing a research report later this month: Perspectives on discriminatory behaviours in health and care arose from our observations in Safer care for all that there is a variable approach to how regulators deal with discriminatory behaviour within their fitness to practise processes. The key aim of the research is to help inform a consistent and appropriate approach by the regulators and Accredited Registers towards the various types of discrimination. The study examined what constitutes discriminatory behaviour from the public’s perspective and what impact this behaviour can have on public safety and confidence. It will be published on 14 June to coincide with our Chief Executive leading a session on equality at the NHS ConfedExpo in Manchester. So keep an eye out on our website/social media for more details. (Since this e-newsletter was distributed, we have now published this research and you can find out more here.
Reforming regulation
Supporting reform of professional regulation remains one of our key strategic aims. We’ve been calling for reform for several years and welcome proposals that will help modernise the system.
We submitted our response to the Government’s latest consultation on 15 May. This consultation sought views on legislation to bring Physician Associates (PAs) and Anaesthesia Associates (AAs) into regulation under the General Medical Council (GMC). However, reforms arising out of this consultation will have a far wider impact – potentially affecting as many as 1.7 million health and care professionals – as they will be used as a model for all other regulated professions and rolled out to each regulator in turn.
We believe these reforms are a key opportunity to give regulators more flexibility to help tackle some of the big challenges in the sector as well as the potential to bring about greater consistency between them. However, we do think there are some important changes to the proposals needed to maximise the benefits of the reforms. We set these out in a briefing published at the end of April: Improving regulation for safer care for all - a briefing on Government consultation on draft AAs and PAs Order. These recommendations are:
- Include all three stages of the fitness to practise process in the draft Order.
- Give regulators clear powers to review conditions and suspensions to make sure a registrant is fit to return to practice unrestricted.
- Allow final decisions by case examiners to be referred to a panel if they don’t protect the public.
- Give the PSA a new targeted power to obtain information so we can oversee reformed regulators effectively.
- Keep the powers regulators have now to handle health concerns about a professional.
We have also started considering how we may need to adapt our own oversight of the regulators, once they have moved across to the new model, as well as through the transition.
We want to help make the most of what these reforms can offer, while being there to spot and address any problems as they come up. In our response to the previous consultation, we recommended specific changes to our powers to balance out this greater freedom. We accept the Government’s decision not to proceed with these changes so are instead considering how we make use of other tools available to us. This includes considering how we deliver our statutory functions such as the performance review and how we make use of policy advice and guidance to support regulators to make use of their new powers effectively.
Find out more
Safer care for all
We published Safer care for all in September 2022. The report focuses on four key challenges we identified for the sector and their potential to adversely impact patient and service user safety. These challenges are:
- Tackling inequalities
- Regulating for new risks
- Facing up to the workforce crisis
- Balancing accountability, fear and public safety.
Following its publication, we hosted an online conference in November. Safer care for all is also threaded throughout our strategic plan, and we asked stakeholders to help us prioritise its 21 recommendations and commitments as part of our strategic plan consultation.
During 2023/24 we intend to focus on the interlinked issues of workforce, inequalities and accountability. A recurring theme in our discussions with stakeholders was that of culture in health and care. We realise that the PSA, alone, cannot tackle poor workplace culture or the problems associated with it, but we hope that through cooperation and collaboration with others on the priorities outlined we can bring about improvements needed to support better and safer care for all.
Find out more
Speaking of cooperation and collaboration – we have this week (6 June) held an online symposium on this subject: How can we successfully collaborate towards safer care for all? We will write-up the discussions, so keep an eye on our website for further details and we will also report more fully in our next newsletter.
General updates
Regulation and Accreditation
Since our last newsletter, Mark Stobbs retired from his role as Director of Scrutiny and Quality. This prompted a slight restructure – the Accredited Registers programme has now moved across to our newly-named Directorate for Regulation and Accreditation.
Recent results and outcomes of our Section 29 appeals
In the past few months, we have concluded six appeals of regulator final fitness to practise decisions. We decided to appeal these decisions because they were insufficient to protect the public. The cases we have appealed cover a range of issues, including cases involving:
- serious misconduct, including dishonesty and failing to safeguard children
- a breach of confidentiality
- procedural errors in the allegations brought before panels.
Cases we have appealed in the last few months include fitness to practise decisions from the General Medical Council, Social Work England, the General Pharmaceutical Council and the Nursing and Midwifery Council. You can find out more about all these cases from the link below.
Find out more
Reviewing regulators’ performance
At the end of March, we published Social Work England’s Monitoring Report. This marked the end of the first year using our new performance review process. We have plans to evaluate how it has gone, but anecdotal feedback so far suggests that it is more proportionate, timely and transparent.
The three reports published since the last newsletter were for:
The most recent change for us is introducing the updated expectations for Standard 3 (as mentioned earlier). We have now published the updated evidence framework to reflect this change and guidance for regulators.
Find out more
Accredited Registers update
Safeguarding consultation
In the last newsletter, we explained why we were carrying out a consultation on strengthening our approach to safeguarding for Accredited Registers. The consultation closed in February, and we received over 300 responses.
On a related note, in April 2023 the Government’s Independent Review of the Disclosure and Barring Regime (‘the Bailey Review) was published. The findings of the Bailey Review, and related Government reviews and Inquiries have potential implications for both the Accredited Registers and the statutory regulators of health professionals that we oversee.
We are considering the findings of the Bailey Review, alongside those of our public consultation. We plan to publish the full consultation report, and next steps, later in the summer. In the meantime, we continue to engage with the Home Office, Ministry of Justice and other key interested parties such as the Disclosure and Barring Service.
New applications for accreditation
We are currently assessing an application for Standard One from the Society of Clinical Perfusion Scientists. Clinical Perfusionist Scientists (also known as Clinical Perfusionists) are highly trained members of the cardiothoracic surgical team and experts in operating cardiopulmonary bypass. The Accreditation Team observed the role in practice in May, at St Bartholomew’s Hospital. Standard One is also known as the ‘public interest test’, and involves making an assessment of whether the benefits of a role are outweighed by the risks, as mitigated by the Register.
We will be announcing a new Accredited Register in July – keep an eye on our latest news page to hear who this is.
New EDI Standard
As mentioned earlier in the newsletter, we have now introduced an EDI Standard for Accredited Registers. We consulted on this between October 2022 and January 2023 and there was widespread support for introducing the Standard. You can find out more in the consultation report.
Find out more
In other news
Welcome to our new Board member
We have welcomed a new Board Member since the last newsletter. Nick Simkins was appointed to our Board by the Privy Council for a four-year term in March. Nick has also joined our Audit and Risk Committee. You can find out more about Nick’s appointment here and our Board here.
One last thing
Have you missed any of our blogs, news or publications? You can find all our most recent blogs here. You can also find all the consultations we have responded to in the last few months here.