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Regulation of Health Care Professionals Regulation of Social Care Professionals in England

The Government’s response to Law Commission report 345, Scottish Law Commission report 237 and Northern Ireland Law Commission report 18 (2014) Cm 8839 SG/2014/26

In considering our response there has been close working with the regulatory bodies, and the Professional Standards Authority to ensure their views have been taken into consideration. We would like to thank them for their hard work and dedication to reforming the system of professional regulation.

In 2011, the White Paper Enabling Excellence: Autonomy and Accountability for HealthcareWorkers, Social Workers and Social Care Workers(Enabling Excellence)1 announced the Government’s intention to ask the Law Commissions to look into simplifying and modernising the current legislative framework.

Enabling Excellence made clear that any review of regulation policy should have the overriding objective that the system should focus on delivering safe and effective care, and should take close account of the Hampton principles of better regulation2. The Law Commissions have made a significant contribution to meeting that challenge.

Since the publication of Enabling Excellence, the context for health and professional regulation has developed. The seminal report following the inquiry into the harrowing events at Mid Staffordshire Hospital by Sir Robert Francis QC published in February 2013 (the Francis Inquiry)3 raised a series of challenges to the way in which health and care professional regulation works. Professional healthcare regulators need to become much more adept at analysing and using the information they have. Where they identify a risk to public protection, regulatory bodies need to take a more proactive approach and cooperate with other organisations (including systems regulators and health and care providers) to address that risk and ensure patients are protected.

The Francis Inquiry also identified barriers to overcoming these challenges: restrictive and complex legislation and insufficient capacity and resource. The Law Commissions’ review helps to address some of these issues – with recommendations aimed at allowing the regulatory bodies to become more proactive – as well as proposing better co-operation between the regulatory bodies, and giving a clearer oversight role to the Professional Standards Authority.

Systems of continuing fitness to practise are key to changing the regulatory model from reactive to proactive, improving quality of care and ensuring that safety is an absolute, and the Law Commissions’ recommendations build on all the work that has been done in this area over the last decade and more.
Changing culture and relationships in healthcare is not an easy task and cannot be easily legislated for. However the legislation surrounding health and care professional regulation needs to be reformed if we are to better support the necessary culture and relationships to grow.

We understand that the regulatory bodies may be disappointed that legislative processes have not moved quicker on this occasion. The Government is committed to legislating on this important matter when parliamentary time allows. In the interim, we are taking forward secondary legislation to improve the regulatory bodies’ processes in order to enhance patient protection and improve public confidence4. In addition, the Health and Social Care (Safety and Quality) Bill, presented by Jeremy Lefroy MP seeks to drive up public safety, professional standards and public confidence by proposing that regulatory bodies and the Professional Standards Authority have public protection as their over-arching objective.

Several key themes arise throughout this response, including, but not limited to public protection and how this can be best served by systems of professional regulation,

balancing the regulatory bodies’ autonomy and proportionate regulation with appropriate safeguards and ensuring consistency in certain key areas across the regulatory system when it is in the public interest to do so. It is important that professional regulation legislation is proportionate, effective and efficient, imposing the least cost and complexity consistent with securing safety and confidence for patients, carers and the public.