Adapting to change in three steps: reflections from the research and academic conference

Mark Platt – Policy Manager at the GDC – reflects on our recent Academic and Research conference from three perspectives: attending, presenting and chairing a break-out session.

As a relatively newbie to the world of professional regulation, but a longer-term actor in the field, I love any opportunity to mix with colleagues to consider, contrast and compare what we do and how we do it. And of course, how we can do it all better.

My first Authority academic and research conference was last year (incidentally while I was interning at the Authority, on projects designed to help with Section 60 reforms; long promised, but at that stage, still not progressed). I managed to squeeze in a presentation, but it all happened rather quickly and I only managed to attend for the first half-day. This time, I grabbed every opportunity offered, which meant that not only did I get to attend, but I also presented at a session, and chaired another. That triple participation, from three different angles, garnered me with perspectives I think are worth sharing.

We are all joining the dots

Nowhere, certainly not in any of the sessions I attended, was there any sense that what we do would stop ‘mattering’, for patients, registrants, or government. While there were differences in perspectives, there was an accord on the need for professional regulation to continue across health and care.

But there was divergence about how to progress what we do and what we need to do to meet the challenges of the new landscapes emerging before us. And this was before COVID-19 had fully raised its head. My big ‘take-away’ was that digital and technical innovation is likely to dominate the future of our work, necessitating more use and better handling of data. Added to that is that context remains king, with national political settlements being important propellants or constrainers for how data is used, and more generally, how we will be expected meet our objectives.

Convergence is coming but divergence still happens

Across all the presentations there was a recognition of different professions working in similar spaces expecting similar treatment. As health and care become more patient-centred, and patients become savvier, regulators need to be increasingly willing and able to collaborate, not least on how they view fitness to practise.

I was stuck by the plenary discussion between Harry Cayton and Deanna Williams, where I agreed with them both, even though they, at times, appeared to be disagreeing with each other. Deanna’s exhortation, that everything must change, is very much in line with my personal view that regulation does need to reform, especially in relation to multidisciplinary working arrangements. But Harry’s perspective, that the challenge for regulators is to do the ‘bread and butter’ work better, is obvious to anyone who has asked patients about their understanding of what we do. Not least, in relation to concerns that span more than one profession and implicate delivery systems, as well as professionals.

The scale of the divergence between regulators, was forcefully demonstrated in a presentation from Dr Asta Medisauskaite and Dr Rowena Viney of University College London. They showed the vastly different range of actions and consequent sanctions made by UK regulators for what appeared to be similar breaches. While some variances can be the result of case specificities and individual regulators’ powers, the fact of similar offences resulting in different outcomes is a concern shared by all of the regulators, and something that has been picked up in developing research and policy work, badged under the gnomish title of ‘seriousness’. As we move towards greater team-working, and it becoming the rule rather than the exception, regulators must work together and in collaboration with the professions and patients to resolve unnecessary divergencies.

We (still) need to communicate better

Lots of presentations highlighted how regulators, irrespective of jurisdiction, can improve how they communicate their missions and action. Our current regulatory system is complex, the legislation is complex, and at the heart of our existence is a complex concept that defies easy explanation, ‘fitness to practise’. Throw into the mix, innovations such as accredited registers (AR) and regulators keen to retain control of their own space, and the recipe for public confusion is clear.

That potential for confusion was brought into stark relief by a presentation from an AR regulator, about an investigation they began which ended fruitlessly (for them) with a struggle for control in the ‘powers matrix’ occupied by numerous other regulators, both professions and systems.

To close on that point, when we undertake positive actions, we can often make them overly complicated, for instance with requirements and terminology around continuous professional development (CPD) and revalidation. This point was made to me quite eloquently in a conversation with a ‘regulatee’ representative during one of the tea breaks that enabled de-pressurisation between sessions.

It’s not over until it’s over…

Two days are a sizeable chunk from a working week, but as ever, good things always seem to go quickly. I thoroughly enjoyed the conference sessions that I attended, and the change of location made it visibly a much bigger and more diverse event than its predecessor.

The programme provided plenty of chances for regulators to consider the range of challenges and opportunities ahead of us. It also provided a great opportunity to stop and really think about what we do, and how we could improve it.

COVID-19 has the potential to radically change how our health and care systems work. I’m not sure whether the time between this conference and next year’s will seem longer or shorter, but I’m fairly sure it will feature lots of 2020 case-studies proving that regulation does matter, as well as identifying how things might be further improved, for patients and professionals alike.

Related material

You can read through Mark's presentation on Working with professionals and patients to develop values-based practice in dentistry. Other presentations from the conference can be found here. You can also watch highlights of the conference.