PSA signals major shift toward preventative fitness to practise regulation in 2026

The Professional Standards Authority (PSA) has set out a decisive direction for 2026, signalling a move toward preventative, data‑driven approaches to regulation—with fitness to practise at the centre of that shift. In its forward look at the year ahead, the PSA outlines how its oversight role will evolve as the regulatory landscape faces unprecedented scrutiny from national inquiries, workforce pressures, and rising expectations of transparency and fairness.

Preventative regulation moves to the forefront

A standout theme for 2026 is the PSA’s commitment to “exploring preventative approaches to regulation using data and insights.” This marks a significant pivot from traditional, reactive fitness to practise oversight—where concerns are addressed only after harm or risk has materialised—toward a model that identifies and mitigates risks earlier in the system.

For fitness to practise, this shift means:

• greater emphasis on early warning indicators
• closer examination of systemic and organisational contributors to risk
• support for regulators to intervene before concerns escalate
• a stronger focus on learning, trend analysis, and cross‑regulator intelligence

The PSA’s system‑wide vantage point positions it to lead this transition, using its comparative oversight of all statutory regulators to identify patterns that individual bodies may not see in isolation.

Fitness to practise learning becomes a core output

The PSA confirms that its Learning Points from fitness to practise reviews, first consolidated into a single report in 2025, will continue as a key feature of its regulatory oversight in 2026. These reports distil recurring themes from fitness to practise decision‑making across regulators, highlighting both strengths and areas requiring improvement.

By embedding this learning into its annual programme, the PSA aims to:

• improve consistency in fitness to practise decision‑making
• support regulators to address recurring weaknesses
• promote fairness, proportionality, and transparency
• strengthen public protection through shared learning

This reinforces the PSA’s role not only as a reviewer of individual decisions but as a driver of system‑wide improvement.

New Standards will shape future fitness to practise expectations

The PSA plans to introduce new Standards for regulators and Accredited Registers in 2026, with clearer expectations around leadership, governance, and organisational culture. These areas are increasingly recognised as critical to the quality and fairness of fitness to practise processes.

The updated Standards are expected to influence:

• how regulators demonstrate cultural competence in fitness to practise
• the handling of discrimination, bias, and fairness concerns
• organisational learning from fitness to practise cases
• the maturity and transparency of regulatory decision‑making

This aligns with wider national scrutiny of healthcare regulation, including the Mann review on racism and antisemitism and the Thirlwall Inquiry into serious patient safety failures.

A year of inquiries will shape the PSA’s fitness to practise agenda

Several major investigations are due to report in 2026, including Ockenden, Amos, Thirlwall, and the Independent Review of Social Work Regulation. Each is expected to raise questions about how regulators identify risk, respond to concerns, and ensure accountability.

The PSA has signalled that it will engage closely with these findings, using them to inform its oversight of fitness to practise processes and its advocacy for reform.

A more proactive oversight role

Taken together, the PSA’s 2026 priorities point to a more proactive, intelligence‑led approach to fitness to practise regulation—one that seeks to prevent harm rather than simply respond to it. By combining data‑driven insights, strengthened Standards, and cross‑regulator learning, the PSA aims to reshape how fitness to practise risk is understood and managed across the sector.

As the regulatory environment faces increasing complexity and public scrutiny, the PSA’s shift toward prevention marks a significant evolution in its role—and a potentially transformative moment for fitness to practise regulation across the UK.

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