The UK’s health and care regulators have published their responses to the DHSC’s fitness to practise reform proposals.

The Department of Health and Social Care’s (DHSC) consultation on extensive fitness to practise reform proposals closed this week.  Responding to what has been described as a “once in a lifetime” opportunity, healthcare regulators have published their individual responses to the consultation.

Proposals include setting out the ambition of reforming the legislation of healthcare regulators across these four key areas:

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

The Nursing and Midwifery Council

The NMC said in its response it is broadly supportive of the DHSC’s proposals that will create “…a system which is able to respond to a changing health and care landscape whilst ensuring that we are accountable to and engaged with the public and the professions we regulate.”  However, it raised a number of specific points including:

  1. limitations of “Nurse” not being a protected title; and
  2. clarity on the NMC’s “independence” and “accountability to Parliament” not the DHSC.

The General Dental Council

The GDC also supported “…the ambition to remove outdated and overly prescriptive legislation, and to put in its place a modernised and flexible framework that can respond to change and innovation while enhancing accountability, transparency and public protection” but said the proposals need to go further.

In particular, it noted:

  1. fitness to practise cases take too long to resolve, and the GDC agrees. It said “This is why we think the new system must be adaptable and responsive, and why we oppose additional review powers that could add more time to the process.”
  2. It noted that reform has been too slow and “while the timetable remains unclear, we continue to urge government to prioritise this long-awaited regulatory reform, ahead of planned reviews of individual healthcare professional regulators.”

The Health and Care Professions Council

HCPC agrees with and welcomes the majority of the proposals in the consultation, and is seeking clarification or modification of certain points, including in relation to detailed aspects of Fitness to Practise (FTP) and Registration.

These include areas such as publishing information relating to qualifications held by registrants, the use of interim measures and the rationale for introducing suspension for failure to pay the fee or to comply with the regulator’s renewal/CPD requirements.

Social Work England

Overall, SWE support much of what is being proposed in the consultation. It said “We believe it will lead to a professional regulation landscape that is more effective, proportionate, fair and flexible, and that will continue to build public confidence in the health and social care professions.”

SWE noted however that it does not come under the legislative framework that is subject to these proposals as it has been established by the Children and Social Work Act (2017) and the Social Workers Regulations (2018).  However, it said “…our legislation provides us with some of the features considered within the current consultation. It is useful therefore for us to reflect on our experience so far of operating these features and sharing what we have learned through this consultation. Equally, there are proposals in the consultation that go beyond our legislation and regulations that could add value to our approach.”

The General Osteopathic Council

GOsC’s said it is supportive of many of the proposals, which it believes will ensure that the future regulatory system is enhanced. Within its response however it noted some disagreements with some of the proposals including rationale for why it has reached that view and also set out where it thinks the proposals could be further clarified or strengthened.

The areas of disagreement include:

  1. Fitness to Practise-Grounds for action – the GOsC view is there should be a separate ‘ground for action’ in relation to adverse physical and/or mental health.
  2. Registration -suspension from the Register – the GOsC view is that the proposal to suspend individuals for administrative reasons, risks blurring the relationship between the regulator and registrants, with regulators potentially adopting registration processes more akin to membership bodies.

The General Optical Council

GOC indicated that it mostly agreed with the consultation response but disagreed that the grounds for appeals and the appeals process should be set out in a regulator’s rules. It said “This has the practical effect of limiting the number of appeals to those that are serious and reducing trivial and vexatious appeals.”

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