The number of UK health profession regulators — which includes the General Pharmaceutical Council (GPhC) — could be slashed from nine to just three or four in radical reforms set out today (31 October) by the Department of Health (DH).
In a consulation document, DH argued that cutting the number of regulators would help provide a regulatory system that is clearer for patients, cheaper to run because of economies of scale and would offer more consistent regulation across the professions.
It says all the research suggests that “efficiencies begin to accrue” when a regulatory body has a register of between 100,000 to 200,000. Five of the existing regulators — including the GPhC — have professional registers with fewer numbers. The GPhC register, which covers Great Britain, has 89,377.
The document says: “Having fewer regulators would simplify the landscape, making it clearer to employers, patients and the public who to contact when they have concerns. Fewer regulators would bring greater consistency of standards and in the fitness-to-practise decision-making process, achieving a fairer outcome for all.”
Introducing a shared online register for all healthcare professionals is also put forward as a way of creating a more efficient regulatory system which also saves money.
Creating a single set of “generic” health professional standards — supported by profession-specific options — is also suggested, alongside having a single adjudicator for all fitness-to-practise decisions. Running joint back-office functions would also bring additional savings, it says.
The consultation document was welcomed by GPhC chief executive Duncan Rudkin because it provides the opportunity to have “a robust, open and wide-ranging discussion about how regulation can best protect and assure patients and the public, and support the professionalism of all health professionals.
“Ahead of any future legislative change, we are continuing work to improve how we regulate, including by working more closely with other regulators, and developing an approach to revalidation that will help the professions we regulate to focus on professionalism, improvement and person-centred care.”
The consultation document brands the existing regulatory system as complex and out of date and in need of radical reform.
The time has come for a new system which better protects the public, supports health services and helps existing workforces meet its future challenges, it says. The new system, it promises, would be “faster, simpler better and less costly.”
It wants to create a new fitness-to-practise system which is less adversarial and “more inquisitorial.”
And the government wants to see regulators have a wider choice of options — similar to the range offered by the General Medical Council and its tribunal service, which regulates doctors.
Dispute mediation, something the government had originally rejected, is also back on the table.
It says: “Dispute resolution or mediation when dealing with enquiries and complaints that do not need a full fitness-to-practise investigation could help resolution of cases at an earlier stage. We would be interested in hearing views on the value of mediation as part of the system of professional regulation.”
There is also a case, the report argues, for regulators to play a bigger role in supporting professionals to meet and retain their expected standards of practice.
Speaking at a hearing of the Health Select Committee on Monday 31 October, health secretary Jeremy Hunt said: “This is something that I have wanted to do for a very long time. It is important for patient safety reasons that [regulation] is streamlined.”
Hunt would not give a timetable for any changes to be made, saying that some legislation would be needed, and that the Parliamentary timetable would be dominated by Brexit.
The government’s consultation on the future of healthcare profession regulatory bodies includes the Pharmaceutical Society of Northern Ireland (PSNI) as well as the GPhC, and the move is likely to have significant impact on pharmacy in the UK.
The Pharmacists’ Defence Association (PDA) issued a statement on Wednesday (1 November), saying it would publish an official response to the consultation in due course. A spokesperson added that the PDA is clear that it wants to see a proposal for regulation that is fair, transparent and effective in how it protects patients and their health.
The spokesperson referred to a Freedom of Information Access request, submitted by the PDA earlier this year, which revealed that since its establishment in 2010, the GPhC had never issued an improvement notice to a pharmacy owner, had never brought a fitness-to-practise case against a registrant for failure to comply with the Standards for Registered Pharmacies, had never disqualified, removed or sought to disqualify or remove, a pharmacy premises from the register and had never sought or obtained a conviction against a pharmacy owner. It had, however, commenced disciplinary proceedings against more than 3,500 individual pharmacists.
Mark Koziol, PDA chairman, said “What is the point of having a pharmacy regulator if it is not dealing with pharmacy owners who preside over the kind of deficient working environments that inhibit pharmacists from doing the best they can for patients? The current pharmacy regulation arrangements are in need of a significant overhaul and we will seek to use this consultation as an opportunity to ensure is the current deficiencies are addressed. We believe it is time for radical changes and improvements to pharmacy regulation.”
The consultation, which also seeks views from members of the public, runs until 23 January 2018.