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Good governance during times of change: what we discussed at our Accredited Registers seminar

On 18 November 2021 we held a virtual seminar for our Accredited Registers. The theme was ‘Good governance during times of change’, to allow reflection on how Registers are adapting to changes such as those brought by the pandemic.

The pandemic has further highlighted inequalities within our health and care systems and population. We have launched an Authority-wide EDI programme to review our internal practices, and as an oversight body we are actively working with our stakeholders to ensure that systems and processes in health and care regulation address these issues.

Can good governance and inequalities co-exist?

The event began with a session led by Kami Nuttall, Chief Executive of Culture Lab Consultancy, who talked about how EDI principles feed into good governance. The discussion began by considering the current inequalities within UK workforces which have been reflected clearly in the context of COVID-19. EDI is integral to good governance, and the session explored how culture is the key ingredient needed to achieve this. Diversity, colleagues noted, is not inclusion. There are also differences between equality and equity. Because equality does not take into account an individual’s starting point in life, providing equitable opportunity is needed to achieve equality.

The session also touched on bias and privilege. A comprehensive understanding of these biases and the privilege we hold can help us make better decisions, and how we make decisions is shaped or influenced by culture. Culture can be defined as unwritten rules, and shaped by shared learnings. EDI is about creating a culture in an organisation where everyone feels they have a right to be there – an inclusive culture that provides the foundation for delivering organisational strategy.

The session was useful in identifying opportunities for further collaborative work to reduce inequalities.

“EDI is good governance and good governance is powered by difference”

Confidence and fairness: introducing virtual hearings

In the second session we looked at what groups can learn about the process of developing virtual hearings during the pandemic, with a presentation from Tamarind Ashcroft, Head of Tribunal Development at the Medical Practitioners Tribunal Service. Colleagues identified the various considerations for their organisations during this process, as well as the benefits they experienced.

Identifying and testing IT platforms were seen by colleagues as a challenge. The move to virtual hearings also raised additional EDI needs for certain groups, so it was important to look at how to adjust processes for accessibility. Another important consideration was around information security when carrying out proceedings.

While moving virtual can pose additional challenges in some areas, colleagues also recognised their potential to offer improvements in others – dialling in remotely, for example, can provide a way to engage when personal circumstances e.g. health/ caring responsibilities may have previously prevented that. It was also recognised that having some services virtually might improve resources both in time and cost.

Are patient and public expectations changing?

Our Board member Marcus Longley spoke in the final session about our work on patient and public expectations of the Accredited Registers programme. He talked about key findings from our research on efficacy in early 2020, which sought to understand how the public interpret the programme, particularly in relation to the kinds of claims they consider it to be making about the efficacy of particular treatments.

This research had been the first time we had formally sought patient and public views since the programme’s introduction, and they were successful. We decided to look at this area again in the Strategic Review, so we could have a more in depth look at areas where there wasn’t a clear consensus. This showed broad general support for us taking greater account of effectiveness of the activities of registrants in our accreditation decisions, which we achieved through our revised Standards and ‘public interest test’ in July.

The session continued with a discussion about advertising, led by Ian Appleyard, Research Manager at the British Acupuncture Council (BAcC). Registers talked about their objectives in this space, which are to ensure the public is reasonably and appropriately informed about a particular treatment or therapy, and to ensure that a registrant’s advertising is in line with the Advertising Standards Authority (ASA) guidelines. Colleagues talked about the challenges of communicating evidence in advertising – and while moving forward within this area will be complex, the session made clear just how necessary it is to find solutions.

It is clear that Registers have adapted to the challenges of the past two years, and that they will need to continue to do so whilst the pandemic continues. We will seek to work collaboratively with the Registers, who together register over 100,000 practitioners, on areas that affect all such as fairness and equality.


Read more about our Accredited Registers programme here.

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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.