Reform or be damned?

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Reform or be damned?

Richard Hough explores the mooted reforms to professional regulation.

Towards the back end of last year, the Department of Health published its consultation on the Government’s plan to reform UK healthcare professional regulation. The consultation poses a variety of questions on the future of healthcare regulation and covers the central themes of protecting the public through more responsive and efficient regulation.

The backdrop to the consultation comes from the Government’s manifesto commitment to legislate to reform what it perceives as a currently outdated “historical patchwork” system of professional regulation of healthcare professions. The current system is seen as being inconsistent, outdated and becoming ever increasingly complex from the perspective of patients, professionals and the public. There are concerns that people are confused by which professionals are regulated by which body and to what standard they are assessed.

In pushing forward with reform, the four UK governments have the ambition to improve the protection of the public from the risk of harm from poor professional practise, and to have a more responsive and efficient regulatory system that will maximise public protection, as well as support workforce development to help overcome the obstacles of delivering healthcare in the future.

As it currently stands, the body responsible for the independent regulation of pharmacy professions within Great Britain is the General Pharmaceutical Council (GPhC). Created in September 2010 after the Pharmacy Order 2010, the GPhC is responsible for the regulation of pharmacists, pharmacy technicians and pharmacy premises within England, Scotland and Wales.

The stated purpose of the GPhC is to set and promote standards for the safe and effective practise of pharmacy at registered pharmacies, maintain a register of pharmacists, pharmacy technicians and pharmacy premises and to establish fitness to practise requirements. This purpose is met through approving the necessary qualifications and training for pharmacists, pharmacy technicians and pharmacy support staff, inspecting registered pharmacies to ensure that they are meeting the mandatory standards and to subsequently investigate concerns and take action against pharmacy professionals who do not meet these standards.

Notable impact

It is likely there will be a notable impact on pharmacy regulation in the UK if reform plans are adopted. These plans could see a reduction from nine to “three or four” healthcare regulatory bodies, which will operate across the UK, with the consultation stating that research suggests that “efficiencies begin to accrue when a regulatory body has a registrant base of between 100,000 and 200,000.”

Based on 2015/16 figures, the GPhC has 89,377 registrants and thus is one of five healthcare regulatory bodies that falls under the 100,000 threshold. The belief is that a reduction in the number of healthcare regulators would ease the burden in costs of the healthcare professional regulatory system and would allow for a more consistent approach to regulation to be adopted.

It is proposed that the Professional Standards Authority for Health and Social Care (PSA), which is responsible for reviewing the work of the regulators of health and care professionals, will take on the role of advising the UK governments on which groups of healthcare professionals should be regulated, as the PSA is considered to be “better placed to provide advice on the regulation of professions.”

The Government hopes that the reconfiguration of the healthcare professional regulatory bodies will lead to more effective public protection through a clearer system of professional regulation and will dispel the current confusion about which organisations are relevant to which matters. Furthermore, it is being put forward that a reduction from nine regulators to three or four would enable the system to be much cheaper to run and would maximise economies of scale.

End of the GPhC?

If the reform plans are adopted, this could spell the end of the GPhC in its present capacity. The consultation discusses the benefits of increased collaborative working (in IT and HR for example) that would accommodate a more cost-effective approach. Similarly, joint working could extend to data sharing between the regulators about the number of fitness to practise referrals, for example, and the benefits of having a shared online register is also discussed.

In response to the consultation, the Pharmacists’ Defence Association (PDA) wants to see a proposal for regulation that “is fair, transparent and effective in how it protects patients and their health.” The PDA explained that, following its Freedom of Information Act request, it had discovered that the GPhC had never issued an improvement notice to a pharmacy owner or brought a fitness to practise case against a registrant for a failure to comply with the Standards for Registered Pharmacies, yet had commenced disciplinary proceedings against more than 3,500 individual registrants since its formation in 2010.

The GPhC’s chief executive, Duncan Rudkin, has said that the consultation provides the opportunity to discuss how regulation “can best protect and assure patients and the public, and support the professionalism of all health professionals.” The GPhC intends to expand on the issues raised in the consultation once it
has considered all the implications and questions posed, but it intends “to play an active part in the discussions.” However, it is fair to assume that the turkeys will not be voting in favour of Christmas...

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