In 2016 we asked whether our Standards of Good Regulation were still fit for purpose? The answer was both yes and no. We have just published our first performance review using the new Standards. In this blog, Graham Mockler, our Assistant Director of Scrutiny and Quality, explains more about why and how they were revised and the introduction of a set of General Standards.
Our new Standards of Good Regulation were published at the end of 2018 following a detailed review process that began in 2016 and included two consultations (one on approach and one on content). We had been using the same Standards since 2010 with minimal changes, and it was time to review these to ensure they remained up to date and took account of regulatory developments in the years that had passed. The new Standards became ‘active’ from January 2019 for all regulators that we oversee. This means that our first assessment against their use began in January 2020, as our reviews, which are staggered throughout the calendar year, cover the previous 12 months.
With the updated Standards, we have maintained the focus on the key regulatory functions of education and training, registration, fitness to practise and setting standards for registrants. We reduced the number of Standards across these areas from 24 to 13, bringing some Standards together to reduce duplication, and ensuring these are focused on outcomes rather than processes. To sit alongside these 13 Standards, we have introduced a set of five General Standards, which go across the regulatory functions. The General Standards represent the biggest change to the Standards. They are:
- The regulator provides accurate, fully accessible information about its registrants, regulatory requirements, guidance, processes and decisions.
- The regulator is clear about its purpose and ensures that its policies are applied appropriately across all its functions and that relevant learning from one area is applied to others.
- The regulator understands the diversity of its registrants and their patients and service users and of others who interact with the regulator and ensures that its processes do not impose inappropriate barriers or otherwise disadvantage people with protected characteristics.
- The regulator reports on its performance and addresses concerns identified about it and considers the implications for it of findings of public inquiries and other relevant reports about healthcare regulatory issues.
- The regulator consults and works with all relevant stakeholders across all its functions to identify and manage risks to the public in respect of its registrants.
These are areas that we have either not assessed at all (Standards 2, 3 and 4), or have assessed as part of wider Standards in the past (Standards 1 and 5). We believe the addition of these General Standards will enable us to gain a greater understanding of the overall effectiveness of a regulator, and how it is working to protect the public. A key addition is Standard 3 on equality, diversity and inclusion. The importance of including this Standard has been highlighted by recent events providing even greater emphasis on the disparities faced by BAME individuals. Through applying this Standard, we expect regulators to be active in identifying and addressing issues in relation to their work where individuals with protected characteristics are, or are at risk of being, disadvantaged.
The Standards that we set for regulators are designed to be challenging in order to drive improvement in the regulation of healthcare professionals and, as a consequence, enhance public protection. We anticipate that some regulators may find it difficult to meet all of the Standards, but expect where Standards are not met (and even where they are) that regulators will act to improve.
In light of introducing new Standards, we have updated our report format to put less emphasis on the number of Standards met and not met. This may seem a strange approach, as it is the overall outcome of our work and remains crucial for both us and the regulators. However, we recognise and want to emphasise that focusing solely on this does not tell the full story of how a regulator is performing. Often, where a regulator has not met a Standard, they will be undertaking work that, if effective, will lead them towards meeting this in the future. Conversely, where a regulator has met a Standard, there may be room for improvement in some aspects of its work relevant to that Standard. We expect that we will see both positive and negative aspects of performance across, and even within Standards, especially where these Standards cover a wider range of areas than before.
If you would like to have a look at our updated reports and how we have assessed the new Standards, the first of these to be published is for the General Osteopathic Council, which can be found here.