Promoting professionalism, reforming regulation UK Council for Psychotherapy (UKCP) response

Transcription

1 Promoting professionalism, reforming regulation UK Council for Psychotherapy (UKCP) response Organisation: UK Council for Psychotherapy (UKCP) About the organisation: UKCP is the leading organisation for the education, training, accreditation and regulation of psychotherapists and psychotherapeutic counsellors in the UK. Our register is accredited by the Professional Standards Authority for Health and Social Care under its Accredited Registers programme. Contact: Louise Lilley, Head of Operations and Regulation Consultation responses: Q1: Do you agree that the PSA should take on the role of advising the UK governments on which groups of healthcare professionals should be regulated? Yes, in principle - provided the PSA consult with the stakeholders including but not limited to any relevant current regulators (including accredited voluntary registers) who may be impacted, and the affected professionals. Q2: What are your views on the criteria suggested by the PSA to assess the appropriate level of regulatory oversight required of various professional groups? The two stage assessment is good, but the criteria should be expanded further. Circumstances where there is no readily available evidence of risk of harm but where harm may still be present should be considered. For example, there may be some instances where service users are less likely to raise a grievance for example, vulnerable people and/or people seeing a professional in a private one to one scenario. In the second stage, we recommend some consideration to be given to financial impact of the behaviour/misconduct e.g. consider whether taxpayer s money has been used negligently by the practitioner. UK Council for Psychotherapy (UKCP), America House, 2 America Square, London, EC3N 2LU 1

2 Q3: Do you agree that the current statutorily regulated professions should be subject to a reassessment to determine the most appropriate level of statutory oversight? Which groups should be reassessed as a priority? Why? Yes, it is always good practice to carry out an in depth analysis of the governance and structure of all statutory regulators on regular intervals. However, we have no particular opinion on which current statutorily regulated professions should be subject to a reassessment as a priority. Q4: What are your views on the use of prohibition orders as an alternative to statutory regulation for some groups of professionals? We prefer the current positive register system, as this allows the public to see that registrants have suitable levels of initial and ongoing education, training, and CPD and are working to appropriate ethical standards compared to a prohibition order/negative register that simply shows that someone has been deemed to be unfit to practise. Q5: Do you agree that there should be fewer regulatory bodies? We do not necessarily think there should be fewer regulatory bodies. The number of bodies should reflect the number of professions that require regulation and whether those professions can be sensibly and easily grouped. While regulators that oversee similar professions that have a good cultural fit could be considered for merging, it also might be felt that a regulator is representing too many disparate professions and should be split. Careful consideration needs to be given to which professions it is optimal to group and indeed which professions should or should not be regulated at all. This may ultimately give rise to fewer regulators, or perhaps more regulators. Q6: What do you think would be the advantages and disadvantages of having fewer professional regulators? A potential advantage of having fewer professional regulators is parity across the organisations which would ensure that each professional is held to account in the same transparent manner. Another potential advantage is that the public may find it easier to understand and deal with a smaller number of regulators. A potential disadvantage is that you may lose profession based expertise, as each profession is different. Also it is unclear the impact this could have on jobs/regulators. Although, it is true that economies of scale may be achieved by merging some regulators and/or functions, there could also be a negative impact. A larger organisation, dealing with more complaints may become more bureaucratic and unwieldy. Complaints and concerns may not be processed in a timely or efficient manner and the quality of the complaints handling may deteriorate. Smaller organisations may also be able to react more quickly to changes in the regulatory environment. UK Council for Psychotherapy (UKCP), America House, 2 America Square, London, EC3N 2LU 2

3 Q7: Do you have views on how the regulators could be configured if they are reduced in number? There should be an exercise to see which professions/processes are similar and have a good cultural fit. Those which are similar could be aligned. Another exercise is to look at how the regulators perform in their duties. A review of their complaints handling should be carried out to identify best practice and any similarities to help minimise some of the disadvantages identified in the response to Q.6. Q8: Do you agree that all regulatory bodies should be given a full range of powers for resolving fitness to practise cases? Yes. There needs to be flexibility in resolving fitness to practise cases - provided the decisions are consistent and across the board although these should be subject to regular review. UKCP has introduced an Alternative Dispute Resolution (ADR) process to deal with complaints that (if proved) would not require removal from the register. If it is not a public safety issue, then it is always preferable to try to resolve a complaint without the need for a formal, adversarial and costly legal hearing. Q9: What are your views on the role of mediation in the fitness to practise process? Mediation can be a useful and effective part of a complaints system, however, we do not believe it should be offered in cases that are serious or relate to public safety or an individual s Fitness to Practise (FtP). UKCP s approach has always been to consider in the first instance whether or not a grievance or complaint can be resolved in a more informal manner. Mediation and ADR processes should be used in cases that are not serious enough to go to a legal hearing, as the process is less distressing, and there is an advantage in moving to a less adversarial approach. Q10: Do you agree that the PSA's standards should place less emphasis on fitness to practise performance and consider the wider performance of the regulators? For voluntary accredited registers we believe the PSA s current balance works and is effective. For registers like ourselves the PSA already considers wider performance in addition to fitness to practise taking into account not only a fuller range of regulatory functions, but also wider organisational activities, such as our work on public policy. We believe this model could be usefully applied to the statutory regulators. Q11: Do you agree that the PSA should retain its powers to appeal regulators' fitness to practise decisions to the relevant court, where it is considered the original decision is not adequate to protect the public? We believe it should be possible to appeal decisions made by regulators, and the PSA is the logical body for those appeals. However, there is a danger that the PSA, as a generalist body, may lack the specific and expert perspective to hear all cases appropriately. We therefore suggest the PSA jointly works with representatives from the relevant professions in these cases. UK Council for Psychotherapy (UKCP), America House, 2 America Square, London, EC3N 2LU 3

