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The Standard - e-newsletter

Our e-newsletter 'The Standard' is published four times a year and the next issue is due out in Winter 2025.

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Autumn 2024: Email Update

Autumn update from the Professional Standards Authority
Welcome to our autumn newsletter (or is it winter?). We have a focus on research in this issue. If you were unable to attend our recent research conference, you can find out more below. There are also more details on our webinar series on sexual misconduct.

Plus our usual updates on reviewing the regulators, including the Nursing and Midwifery Independent Oversight Group (NMCIOG), fitness to practise appeals and an Accredited Registers update.
In this issue: Please let us know if you would like to receive this e-newsletter in Welsh/ Rhowch wybod i ni os hoffech dderbyn yr e-gylchlythyr hwn yn Gymraeg. (Email/E-bost: Comms@professionalstandards.org.uk)
Change ahead for the NHS - and for regulation
Over the coming weeks, we will be contributing to the development of the Government’s ten-year plan for the NHS, as part of the wide-reaching consultation announced by Health and Social Care Secretary Wes Streeting. The Government’s plans will also be informed by the findings of two new reviews of the patient safety landscape. The reviews are being led by Dr Penny Dash, following her recent review of the effectiveness of the Care Quality Commission, the regulator of health and care services in England.

Regulation can support a more preventative approach to healthcare. For example, making sure professionals are equipped with the right skills and knowledge to thrive in changing environments will help us make the most of new technologies. This is why as well as contributing to the Government’s plans for healthcare delivery, we are also reviewing our own regulatory approach, through our Standards Review. You can read more about this below.
Just before we circulated this newsletter, the Government announced its independent review of physician associate and anaesthesia associate professions. We published a short statement when the Terms of Reference were announced and you can read it here.
A spotlight on recent research-related events and publications
This year, our annual Research Conference was held on 17 October in collaboration with the team who led the Witness to Harm research project on the experiences of witnesses in fitness to practise proceedings. The project was funded by the National Institute for Health and Care Research. The latest findings and outcomes from the research were a central focus of the conference. Building on this theme, additional sessions presented other research into improving fitness to practise and work to address sexual misconduct. The event brought together researchers, regulators, policymakers and other key stakeholders to learn, ask questions, network, and further the conversation on these key themes.

The conference opened with a keynote speech from Professor Louise Stone from Adelaide Medical School, University of Adelaide, Australia on sexual harassment in medicine.

On sexual misconduct, we will continue to organise presentations and discussion on different aspects of this issue, and in doing so, help identify effective interventions that will support a preventative approach (see more details below).
 
Webinar series on tackling sexual misconduct in healthcare
We have launched a series of webinars focused on tackling sexual misconduct by health and care professionals. The webinars feature expert-led presentations and discussions on different aspects of the issue, bringing together stakeholders from across the sector, including regulators, Accredited Registers, and patient and registrant representative organisations.

The webinars include hearing from those in the sector working to address sexual misconduct, reviewing the latest research evidence, and learning from examples of how other sectors and countries are tackling the problem to identify what more can be done.

The series launched in early September with a presentation on NHS England’s Domestic Abuse and Sexual Violence programme, including their charter on sexual safety at work. A further webinar was held on 24 September exploring the culture challenges within the ambulance sector and the work that is being done to improve sexual safety.

Why we are doing this
Sexual misconduct by health and care professionals towards their patients and colleagues has long been a concern to the PSA. We first commissioned research in 2018 on whether sexual misconduct targeting colleagues could impact patient safety after losing three fitness to practise appeals which involved this aspect. We had noticed a worrying trend of regulators and the courts appearing to treat this type of sexual misconduct less seriously than when boundaries were overstepped with patients.

More recently, there has been a focus on harm caused by sexual misconduct between healthcare professional colleagues – particularly through the work of Surviving in Scrubs, the Working Party on Sexual Misconduct in Surgery, and NHS England. Worryingly, the 2024 NHS England Staff Survey showed that 9% of staff (of the 670,000 who responded) experienced unwanted sexual behaviour.

What we hope to achieve
Through this discussion series, we are hoping to facilitate learning and robust discussion amongst stakeholders so that, collectively, we can better understand the issue, develop effective solutions, and take meaningful steps forward.

These discussions will continue through to Autumn 2025, after which we are planning to produce a report including recommendations for the future contribution of regulators in this area. 

