Approach to regulating social care and health professionals becoming ‘unfit for purpose’

Overseeing body, the Professional Standards Authority, described the current regulatory system as outdated and incoherent

PSA: 'iron cage' of regulation needs rethinking. Photo: waferboard/ flickr

[Note: This article, and its headline, were amended on 20/4/16 to make clear that the PSA report concerned the overarching regulatory approach to all health and social care professionals, not solely social workers]

The way health and social care professionals, including social workers, are regulated needs a “radical overhaul”, according to a report by the Professional Standards Authority that questioned whether the current system was fit for purpose.

Frightened into compliance

In its ‘Rethinking Regulation’ report published last week, the overseeing body said regulation which attempts to “frighten [registrants] into resentful compliance” is to the detriment of performance.

Rather than inflexible and punitive regulation, which stopped practitioners from being innovative, there should be a greater focus on how regulators can support registrants’ professionalism and prevent them from being overburdened with rules and guidance, the report said.

It added the idea that risk of harm can be totally eliminated threatens to corrode the public trust in professionals and in regulation itself.

“All health and care interventions have an element of risk which cannot be totally eliminated,” the PSA pointed out.

Mission creep

“Too often we have seen examples of regulatory mission creep, where regulators have sought to expand the boundaries of their activity in ways that have resulted in confusion for the public and internal conflict of interest.”

This “creep” was flagged up by the Law Commission in a report last year, in which it was suggested the approach used by some health and care regulators may be breaching registrants’ human right to a private life.

“Registrants’ careers and lives, and those of their families, can often be seriously and lastingly damaged too, sometimes by [registrants’] words or actions lasting no more than a few moments,” the PSA report said.

The PSA also concluded that a “proliferation of regulatory organisations inevitably impedes the pace of change and improvement across the sector. It also embeds operational inefficiency and unnecessary expense.”

Fragmented system

Instead of the current fragmented system, there should be shared objectives between professional and systems regulators, the report recommended.

There are more than 20 different regulatory bodies and 12 professional regulators for health, care and social work in the UK. The report said this “vastly complicated and incoherent” regulator system existed despite a lack of understanding of the benefits of regulation and its influence on registrants behaviour.

Next steps

The PSA proposed several steps that should be taken to improve regulation:

  • A shared “theory of regulation” across the sector
  • Shared objectives for system and professional regulators, and greater clarity on respective roles and duties
  • Transparent benchmarking to set standards
  • A reduced scope of regulation so it focuses on what works
  • A proper risk assessment model for who and what should be regulated put into practice

A PSA spokesman said the report had been distributed widely and it was hoped it would stimulate discussion about what the next steps should be.

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4 Responses to Approach to regulating social care and health professionals becoming ‘unfit for purpose’

  1. Chris Bellis August 19, 2015 at 2:15 pm #

    I am recently retired from Ofsted. Before that I worked for HCC, CSCI, and SSI.I was an inspector. Each change that was made ( with each re-organisation) seemed to make things worse, and new senior managers were even more out of touch than the previous lot. I remember carrying out an “inspection” in an East Midlands town where it was not even scheduled that the inspector visited the SSD. I wrote the report having done some unpaid overtime visiting the offices, for which i was told off by senior management. it was supposed to be done using local government supplied data (I’d have loved the bright spark who came up with this idea to have to fly in an aircraft inspected as a desktop exercise.) Ofsted has since put this city into special measures. We should return to the system of local inspection units run by local government, and with the overall system supervised by the equivalent of SSI. When I was in SSI we had about 50 inspectors for the whole country. The same was true of HMI. Both SSIs and HMIs had considerable experience in senior management and by and large commanded the respect of the services inspected. The new system, although vastly more expensive, relies on much more junior front line staff with many more layers of management. The system is not fit for purpose, and everybody knows it. Save some money and give the job back to independently regulated local government inspection units, but make sure that this time they don’t have to take the dross from other services, as happened in a few local authorities, and which caused people to moan about independence, little realising the horrors that were to be inflicted after the re-organiation..

  2. L Wilson August 19, 2015 at 2:38 pm #

    Even though I have a smaller caseload than I have ever had in 30 years employment in LA, it takes longer than ever to ‘meet’ the regs demanded, so my view is, ‘bring it on’

  3. Shirack August 19, 2015 at 7:02 pm #

    They should also scrap SW registration. Deprives the workforce of many who just needed to recharge batteries. A lazy system for employers who, upon interview should satisfy themselves as to the suitability of applicant. Process is just another moneymaker and brought about by “professional” status seekers.

  4. Stuart. August 19, 2015 at 8:22 pm #

    Chris Bellis is my new hero – totally overdue for his comments and the findings of the PSA to be made public.

    But it’s the Tory government that needs to listen and respond….

    About every new government that comes to power ( at least since I was eligible to vote and probably a long time before that) does so on a claim to save money by abolishing x number of quangos, yet they somehow manage to create more.

    They seem to be ruled by the ‘not invented here’ syndrome, – they simplistically think ‘we’ll think of something better’ but without a real understanding of what’s there already that needs adapting instead of duplicating.

    Maybe I’ll write to my MP.

    Ah but there’s no election for years, he’ll be too busy….