Reforming regulation

15 February 2018

The legal framework governing the UK’s health professions regulatory bodies needs reform. That is the clear message we gave to the Department of Health and Social Care recently, in our response to their consultation about reforming the regulation of health professionals. 

The government’s consultation provides the opportunity to identify how regulation needs to change so it works as well as possible for patients and the public, and effectively supports the professionalism of all health professionals. And we hope this consultation will lead to positive reforms.

In our response, we made the case that we need to change the way we regulate to improve protection and assurance for patients and the public, and better support the professionalism of all health professionals.

 Health and social care has changed considerably to meet the changing needs of the population, and it will continue to change. Regulation must change too to match that.

Changing the legal framework

Regulation is most effective at ensuring safe and effective care when it has a wide range of flexible regulatory tools that can be used to provide assurance and help to promote improvement.  We are seeking changes to our legal framework, which governs how we work, to improve our ability to regulate effectively, and to give us the flexibility we need to be able to respond effectively to external changes. 

In return we need to be held to account. We would gladly, and indeed should, provide more assurances to the Parliaments and Assemblies across Great Britain to whom we are accountable, to ensure there are checks and balances over our decisions and actions.

We are conscious that this consultation has taken place at a time when there are many other demands on government and on the parliamentary time needed to legislate for the changes proposed, and so none of us yet know what will happen following this consultation. More importantly, we also appreciate that the consultation has taken place at a time when everyone in pharmacy, and in healthcare generally, is exceptionally busy caring for their patients in a rapidly changing and uncertain environment.

Number of regulators

What hit the headlines in relation to this consultation was the proposal that there should be fewer regulators, and that some of the existing regulators should be merged. We think it is right that this debate is had, and we have an open mind about this issue.

The number and configuration of regulators is of course ultimately a decision for governments. In our response we argue that the contextual understanding of professions, where and how they work must not be lost. We all need to probe the evidence base for changing the number of regulators and explore whether any particular proposals would lead to better outcomes for patients and the public, which is the important thing.

Supporting professionalism

We welcome the clear focus within the consultation on supporting professionalism. We have long said that regulation is more than enshrining and enforcing minimum standards. Our focus should be on promoting and supporting professionalism because it enhances patient safety and quality of care.

As part of that, we need to make sure that the environments in which health professionals work enable them to meet professional standards. This consultation focuses on reforms to regulation of health professionals, but in our response we say there should also be a debate about our powers to regulate registered pharmacies. As the regulator of both pharmacy professionals and registered pharmacies, we believe the environments in which health professionals work are critical to the context for delivering professional, safe and effective care. Strengthening the regulation of both the professionals and the places in which they work is therefore a critical part of assuring and improving care.

Having a debate about this is particularly important at a time when there is increasing focus on how the environments in which health professionals are working could affect patient safety. Both in pharmacy, and in other areas of healthcare, professionals are raising concerns that the environments in which they are working are affecting their ability to provide safe and effective care.

Most recently, the case of Dr Bawa-Garba has raised a number of concerns among health professionals. These include concerns about how their regulator, and the courts, may respond when they make errors when working in often very challenging environments.

This is a difficult and tragic case and we will be considering any implications with others. We will actively engage with the rapid review commissioned by the Secretary of State and led by Professor Norman Williams, and carefully consider all of the outcomes of that review.

I would encourage you to read the statement we’ve issued in response to the issues raised in this case. And I would strongly urge you to continue to report errors and take part in processes to learn from errors. It is undoubtedly difficult to speak up when things go wrong, but it is vital for patient safety that errors are reported and discussed.

And I want to make clear that this responsibility lies with all of us. As the regulator, we will work hard to promote a culture of openness, honesty and learning across pharmacy, and we will be urging everyone who employs pharmacy professionals to do the same.