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Accredited Registers - what could an alternative to statutory regulation mean for the NHS, the public, patients and the workforce

The Academy for Healthcare Science (AHCS) was accredited by the Professional Standards Authority soon after the Accredited Registers programme was introduced eight years ago. Accreditation of voluntary registers addressed the clear discrepancy in public protection, between health and care occupations which were subject to statutory regulation, and those which had no form of independent assurance whatsoever. The programme has provided a system of oversight for these vital areas of the wider health and care workforce, creating a benchmark for standards of practice, and strengthening public confidence in these professions as whole.

I welcome the Authority’s Strategic Review of the Accredited Registers programme. It is an opportunity for a renewed focus on what the priorities should be going forward, thereby providing the public and those working in heath and care with the clarity they need.

Working towards and maintaining accreditation for eight years has been a big commitment for us and for those who joined our register – therefore it is crucial that we take this opportunity now to ensure that the programme is as effective as it can be, and fit for the future

Perhaps it is also a great opportunity to explore ways of how the programme can get better engagement and involvement from, Regulators such as Care Quality Commission (CQC), the NHS, employers and the public, the review provides the opportunity for this, and I hope that these groups contribute and provide advice.

Benefits of Accredited Registers

There is a need to make sure that every professional who encounters the public can demonstrate that they are working to agreed, authorised standards. Currently, a breadth of practitioners can continue to treat patients and clients without oversight from a recognised body, which is first and foremost a clear risk to public safety. It also negatively affects other regulated professionals, especially if something were to go wrong in areas of a patient’s treatment delivered by these practitioners.

 For those in private practice, being on a register lets their clients know that the practitioner is committed to high standards and has the safety and interests of the public at their heart. People must work hard to meet and maintain compliance of the register standards and undertake continuing professional development. Gaining accreditation – it is not an easy process in the first place, and it is also a commitment to maintain and continue to develop year on year.

New professions proliferate in the healthcare world, which is why an enabling and responsive system of accreditation could be an appropriate alternative to statutory regulation. While the statutory regulators have demonstrated an increased agility during the pandemic, it is not always been able to keep up with the changes needed in the fast-paced world of healthcare today.

The Accredited Registers Programme allows the development of communities of interest, development of new roles, recognition of agreed standards, and regulation of these new groups – something that I think would be of benefit when new roles are being developed and established. Respecting and recognising the new roles and added value.

The Strategic Review

With regards to the extent of its use by employers and specifically the NHS, the programme has a lot of unfulfilled potential, and therefore to really have the impact on patient safety and workforce development, it must be integrated, mainstreamed, and fully utilised by the NHS and employers. Complete support and recognition from these institutions will give the Accredited Registers the opportunity to demonstrate the added value to patients the public, the NHS, employers and of course registrants. Developing a sense of identity and of being valued, in effect making accredited registers requirement for employers using healthcare practitioners in unregulated roles. Standards and entry points to registers will be better understood if there is greater unity and could improve the level of care across the board.

It creates opportunities for all staff to be developed and respected.

The public could have more information than they do currently about the people who look after them – this is evident in the fact that there is always lots of talk and recognition and media interest about doctors and nurses, and not much about other groups of the workforce. This must be better in the longer term for overall recruitment into the NHS and other areas of health and social care.

The Accredited Registers programme is also an enabler through accountability and encouraging through standards in registration an ongoing approach to improvements in the quality of care.

It would be helpful to see greater use of umbrella systems for professions which have multiple registers. A proliferation of registers is confusing for the public and employers – leaving them with the burden of choice when the Accredited Registers is supposed to make this process straightforward and self-explanatory. It also suggests greater divergence – if these professions are all meeting common standards, and assessed through the same process, then there is no need for duplication. This is also a means by which the sustainability of the registers and the cost to registrants can be addressed. Reducing the duplication of governance systems.

I welcome the proposal for a tiered system within the Accredited Registers programme in the future. The current approach does not consider the varying degree of risk between different professions, and how these risks must be managed and mitigated with entirely different mechanisms. It is not as simple as statutory versus non-statutory regulation. Some registers require measures such as licensing, while for others this would not be appropriate.

 This change could enable a right-touch approach that is appropriate to the level and nature of risk. Healthcare scientists, for example, can pose a level of risk even without direct contact with patients, such as if a practitioner gave inaccurate test results leading to a misdiagnosis. It is important to ensure that any changes to the programme, such as a tiered system, are embraced by employers and other stakeholders to avoid failing at the first hurdle.

The strategic review should give insight into the way forward, as going backwards is not an option, there is too much at risk for the public, for patients, the workforce and for healthcare ,were we to lose the system of oversight that accreditation brings.

 There is a breadth of unfulfilled potential if it were seen to be something that works for all and is recognised by all – the public, the NHS, employers, and the Government. The Review is a good place to start in achieving this.

I would urge everyone to make sure their voice is heard.

Related material

You still have time to give us your views – as part of the Strategic Review of the Accredited Registers, the Authority launched a consultation, but the deadline for giving feedback is fast-approaching - 18 February 2021. Read through the consultation, including a summary of the questions and details of how to submit your response.

Find out more about the Strategic Review as well as an update we published in November.


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Please note the views expressed in these blogs are those of the individual bloggers and do not necessarily reflect those of the Professional Standards Authority.