Welcome to our Winter newsletter.
Safer care for all - solutions from professional regulation and beyond
Publication and launch
We published our report Safer care for all on 6 September 2022. In the report we highlighted some of the biggest challenges affecting the quality and safety of health and social care across the UK today and put forward recommendations that we hope can start a debate. Since we published the report (and held our conference) – the current challenges facing the NHS have been hitting the headlines. Unfortunately, there is no easy or quick-fix to the workforce crisis and the recommendations we put forward in the report do not offer any short-term solutions, but we hope that the four UK governments can work together to develop a coherent strategy for the regulation of professionals, to support delivery of their national workforce strategies. In the report, we also pose the question: ‘Does regulation need to change to deliver the workforce of the future?’ You can find out more about our thinking on the workforce crisis in chapter 3 of the report: Facing up to the workforce crisis and regulation’s future role.
Safer care for all conference
Do health/care professionals have a duty to tackle inequalities? Is regulation keeping patients safe? Are learning cultures compatible with individual accountability and openness when mistakes are made? Over 250 attendees came together (virtually) on 9 November 2022 to discuss and debate these questions and explore issues highlighted in Safer care for all – solutions from professional regulation and beyond.
We invited stakeholders to the conference to move the debate forward following the report’s publication. The conference provided an opportunity to hear experts’ views as well as consider and contest the themes raised in the report – including our main recommendation – the creation of a health and social care safety commissioner in all four UK countries. Speakers and delegates came from both professional and system regulators as well as patient organisations, the ombudsman, the NHS, health and care sector organisations and Chairs from major healthcare inquiries.
Our main aim in hosting the conference was to start working towards solutions that will support safer care for all. We are grateful for all those who attended, gave presentations, asked questions and contributed to helping us plan how we can take this work forward.
What happens next?
We realise that writing the report and putting forward its recommendations was the easier part of the process, identifying the solutions and working together (with the wider regulatory world) to realise them will be the harder part. We are writing up the main themes resulting from the conference’s discussions and plan to publish these on our website.
Find out more
Help us shape our work
Why are we consulting on our strategic plan?
We are consulting on our strategic plan to get stakeholder views and their input on our draft plan. This approach will enable us to set clearer, longer-term aims against which we will monitor progress and achievements. This plan covers the period 2023-26.
How to respond
We would welcome your views on our proposed strategic plan. The deadline to respond is 24 February 2023.
Find out more
Consultation on strengthening our approach to safeguarding with Accredited Registers
Our public consultation on whether to introduce clearer requirements for Accredited Registers to incorporate criminal records checks for practitioners closes on 7 February 2023. We have had a particularly high response rate so far. To help understand different impacts we have asked the charity Unlock, which supports people with criminal records, to survey its members. These types of checks are an important part of safeguarding, but protecting the public goes much broader. To help explore other dimensions of safeguarding, Kenny Gibson, the National Head of Safeguarding at NHS England, will be attending our Accredited Registers seminar today (1 February 2023) to provide an overview of best practice in safeguarding more broadly. We hope this will lead to further joint working, since Accredited Registers and their practitioners are well placed to help identify and act on safeguarding concerns.
Find out more
Updating our approach to assessing equality, diversity and inclusion - Standard 3
As part of our organisational equality, diversity and inclusion (EDI) action plan, we are revisiting how we assess regulators against Standard 3 of our Standards of Good Regulation. Standard 3 is: ‘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 assessing regulators against Standard 3 since the start of the 2019/20 performance review cycle and decided that, given the progress we have seen made by regulators in that time, it was appropriate to reassess what we expect of regulators in this area. We are currently reviewing our expectations, with a view to making these more challenging to continue to drive improvement. We expect to introduce updated assessments against Standard 3 from April 2023.
Consultation on strengthening equality, diversity and inclusion in the Standards for Accredited Registers
Our public consultation on strengthening Equality, Diversity and Inclusion (EDI) closed on 17 January 2023. Thank you to all who responded. The consultation sought views on whether to introduce a new EDI Standard for Accredited Registers. This would require Registers to ask for information about the protected characteristics of their registrants, so it can be used to help identify potential barriers for different groups. This would be in line with the approach introduced for the statutory regulators a few years ago. It could provide a rich source of data about different groups of practitioners. Over time, we hope this could help address health inequalities and barriers to entry for different professions. We also believe there is scope to expand the programme with Accredited Registers for some of the new roles being introduced to help deliver health and social care. This may help those impacted by inequality to gain improved access, experience and outcomes and therefore enhance their health and wellbeing. We hope to work with stakeholders to achieve this. We are now analysing the results of the public consultation, and will take proposals to our Board in March 2023.
