Overview of the Department of Health and Social Care’s proposed reforms to the regulation of healthcare professionals

The UK model of regulation for healthcare professionals is rigid and complex and needs to change to better protect patients and service users, support our health services and to help the workforce meet future challenges. This consultation seeks views on proposals to modernise the legislation of the healthcare professional regulators. 

The proposed reforms cover four key areas. These are: 

  • Governance and Operating Framework
  • Education and Training
  • Registration
  • Fitness to practise

 When considering reforms to the regulator’s legislation, we have followed a number of principles:

  • Public safety is paramount and at the heart of professional regulation;
  • Registrants’ rights must remain protected;
  • The system should be able to respond to changing workforce models and developments in health and social care delivery without the need for ongoing legislative change;
  • Regulators should have broadly equivalent powers to maintain a level of consistency and effective public protection;
  • Overly detailed legislation should be replaced; and
  • Minimising the cost of regulation where possible, provided this is consistent with public protection.

What the Department of Health and Social Care is proposing for fitness to practise reform

  1. Consistent fitness to practise arrangements across all the regulators to overcome “considerable variation” in the fitness to practise powers currently available to the regulators. “Consistent fitness to practise arrangements” will:
    1. provide regulators with an amended set of powers, allowing more cases to be concluded earlier through accepted outcome decisions made by case examiners
    2. provide regulators with the ability to set their operational procedures through rules, removing the requirement for legislation
    3. remove the General Medical Council’s right to appeal Fitness to Practise panel decisions
    4. amend the power to require information in relation to fitness to practise cases to expressly exclude reflective practice material
    5. provide a right for anyone to request a review of a fitness to practise decision made by a case examiner, or made at the initial assessment stage of a case; and
    6. provide all regulators with a power for the Registrar to review a decision made by a case examiner, or at the initial assessment stage of a case.

The DHSC said:

“These changes aim to deliver a fitness to practise process that is less adversarial and with more cases resolved without the need for a fitness to practise panel hearing. This will provide benefits to all parties involved in fitness to practise proceedings. It will deliver protection for the public more quickly. It will reduce the stress on registrants and others that are party to the fitness to practise process, and it will increase the likelihood of reflection and learning from cases.

“Currently, regulators focus much of their effort and resource on the small minority of registrants whose fitness to practise is a concern. These changes will enable regulators to provide a greater level of support to improve the professionalism of all of their registrants.”

A three-stage fitness to practise process for all regulators

The DHSC proposal will introduce a three-stage fitness to practise process for all regulators:

  1. Initial Assessment – to determine whether a concern received about a registrant meets the criteria for onward referral in the fitness to practise process.
  2. Case Examiner Stage – to carry out a detailed assessment of the case from the written information and evidence available, and where possible, make a decision based on their assessment of impairment and whether action is needed to protect the public.
  3. Fitness to Practise Panel Stage – If a case is referred to a Fitness to Practise panel, the panel is required to make a determination as to whether a registrant’s fitness to practise is impaired.

Automatic removal

DHSC is proposing to introduce a new power that will enable regulators to automatically remove a registrant from the Register, if they have been convicted of specified serious criminal offences (known as listed offences).

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