1. Extending Professional Regulation Presentation to Association of Advanced Nursing Practice Educators 27 February 2009

2. Topics Covered Extending Professional Regulation Working Group Policy Drivers impacting upon Extending Regulation Risk, cost, benefits, form of Regulation Decision making on Extending Regulation Legislating

3. Extending Professional Regulation Working Group Established by the Secretary of State for Health in England, in consultation with Ministers in Scotland, Wales and Northern Ireland Remit to take forward work on the scope of professional regulation set out in the White Paper, Trust, Assurance and Safety – The Regulation of Health Professionals in the 21st Century

4. Extending Professional Regulation Working Group (cont.) Membership –Representatives from health and social care sectors, –Patient/Public Groups –Regulatory bodies, –Employers –Devolved administrations

5. Extending Professional Regulation Working Group (cont.) First convened on November 2007 Regular meetings since that date 2 stakeholder events: May 2008 and November 2008 Dedicated event in April 2008 for Public and Patient interest groups Interim report published June 2008 Final report due early 2009

6. Policy Drivers Trust, Assurance, and Safety – ch.7 –Some existing professionals who are not statutorily regulated have been in practice with patients for many years; practice that carries at least the same potential risk to people who use their services as that of the statutorily regulated professions. –The Government believes that these professionals should also be subject to a system of regulation that is proportionate to the risks and benefits entailed.

7. Policy Drivers (cont.) Hampton Review Formation of Better Regulation Executive (part of Dept for Business, Enterprise, & Regulatory Reform Development of five key principles of regulation: –Proportionality –Accountability –Consistency –Transparency –Targeting

8. Methodology of Working Group Consider groups aspiring to regulation in the following terms: –Do they pose a risk to the public, and what level is this risk? –What would be the costs associated with regulation –What would be the benefits gained from regulation –What type/form of regulation would be appropriate

9. Risk to the Public Safety, effective care and respect should be the sole legitimate benefits to be considered in assessing whether to extend professional and occupational regulation. Beneficial by-products to the profession (e.g. enhanced status, pay) are not the primary purpose of Regulation

10. Costs and Benefits of Regulation COSTS –The professional time needed to comply with the requirements of the regulators, –The costs to employers of ensuring that professionals have information and systems in place that are necessary for professional regulation –The costs of professional fees from registrants –The transitional costs of establishing new regulatory regimes for newly regulated bodies, which are normally borne by the taxpayer; –Statutory professional regulation implies a relatively high component of legal costs, compared to other forms of assurance

11. Costs and Benefits of Regulation (cont.) BENEFITS –Controlling entry to the regulated professions –Setting standards; –Ensuring high quality education to assure those standards; –Removing from practice a proportion of those who fall significantly short of those standards; –Promoting and enforcing codes of conduct; –Helping to foster, develop and sustain an ethos of professionalism amongst registrants –Reduced risk to patients and service users that they will experience poor treatment or care.

12. Regulatory Models Statutory Regulation is not the only form of regulation Other regulatory vehicles which might be more proportionate Within an organisation there may already be multiple layers of “regulation” in existence

13. Possible Alternatives to Statutory Regulation A supported “buyer-beware” approach, Voluntary registration of practitioners; Employer-based regulation Licensing regimes

14. Decision making Current position –Government can initiate (White Paper Groups) –Aspirant groups approach Health Professions Council Future position –Proactive approach to regulation –Risk/evidence based policy-making Ultimate decision maker – Parliament

15. Delivering legislative change – Regulation of New Professions Section 60 of the Health Act 1999 Statutory Instrument (secondary legislation) Laid before Parliament(s) for scrutiny, debated by Parliament(s)

16. Legislative process approximately 18-24 months 3 main phases: –Policy Refinement –Drafting & Consulting on the Legislation –Parliamentary Process The s.60 Process

17. Nature/complexity of policy Scope creep Devolution Parliamentary Scrutiny Process itself Key Issues and Risks in s.60 process

18. Current Orders include: White Paper Reforms General Pharmaceutical Council PMETB Hearing Aid Dispensers Current s.60 programme

19. Current s.60 programme (cont.) Possible future Orders: Strengthening Governance and Accountability Modernising Scientific Careers Revalidation of Medical and Non Medical Health Professionals