The future fitness to practise is a very topical subject at the moment.  We recently wrote an article on ‘The Future of Healthcare Regulation according to Matt Hancock’ in which we looked at the Health and Social Care Secretary’s vision for healthcare in the future.

In the same week, the Professional Standards Authority published research it commissioned on public perspectives on future fitness to practise to gauge how patients, the public and carers would wish to be involved in the likely future model, and views on oversight of new arrangements.

This research provided some interesting and surprising insights on what the public would be comfortable with in the context of a reformed fitness to practise framework.

Legislative reform of professional regulation

As part of wider reforms to the legislative framework for professional regulation announced by the Government, it is proposing to extend powers to all of the health and care professions’ regulators so to allow them to dispose of any fitness to practise cases, including the most serious, at the end of the investigation without a hearing.

The new consensual disposal process proposed by the Government, is a move away from the current adversarial approach to fitness to practise where decision making is predominantly the responsibility of tribunals.

Public Perception

Whilst concerns have been raised over the impact of the fitness to practise reform proposals on public protection and safeguarding, on the whole public opinion has been supportive of the proposals.

The research found that participants were supportive of moves to reduce the number of public hearings and use a more consensual model however, they felt there were risks in reducing the number of hearings since this would mean less external scrutiny of decisions. There was, therefore, a general view that independent oversight should be retained and the whole regulatory system leading to final decisions on fitness to practise.

Participants also wanted reassurance that, if there was no cross-examination in public at a hearing, the complainant would still have a voice and the evidence would be properly scrutinised and challenged. They called for witnesses to be able to give their side of the story in a way that is as user-friendly as possible and still able to convey nuance and emotion.

The research concluded that the proposed reform of fitness to practise would not adversely impact on public confidence in professional regulation.  The conclusion reached was:

“Given the low levels of awareness of regulation and fitness to practise cases, coupled with the relatively high levels of confidence in health and social care professions, there was a general feeling that the proposed changes are likely to have little impact on public confidence as a whole. However, it was acknowledged that this could change if a concerning case involving a professional, who had caused significant harm, came to light that had been dealt with inappropriately through a consensual process.”

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