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‘Overcomplicated’ healthcare regulation needs ‘radical’ overhaul to survive

“Overcomplicated, out of date and expensive” health and social care regulation in the UK needs “radical” change in order to survive the future challenges of the population, a report by the Professional Standards Authority has found.

PSA, which oversees healthcare regulators in the country, is calling for a complete redesign of the regulatory framework to deal with issues stemming from an ageing population, long-term conditions, comorbidity, the rising cost of health technologies and a global shortage of health and care workers.

The report argues that, without reform, the health and care system in the UK would break from the pressure.

Harry Cayton, chief executive of the PSA, said: “Piecemeal adjustments to health and care regulation have, over time, made the system cumbersome, ineffective and expensive. Every part of our health and care system is changing in order to meet future needs. If patients are to benefit, regulation must undergo radical change too.

“Regulation is asked to do too much – and to do things it should not do. We need to understand that we cannot regulate risk out of healthcare and to use the regulation only where we have evidence that it actually works. Ironically, the regulations that are meant to protect patients and service users are distracting professionals from this very task.”

The report, entitled Rethinking Regulation, explains why regulation isn’t currently “fit for purpose” and begs for a radical overhaul to “better support professionals” working in the health sector.

It adds that regulation of professionals must take into account the places in which they work rather than impose isolated changes.

The authority also sets three main pillars of “deregulation, less regulation and better regulation” accompanied by a series of recommendations seeking to reshape how regulation currently works in order to meet future demands.

Recommendations include sharing objectives for system and professional regulators; transparent benchmarking to set standards; rebuilding the trust between professionals, the public and regulators; reducing the scope of regulation so it focuses only on what works; and a proper risk assessment model for who and what should be regulated.

Furthermore it advocates breaking down boundaries between statutory professions and accredited occupations, as well as making it easier to create new roles and occupations.

The report added: “Some of this needs merely a change in thinking, a new attitude, a willingness to do less regulating and to take more responsibility for the quality of our own work, our team’s performance, our organisation’s delivery.

“Other changes will need legislation and a willingness to deregulate, and to sharpen regulatory tools where necessary. It will need policymakers and politicians to take a more considered response to problems of quality and the public to understand that no regulator can eliminate risk entirely. Regulation needs to be redesigned for the future of health and care, not trapped in its own past.”

The authority aims to highlight how radical changes can only come about if regulation focuses solely on what it should do, allowing powers, accountability and responsibility to be handed back to healthcare professionals.

It added that overregulation has a “potentially demoralising impact” on professionals, especially where regulation “demands too much”, which could ultimately expose the public to risk of harm.

PSA is currently working on a ‘risk matrix’ to assess the appropriate level of assurance needed to protect the public and reduce cost and increase flexibility by deregulating some occupations with “no detriment to public protection”.

The report also noted that system regulation has a more confused role and set of responsibilities than professional regulation, thanks to governments “merging, abolishing, altering, adding to and reconstructing” regulators since the creation of the Commission for Healthcare Improvement in 2000.

The range of demands are often contradictory, the report says, as it asks regulators to comply with a series of inconsistent wishes: being less intrusive but more effective, kinder but more ruthless, faster but more careful, more responsive to the community but not captured by the industry, amongst others.

It concluded that “if regulation was going to improve care, it would have done it by now” and emphasised the importance of a more “nuanced, more sophisticated use of professional and system regulation working in concert” to guarantee professionals can personally provide quality care and receive enough support for it in their workplace.

“We must seek to understand what motivates individuals, team and organisations to succeed, not attempt to frighten them to resentful compliance,” it added.


Ralph   13/08/2015 at 00:31

This is the most sensible report I have read an overview of for decades. I only hope that the ivory-towered PC brigade can swallow this..

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