We have more webinars planned for the new year. If you are interested in attending future webinars, please get in touch with Douglas Bilton at douglas.bilton@professionalstandards.org.uk
Would a common code of conduct across professions benefit patients and service users? Our recent research suggests this may not be the case
We wanted to explore the potential benefits of establishing a common code of conduct applicable across different types of health and care professions to help retain staff, support multi-disciplinary working, improve workplace culture, and ensure consistency in regulatory decision-making while reducing complexity in the system.

We commissioned Solutions Research earlier this year to carry out qualitative research. The research explored the views of members of the public, registrants and wider stakeholders on introducing a common code and its likely benefits. The research found that, though there are advantages to having one code of conduct across health and care professions, it would not necessarily reduce complexity. There was also a risk that a common code would need to be diluted to cover so many and varied professions. This view was further reinforced by conversations with other stakeholders, including several of the regulators we oversee who expressed concerns about the practicalities around implementing a common code and, for some, a desire to recognise the differences between professions.

Joint statements
We have reviewed the report’s findings as well as the views stakeholders have shared with us and concluded that the work required to overcome these challenges would not be justified by the potential benefits of a common code. Instead, we believe that similar benefits could be achieved through the judicious use of joint statements when and where relevant. 
Scottish Government Regulation Conference 2024
We always enjoy attending this conference organised by the Scottish Government, which is a unique opportunity to bring together stakeholders from across health, social care, and other sectors too, to talk about professional regulation in the Scottish context. 

This year, the theme was ‘The role of regulation in the workforce of the future’. Among other things, we heard from regulators about important work on speak up culture, their role in helping to address workforce shortages, and how to involve patients and the public in shaping regulatory policy. 

PSA’s Head of Policy, Dinah Godfree, and Head of Accreditation, Os Ammar, led a lively discussion to talk about how governments could use regulation as a tool to support workforce change, by developing what we are calling ‘a regulatory strategy’. The concept appeared to resonate with many people in the room, from regulators to frontline workers. Our audience identified examples of different workforce changes which could benefit from such an approach and from early thought about how to anticipate and mitigate risks. It was clear from the conversations in the room that collaboration will be a key component of this kind of strategic approach. 

There was also a talk by officials from the Department of Health and Social Care (DHSC), setting out the story so far on reform of the regulators we oversee – noting that the UK Government will set out its priorities for professional regulation in due course. They also talked about the Labour Manifesto commitment to regulate NHS managers in England, and the questions that would need to be answered to take this forward, including what model of regulation would be most appropriate. We will continue to contribute our thinking to this work through our engagement with DHSC and NHS England.
Our Director of Policy and Communications, Melanie Venables, was also in conversation with other senior leaders on two panel discussions. While these were focused on two different themes – regulation of the healthcare science roles, and the benefits of upstream regulation – some common themes ran through both. Both the panel and audience were keen to explore what could help support professionals to maintain standards – including unlocking the potential of artificial intelligence and other technologies to help patients and employers navigate complex regulatory landscapes. 

We look forward to returning next year and to continuing these conversations in the meantime. 
Watch this space
We are currently commissioning research on the barriers and enablers to making a complaint to a professional regulator. We will provide more details in our next newsletter.
 
Updates on key areas of our work
Nursing and Midwifery Council – Independent Oversight Group
Our enhanced monitoring of the NMC to ensure improvements are implemented and sustained is in progress. The Independent Oversight Group has now started to meet. The purpose of the IOG is to scrutinise the impact of measures introduced by the NMC to improve its culture and performance. Initial meetings have focused on the NMC’s Fitness to Practise plan; and the wider culture improvement plan. 

The group includes Chief Nursing and Midwifery Officers from the four UK nations, representatives from trade unions, officials from DHSC and Devolved Administrations. Experts in Equality, Diversity and Inclusion (EDI), organisational culture, the patient experience, and the registrant experience have also been appointed to the group. 

We are reviewing our Standards of Good Regulation – more about this below. We will ensure that the work of the NMCIOG as well as the findings of the Independent Culture Report will be reflected in this work.

We will continue to publish updates on our website.
 
