Re: NMC accountability may change?

[Guest guest]

Thanks for this , and for keeping a weather eye on things. I will look out for this legislative change, which we knew was coming. Usually with these things, there are all sorts of risks and opportunities in an apparently bureaucratic and innocuous change, so I will check this one out with interest. There is a wish to 'tidy up' the many different ways that professionals are regulated, which kind of makes sense. Things like professional conduct are the same regardless of profession: breach of confidentiality always matters, for example, whether it is a doctor or physio or health visitor; likewise criminality that exposes the 'vulnerable public' to risk. But issues like determining standards does need to be profession based - not something that clearly happens in NMC these days. The UKCC used to have a parallel system in the National Boards, which were responsible for things like research and identifying suitable standards, which were then regulated by the UKCC. When it was 'streamlined' into one body, the NMC, it was never clear where that function would come from. I think it got lost - not that the Boards did brilliantly for health visiting - they were the ones that introduced this 'public health nursing' nonsense. So, the suggestion about stopping specialist regulation looks potentially worrying, given the currently stalled review of the third part of the register, but it could also be an opportunity to open some discussions again about how standards get set for health visiting: the current arrangements are not good, so it is no use arguing for them to continue as they are. But that doesn't mean I would just like the SCPHN register closed without any replacement, which is always a risk.best wishes. On 8 Mar 2012, at 16:08, hwood@... wrote: Snipped from the HSJ: Health regulators face legal overhaul 1 March, 2012 | By Steve Ford Provisional plans have been drawn up that would give the Nursing and Midwifery Council and other professional regulators increased flexibility to use their powers while also making them more accountable. The law commissions of England and Wales, Scotland and Northern Ireland said the different regulators currently operated within a wide variety of legal frameworks, which had led to a "great deal of inconsistency in their powers, duties and responsibilities". They have been asked by ministers to look at how the regulation of health and social care professionals across the UK can be made "clearer, simpler, more modern and more consistent". The law commissions published proposals today setting out plans for a new single legal framework covering the nine professional regulators across the UK. Under the proposals, the regulators would be given "greater autonomy to adopt their own approach to regulation in light of their circumstances and resources". However, they would be required to hold a consultation whenever "issuing or varying anything which is binding, anything which sets a benchmark or standard, and a competency". In addition, it has been proposed that there would be a duty on each regulator to provide information to the public and registrants about its work. Meanwhile, the government would be given "default powers" to intervene where a regulator has failed or is likely to fail to perform any of its functions. It would also be given the power to abolish or merge any of the existing regulators, or to establish a new regulatory body. This would replace the current position in which the NMC, General Medical Council and other regulators are accountable to the Privy Council rather than a government department. A consultation on the commission´s proposals will close on 31 May. An NMC spokeswoman said: "The NMC will be responding to the consultation and we encourage all nurses and midwives to contribute. Our response will be published on our website in due course." The Commissions' paper is at http://www.scotlawcom.gov.uk/consultations/ I was intrigued by the statement in this paragraph: '3.32 Some regulators are required, when exercising their principal functions, to: (1) have proper regard for the interests of service users and any differing interests of different categories of registrants; ' In relation to this, the consultation says: '3.39 Some regulators are also required to have proper regard to certain matters when undertaking their general functions, such as the differing interests of different groups of registrants. This appears to be an attempt to establish guiding principles for decision-making by the regulators, which has been a successful innovation used in other jurisdictions*. The difficulty is that the matters listed are selective and do not provide a comprehensive guide for decision- making. For example, there is no mention of the need to consider the interests of the wider public or ensure that the functions are carried out efficiently and expeditiously. We are attracted by the idea of establishing general principles for decision-making and welcome further views on what these principles might consist of.' *The examples used are the Children Act 1989 and Mental Capacity Act 2005. I'm not sure how one would frame 'general principles which would underpin decision making' like this. There are some further interesting bits on specialist registers, from which I quote these bits: '5.5 The public may see the purpose of registration as giving a stamp of approval to an individual as a professional. This may be particularly significant where the profession is largely self- employed, registration is voluntary, a significant number of practitioners are unregulated or the professional works from home or some other non-official environment. For members of the public seeking professional support, registers can play a useful role in providing additional information to inform their choice. However, the information on registers alone would not be sufficient to help them choose one professional over another as it does not indicate who would offer the best service. Notwithstanding the limits of registers in this respect, most regulators maintain lists of specialist practitioners or include in each individual entry educational qualifications above the standard required for qualification. These lists and entries may help guide public choice and inter-professional referrals, although they may be less relevant where registrants are employed predominantly in the public sector.' 'Provisional view Specialist lists 5.26 It would be possible to give the regulators broad powers to divide their registers into different parts and establish specialist lists. Arguably, the regulators are best placed to know which specialisms may be useful for potential users of the register and whether particular specialisms are sufficiently differently from the ordinary to make it necessary or desirable to create a specialist register. 5.27 On the other hand, there are concerns that specialist lists could be used to advance careers in the profession rather than as a mechanism to enhance public protection, and that there are other ways in which for example specialisms can be advertised such as by the relevant professional bodies and employers. On this basis it might be more appropriate for such decisions to be a matter for Government. 5.28 It is also important to consider that the existence of specialist lists and different parts of the registers is referred to in other legislation. For example, the Performers List Process requires an NHS authority or board to satisfy itself that a General Practitioner is a suitable person to be delivering NHS services by requiring them to provide a range of information including a declaration that they are on the General Medical Council´s specialist register. Therefore, if regulators were given powers to alter or remove specialist lists this could have consequential implications for other legislation which would need to be amended. This may reinforce the view that such decisions should be a matter for Government.' It goes on to state: '5.29 On balance we think that the regulators should not be given powers to establish specialist lists. Instead, we propose that the statute itself should specify which types of registers should be established by the regulators, including any different parts and specialist lists. Our assumption is that the existing types of registers would be maintained in the new statute. The Government would then have powers to make regulations to create or remove specialist lists or alter the existing parts of registers.' The Consultation question states: Provisional Proposal 5-3: The statute should specify which registers must be established by the regulators, including any different parts and specialist lists. The Government would be given a regulation- making power to add, remove or alter the parts of the register and specialist lists.' Well, so much for self regulation....There are other interesting points on student registration and volunrtary registers for paraprofessionals & assistants, but the detail is a bit bulky for an email. It's a big document and covers a lot of issues, not least education amd fitness to practice. H Cowleysarahcowley183@...http://myprofile.cos.com/S124021COn