The statutory regulators have had to respond quickly to the Coronavirus pandemic. This has revealed the potential for regulation to adapt by finding alternative ways of working and new ways to communicate – but it's also created risks which have to be considered to protect the public's safety. We hear from two regulators who have had to respond to the pandemic in different ways: Katherine Timms, Head of Policy and Standards at the Health and Care Professions Council, and Marcus Dye, Director of Strategy at the General Optical Council, share how their organisations have responded to the constant challenges thrown up by Covid-19.
Health and Care Professions Council
The legislation underpinning regulation in the UK is fairly outdated and doesn’t support an agile, flexible approach, particularly in the case of Covid-19, where we had to act quickly. That said we’ve managed to overcome most, if not all, of the challenges we’ve faced during this difficult time, and so I think one of our biggest learning points in all of this is that barriers we see can sometimes be an illusion!
A different way of working
At the start of the Covid-19 crisis we had to adapt to an entirely new way of working, at pace; moving around 250 staff to homeworking within a matter of weeks, with various impacts to our existing regulatory processes:
- our Registration team had to alter the way we process applications, to reduce our reliance on post;
- our Tribunal service moved to hosting hearings remotely, and began looking at new ways of managing bundles (paperwork connected with hearings) electronically; and
- our Education monitoring and approval processes became virtual.
Making sure we weren’t a barrier to increasing the healthcare workforce to meet demand, whilst ensuring those returning to practice didn’t pose a risk to the public, was a fine line. We relied on our existing frameworks to ensure those we facilitated to come back to practice, through the establishment of a Temporary Register, would be safe. And we tailored our fitness to practise processes to ensure they could be swiftly removed if there were any concerns raised.
Support and guidance
As the pandemic and news has evolved, these priorities have changed. Registrants initially asked us questions about Personal Protective Equipment (PPE), adapting their practice, managing risk and raising concerns, but more recently we’ve seen a shift to consideration of resuming private practice and community services. To support registrants as far as possible we developed a new Covid-19 hub on the website. This responds to FAQs across all stakeholders, but also is a source of standards-specific guidance in light of Covid-19. Our Covid-19 information sheets address each of the 10 over-arching Standards of conduct, performance and ethics. We continue to review this content.
In acknowledging the pressures our registrants are facing, we also made the decision to pause some of our processes to avoid any additional burdens on them; for example our audits of continuing professional development profiles.
In considering the future of the Temporary Register there are many factors to take account of. There could be consequences if this register is closed too early and subsequently need to be re-opened because of further Covid-19 peaks. Impacts might be felt on temporary registrants’ willingness to work, public understanding of their role, and the speed with which the NHS is able to call on this group to support any future workforce demand.
Nevertheless, the extended use of the Temporary Register beyond that which is necessary presents regulatory risks. There are differences in the regulatory controls we can exert on temporary registrants as compared with full registrants, and there are less formal processes to safeguard registrants, for example providing them with an opportunity to evidence their fitness to practise where concerns are raised.
Furthermore, those practising on the full Register may also be discouraged by the ongoing temporary registration of a workforce who do not pay fees, and are not subject to the usual regulatory processes; for example, obligations to provide evidence of continuing professional development.
Retaining the Temporary Register(s) too long after the Covid-19 peak presents a real risk of undermining regulatory processes.
We are working with NHS and Government colleagues across the four countries to ensure we clearly understand all the risks and take appropriate action to mitigate them.
Looking to the future, there are many questions we need to answer. How has this pandemic changed the public’s expectation of our professions, and us as a regulator? What can we learn from this experience in terms of how we work? How can we harness our learning to continue to improve public protection? I think this is an exciting set of questions to work through and I believe, collectively as regulators, we can find the answers and be better regulators for it.
General Optical Council
At the General Optical Council, Covid-19 has brought many challenges for us to navigate as we’ve come to terms with regulating during a pandemic. But it’s also presented us with opportunities to implement change and growth in order to continue to fulfil our role of protecting the public.
Challenges of a pandemic
In line with Government guidance, we closed the GOC office in mid-March and made the shift to remote working. Working from home was new for many staff members and teams and required us to adjust to a new way of working in a short period of time and learn how to carry out certain functions remotely.
Supporting our registrants to protect patients and the public
We knew early on that our registrants may be required to alter their practice for extended periods of time in order to protect patients and the public and that there might be aspects of our own legislation and regulations that might prevent this. It was especially important not to have any unnecessary regulatory barriers to the remote delivery of care which was needed to ensure that patients still accessed the eyecare they needed, but the risk of infection through travelling to optical practices was reduced.
Early on, we issued a joint statement with other health and care regulators outlining how we would continue to regulate during Covid-19.
We then published a series of statements intended to clarify aspects of our legislation related to remote care delivery during the pandemic, including statements on the supply of spectacles and contact lenses, contact lens aftercare and more recently infection prevention and control. All of our guidance for registrants can be found on our Covid-19 page.
We have also increased the frequency that we communicate with our registrants to ensure they remain up to date with the latest guidance from us, professional bodies and the Government.
Key changes to how we deliver regulatory functions
In addition to supporting our registrants, we have had to consider different ways to deliver our own regulatory functions. Covid-19 has forced us to embrace modern technology in ways we’ve never had to before. Remote hearings have become the norm, and we have been able to progress many cases that would have otherwise been postponed.
We also held our first ever remote Council meeting which was a success and allowed us to make progress on various projects across the organisation.
Even in these difficult times, it is important for registrants to maintain and develop their knowledge and skills so we have retained our overall requirements for registrants during our current three-year Continuing Education and Training (CET) cycle. We have however waived our annual expectation in 2020 to complete part of this CET to recognise current difficulties in accessing learning and have produced additional guidance to encourage more remote delivery of CET.
Correspondingly, we have also sought to encourage and support more remote delivery of undergraduate education and have quality assured revised proposals from our education providers.
In March we set up a Covid-19 taskforce made up of our CEO, senior management team and relevant managers to keep on top of any risks arising. The taskforce met daily at the start of the pandemic due to rapidly changing circumstances, then moved to three times a week and now meets weekly. The taskforce considers impacts on our staff, the organisation and our registrants and agrees any actions to be taken.
We will continue to monitor how Covid-19 impacts the optical sector and our regulatory work and make adjustments as needed, particularly as we enter a new phase of the pandemic which may see local lockdowns across the UK. Our overarching objective is to protect the public and maintain their health and safety and we remain committed to supporting our registrants to provide safe and high-quality eye care.
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