Blog: Inside Regulatory Reform

Published on 16 May 2023

Our Assistant Director of Regulatory Reform, John Lucarotti, explains our thoughts on the proposed regulation of Anaesthesia Associates and Physician Associates

As the independent regulator for nurses and midwives in the UK, and nursing associates in England, it’s vital we have the right tools to regulate well, so we can better support our professionals to deliver the best possible care for people and communities. It’s why we have long called for wholesale reform of our governing legislation.

Earlier this year, the Government started consulting on introducing statutory regulation for Anaesthesia Associates and Physician Associates by the General Medical Council. While on first glance it looks like this is something only related to these two medical roles, the consultation is much more fundamental than that. It will affect the regulation of all health and care professionals and the way in which they care for everyone in the UK.

That’s because the legislation will be a template for replacing our existing legal framework.

That makes our involvement in this consultation crucial, so we can make sure it is the best blueprint possible to enable us to regulate effectively for the public, and respond to the changing needs of the health and care system well into the future.

Making the most of this opportunity for reform

There’s a lot to like in the draft legislation. In particular, we welcome the fact that this is a more simple, more proportionate legal framework. For example, the new legislation would mean we could more accurately reflect our health and character requirements, which recognise that professionals with a range of health conditions can – and do – provide great care.

The legislation would provide new powers to set and amend our processes, which we’d approve following consultation and engagement.

This would be a fundamental change for us, allowing us to amend and flex our requirements much more quickly in the future, becoming a more modern, independent, fit for the future regulator that consistently reflects the needs of people and communities across the UK.

On the whole, we’re happy with it. The draft Order provides a clearer, more coherent approach to regulation. It largely aligns with our aspirations for reform and would provide us with the flexibility to make further improvements. However, it’s important to get the balance right between reducing unnecessary detail and making sure there is sufficient clarity around what the regulator can do. In some areas we don’t think that this has been achieved.

Initial assessment of fitness to practise cases

We think that, in the future, many fitness to practise referrals should be concluded without needing to go to a panel or case examiners where it’s clear there’s no risk to the public or its confidence in health and social care professionals. This approach is essential for preventing delays for professionals and members of the public caused by cases unnecessarily progressing into the fitness to practise process and enabling us to concentrate on serious cases.

This could be for a number of reasons including where the referral doesn’t actually affect someone’s fitness to practise, or where the issue has been resolved by the time we look at it. We don’t think that the draft legislation gives us the powers we need in this area.

Greater flexibility over revision and appeals processes

The proposed framework for revising and appealing the decisions we make is too rigid, restricting us from designing fair, proportionate and accessible processes. We want to be able to make the right decision to protect the public quickly and fairly. The draft legislation could stop us from doing this unless it’s amended.

More straightforward approach to register readmissions

We also think the proposed framework around how people come back on to the register after they’ve been removed is complicated and requires multiple decision makers. We’re asking the Government to simplify the legal drafting to allow us to design more proportionate processes in this area.

Our response to the consultation has more detail

If you’d like to find out more about how the draft legislation might influence the way in which nursing and midwifery care is delivered in the future, visit our web hub, or read our consultation overview or our detailed response.

We were delighted to have confirmation from the Department of Health and Social Care that it would consider our legislation next, alongside that of the General Medical Council and Health and Care Professions Council. So I hope to be able to write again soon to provide an update, this time reflecting our own legislative framework.

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