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Research and policy update

Performance review

Covid-19 lessons learned

We have all found ourselves living through strange times. This time last year we didn’t really have any idea what we would be in for – we were just about to go into the first national lockdown. Very few of us will not have been affected by the pandemic but for those working in health and care and those who regulate them – it has presented unimagined challenges. This is the first time regulators have had to respond to a pandemic. They have had to respond quickly, exceptionally and with outdated legislation. We hope this pandemic will resolve soon, but it is already continuing longer than anticipated and public health experts warn there may be others in its wake. So, it is crucial that we learn from this one as quickly as we reasonably can, given the ongoing pressures on everyone in the health and care system.

In autumn, we began to review the ways in which the regulators we oversee were responding to the pandemic. They have collaborated with us, providing us with a series of case studies covering their four functions (guidance and standards, education and training, registration and continuing professional development, and fitness to practise).

Our report focuses on the first wave up to July 2020. We will be looking to identify learning both for the ongoing situation and for responding to other crises that may arise in future, and on the implications for regulatory reform. After publication, we would like to arrange onward discussion, but will only do so when we are confident that our stakeholders are ready to go forward. 

Read a blog from Christine Braithwaite, Director of Standards and Policy, anticipating the publication of our Covid-19 lessons learned report.

Regulation reset

Each year we hold a symposium for the regulators we oversee, to give us all and opportunity to identify emerging issues and identify future challenges. Though we were online this year, it did not affect the quality of engagement and discussion around the three questions posed over three days:

On Day 1, our panel focused on what we had learnt from Covid-19 about regulating effectively, assessing the changes that had been made to support the workforce.

On Day 2, our delegates considered how regulation should evolve to support the future workforce, with a three-nation perspective spanning education, social care and patient advocacy.

The third and final session explored issues around equality, diversity and inclusion in the context of regulation by asking the question ‘Is regulation too white?’.

A rich discussion followed with input and insights from our panel and guests explored how regulators can better implement a more equal and inclusive workplace and system.

Regulation in the Welsh context

On 4 March, we held our fourth annual Regulatory developments in the Welsh context seminar, hosted jointly with the Welsh Government. The theme for this year’s event was flexibility and resilience of a regulatory system under pressure, and we were delighted to be joined by more than 80 attendees to discuss how the health and social care system and its workforce in Wales have adapted to meet the challenges of the pandemic. The event opened with an address by Minister for Health and Social Services Vaughan Gething, who reflected on the significant changes that have been and continue to be required in working environments, professional practice, and education and training in response to Covid-19. The Minister was clear on his view that regulation must adapt to the ‘new normal’ so that it remains proportionate and enables workforce flexibility, but he also emphasised the need to keep patient safety at the heart of any future reform.  

The seminar provided an opportunity to consider how organisations and frontline workers have responded to the pandemic. There were speakers from the Authority on emerging findings from the Covid Learning Review, Social Care Wales on regulating during a pandemic, Health Education and Improvement Wales on effective partnership working and the Association of Child Psychotherapists on challenges for mental health practitioners. Key issues arising from the discussion included the risks and opportunities presented by remote working and practice, ensuring support for health literacy and digital skills in the general public, and the need for regulators and other bodies to consider the professional/public interface and the value of coproduction in our work. There were also multiple examples of how governments, regulators and practitioners from across the four countries of the UK have worked together to share learnings and promote unity over the past year. With the lifting of lockdown on the horizon, proposals for reform to professional regulation expected soon and the Welsh Parliament elections planned for May, we were left with much to consider about how we can hold on to this collaboration and innovation while ensuring that the system effectively meets the challenges of the new normal and continues to keep the public safe.

Thank you/Diolch to all our speakers and participants for an interesting discussion.

Current/future research projects

We are currently working on two research projects:

Perspectives on consistency

The first one will involve qualitative research with patients and service users, the public, and registrants to explore their perspectives on consistency within professional regulation. Why do we believe it is important to focus on this area? We believe it matters because we have multiple regulators with a myriad of rules and the regulatory system needs to become simpler to work well together. Inconsistency in rules, language and even fitness to practise outcomes creates confusion – not only for members of the public, but also for professionals themselves – it can appear to be unfair and lack transparency. We hope that the findings of this research will contribute to our ongoing work on consistency which in turn can improve regulation for multi-displinary teams ensuring they work in a well-coordinated system which supports and guides them and holds them to account fairly and transparently

Ethical dilemmas

We have probably all seen the news about how the Covid-19 vaccine is being rolled out, but probably have not thought so much about why certain groups will receive it before others and who makes these decisions. Imagine if you had to make these choices – what factors would you take into consideration. How would you decide choosing one person before another?

Our second project will look at ethical dilemmas encountered by health professionals during the pandemic. The research will seek to identify and analyse some of the challenging situations they have had to face, and continue to encounter relating to the ethics of care.

We hope to publish both the reports resulting from these projects in the spring.

You can find all our published research here.

Introducing a patient safety commissioner

Baroness Cumberlege’s report First do no harm: Independent Medicines and Medical Devices Safety Review, concluded that patients’ voices have not been heard within health and care. The Review highlighted a ‘disjointed, siloed’ healthcare system and recommended introducing a patient safety commissioner. We welcomed the Government’s commitment to introduce this role, but in implementing it, we want the Government to ensure that it addresses rather than adds to the complexity of the current UK health/care system. If the remit of the role is to be limited to medicines and medical devices, then it is crucial that the Patient Safety Commissioner has a duty to link closely with the work of other bodies involved in patient safety across the UK. You can read our statement as well as our response to the Cumberlege Review.

Okenden report

Another report that made for sombre reading is the Ockenden Report covering the emerging findings and recommendations from the independent review of maternity services at the Shrewsbury and Telford Hospital NHS Trust. Its findings echo other recent reviews and again outlines the difficulties that patients face in making their voices heard when things have gone wrong. It is crucial that the system is able to learn and ensure that changes are made to avoid a repeat of these tragic events.

We will be examining the report further and working with the professional regulators we oversee as they consider any actions to address the findings of relevance to professional regulation.    

Consultation responses

The regulators often consult on different areas of their works – engagement with stakeholders is key to shape how their work evolves and continues to protect the public. Regulators engaging with key stakeholders is also included as part of our Standards of Good Regulation. One way the regulators (and wider government) do this is by consulting on proposals for changes to their policies and processes.

We do not necessarily respond to all the consultations that come our way. We usually decide what value we can add in our responses. We have responded to these consultations in the last few months:

You can find all our consultation responses here.