Regulation of Health and Social Care Professionals Consultation

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could be made to provide better information for patients, the public and employers when considering post-registration qualifications. 76 5.105 The Health Professions Council currently annotates its register to indicate where a registrant has undertaken additional training on medicines and has obtained entitlements to supply, administer or prescribe these medicines. The Council is required to do this under the Prescriptions Only (Human Use) Order 1997. 77 The register is annotated where: (1) A chiropodist/podiatrist, physiotherapist or radiographer has completed an approved programme enabling them to become a supplementary prescriber; and (2) A chiropodist/podiatrist has completed an approved programme allowing them to sell or supply prescription only medicines and/or administer local anaesthetics. 5.106 The Council is consulting on whether, in addition, post registration qualifications in neuropsychology and podiatric surgery should be annotated in the register. 78 5.107 The Council for Healthcare Regulatory Excellence has raised concerns that only some of the regulators provide access through their online registers to information about health professionals currently prevented from practising because of fitness to practise sanctions. It recommended that the regulators should provide information about all current fitness to practise sanctions on their online registers, including suspensions and those who have been struck off. 79 Some of the regulators have specific rules requiring details of sanctions to be published in the register. For example, the General Pharmaceutical Council requires all warnings, undertakings, suspensions, conditions and determinations of impaired fitness to practise to be entered in the register. 80 The General Medical Council’s regulations also provide a detailed list of sanctions which must be included in the register. 81 Others deal with this issue by giving the Registrar general discretion to enter any information which is material to the case. 82 5.108 Some but not all of the regulators are required to publish information about former registrants who have been struck off or erased from the register. For example, the General Medical Council is required to publish against each entry in 76 Trust, Assurance and Safety – the Regulation of the Health Professions in the 21 Century (2007) Cm 7013, para 6.12. 77 SI 1997 No 1830. Issued under the Medicines Act 1968. 78 Health Professions Council, Consultation on Our Proposals for Post-Registration Qualifications (2010). 79 Council for Healthcare Regulatory Excellence, Health Professional Regulators Registers: Maximising the Contribution of the Regulators’ Registers to Public (2010). 80 General Pharmaceutical Council (Registration Rules) Order of Council 2010, SI 2010 SI 1617, r 5. 81 General Medical Council (Form and Content of the Registers) Regulations (No 2) 2010, reg 2 and 5(k). 82 Health Professions Council (Registration and Fees) Rules Order of Council 2003, SI 2003 No 1572, r 3(4). 92
the register any order for erasure by Fitness to Practise Panel. 83 The General Chiropractic Council and General Dental Council have adopted the practice of maintaining in their registers the details of those who have been struck off, but are not required to do so by their governing legislation. Provisional view 5.109 In accordance with provisional proposal 2-2, we believe that the regulators should in most cases have a significant degree of flexibility in determining the content of their registers. This would include powers to indicate a person’s name, gender, title, address, date of registration, qualifications and specialisms. 5.110 We welcome further views on annotating the register to indicate additional qualifications. The advantage of indicating additional qualifications is mainly where it leads to a protected title or protected functions. It provides clarity for the public about which professionals do not have the qualifications or meet the standards for that specific title or role. But where a qualification is indicated which is not linked to a protected title or function the advantages are less clear. This could add clarity in recognising standards for certain areas of practice. However, this may result in confusion about the purpose or meaning of the annotation. 5.111 In our view there are compelling reasons why primary legislation should establish minimum requirements where issues of public protection are relevant, such as requiring all registers to include details of any existing sanctions that have been issued following a finding of impaired fitness to practise. At present, the legal framework often leaves this matter to the discretion of the Registrar. We propose that the statute should establish greater clarity and require all current fitness to practise sanctions to appear in the public register. However, we welcome views on whether there are exceptions where it is not appropriate to make certain sanctions public or whether the level of information provided should be limited, for example where the sanctions relates solely to a professional’s ill health. 5.112 We also believe there are strong arguments for including on the register the details of other sanctions or forms of disposal which have been issued without a finding of impaired fitness to practise. This might include undertakings, warnings and Interim Orders. However, since in these cases the professional’s fitness to practise has not been found to be impaired, we propose that the regulators should be given discretion to include details of these sanctions. In making this decision they will need to consider whether it is necessary in order to protect, promote and maintain the health, safety and well-being of the public. 5.113 It may also be important for public protection reasons to include in the registers details of former registrants who have been struck off. This would help the public to identify individuals who have been struck off the register but continue to provide similar services under a different, unregulated title. In such cases, fitness to practise sanctions may remain relevant long after the panel has issued its determination. The Council for Healthcare Regulatory Excellence has recommended that regulators should publish information about health professionals who have been struck off on their online register for at least 5 years 83 General Medical Council (Form and Content of the Registers) Regulations No 2 2010, reg 2 and 5(k). 93
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Law Commission Scottish Law Commiss
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CODE OF PRACTICE ON CONSULTATION Th
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The default powers of the Privy Cou
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Review hearings 187 Should regulato
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FOREWORD BY THE CHAIRMEN OF THE LAW
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TABLE OF ABBREVIATIONS CHRE Council
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approval imposes burdens on the Dep
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1.14 Second, recent times have witn
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constrain the costs of the current
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1.26 The regulation of social care
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1.34 We will be undertaking a wide
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on several occasions. 4 2.3 There a
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workers), some are largely self-emp
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(2) to guarantee minimum procedural
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(8) the instrument is scrutinised b
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subject to scrutiny by the Joint Co
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PUBLIC CONSULTATION 2.37 Consultati
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(1) that which is binding (such as
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2.54 The role of the Privy Council
