Skip to main content

Safer care for all

Solutions from professional regulation and beyond

In our report - Safer care for all - (published in September 2022) we examine the current state of professional health and care regulation in the UK. However we go beyond this in identifying and proposing solutions to some of the huge challenges facing health and social care today.

Our report considers four main themes:

  1. Tackling inequalities
  2. Regulating for new risks
  3. Facing up to the workforce crisis
  4. Accountability, fear and public safety

Next steps for Safer care for all and how it ties in with our strategic direction

We published Safer care for all in September 2022. Since then we have been carrying out extensive engagement with stakeholders (including by consulting on our draft Strategic Plan) to develop our focus for the next three years and plan for 2023-24.

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 with the ambitious aims we've set out in our strategic plan, we can make a start and work with others to to highlight improvements needed to assure better and safer care for all.

  1. Workforce – we know that workforce shortages impact patient safety as well as professionals’ workplace wellbeing. We want to focus on building the evidence base around the regulatory barriers. Working with regulators and wider stakeholders, we want to identify solutions to help create a more agile workforce as well as encourage innovation. We think this work will help us shape a practitioner regulatory strategy. We believe this is needed to support health and care workforce strategies across the four countries of the UK.  
  2. Inequalities – in addition to the work we are doing to revise our expectations of how regulators will meet Standard 3 as part of our performance review process (Standard 3 of our Standards of Good Regulation is focused on regulators understanding the diversity of their registrants, patients and service users and not creating barriers through any of their processes/disadvantage people with protected characteristics), We are also introducing a new EDI standard for the Accredited Registers. Our work in this area will focus on engaging and convening stakeholders on key issues where we can add value and support action. This will include disseminating our consumer research on perceptions of discriminatory behaviour in health and care and looking at barriers to complaints and the role of healthcare professionals in tackling health inequalities.
  3. Accountability – our main focus in this area will be to work with regulators to encourage clear messaging on the role of professional regulators when there have been serious failures of care. We also want to facilitate and encourage stakeholders to look at how to learn from serious patient safety incidents. This will include consideration of the wider issues we are aware of that may impact on professionals’ fear of regulation and wider accountability mechanisms, such as blame culture, barriers to candour and experience of ‘moral injury’ by healthcare professional involved in major failures of care.      
  4. Safety system – work in this area will be primarily focused on building our evidence base on how the functions proposed for the Health and Social Care Safety Commissioner might be delivered in different ways across the four UK countries and engaging with existing bodies fulfilling some or all of these functions across the UK. We want to explore how improvements in the safety system might be achieved. We also intend to engage with stakeholders on the case for a more coordinated approach to public inquiries and reviews (through a Commissioner role or otherwise).     

We will continue having conversations with stakeholders as we take forward this work through the year so watch this space.

 

Take a closer look at the four issues


Tackling inequalities

There are still unequal and unfair outcomes for protected groups in aspects of professional regulation. There is also a lot we still do not know about how inequalities affect all-important complaints mechanisms when care has gone wrong – or indeed what this could tell us about biases in care itself. Professional regulation must work to address its own issues, and support professionals to help tackle inequalities in the design and delivery of care. But as a sector, we also need to be better at hearing diverse voices, and collecting, analysing and sharing data.

>>Find out more


Facing up to the workforce crisis

Workforce shortages are putting patients and service users at risk across the UK. Engrained attitudes to professional regulation and qualifications aren’t helping. Is it time to rethink the contribution of professional regulation to workforce planning?

>>Find out more


Regulating for new risks

Changes in the way that care is funded and delivered are sometimes made with limited focus on the risks and impacts on patients and service users, and how to manage them. Reforming the regulators gives us an opportunity to address known problems, and may even build in some agility for the future – if we take the opportunity presented to us. But we also need better, more reliable ways to anticipate these changes.

>>Find out more


Accountability, fear and public safety

Just cultures and individual accountability are both essential to better, safer care, and must coexist. Professional regulation should be clearer about its role, to reduce unnecessary anxiety and inappropriate complaints. We need to find ways for these new approaches to safety such as ‘safe spaces’, to incorporate openness with patients, service users and families, and action against individuals where it is needed for public safety.

>>Find out more

Read all recommendations

You can find a table of all our recommendations here. This is not also a case of the 'we say, you do' - we have also committed the Authority to play an active role in tackling these challenges. These commitments are also listed in the table.


What would you like to read?

We have several versions available.  Not got time to read the report in full? You can read through the executive summary here. This encapsulates the four main themes set out in the report as well as the recommendations we have put forward. Even more pressed for time? Then read The essentials - this (very) short section tells you what the report is all about.

