Skip to main content

Reforming regulation - views on consultation regulating healthcare professionals, protecting the public


The Government's consultation Regulating healthcare professionals, protecting the public has ran from March to June 2021.We submitted our full response on 11 June 2021.

You can read our full response to the consultation  here.

We welcomed the Government's consultation and supported much of what was in it. However, there were three areas that gave us cause for concern and we believe they could inadvertently create a gap in public protection. There are some simple, but important, changes that we believed could be made to make sure that we can create a future regulatory system that protects the public.

Our three concerns related to the potential to reduce public protection, transparency and accountability - we set them out below along with our proposals on how to fix them. You can find out more in our short report Three things to get right for public protection.

Top three things to get right 

Using 'accepted outcomes' to settle fitness to practise cases

1. Apply the public protection safety net we have now to all final fitness to practise decisions, and not just those that are made by panels

We currently check almost all final fitness to practise decisions made by regulators' panels. But the Government consultation proposes to settle many of these cases using 'accepted outcomes'. Even in the most serious cases, our powers to check these decisions would no longer apply. 

If there is no independent oversight of these decisions, similar to our current power, and no way to appeal decisions we believe do not protect the public properly to the Courts for review, then a valuable safety net will be lost with the potential to create a gap in public protection.  

Find out more >>

Reducing the grounds for action in the fitness to practise process

2. Keep the powers regulators have now to handle health concerns about a professional if there is a risk to the public

The consultation is proposing that the regulators grounds for taking action in fitness to practise will be reduced, and 'health' will be removed as one of the grounds for action.

This could make it harder for regulators to restrict the practice of professionals with a health condition. This would apply especially if they haven’t yet harmed a patient but may do so, based on an expert assessment. Unlike now where it is enough to establish that the professional poses a risk to patients that needs to be managed, regulators would have to prove that the health condition made their registrant incompetent.

Find out more >>

Governance: balancing flexibility with transparency and accountability

3. Keep some independent checks & balances to make sure that the way regulation works is safe & consistent across professions where it needs to be

The Government wants to give regulators more freedom so they can decide how they use the duties and powers they will be given in law. In principle we agree, as regulatory agility is important, though much depends on how this freedom is balanced with accountability. These new freedoms could lead to processes that are expedient for regulators but do not protect the public as well as they should. They could also enable major differences to emerge between the different regulators’ ways of working.

A proportionate power for the Authority to check how rules were made would guard against unjustifiable inconsistency and unsafe processes, while still giving the regulators more autonomy and a quicker process than what they have now. These reforms are an opportunity to make professional regulation both more consistent and more agile. Let’s get the balance right for public protection.

Find out more >> 

Useful resources

  1. Read our full response here.
  2. Read our short report First look at Government consultation on reforming regulation
  3. Read our short report Three things to get right for public protection - on the Government consultation on 'Regulating healthcare professionals, protecting the public'
  4. Frequently asked questions explaining more about fitness to practise, section 29 and the proposals put forward in the Government's consultation in the three areas that are giving us cause for concern.
  5. The added value of our power to appeal which goes beyond the appeal process itself and brings extra benefits including creating case law, improving decision-making and making the fitness to practise process fairer and more transparent
  6. Read through some examples of our power to appeal in practice in these case studies
  7. Read guest blogs expressing different perspectives on reforming regulation from: the Patients Association, the Pharmacists' Defence Association, Council of Deans of Health, Action against Medical Accidents, Sarah Ellson, partner at Field Fisher, the Medical and Dental Defence Union of Scotland. Read all our blogs here
  8. Read research - we have commissioned independent research and advice to help inform our thinking on reform, including Does consistency between regulators matter?Patient and public perspectives on future fitness to practise processes and Cognitive biases in fitness to practise decision-making: from understanding to mitigation