Regulatory reform of healthcare professional regulation

It intends to proceed as follows:

• First, consult on reforms to the General Medical Council’s legislation which will introduce the regulation of Anaesthesia Associates (AAs) and Physician Associates (PAs) under a regulatory framework that will be the template for future reforms for all regulatory bodies.
• Then introduce further legislation for the reform of the regulation of doctors, following that template.
• Work with the Nursing and Midwifery Council (NMC) and Health and Care Professions Council (HCPC) on reforming their legislation in line with the template.
• Finally, make legislative changes for the remaining regulators.

Following the enactment of the Health and Care Act 2022, the Government is still working on looking at the number of healthcare regulators, and (to uses its phrase) considering whether “opportunities for simplifying the landscape exist”.

The proposed new regulatory framework for healthcare professional regulators includes significant changes to:

• Governance and operating framework: Regulators will be given increased autonomy, balanced by increased accountability and a new governance model. They will have the power to make their own rules without parliamentary approval. They will be under a duty to cooperate and collaborate with other regulators and wider stakeholders. The regulators will be given the power to set their own fees, as well as determine a longer-term fees framework.
• Education and training: The reforms are intended to give regulators greater flexibility as to how they set the standards, and how they quality assure education and training.
• Registration: The new framework sets out the essential requirements to maintain public protection, then aims to give the regulators the powers they need to uphold the integrity of the register and maintain public confidence. Regulators will be able to set out the detail about what needs to appear on the register, as well as the requirements for registration (standards and procedures). The Government considers that a requirement to hold adequate indemnity cover and meet English language proficiency standards, as well as a duty for regulators to carry out periodic checks that registrants continue to meet the standards for practice, are essential for public protection, and these will appear in the new high-level framework.
• Fitness to practise: there will be two new grounds for impairment: misconduct, and inability to deliver care to a sufficient standard. The latter will cover concerns arising from lack of competence, health, and English language skills. There will be a three-stage fitness to practise process:
  • Initial assessment: The regulators will have power to define their process for deciding whether a matter should be referred to a case examiner.
  • Case examiner consideration: Case examiners will have the power to make decisions on impairment and what action should be taken as a result. If the registrant agrees with the decision and outcome, it will stand. If they fail to respond within 28 days, the case examiner may decide that the decision and outcome should stand. If the registrant disagrees with the proposed decision and/or outcome, the case moves to the third stage.
  • Panel consideration: Final measures available to case examiners and panels following a finding of impairment will be conditions, suspension and removal from the register.

There are also high-level provisions covering interim measures, and reviews, revisions and appeals against decisions.

• The framework also includes provisions designed to ensure fairness (requirements to give people an opportunity to make representations, notification requirements) and transparency (publication requirements). There are also evidence gathering powers, as well as provisions giving the regulators power to make procedural rules.

You can see the Government’s full response to the 2021 consultation on healthcare professional regulation here. The consultation on the AA/PA legislation opened on 17 February 2023 and runs until 16 May 2023. You can read more, and take part here.