You can also download:


There is also a Welsh translation available of front part of the report, including The essentials and the executive summary. You can download it here

We also have a Word version of the full report available. Please get in touch - using the email address below - if you would like a copy.

Please get in touch with us if you would like a Word version of the full report.

Starting the discussion

Safer care for all conference 

When we published Safer care for all in autumn 2022, one of our main aims was to start a debate on the issues highlighted and the recommendations we put forward in the report. To take the next steps we organised a conference. On 9 November 2022, over 250 attendees came together (virtually) to discuss issues highlighted in the report, including:

  • 'Does regulation need to change to deliver the workforce of the future?'
  • '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?'

The conference provided an opportunity to hear experts’ views as well as consider and contest the themes raised in the report. 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. You can find a summary of the main themes that came out of the discussions here.

Safer care for all guest blogs

We are also publishing a series of guest blogs written by stakeholders from across the sector. You can find all our guest blogs published to date below:


Read our blogs

  • Five priorities to address health inequalities

    May 16, 2024, 15:09 by Christine Braithwaite, PSA Director of Standards and Policy
    In this blog we outline five priorities we identified at our event in December to address healthcare inequalities - actions that could be taken by regulators, and could make a real difference towards addressing, and solving, the problem of healthcare inequality
    Full story
  • Safety nets and sledgehammers

    May 1, 2024, 09:47 by Anna van der Gaag Visiting Professor, Ethics and Regulation, University of Surrey
    In this guest blog, Anna van der Gaag, reflects on our recent round-table exploring how to bring the best of safety culture initiatives and the best of regulatory processes together to do more for patient safety
    Full story
  • Looking back to help us look forward

    Jan 10, 2024, 11:53 by Caroline Corby, PSA Chair
    PSA Chair, Caroline Corby, shares her thoughts on the coming year - with 2023 being a busy year for us, it's looking like 2024 is shaping up to be just as busy
    Full story
  • Public protection at the heart of reform

    Dec 19, 2023, 12:43 by Alan Clamp, PSA Chief Executive
    In this blog, PSA Chief Executive asks now that legislative reform underway, what are the next steps for professional healthcare regulation?
    Full story
  • Reflections from our roundtable in Scotland: barriers to complaining

    Nov 17, 2023, 14:35 by Moi Ali, PSA Board Member
    What are the barriers to complaining? In this blog, PSA Board member Moi Ali reflects on our recent roundtable in Scotland discussing this subject
    Full story
  • How can regulation support the healthcare workforce in Wales – now, and in the future?

    May 3, 2023, 08:09 by Professor Marcus Longley
    In this blog, our Board member, Marcus Longley, gives a brief overview of discussions as part of our joint seminar looking at the current regulatory context in Wales
    Full story
  • Race inequality in health and care. Who’s responsible?

    Jan 25, 2023, 16:59 by Sam Rodger, Assistant Director, Policy and Strategy, NHS Race and Health Observatory
    In the latest in our series of guest blogs to discuss issues raised in our report Safer care for all, Sam Rodger from the NHS Race and Health Observatory discusses how making race equity everybody's job risks it being nobody's job, but we can all have a shared ambition to create a culture of equity
    Full story
  • A vision for an anti-racist NHS

    Jan 17, 2023, 10:57 by Indranil Chakravorty, Chair of the Bapio Institute for Health Research
    As part of our series of guest blogs to look in more detail at the themes highlighted in our report Safer care for, Indranil Chakravorty, Chair of the Bapio Institute for Health Research writes about their vision for an anti-racist NHS
    Full story
  • Cultural Safety – seeking to turn the tide of health inequities in Aotearoa New Zealand

    Jan 6, 2023, 10:50 by Joan Simeon, Kiri Rikihana, Richard Tankersley, Jane Dancer, at The Medical Council of New Zealand
    In our latest blog, Joan Simeon, Kiri Rikihana, Richard Tankersley, Jane Dancer at The Medical Council of New Zealand, discusses the role of healthcare practitioners, and regulators in addressing health inequities in Aotearoa, New Zealand, and how the practice of cultural safety can improve patient outcomes.
    Full story
  • Who isn't complaining? Learning from those who do not complain

    Dec 16, 2022, 13:26 by Jacob Lant, Head of Policy, Public Affairs, Research and Insight, Healthwatch England
    In this blog, Jacob Lant, Head of Policy, Public Affairs, Research and Insight at Healthwatch England, explains how the healthcare system can use complaint processes to address inequalities in healthcare and how this can help us understand the demographic of those who are not complaining to learn about those who are receiving poorer outcomes.
    Full story

Get in touch

Contact us if you would like to join the discussion about how we can work together to make health and social care safer for all. You can get in touch by emailing engagement@professionalstandards.org.uk