Our role to protect the public by improving the regulation of health and care professionals sometimes takes us beyond the UK. Overseas regulators and governments occasionally commission us to advise them, or to carry out reviews or investigations. But how do we approach our international work? What is it like to carry out a review in another country? And with so much happening in health and care regulation in the UK, why go halfway around the world to work with a regulator in a different field? Senior Scrutiny Officer Michael Humphreys explains more about this international aspect of our work.
What we were asked to do
Engineers and Geoscientists British Columbia (EGBC) asked us to review its legislation and governance. It wanted to know how its legal framework supported or hindered its effectiveness as a regulator. It also wanted us to assess its governance. We agreed to carry out the review, which would involve one member of staff from the Authority spending a week at EGBC’s offices in Burnaby, near Vancouver. With experience of working on our annual performance reviews of regulators in the UK, I volunteered.
Planning the review
The site visit is crucial, but it’s only one part of the review process. When we’re carrying out an international review, the work starts before we go anywhere. Before undertaking the visit, we worked with EGBC to:
- agree the standards we would use to assess its governance;
- identify evidence it would provide; and
- draw up a schedule for the week, including attending Council and committee meetings, and conducting interviews with staff and Council members. EGBC rearranged dates of some of its committee meetings so that they were taking place during the week of our visit.
EGBC staff arranged for us to have access to a secure area of its website. This meant we could review documents about its structure, policies and processes from our London office. There was also more general reading to understand EGBC’s legal framework and to get a feel for the environment in which it works. We provided a progress report based on our initial document review, so that we had some preliminary points for discussion identified ahead of the visit. After all that, I was ready to go.
On the ground
As one of our previous blogs notes, the world of professional healthcare regulation in the UK is complex. It has never seemed more complex to me than when I was asked, immediately on disembarking from a nine-and-a-half-hour flight, to explain the purpose of my visit to Canada.
It is a privilege to be able to travel to a beautiful and culturally diverse city like Vancouver. But there isn’t really time to see the sights. When we travel to conduct a review, we need to ensure that we get maximum value from our time on site. That makes a week’s visit intense. On top of a full programme of activity each day, there are notes to be made and research to be checked. You can’t expect to be able to remember everything when the time comes to write the report. Fortunately, a certain amount of jet lag makes it easy to find some quiet time in the very early morning to catch up on the day’s notes.
Support and engagement from the host organisation are indispensable too. Practically, we need staff to work with us so that we can get the information we need. But for the review to work well, it makes a big difference if the people we speak to are engaged with the project. The staff and Council members at EGBC were friendly, generous with their time and open to discussing and questioning what the organisation does and how. After a week that felt both very long and very short, I returned to the UK to work with colleagues to complete the review report.
What we found
Our review found that EGBC met seven of the nine governance standards against which we assessed it. It was already working towards the two standards it did not meet. We were satisfied that EGBC is committed to regulating the engineering and geoscience professions in the public interest. However, we considered that there is some way to go before its legal framework fully supports it in doing so.
We saw that EGBC is trying to get changes made to its legal framework, to help it protect the public. For example, unlike most other regulators of engineering and geoscience in Canada, EGBC does not currently have the ability to regulate organisations. We know that the environments professionals work in are a key influence on their behaviour. As well as seeking a change in the law to allow it to regulate organisations, EGBC has set up a voluntary scheme, where organisations sign up to a set of quality standards. The scheme gives EGBC a way to influence corporate behaviour to prevent harms from occurring, while it works towards a change in the law. We commended EGBC’s efforts to update its legal powers to protect the public.
Why do an international review?
We believe that our work with EGBC has benefits for us and them. We were able to give EGBC an independent assessment of its governance arrangements. And we made a number of recommendations to help EGBC regulate more effectively and transparently in the public interest.
Thinking about the challenges EGBC faces, and the things it is doing particularly well, helps us to test our ideas about right-touch regulation and to see how different issues arise in a variety of contexts. That allows us to look at them from a different perspective, while remaining focused on what is necessary to protect the public. We are always interested to learn from other organisations in the UK and internationally who share that commitment to regulating effectively in the public interest.
You can read our legislation and governance review of EGBC here. You can find out more about EGBC, including its response to our review, on its website here.