Website of the Department of Health

Reform of professional regulation and clinical governance

This sets out proposals for the reform of the regulation of health professionals in the United Kingdom.

Marking the first comprehensive overhaul in more than three decades, the Government has published a White Paper setting out landmark proposals for the reform of the regulation of health professionals in the United Kingdom.

Trust, Assurance and Safety - The Regulation of Health Professionals in the 21st Century includes proposals which will ensure patient, public and professional confidence in the health professionals' watchdogs, improving patient safety and ensuring the fair treatment of health professionals.

At the same time, the Government is publishing its response to the Fifth Report of the Shipman Inquiry.  Together, the two publications make the protection of patients and the public the first priority of all who are concerned with healthcare, set out proposals which will sustain and enhance the high regard in which the public hold health professionals and ensure that good regulation does not get in the way of good patient care.

Background

While the public and patients rightly hold the substantial majority of health professionals in high esteem, the need for reform to sustain confidence in regulation of healthcare professionals has been underlined by the findings of a number of high profile inquiries into doctors who have harmed their patients, most notably the Shipman, Kerr-Haslam, Ayling and Neale Inquiries.

The country needs a system in which patients, the public and health can have confidence that the regulators of healthcare professionals do so in a way that is fair to both patients and health professionals.

The Department published in July 2006 a review of non-medical healthcare professional regulation and a report on the reform of medical regulation by the Chief Medical Officer, Good doctors, safer patients.

Following the publication of these reports, the Department ran a public consultation from 14th July 2006 until 10th November 2006, which generated more than 2000 responses.

Trust Assurance and Safety - The Regulation of Health Professionals in the 21st Century (the White Paper setting out the Government’s plans to reform Professional Regulation)

Building on the responses to consultation, the Department of Health published on 21st February 2007 the White Paper, Trust, Assurance and Safety, The Regulation of Health Professionals in the 21st Century, which sets out how we will reform and modernise the system of professional regulation.  The White Paper signals a move towards a more robust regulatory system which earns and sustains the confidence of all encountering it.

Some of the key changes include:

• measures to make regulators more independent, such as the appointment of council members, professional members no longer forming the majority of these councils and an independent adjudicator for doctors;
• measures to ensure healthcare professionals are objectively revalidated throughout their career and remain up to date with clinical best practice;
• the creation of GMC Affiliates to help deal with more cases concerning doctors at a local level and to ensure independent oversight of aspects of revalidation;
  changing the standard of proof used in fitness to practise cases from the criminal standard to the civil standard with a sliding scale; and
  
  
• moving towards a more rehabilitative approach to regulation, with the development of a comprehensive strategy for prevention, treatment and rehabilitation services for all health professionals.

Responses to the Shipman Inquiry

Alongside the White Paper, we have also published on 21st February 2007 the Government’s response to the Fifth Report of the Shipman Inquiry, Safeguarding Patients, which sets out a wide-ranging plan of action to put in place new safeguards for society, building on and strengthening existing clinical governance processes.  It also addresses the recommendations of the inquiries into the conduct of Richard Neale, Clifford Ayling, Michael Haslam and William Kerr.

Some of the key changes include:

• better support for patients who want to register concerns and measures to ensure they are taken seriously;
• making more systematic use of information about the clinical outcomes of individual practitioners and teams;
• ensuring that information from different sources is brought together so that a fuller picture about professionals is properly considered; and
• requiring all primary care organisations to adopt best practice in investigating and acting on concerns.
  

In addition to this, the Department of Health also published on the same day an overview of the Government’s proposals and actions in relation to all the recommendations in the six reports of the Shipman Inquiry, Learning from tragedy, keeping patients safe.