Health Care Regulation in the United Kingdom

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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
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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

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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

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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

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4 Governments 3.5 Legal Systems
15 health boards 1 EMS
4 health boards 1 EMS
28 Strategic Health Authorities 533 NHS
Trusts 38 EMS
22 health boards 1 EMS
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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

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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

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Regulating Public Services
An example - 41 public Emergency Medical Services
delivering locally managed care but to one
national standard
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Key Regulatory Functions

• setting standards
• approving education and training
• registering practitioners
• investigating complaints
• adjudicating on fitness to practise cases
• prosecuting bogus practitioners

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Integrated Regulation
Sets Standards
HPC
approves training that meets them
registers practitioners who meet them
holds registrants to its Standards
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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

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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

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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?

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Sanctions

• no further action
• mediation
• caution
• conditions of practice
• suspension
• striking off

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Speaker Contact Information

• Jonathan Bracken
• Health Professions Council
• 184 Kennington Park Road
• London SE11
• 011 44 207 227 7077
• jonathanbracken_at_bdb-law.co.uk
• www.hpc-uk.org