Health Care Regulation in the United Kingdom
Jonathan BrackenLegal Adviser to the UK Health Professions Council
Presented at the 2005 CLEAR Annual ConferenceSeptember 15-17 Phoenix, Arizona
Presented at the 2005 CLEAR Annual ConferenceSeptember 15-17 Phoenix, Arizona
The UK Health Regulators
• Nursing and Midwifery Council 600,000
• General Medical Council 200,000
• Health Professions Council 160,000
• General Dental Council 37,000
• General Optical Council 30,000
• General Osteopathic Council 3,000
• General Chiropractic Council 2,000
• Royal Pharmaceutical Society (GB) 45,000
• Pharmaceutical Society (NI) 300
1,077,300
Presented at the 2005 CLEAR Annual ConferenceSeptember 15-17 Phoenix, Arizona
The Health Professions Council
• arts therapists
• biomedical scientists
• clinical scientists
• dieticians
• occupational therapists
• operating department practitioners
• orthoptists
• paramedics
• physical therapists
• podiatrists
• prosthetists and orthotists
• radiographers
• speech therapists
Presented at the 2005 CLEAR Annual ConferenceSeptember 15-17 Phoenix, Arizona
The UK Regulatory Model
Each regulator has the power to:• generate its own revenues
• adopt and manage its own budget
• appoint its legal and investigative staff
• hire, discipline and terminate staff
• institute actions in its own name
• issue “subpoenas”
• share data with others who monitor performance
• act on “a preponderance of the evidence”
Presented at the 2005 CLEAR Annual ConferenceSeptember 15-17 Phoenix, Arizona
4 health boards 1 EMS
15 health boards 1 EMS
22 health boards 1 EMS
28 Strategic Health Authorities533 NHS Trusts38 EMS
4 Governments; 3.5 Legal Systems
Presented at the 2005 CLEAR Annual ConferenceSeptember 15-17 Phoenix, Arizona
UK Demographics
• population of 60 million• in an area smaller than Oregon• with an unequal distribution of:
50,000,000 (84%) in England
5,000,000 (8%) in Scotland 3,000,000 (5%) in Wales 1,700,000 (3%) in Northern
Ireland
Presented at the 2005 CLEAR Annual ConferenceSeptember 15-17 Phoenix, Arizona
A Delivery Snapshot
• regulation covers around 1 million practitioners
– 475,000 are directly employed by the NHS
– 400,000 are independent NHS contractors
• taxpayers fund 85% of UK health care spending
• 10% of the UK population has health insurance
Presented at the 2005 CLEAR Annual ConferenceSeptember 15-17 Phoenix, Arizona
Regulating Public Services
An example - 41 public Emergency Medical Services delivering locally managed care but to one national standard
Presented at the 2005 CLEAR Annual ConferenceSeptember 15-17 Phoenix, Arizona
Key Regulatory Functions
• setting standards
• approving education and training
• registering practitioners
• investigating complaints
• adjudicating on fitness to practise cases
• prosecuting bogus practitioners
Presented at the 2005 CLEAR Annual ConferenceSeptember 15-17 Phoenix, Arizona
Integrated Regulation
Sets Standards
approves training that meets them
registers practitioners who meet them
holds registrants to its Standards
HPC
Presented at the 2005 CLEAR Annual ConferenceSeptember 15-17 Phoenix, Arizona
The Standards
• Standards of Proficiency• Standards of Education and Training• Standards of Conduct, Performance and Ethics• Standards of Continuing Professional Development• Standards for Returning to Practice
Presented at the 2005 CLEAR Annual ConferenceSeptember 15-17 Phoenix, Arizona
Standards of Proficiency
• Foundation of HPC regulation• Represent threshold standards for each profession,
which apply: on entry to the Register on renewal or re-admission throughout professional life
“The Council shall …establish the standards of proficiency necessary to be admitted to the different parts of the register being the standards it considers necessary for safe and effective practice…”
Presented at the 2005 CLEAR Annual ConferenceSeptember 15-17 Phoenix, Arizona
Fitness to Practise
• A non-punitive process conducted by the regulator• No “prosecution”, “charge” or “guilt”• Allegations are that a health professional's fitness to
practise is impaired by reason of : misconduct criminal conviction lack of competence health determination of another regulator
• The issues to be determined are: is fitness to practise impaired? what must be done to protect the public?
Presented at the 2005 CLEAR Annual ConferenceSeptember 15-17 Phoenix, Arizona
Sanctions
• no further action
• mediation
• caution
• conditions of practice
• suspension
• striking off
Presented at the 2005 CLEAR Annual ConferenceSeptember 15-17 Phoenix, Arizona
Speaker Contact Information
Jonathan Bracken
Health Professions Council
184 Kennington Park Road
London SE11
011 44 207 227 7077
www.hpc-uk.org