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Parliament”. 34 It is likely that
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(1) a report on the exercise of its
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earlier in this Part, Orders in Cou
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2.87 But the retention of section 6
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safety and well-being of the public
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Provisional Proposal 2-18: The Gove
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2.119 But we also consider it impor
Page 54 and 55: PART 3 MAIN DUTY AND GENERAL FUNCTI
Page 56 and 57: asset”. 10 The courts have also r
Page 58 and 59: practise is impaired. Thus, in maki
Page 60 and 61: interests of its members. Under our
Page 62 and 63: 3.36 In our view, the need for gene
Page 64 and 65: PART 4 GOVERNANCE 4.1 All of the re
Page 66 and 67: egulators would be placed directly
Page 68 and 69: powers to investigate and intervene
Page 70 and 71: 4.30 A regulator not included in ta
Page 72 and 73: Education and training 4.39 Most co
Page 74 and 75: must be lay or that there should be
Page 76 and 77: 4.57 The General Medical Council ha
Page 78 and 79: 4.66 Moreover, it is not evident th
Page 80 and 81: PART 5 REGISTERS 5.1 A key statutor
Page 82 and 83: 5.9 However, the significance of re
Page 84 and 85: 5.18 In effect, statutory powers wo
Page 86 and 87: 5.25 Finally, a small number of the
Page 88 and 89: Voluntary registers 5.33 Our provis
Page 90 and 91: Council may register a person (or g
Page 92 and 93: through negligence on the part of a
Page 94 and 95: 5.61 We propose that the statute sh
Page 96 and 97: communicated, which have no formal
Page 98 and 99: the statute should impose the same
Page 100 and 101: 5.90 In some cases, the right to ap
Page 102 and 103: not complied with continuing profes
Page 106 and 107: and provide links to information ab
Page 108 and 109: which practitioners have undertaken
Page 110 and 111: the Government in its guidance to d
Page 112 and 113: eing met by the local education pro
Page 114 and 115: 6.13 Second, our legal framework wo
Page 116 and 117: Medical Council must satisfy the re
Page 118 and 119: 6.31 The Health Professions Council
Page 120 and 121: (1) which qualifications are approv
Page 122 and 123: 6.48 Finally, there are a number of
Page 124 and 125: Good Medical Practice which covers
Page 126 and 127: and other optical appliances, such
Page 128 and 129: 6.72 We also believe that the new l
Page 130 and 131: looked at in detail only when conce
Page 132 and 133: professionals to remain registered
Page 134 and 135: Misconduct 7.6 Most of the governin
Page 136 and 137: (1) an order under section 246(2) o
Page 138 and 139: THE FITNESS TO PRACTISE FINDINGS 7.
Page 140 and 141: Option 2: consolidation of the exis
Page 142 and 143: (a) has in the past acted and/or is
Page 144 and 145: that many of the regulators have de
Page 146 and 147: PART 8 FITNESS TO PRACTISE: INVESTI
Page 148 and 149: language is not English. 7 However,
Page 150 and 151: of working around their legislative
Page 152 and 153: 8.22 Some of the regulators, such a
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undertake this task, for example, i
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Assessments 8.37 Most regulators ha
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(1) an Investigation Committee whic
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THRESHOLD TEST 8.52 Having undertak
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egulators accept undertakings given
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hearings or other safeguards, espec
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epeated. Second, following an inves
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Provisional view 8.84 The current p
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PART 9 FITNESS TO PRACTISE: ADJUDIC
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of the individual circumstances of
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practise process to be considered i
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to set up and the new arrangements
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oversee their Panel appointment pro
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the regulators to ensure that Panel
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9.50 For most regulators the fitnes
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enable the regulators to deliver ma
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(3) a private hearing is necessary
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Question 9-16: Should the statute p
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and final sanction”. 63 We theref
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Question 9-22: Should the statute g
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found to be unfit to practise. 73 W
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accountable, consistent, transparen
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above. The Council for Healthcare R
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Provisional Proposal 9-32: The stat
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that the sanction is clearly inappr
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away from self-regulation in health
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may appoint employees and has a wid
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Provisional Proposal 10-3: Appointm
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general functions should be retaine
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the imposition of a relevant sancti
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independence of the new Medical Pra
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11.5 However, it may be that the co
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Act 1972. For example, the Medicine
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is fit to carry on such a business
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extend to all businesses or to all
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Council and Care Quality Commission
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in the 2011 White Paper Enabling Ex
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12.13 The Council for Healthcare Re
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12.23 We welcome views on the examp
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places a general duty to cooperate
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equired to give due consideration t
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professions are not subject to the
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attach to systemic failures to impl
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Order 1976. The definition of the U
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oute to UK registration. 30 The Gen
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13.39 The potential advantages of t
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(6) professional bodies that repres
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Provisional Proposal 4-2: The statu
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(5) the appointment of visitors and
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Provisional Proposal 8-13: The powe
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Provisional Proposal 10-3: Appointm
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PART 13: CROSS BORDER ISSUES Provis
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GENERAL SOCIAL CARE COUNCIL It shal
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(8) Standards Committee GENERAL OST
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(22) Licentiate in medicine and sur
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(68) Speech therapist NURSING AND M
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