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Checking and appeal regulators' final fitness to practise decisions
Recent results and outcomes of Section 29 appeals
Since our last newsletter, we have concluded 11 of our appeals of regulator final fitness to practise decisions. We decided to appeal these decisions based on our belief that they were insufficient to protect the public. The cases we have appealed cover a range of issues, including:
- cases involving physical abuse of vulnerable patients
- cases where dishonesty was not taken seriously enough by the panel
- cases where vulnerable service users were taken advantage of
- a case where a conviction for indecent assault of a minor was not treated as seriously as we considered it should have been.
Cases we have appealed in the last few months include fitness to practise decisions from the General Medical Council, the Nursing and Midwifery Council and Social Work England.
Find out more
Reviewing the regulators' performance and how they are meeting the Standards of Good Regulation
Our new performance review process
In early 2022, we introduced a new way of carrying out our performance reviews. We moved from a process whereby we looked in detail against every one of our 18 Standards of Good Regulation each year for all regulators, to a three-year cycle. In our new process, we continue to monitor and report on the performance of each regulator every year, but we are more risk-based in terms of where we focus our attention.
Why did we do this?
We wanted to improve our processes to ensure our approach to performance reviews was more proportionate and transparent, faster, and made greater use of engagement with regulators and wider stakeholders. These were identified as key priority areas in feedback we received from regulators and wider stakeholders who are interested in our reports. Introducing a cycle that includes a detailed review every three years, with close monitoring in other years, has allowed us to be more proportionate and targeted in our work, focusing on key risks each year. We now spend more time on areas we need to focus on rather than ensuring we look at every Standard in a certain level of detail.
In our new approach, we provide much more detail to the regulators about our analysis of their performance and how we make decisions about this. This has been an important development to provide greater clarity to regulators as to why they have or have not met our Standards, what they are doing well and what they might need to do to improve.
We have also introduced greater engagement with the regulators and wider stakeholders in our new process. We now meet regularly with each regulator to discuss key issues and developments. Over the past year we have also met with and heard from numerous other stakeholders who have an interest in the regulators’ work. This engagement is crucial to help highlight areas of the regulators’ work that we might want to look at more closely. It is particularly important as part of our more proportionate, targeted approach.
We are pleased with how the new process has shaped up so far, and will be looking to see how we can continue to improve it. Please do contact us with any questions or comments about our new process.
One of the key improvements we wanted to implement based on the feedback we received, was to publish our reports more quickly. We previously did most of our analysis after a review period had ended. This meant that it could take some time to publish our reports and that we could be reporting on things that had happened over a year ago. Consequently, sometimes regulators did not have long to address our findings before the end of the next annual period. For our new process, we therefore moved much of our analysis work in-year and set ourselves a target of publishing each report within three months of the end of the review period. We are pleased to say that we have met this KPI for all of our reports so far.
During 2022, we published several shorter monitoring reports and, in December, we published our first periodic review – this was for the General Dental Council. You can read all our recent reports here
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Accredited Registers update
Accreditation of the UK Society for Behaviour Analysis (UK-SBA)
On 10 January 2023, we announced accreditation of the UK-SBA. The UK-SBA registers people working in the field of behaviour analysis. Service users will typically be autistic children and adults, and/or people with learning disabilities. Behaviour analysts aim to help people learn new skills, as well as reducing engagement in behaviours that might be harmful to them or others. Before accreditation, we required the UK-SBA to strengthen its approach to handling concerns about registrants using behaviour analysis in a punitive way. We also highlighted that we expect the UK-SBA and its registrants to follow principles set out by the National Autistic Society’s principles to guide support for autistic people.
Health Practice Associates Council (HPAC) meets our 'public interest' test
The current pressures on paramedics and other frontline crew members, and the associated poor mental welfare, have been well documented. Last year we welcomed an initial application for Standard 1 (‘public interest test’) from HPAC, a UK-wide organisation that registers people working in the pre-hospital health care sector, such as ambulance staff, who are not required by law to be registered with a statutory regulator. We offer an initial assessment against Standard One (‘the public interest test’) to prospective applicants to check whether a Register falls within the scope of the Accredited Registers programme. With regards to HPAC, we found that, overall, the public interest test is provisionally met. Our report was published on 11 January 2023. We look forward to HPAC's full application within the next few months. We hope this will help make sure that people working in these types of frontline roles have access to appropriate support, as well as giving assurance to the public and employers about their suitability for the role.
Find out more
In other news
Welcome to our new Board member
We are pleased to welcome a new Board member - Juliet Oliver who joined our Board at the start of the year. Though we are also sad to say goodbye to two outgoing Board members: Antony Townsend and Renata Drinkwater. Find out more about Juliet here in her introductory blog. You can also find out more about the Authority's Board here.
One last thing
Have you missed any of our blogs, news or publications? You can find all our most recent blogs here, including guest blogs on the themes highlighted in Safer care for all. You can also find all the consultations we have responded to in the last few months here.