Healthcare regulators have been placed under the spotlight following the release of a government paper Promoting Professionalism, Reforming Regulation.
But what sort of reform was likely? And having said there was no clear rationale for the current position of having nine regulatory bodies, could high street regulation be merged?
When the government launched its consultation in October of last year, it described regulation for healthcare professionals as ‘complex and outdated’.
‘The regulation of healthcare professionals must change in order to protect patients, to support the transformation of our healthcare services and to meet future challenges. It needs to be faster, simpler, better and less costly,’ the Department of Health stated.
However, views have since been gathered across the full range of healthcare sectors, who were seemingly united in a reluctance towards combining forces. Joint working and co-operation between healthcare regulators was the preferred route towards a modern and efficient system.
GOC registrar and chief executive Vicky McDermott told Optician in no uncertain terms that speculation about merging regulators was nothing more than a distraction.
‘There is little to no evidence this would be better for anybody,’ she said.
Meanwhile, a response by the General Pharmaceutical Council (GPhC) stressed that having specialist regulators brings the advantage of them understanding the context of the professional groups they regulate.
The GPhC rejected the notion of a ‘high street regulator’, which had sometimes been proposed as an option for merger, particularly by the Professional Standards Authority (PSA) as part of its calls for a ‘single assurance body’.
A response by the GPhC said: ‘If the definition of “high street healthcare” means services available to the public in retail settings, that is in itself quite restrictive, and does not reflect ways in which access may occur. For example, within the context of pharmacy, services will be increasingly delivered online, both as clinical consultations and the dispensing of medicines, and delivered directly to a patient’s home, as well as a variety of other settings not on the high street, such as care homes.’
Beyond talk of mergers, the DoH noted criticism, not least from the regulators themselves, that the current system is slow, expensive, complicated, reactive, overly adversarial and confusing for patients, professionals and employers.
It said regulators continued to be hampered by a legislative framework, in parts more than 150 years old, with outdated procedures.
‘From the perspective of patients and the public, the current system of regulation can be confusing, inconsistent and slow. People are not always clear which professionals are regulated by which regulatory body or against which standards,’ the government consultation document added.
Merger a red herring
Speaking to Optician last week, GOC chief McDermott (pictured) agreed medical reform was needed and deemed the Opticians Act as ‘out of date’.
However, she described the concept of a regulatory merger as a ‘red herring’ and believed the DoH had ‘more important things to consider than re-arranging the deckchairs’.
Increased political will should apply to addressing NHS hospital delays and backlogged clinics rather than to redesigning the regulatory system, she stressed.
In making its response to the consultation, the GOC noted the enhanced roles that optometrists and dispensing opticians now played in relieving the strain on hospital eye services. Collaboration with ophthalmologists, orthoptists and ophthalmic nurses had become increasingly important.
‘But to carry out our role as effectively as we can, we need greater freedom to innovate and strip away rules that are outmoded or just don’t make sense. In the popular imagination, “opticians” test vision and sell spectacles. In fact they do much more than this, playing an essential role – on the high street and in hospitals – in improving the eye health of the nation.
‘Our ability to support this objective, by protecting the public and promoting higher standards of patient care, would be enhanced greatly by a flexible, modern system of regulation designed around patients,’ the GOC’s response stated.
Opportunity to improve
Speeding up the fitness to practise process and business regulation were two areas where the GOC was looking to enact change, McDermott said.
She said the GOC would take the government consultation as an opportunity to improve how it could operate as a regulator. Another goal was to streamline the complaints process, and McDermott referred to a memorable Carlsberg television advert shot in a dusty old complaints centre, where the only phone call received was from a wrong number. ‘Wouldn’t it be great if that was our FTP department,’ she said.
Despite clear resistance to a regulatory merger, she stressed there was a need for radical regulation change. As part of this, the process must be aligned closer to the patient journey itself, which passed through various healthcare professionals with different regulators.
‘I think the reform required is really radical but changing the name above the door is the least radical thing you could do,’ she added. ‘The profession is going through rapid changes at the moment, including the demographics accessing eye care and changes to technology around eye tests and optical products. These things are really fundamental. We need a much more flexible form of regulation to ensure we keep up with that.’
McDermott also said the DoH could not continue to ‘shrug their shoulders’ and must find time to look at legislation in the Opticians Act 1989, unchanged since 2005, and urged all of optics to bang on the government’s door.
‘My call to action is to make sure we are being heard,’ McDermott added.