Professional bodies and services
The registration of health professions has grown dramatically over the last three years and is set to continue its expansion in the near future. The Department of Health currently has a consultative document on proposals to extend registration further to include care staff and eventually to all staff who "touch" patients. (See DoH consultation document Registration of healthcare staff in England and Wales.)
The primary reason for registration is the protection of the public but there are a number of other benefits which can be found in the Health Professions Council/UNISON joint publication on "10 benefits of registration" which can be ordered from the HPC or UNISON.
In summary the reasons and benefits of registration are:
Protection of title
Protection of professional titles means that only those people meeting the legally recognised standards of your profession can practise in the United Kingdom and use registered professional titles. Before 9 July 2003 anyone in the UK could use a professional title like 'paramedic' and practise freely without any training or any professional standards.
Now both the public and your profession are protected from unscrupulous practitioners fraudulently using registered titles. Those who use a professional title that they are not entitled to use can and will be prosecuted.
Independent regulation - for the professions, run by the professions
While regulation is now statutory (i.e. set by law), the regulation itself is independently run. This means that the regulators are not a government department, but instead are run by elected Councils made up of members of the professions regulated, plus members of the public. Some regulators have charitable status and some, such as the HPC, are statutory bodies but not charities.
This independence is one of the regulators' most important and strongest features, and would be lost if regulation were directly run and funded by government.
Professional input - your involvement
Just one of the impacts of this independence is the input that the professions have into the standards that regulate them. If a health professional has an allegation made against them, a panel that includes at least one member of their profession, to ensure good professional input into panel decisions, considers that allegation.
In addition, registered health professionals have input into the standards of education and training, the assessment of courses, the assessment of applications, and the standards of proficiency. This professional input ensures that we have the most up-to-date working knowledge from each profession we regulate embedded into every activity we carry out.
Any registrant can stand for a place on the regulatory councils.
Protection against rogue practitioners - upholding your profession's reputation
Every person, who uses a professional title without the knowledge, qualifications and training to ensure their safe and effective practice, is undermining the reputation of your profession.
Prosecuting those people who illegally use professional titles, and bringing fitness to practise proceedings against those very few registered professionals who do not keep to the registering bodies standards, does not just protect the public, it also protects the rest of the registrants.
Recognition of the professions - including employment in the NHS
The Department of Health has issued a circular which states that in order to be employed by a local authority, NHS Trust or Primary Care Trust, in the capacity of one of the HPC regulated 12 professions, you must be on the Health Professions' Council's Register. Registration is therefore necessary in order to be employed by these bodies.
Defined standards of conduct and ethics - clear guidance for registered professionals
The standards of conduct, performance and ethics for professions is an important aspect of the work of all registration bodies. They all have a document, which lays out clear guidelines concerning the expectations of the health professional, of each registrant and prospective registrant.
Dealing with ill health and practice
All registration bodies have some criteria that states that registrants must be of good health and character in order to practise. It also lays out ways in which these bodies can deal with registrants whose ability to practise safely is impaired because of their health.
There is a dedicated health committee to hear cases of registrant's health, and while the health committee can still strike registrants off, suspend or caution them, there is scope to, for example, limit registrants' practice until they are well enough to resume full practice.
Defined standards of proficiency
With the publication of the standards of proficiency for all professions, there are clear standards laid out for each profession, concerning expectations, skills, knowledge and understanding.
Professional and consistent assessment of international applicants-maintaining standards Health professionals from other countries are seeking opportunities for employment in the UK in increasing numbers. Regulation of the profession means that anyone who wishes to practice in any of the professions regulated must be registered with the relevant Council.
This means that all international applicants are dealt with professionally and consistently, and that standards for the professions are maintained. Health professionals do not have to worry that their internationally trained colleagues will be lacking in knowledge or training.
Working in the European Economic Area - freedom of movement and the Regulators
Registration with the relevant bodies will dramatically improve your chances of registration with other EEA regulatory bodies. A letter you can obtain from your Council while you are registered (a 'letter of good standing', which under the new rules is now available without charge to registrants) must be recognised by other EEA regulatory bodies as giving a legal right to full and proper consideration of any application to work there.
Regulating the Regulators
The Regulators are themselves now subject to regulation. The Council for the Regulation of Health Professions (CRHP) was set up following the Bristol inquiry to ensure greater consistency in the operation and decisions of the regulatory bodies. It is an overarching body, which has representatives of all the registration bodies on its governing structures. The CRHP is an independent organisation that is underpinned by a statutory authority.
The Kennedy Report arose as a result of the Bristol Royal Infirmary Inquiry and it stated that:
'É. a single body should be charged with the overall co-ordination of the various professional bodies and with integrating the various systems of regulation.'
There are nine professional councils in the UK, all of them have the legal right to test a registrants competency, determine their educational standards and to ensure they remain of good character while on the register. It is these bodies that the CRHP regulates.
- GCC - General Chiropractic Council
- GDC - General Dental Council
- GMC - General Medical Council
- GOC - General Optical Council
- GOsC - General Osteopathic Council
- HPC - Health Professions Council
- NMC - Nursing and Midwifery Council
- PSNI - Pharmaceutical Society of Northern Ireland
- RPSGB - Royal Pharmaceutical Society of Great Britain
The scope of regulation
Currently there are 1.5M registrants of which 50%+ are non-NHS. Consultation is underway for new groups to be registered within the next twelve months. These are:
- Healthcare assistants (250,000)
- Acupuncturists (2,500)
- Herbalists (1,300)
The Council (CRHP) may do anything, which appears to it to be necessary or expedient for the purpose of or in connection with, the performance of its functions. For example:
- Investigate and report on the performance of regulators
- Comparison in performance between regulators
- Recommend changes in the way it performs functions
Reference of cases to court - Sec 29
If the Council for the Regulation of Health Professions considers that -
- a relevant decision has been unduly lenient, whether as to any finding of professional misconduct or fitness to practise on the part of the practitioner concerned (or lack of such a finding), or as to any penalty imposed, or both
- a relevant decision should not have been made
and that it would be desirable for the protection of members of the public for the Council to take action under this section, the Council may refer the case to the relevant court. This is an important legal authority that rests with the CRHP and they expect some 600 cases to referred to them each year for further action. So far only a small proportion have lead to a court referral.