1. Health Care Regulation in the United Kingdom Jonathan Bracken Legal Adviser to the UK Health Professions Council Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona

2. Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona The UK Health Regulators Nursing and Midwifery Council600,000 General Medical Council200,000 Health Professions Council160,000 General Dental Council 37,000 General Optical Council 30,000 General Osteopathic Council 3,000 General Chiropractic Council 2,000 Royal Pharmaceutical Society (GB) 45,000 Pharmaceutical Society (NI) 300 1,077,300

3. Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona The Health Professions Council arts therapists biomedical scientists clinical scientists dieticians occupational therapists operating department practitioners orthoptists paramedics physical therapists podiatrists prosthetists and orthotists radiographers speech therapists

4. Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona The UK Regulatory Model Each regulator has the power to: generate its own revenues adopt and manage its own budget appoint its legal and investigative staff hire, discipline and terminate staff institute actions in its own name issue “subpoenas” share data with others who monitor performance act on “a preponderance of the evidence”

5. Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona 4 health boards 1 EMS 15 health boards 1 EMS 22 health boards 1 EMS 28 Strategic Health Authorities 533 NHS Trusts 38 EMS 4 Governments; 3.5 Legal Systems

6. Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona UK Demographics population of 60 million in an area smaller than Oregon with an unequal distribution of: 50,000,000 (84%) in England 5,000,000 (8%) in Scotland 3,000,000 (5%) in Wales 1,700,000 (3%) in Northern Ireland

7. Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona A Delivery Snapshot regulation covers around 1 million practitioners –475,000 are directly employed by the NHS –400,000 are independent NHS contractors taxpayers fund 85% of UK health care spending 10% of the UK population has health insurance

8. Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona Regulating Public Services An example - 41 public Emergency Medical Services delivering locally managed care but to one national standard

9. Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona Key Regulatory Functions setting standards approving education and training registering practitioners investigating complaints adjudicating on fitness to practise cases prosecuting bogus practitioners

10. Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona Integrated Regulation Sets Standards approves training that meets them registers practitioners who meet them holds registrants to its Standards HPC

11. Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona The Standards Standards of Proficiency Standards of Education and Training Standards of Conduct, Performance and Ethics Standards of Continuing Professional Development Standards for Returning to Practice

12. Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona Standards of Proficiency Foundation of HPC regulation Represent threshold standards for each profession, which apply:  on entry to the Register  on renewal or re-admission  throughout professional life “The Council shall …establish the standards of proficiency necessary to be admitted to the different parts of the register being the standards it considers necessary for safe and effective practice…”

13. Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona Fitness to Practise A non-punitive process conducted by the regulator No “prosecution”, “charge” or “guilt” Allegations are that a health professional's fitness to practise is impaired by reason of :  misconduct  criminal conviction  lack of competence  health  determination of another regulator The issues to be determined are:  is fitness to practise impaired?  what must be done to protect the public?

14. Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona Sanctions no further action mediation caution conditions of practice suspension striking off

15. Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona Speaker Contact Information Jonathan Bracken Health Professions Council 184 Kennington Park Road London SE11 011 44 207 227 7077 jonathanbracken@bdb-law.co.uk www.hpc-uk.org