Written evidence from Professional Standards Authority (HCP0002)

1.                 Introduction

1.1             The Professional Standards Authority for Health and Social Care is pleased to provide the Health Committee with written evidence on the Health and Care Professions Council.

1.2             This submission from the Authority is made under the arrangements described by the Committee in its recent report After Francis: making a difference, whereby the Committee will take evidence from the Authority on the performance of each regulator and draw on this in preparing for regular accountability hearings.

1.3             In June 2013 we laid our 2012/13 Performance Review before Parliament. This provided the Authority’s assessment of the HCPC’s performance against 24 Standards of Good Regulation in the 2012/13 financial year. We were grateful for the opportunity to discuss our findings with the Committee on 9 July 2013.

1.4             This Memorandum supplements and complements the findings of our 2012/13 Performance Review.

1.5             In particular we draw upon our report of our audit of the HCPC’s handling of 100 cases closed at the initial stages of its fitness to practise process without a final hearing. A copy of this report accompanies this memorandum.

2.                 Findings from the 2012/2013 Performance Review

2.1             In 2012/2013 the HCPC met all our standards of good regulation. This demonstrated an improvement on 2011/2012 where we found that the HPC (as it was at the time) was not meeting the third standard of good regulation for education and training.

2.2             We consider that the HCPC’s performance in 2012/2013 is particularly notable as it completed the transfer of the register of social workers in England during this period. This added over 80,000 registrants to the HCPC registers, making it the second largest regulator in the health and care professions sector in the UK.

2.3             Despite the considerable additional work involved in preparing for and implementing the transfer of the regulation of social workers in England, the HCPC has maintained its efficient and effective performance across all areas of responsibility. This noteworthy given the increase in the volume of allegations it is handling and the expansion of its scope.

3.                 2013 Audit of initial stages of fitness to practise processes

3.1             In June 2013 we audited 100 cases that the HCPC closed in the initial stages of its FtP investigation process. The aim of the audit is to seek assurance that the regulator is protecting patients, service users and the public, and maintaining confidence in the reputation of the profession and the system of regulation. We assess whether the regulator achieves these aims in the cases we review and consider whether any weaknesses in the handling of any of these cases might suggest that the public may not be protected, or confidence not maintained in the system of regulation if the approach was adopted in future cases.

3.2             In our previous audit of the initial stages of the HPC’s FtP processes, published in February 2010, we found that they dealt with cases ‘efficiently and effectively’ and that ‘the vast majority of decisions taken on cases were reasonable and protected the public’.

3.3             Our conclusion from our 2013 audit was that the general case work system operated by the HCPC demonstrates that public protection is maintained. We identified a number of examples of good practice, specifically around active case management and progression of cases.

3.4             However we found areas for improvement in 53 of the 100 cases we audited, including 25 cases where we had concerns about decision making and six cases where we considered there were potential implications for public protection and/or maintaining public confidence in the professions or the system of regulation. The HCPC has outlined actions to address the areas of concern we highlighted in report.

4.                 Scrutiny of final panel decisions under section 29 of the National Health Service Reform and Health Care Professions Act 2002

4.1             The table below presents data arising from the Authority’s review of final fitness to practise decisions. The Authority has the power to appeal to the High Court if we consider that a final fitness to practise decision is unduly lenient and it is in the public interest.
 

5.                 Regulation post-Francis

5.1             The Francis Inquiry has thrown a spotlight on the effectiveness of regulatory and supervisory organisations, both individually and as part of a wider safety and quality structure. One of the key lessons from this Inquiry, and the Government’s response, is that a regulator’s effectiveness should be gauged on its contribution to the achievement of the common goal of safe, high-quality care, as well as on its fulfilment of particular and focused statutory duties.

5.2             The HCPC have perhaps a greater challenge than other professional regulators in this respect, due to the breadth of their register with 16 different professions operating across a variety of settings. The efficiency and effectiveness with which it meets own statutory responsibilities is commendable. However, in the future, regulators will also be judged by the extent to which they work with others as part of the safety and quality architecture of health and social care, for the benefit of patients, service users and the wider public. This will require a more coordinated approach and the Committee may wish to understand how the HCPC plans to cooperate and collaborate with other organisations in the future to achieve common regulatory outcomes.

November 2013