The future of Fitness to Practise – DHSC Consultation

An important consultation to overhaul fitness to practise has been launched by the Department of Health and Social Care.

This week, the Department of Health and Social Care (DHSC) launched what has been described as a “once in a lifetime” opportunity to overhaul fitness to practise in the UK. 

Setting out its approach, the DHSC said it was guided by a number of principles including:

• The system should be able to respond to changing workforce models and developments in health and social care delivery without the need for ongoing legislative change;
• Regulators should have broadly equivalent powers to maintain a level of consistency and effective public protection; and
• Overly detailed legislation should be replaced.

Whilst the consultation included other reforms relating to governance, education and registration, in this article I will focus on the fitness to practise reforms proposed.  Please note this article is a brief overview of the consultation.  Please refer to the consultation document for a comprehensive overview of the proposals.

Fitness to Practise reforms

“These changes aim to deliver a fitness to practise process that is less adversarial and with more cases resolved without the need for a fitness to practise panel hearing. This will provide benefits to all parties involved in fitness to practise proceedings. It will deliver protection for the public more quickly. It will reduce the stress on registrants and others that are party to the fitness to practise process, and it will increase the likelihood of reflection and learning from cases.”

What is being proposed?

Three-Stage Fitness to Practise process

The DHSC proposals will introduce a three-stage fitness to practise process for all regulators:

1. Initial Assessment – a consistent set of powers to determine whether a concern received about a registrant meets the criteria for onward referral in the fitness to practise process.

2. Case Examiner Stage – to carry out a detailed assessment of the case from the written information and evidence available, and where possible, make a decision based on their assessment of impairment and whether action is needed to protect the public.

They will have a full suite of measures available (including applying conditions to a registrant’s practice, suspending their registration, or removing the registrant from the register) with which they can conclude a case but only through an accepted outcome.

3. Fitness to Practise Panel – the panel is required to make a determination as to whether a registrant’s fitness to practise is impaired.

Grounds for action

Grounds for action set out the reasons why regulators might need to investigate and take action where there is a concern about a registrant’s fitness to practise.  Proposal is that the grounds for action should be consistent across all regulators as being:

• Lack of competence
• Misconduct

Measures available to case examiners and Fitness to Practise panels

• Warning where fitness to practise is not found to be impaired
• Where practise is found to be impaired – Conditions, Suspension Orders & Removal Orders.

Automatic removal orders

Where a registrant is convicted of a listed offence (based on the list in Schedule 3 of the Social Work Regulations), the regulator will be able to remove a registrant from the register automatically.  This is the only measure the regulator can impose without an initial assessment.

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