The exposure of the parlous state of the General Social Care Council’s conduct system, which hands out judgements against social workers for poor standards, has triggered a major rethink of the way the regulator operates.
The Council for Healthcare Regulatory Excellence has issued 20 recommendations following its damning review, many of which would bring the GSCC into line with healthcare regulatory bodies such as the General Medical Council.
These include clarifying its public protection role, scrapping the conduct system for social workers and replacing it with a “fitness to practise” regime, and making the GSCC more financially independent of government, perhaps, for example, making it more like the GMC, which is a registered charity.
The government has yet to agree to all of them, and the ideas have been met with scepticism by some quarters in the sector.
Users of Community Care‘s online discussion forum, CareSpace, are already voicing concerns about a possible increase in social workers’ registration fees, while June Thoburn, who was vice-chair of the GSCC until last year, questions whether the fitness to practise model is appropriate for social work.
“It’s much easier to assess whether a GP, a nurse or a surgeon, who have a more defined remit, are fit to practise,” she says. “Social work involves a great deal of knowledge, and a regular assessment of fitness to practise would be an incredibly expensive system.”
Code ‘needs rethink’
Thoburn, emeritus professor at the University of East Anglia, points out that the GSCC’s code of conduct already makes provisions for incompetence, in line with healthcare regulation. It states, for example, that social workers must inform their employer about any “personal difficulties” that might affect their “ability to do their job competently”.
However, the CHRE’s head of scrutiny and quality, Mike Andrews, says the code is not explicit enough. Fitness to practise works for healthcare regulation, he argues, so it should work for social work.
Broader range of sanctions
Other recommendations in the CHRE’s report included that conditions be made available as a sanction, as used by healthcare regulators. So instead of being restricted to admonishment, suspension or removal from the register, the GSCC could prevent a social worker from visiting service users on their own or instruct them to undertake retraining in a certain area.
The GSCC has been seeking the power to introduce a broader range of sanctions against social workers found guilty of misconduct for some time, but their absence in the past may have led to some of the problems with case management.
“There’s little point in bringing a case where the only sensible sanction would be imposition of a condition if the council doesn’t have that power,” says Bill McClimont, a former member of the GSCC’s governing council.
Potential rise in hearings
If the government acts on the CHRE’s recommendations, the GSCC will have a wider and more frequent regulatory function. “In the future, there won’t be the same concentration on the most dangerous, most difficult cases,” says McClimont, vice-chair of the UK Home Care Association. “And I suspect you might even see a few more brought that don’t result in findings against the applicant.”
However, unless the government subsidises the GSCC to a greater degree, it is likely this will mean a significant increase in registration fees for social workers.
Most of the commentators contacted by Community Care agreed that registration fees will rise steeply, albeit over a period of time. McClimont suggests social workers would eventually have to pay at least five times as much as the current £30, and Thoburn estimates the new fee will be somewhere around the £200-£300 mark.
“It’s going to cost much more than the government budgeted for, given the volume of cases,” says Thoburn.
The regulator may also lose some of its functions to a proposed National College for Social Work, recommended by the Social Work Task Force, while the GSCC, Social Care Institute for Excellence and Skills for Care are also facing a review of their overall cost-effectiveness. This report, commissioned by the DH, is now due after the final recommendations of the taskforce are issued at the end of the month.
Whatever the outcome of this mass re-assessment, one thing is clear: social care regulation is set for a period of substantial change.