What role does the Professional Standards Authority (PSA) play in healthcare fitness to practise regulation?

This week the PSA reported that it is not going to refer the NMC’s decision in the case of Helen Lockett, previous Director of Operations and Executive Nurse at the Liverpool Community Health NHS Trust to the High Court.

What is the PSA’s role in fitness to practise cases?

The PSA is the regulatory body for the UK’s 10 health and care regulators.  They have the power to review fitness to practise decisions made by any of the health and care regulators.

Health and care regulators are required to submit fitness to practise decisions to the PSA. In cases where the PSA has taken a view that a decision was unduly lenient and/or do not protect the public, they will request further evidence from the health and care regulators and furthermore have the power to refer a case to the court for review.  In effect, this is an appeal of the fitness to practise decision and a court of law has the power to overturn decisions.

In addition, the PSA also undertake an auditing function where they audit a random sample of fitness to practise cases closed by investigating committees/case examiners and staff at the initial stages of the fitness to practise process.

However, unlike formal reviews, auditing limits the PSA to feeding back any concerns to the regulatory body by way of audit reports.  The power to intervene therefore is limited in auditing cases.

Another bite of the apple?

The PSA very rarely formally intervenes in fitness to practise cases but what the case of Helen Lockett demonstrates is that the decision of your health or care regulator might not be the end of your case. 

There is the potential for further regulatory sanction.  It has been evidenced through research that legal representation in fitness to practise cases is vitally important for improved outcomes and this is true also of the PSA’s power.  Proper legal representation and advice can head off the potential of a second challenge.