4 Q12: Do you think the regulators have a role in supporting professionalism and if so how can regulators better support registrants to meet and retain professional standards? Yes, this is very important. All regulated professions should have clear standards of education, training, continuing professional development and ethics. These should be checked and monitored by their regulator throughout their working lives. There should be more emphasis on what measures regulatory bodies can take to support the professional development of their registrants, and to support the maintenance of appropriate professional standards. Efficient Regulation Q13: Do you agree that the regulators should work more closely together? Why? Yes. Transparency, shared learning, and aligned processes all contribute to the protection of the public. Q14: Do you think the areas suggested above are the right ones to encourage joint working? How would those contribute to improve patient protection? Are there any other areas where joint working would be beneficial? We agree that there are benefits to a shared online portal. There are also advantages to developing a single set of standards and a single adjudicator, however, in both cases these must provide scope for the difference between professions to be taken into account. In the case of integrating back office functions, we do not believe economies of scale can automatically be presumed, and careful consideration must be given to the evidence before embarking on such integration. Q15: Do you agree that data sharing between healthcare regulators including systems regulators could help identify potential harm earlier? Yes, but we need to be careful how this is done so that we avoid any breaches of an individual s rights and data protection. The rights of the individual must be carefully balanced against that of the public, and the information must be used proportionately. Q16: Do you agree that the regulatory bodies should be given greater flexibility to set their own operating procedures? The flexibility we have as an accredited voluntary register allows us to act quickly and responsively to issues involving the profession and protection of the public. We would like to see that flexibility retained, and also considered as a model for statutory regulators. Q17: Do you agree that the regulatory bodies should be more accountable to the Scottish Parliament, the National Assembly for Wales and the Northern Ireland Assembly, in addition to the UK Parliament? UK Council for Psychotherapy (UKCP), America House, 2 America Square, London, EC3N 2LU 4

5 We have no particular opinion on this. Q18: Do you agree that the councils of the regulatory bodies should be changed so that they comprise both non-executive and executive members? Yes, this is similar to how the UKCP board operates. We agree that a diversity of perspectives within councils and boards is a good thing. We also believe that integrating the perspective of executive members, in addition to non-executive members, helps foster realistic thinking and plans that are achievable within the organisations staffing and resourcing capacity. Q19: Do you think that the views of employers should be better reflected on the councils of the regulatory bodies, and how might this be achieved? We believe that regulators should consider the needs of employers, however, we do not believe this should involve direct participation on the councils and boards. There are potential conflicts of interests with employers wanting either lower or higher levels of regulation than are proportionate or in the interests of public safety. We believe consultation and communication between councils and employers is a better model than direct participation. Q20: Should each regulatory body be asked to set out proposals about how they will ensure they produce and sustain fit to practise and fit for purpose professionals? Yes, this should be a primary function of regulators. Q21: Should potential savings generated through the reforms be passed back as fee reductions, be invested upstream to support professionalism, or both? Are there other areas where potential savings should be reinvested? This should be down to the individual regulator, however in cases where any benefit of fee reduction would be nominal to practitioners, we view it as more appropriate to invest upstream to support professionalism. Impact Assessment Q22: How will the proposed changes affect the costs or benefits for your organisation or those you represent? - an increase - a decrease - stay the same Please explain your answer and provide an estimate of impact if possible. The proposed changes should not affect UKCP as we believe the consultation is almost exclusively about statutory regulators, and we are not such a body. UK Council for Psychotherapy (UKCP), America House, 2 America Square, London, EC3N 2LU 5

6 Q23: How will the proposed changes contribute to improved public protection and patient safety (health benefits) and how could this be measured? We believe our answers to earlier questions set out how we believe the proposals do or do not contribute to public protection and patient safety. However, we would re-emphasise that there is a risk that merging multiple organisations to a new larger one, may be not necessarily be cost effective, and may also dilute services provided. We recommend that the government provide examples of successful mergers of a similar nature, to the public as part of the next round of consultation. In terms of measurement, an analysis could be conducted of the number of cases brought, waiting times, and measures of satisfaction and trust among both the general public, and members of the public who have used the complaints or dispute resolution processes. Equality Analysis Q24: Do you think that any of the proposals would help achieve any of the following aims: - Eliminating discrimination, harassment, victimisation and any other conduct that is prohibited by or under the Equality Act 2010 and Section 75(1) and (2) of the Northern Ireland Act 1998? - Advancing equality of opportunity between persons who share a relevant protected characteristic and persons who do not share it? - Fostering good relations between persons who share a relevant protected characteristic and persons who do not share it? If yes, could the proposals be changed so that they are more effective? If not, please explain what effect you think the proposals will have and whether you think the proposals should be changed so that they would help achieve those aims? Equality and discrimination are important issues for regulators, which go far beyond the reforms suggested in this consultation. We believe the Government should revisit this issue with fuller consultation as, in its present form, we do not find this question meaningful. UK Council for Psychotherapy (UKCP), America House, 2 America Square, London, EC3N 2LU 6