Find out more
Fitness to Practise Appeals update 
In the past few months, we have concluded 10 appeals of regulator final fitness to practise decisions. This included one where we joined the GMC’s appeal. We decided to appeal these decisions based on our belief that they were not sufficient to protect the public. The cases we have appealed cover a range of issues, including cases involving:
  • a registrant who behaved inappropriately towards colleagues, on social media and failed to respect a patient’s dignity
  • a registrant’s handling of two patient telephone consultations and where he subsequently acted dishonestly
  • a registrant who mocked a vulnerable patient, was rude, off-hand and did not offer the level of care expected 
  • a registrant who breached professional boundaries
  • a registrant who intimidated and stole money from an elderly patient 
  • a registrant who had a history of accessing medical records when there was no clinical need to do so
  • a registrant who made racist and derogatory comments over a two-year period 
  • a registrant who failed to provide adequate and one-to-one care to a highly vulnerable patient
  • a registrant who behaved inappropriately towards three colleagues, but the panel found the behaviour to not be sexually motivated
  • a registrant who sexually harassed colleagues over a lengthy and sustained period of time.
Read more about all our recent appeals
Reviewing the regulators’ performance 
We have continued carrying out and publishing our performance reviews. Since our last newsletter, we have published monitoring reports for:
  • The Health and Care Professions Council (HCPC) who met 16 out of 18 Standards. The report details why the HCPC did not meet Standard 15 (fitness to practise timeliness) as it is taking too long to progress cases. The HCPC also did not meet Standard 17 as we were not satisfied with their handling of a case involving serious risk. We have written to the Secretary of State for Health and Social Care and the Chair of the Health and Social Care Committee to provide an update on the HCPC’s performance in relation to Standard 15, and we will continue to closely monitor the HCPC’s performance in this area.
  •  The General Chiropractic Council (GCC) met 17 out of 18 Standards. We recognised the challenges faced by the GCC as a small organisation, but concluded that fitness to practise investigations were taking too long this year and therefore, Standard 15 was not met.
  • The General Pharmaceutical Council (GPhC) met 17 out of 18 Standards. Our report provides more detail about why we found Standard 15 still unmet. As with the HCPC, we have written to the Secretary of State for Health and Social Care and the Chair of the Health and Social Care Committee to provide an update on the GPhC’s performance, and we will continue to closely monitor the GPhC’s performance in this area.
Read all our recent reviews
Reviewing our Standards
We are progressing with our project to review our Standards. This review will cover both our Standards of Good Regulation (that underpin our statutory regulator performance reviews) and our Standards for Accredited Registers (that underpin our accreditation of non-statutory registers). 

Our Corporate Strategy 2023-26 included an ambition to help make regulation better, and fairer. Reviewing our Standards is an important part of how we will lay the groundwork for achieving this in the years that follow. It is an opportunity for us to refocus regulation, placing greater emphasis on ‘upstream’ (Upstream regulation aims to move the focus from one of enforcement to one that seeks to prevent harm from occurring in the first place) and preventive measures that can support professionals to achieve high standards of care. Our Standards also need to take account of new UK Government’s priorities for professional regulation, and for health and care transformation more broadly.

As part of this, we want to explore possibilities for alignment of both sets of Standards. While there will remain important differences between the two, we believe that we should strive for consistency of Standards where this is appropriate and relevant, and explain where there is a need for difference. We also want to look at whether we should widen their scope, including around culture and governance. 

To gather initial feedback, we conducted pre-consultation workshops between June and October 2024 with stakeholders including regulators, Accredited Registers, organisations representing patients, organisations representing registrants, government bodies, and patients and service users from across the UK. We used the feedback we heard to help develop the consultation document, which we are planning to launch in January. 

We will let our stakeholders know when it is published, so keep an eye on our website and social media channels for more details. 

If you want to find out more, please email standardsreview@professionalstandards.org.uk
Find out more about our Standards Review
Accredited Registers update

New applications for accreditation
We haven’t received any new applications for assessment since the last newsletter, but we are expecting to receive at least one at the beginning of December. We are also increasingly being contacted by prospective registers. We anticipate receiving at least two applications in the final quarter of 2024/25 and there are signs of an increased volume of Standard One and full applications in 2025/26. 

Our ongoing assessment of the National Association of Care and Support Workers (NACAS) has been adjourned as we wait for more information to support an Accreditation Panel’s decision. 

An appeal lodged by the International Foundation for Therapeutic and Counselling Choice (IFTCC) has been found part upheld and the matter has been referred back to an Accreditation Panel.  

Keep an eye on our latest news page to hear about new applicants and learn about opportunities to Share Your Experience..
Find out more about the Accredited Registers programme
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