Health Care Regulation in the United Kingdom Jonathan Bracken Legal Adviser to the UK Health Professions Council Presented at the 2005 CLEAR Annual Conference

Health Care Regulation in the United Kingdom

Jonathan BrackenLegal Adviser to the UK Health Professions Council

Presented at the 2005 CLEAR Annual ConferenceSeptember 15-17 Phoenix, Arizona


The UK Health Regulators

• Nursing and Midwifery Council 600,000

• General Medical Council 200,000

• Health Professions Council 160,000

• 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


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


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”


4 health boards 1 EMS



28 Strategic Health Authorities533 NHS Trusts38 EMS

4 Governments; 3.5 Legal Systems


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


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


Regulating Public Services

An example - 41 public Emergency Medical Services delivering locally managed care but to one national standard


Key Regulatory Functions

• setting standards

• approving education and training

• registering practitioners

• investigating complaints

• adjudicating on fitness to practise cases

• prosecuting bogus practitioners


Integrated Regulation

Sets Standards

approves training that meets them

registers practitioners who meet them

holds registrants to its Standards

HPC


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


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…”


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?


Sanctions

• no further action

• mediation

• caution

• conditions of practice

• suspension

• striking off


Speaker Contact Information

Jonathan Bracken

Health Professions Council

184 Kennington Park Road

London SE11

011 44 207 227 7077

[email protected]

www.hpc-uk.org

Documents

Health Care Regulation in the United Kingdom Jonathan Bracken Legal Adviser to the UK Health Professions Council Presented at the 2005 CLEAR Annual Conference