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Reforming healthcare professional regulation

Three things to get right as part of government reform consultation
We have now published our response to the Government consultation on legislation to bring Physician Associates and Anaesthesia Associates into regulation

Reforms to healthcare professional regulator powers

The Government is taking forward major reforms to the powers and governance of the healthcare professional regulators. They are currently consulting on legislation to bring Physician Associates (PAs) and Anaesthesia Associates (AAs) into regulation under the GMC.

The Authority has published a briefing for stakeholders on the reforms - Improving regulation for safer care for all - a briefing on the Government consultation on the draft Anaesthesia Associates and Physician Associates Orderoutlines the Authority’s top five recommendations to make the reforms a success.  

Although it looks like this consultation is focused only on regulating two new professions it will also shape the future of professional regulation: it will be used as the model for all other regulated healthcare professions, and rolled out to each regulator in turn – with doctors, nurses and allied health professionals next in line. We are therefore encouraging anyone with an interest to respond to the consultation, which closes on 16 May 2023

These proposals are an opportunity to give regulators a lot more flexibility  as well as greater consistency between regulators. They will also allow a less formal route for dealing with concerns about professionals. However, we think that it’s important to find the right balance between flexibility and accountability. There are also some important changes that we think are needed to maximise the benefits of the reforms – we have highlighted those we think are the most important for public protection in our briefing or see them below.

The legislation currently out for consultation has been developed following a public consultation in 2021 – you can read the Authority’s response to this consultation here. In our previous response we made some specific proposals for changes to our own powers to balance out the greater freedoms proposed for regulators. We accept the Government’s decision not to proceed with these changes and are looking at how we can make use of other tools available to us to help regulators make use of their new powers safely and effectively including possible changes to our performance review and use of policy advice and guidance. 

Our recommendations for making the most of these reforms:

  1.  Include all three stages of the fitness to practise process in the draft Order. 
  2. Give regulators clear powers to review conditions and suspensions to make sure a registrant is fit to return to practice unrestricted.
  3. Allow final decisions by case examiners to be referred to a panel if they don’t protect the public.
  4. Give the Authority a new targeted power to obtain information so it can oversee reformed regulators effectively.
  5. Keep the powers regulators have now to handle health concerns about a professional.

Other reforms underway:

The Health and Care Act

The Health and Care Act was passed by Parliament in 2022. It is a large and wide-ranging piece of legislation, however the key elements of interest for professional regulation include new powers for the Secretary of State to: merge or abolish any of the healthcare professional regulators deregulate professional groups.

We published our view of the Government’s proposals for reform of professional regulation in the Health and Care Bill in October 2021.

The Government commissioned KPMG to carry out a review of the regulatory landscape and provide options for reconfiguration. They also consulted on introducing a new transparent process for deciding when statutory regulation is appropriate, see further details below. Government haven’t yet announced what action they intend to take in these two areas.  

Within the wider provisions of the Act is the formal establishment of integrated care systems (ICSs). ICSs are partnership organisations that bring together providers and commissioners of NHS services across a geographical area with local authorities and other local partners to plan health and care services to meet the needs of the local population. This represents a shift from the previous focus on competitive purchasing of services via Clinical Commission Groups (CCGs).

The Government also amended the legislation to commit to introduction of a licensing scheme for non-surgical cosmetics, see further details below.

Non-surgical cosmetic procedures

The Government committed to introduce a licensing regime in England for non-surgical cosmetic procedures such as Botox and fillers through an amendment to the Health and Care Act 2022. This follows new legislation to ban procedures for cosmetic purposes on under 18s in England. A public consultation will help inform the scope and details of the regulations.

We published our view on licensing of non-surgical cosmetics at the time. We will respond to the public consultation when it is launched and will work with Government, regulators and registers on the development and implementation of a licensing scheme.

Healthcare regulation: deciding when statutory regulation is appropriate

The Government consulted between 6 January-31 March 2022 on plans to introduce a new policy for deciding which groups should be regulated by law, based mainly on the risk they pose to the public.

We published a news update on the consultation announcement along with some FAQs. We submitted our formal response to the consultation welcoming the move to a transparent, risk-based approach to deciding which roles are regulated. Government hasn’t yet published its response and next steps following this consultation.