Why are social workers subject to more fitness-to-practise concerns than other professions?

By Michael Guthrie, HCPC director of policy and standards

At the HCPC we oversee the fitness to practise process for 16 different professions. This involves considering concerns about the conduct or competence of more than 340,000 practitioners.

Covering a range of professions means we’re able to compare trends in complaints we receive across different professional groups. The data shows we receive most fitness to practise concerns about paramedics and social workers in England.

In 2014-15 social workers in England made up 27% of the HCPC register but 58% of the 2,170 fitness-to-practise concerns we received. The trend was less marked in cases that reached a hearing, but social workers in England still accounted for 44% of hearings that year.

At final hearings we considered cases which included serious failings in safeguarding; dishonesty; serious criminal offences including fraud; and inappropriate sexual or personal relationships with service users and carers.

The biggest source of concerns was members of the public (56%), followed by employers (24%).

These trends have sustained every year since we took on responsibility for regulating social workers in England in 2012.

Is it disproportionate?

So why do we receive disproportionately more concerns about social workers than for almost all other professions?

When we discuss this issue with stakeholders, we often talk about the role of the social worker in making decisions which can have a profound impact on people’s lives.

Social workers also often work with people at times of their lives where they are distressed or vulnerable. In some areas of work, service users may not always value social work intervention.

We find that concerns raised by members of the public are often prompted by dissatisfaction with social work decisions and often concern multiple social workers they’ve had contact with.

Other possible explanations include professionalisation as social work education and training has developed over time; and the environments in which social work is carried out.

How should we react?

So how should we react? Among the different regulators of health and care professionals in the UK there is an increasing recognition that we need to try to rebalance our energies, away from reactively dealing with instances of poor practice and conduct, towards an approach which focuses more on prevention.

It has been suggested that this could have benefits in reducing both the financial and non-financial costs involved in fitness to practise action (PSA 2015). So we’ve commissioned a team at the University of Surrey to look at why paramedics and social workers in England are over-represented in the fitness to practise cases we handle.

The research will involve a literature review, interviews and focus groups. A core component will be a substantial review of fitness to practise cases in these professions. We want to understand more about the characteristics and themes of all the cases we handle, including those that do not need to progress to a hearing.

We hope that the findings might identify ways that all those involved in practice, education, employment, representation and regulation in these professions could work together to prevent problems occurring in the future. For example, is there more we can do with educators and employers to highlight the issues that are raised in fitness to practise cases?

The research will also assist us in thinking about how we might ourselves undertake similar analysis in the future about trends in other professions, or about cross-professional issues. The research is planned to report in September 2017.