Regulation of Health and Social Care Professionals Consultation

in the 2011 White Paper Enabling Excellence:
There may also be duplication of effort from local systems of
management and clinical governance and regulatory oversight, which
carries a risk of confusion about who is responsible for addressing
concerns about poor practice. An over-reliance on a centralised
national system of regulation can weaken local responsibility for
managing problems effectively and promptly. The right balance needs
to be achieved between national regulation and effective local
governance and scrutiny. 3
12.5 There have been several calls for a reassessment and clarification of the role of
professional regulation in this complex field. 4 The advantages of more effective
interfaces can include the reduction of unnecessary costs, meeting service user
expectations, facilitating learning within health care organisations and improving
the ability of the system as a whole to deliver public protection. 5
12.6 Many of the regulators have developed systems to encourage more effective
interfaces. For example, some of the regulators have agreed a memorandum of
understanding with the Care Quality Commission. 6 The General Medical Council
recognises a four layer model of medical regulation involving personal regulation,
team-based regulation, workplace regulation and professional regulation, on the
basis that effective regulation requires the support and co-operation of others. 7
This strategy has led to the introduction of UK wide employer liaison advisers to
provide support to medical directors, employers and Responsible Officers with
their concerns about individual doctors and when to refer cases to the Council.
Provisional view
12.7 The regulatory landscape is extremely fragmented in the field of health and social
care. A radical option for reform would be to consolidate all the different systems
into a single overarching legal framework. However, this option can be described
as at best extremely ambitious, and would raise significant practical and resource
issues given the wide range of disparate systems that would potentially fall within
scope. In any event, it is beyond the remit of our review to consider the entry
thresholds to the different complaints and other processes detailed above.
12.8 Alternatively, the statute could attempt to define precisely which matters are
lawfully the responsibility of the regulators and which matters are outside their
remit. Currently, the law gives the regulators general functions – maintaining
registers, setting standards for education, conduct and practice, and undertaking
investigations and adjudicating allegations of impaired fitness to practise – and a
3 Enabling Excellence: Autonomy and Accountability for Healthcare Workers, Social
Workers and Social Care Workers (2011) Cm 8008, para 1.5.
4 For example, Kings Fund, Building Effective Interfaces: Systems for Complaints, Litigation,
Regulation, Discipline and Clinical Governance (2002).
5 As above, p 1.
6
The General Dental Council, the General Medical Council, General Social Council and the
Nursing and Midwifery Council.
7 General Medical Council, Corporate Strategy 2010-2013 (2010) p 20.
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