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Health Care Regulation in the United Kingdom Jonathan Bracken Legal Adviser to the UK Health Professions Council Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona The UK Health Regulators • • • • • • • • • Nursing and Midwifery Council General Medical Council Health Professions Council General Dental Council General Optical Council General Osteopathic Council General Chiropractic Council Royal Pharmaceutical Society (GB) Pharmaceutical Society (NI) 600,000 200,000 160,000 37,000 30,000 3,000 2,000 45,000 300 1,077,300 Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona 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 Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona 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” Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona 4 Governments; 3.5 Legal Systems 4 health boards 1 EMS 22 health boards 1 EMS 15 health boards 1 EMS 28 Strategic Health Authorities 533 NHS Trusts 38 EMS Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona 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 Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona 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 Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona Regulating Public Services An example - 41 public Emergency Medical Services delivering locally managed care but to one national standard Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona Key Regulatory Functions • • • • • • setting standards approving education and training registering practitioners investigating complaints adjudicating on fitness to practise cases prosecuting bogus practitioners Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona Integrated Regulation Sets Standards approves training that meets them HPC registers practitioners who meet them holds registrants to its Standards Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona 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 Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona Standards of Proficiency “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…” • 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 Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona 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? Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona Sanctions • • • • • • no further action mediation caution conditions of practice suspension striking off Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona 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 Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona