Regulation exists in many forms, from employer-led to licensing to statutory, with many variations in how to structure and manage processes.
Its purpose is to provide public assurance and protection.
In 2005, the Hampton review final report Reducing administrative burdens: effective inspection and enforcement
presented a set of principles that provide a solid base and context to think about regulation. Known as the Hampton principles, they proposed that regulation needs to be:
- proportionate to the risk that it seeks to mitigate
- accountable, to ensure that all those with an interest are able to influence it
- consistent, so that it does not unreasonably place a heavier burden on any particular sector
- transparent, so that its activities can be scrutinised effectively
- targeted, to avoid blanket approaches that impose regulatory burdens unnecessarily.
In addition to this, the General Medical Council (GMC) has developed a helpful four-layer model of regulation:
1. The most effective protection against poor practice is the individual practitioner.
2. Next, their peers and colleagues should provide assurances, with everyone working together to ensure that each other’s care is safe, effective and respectful.
3. That culture of care in the team should in turn be embedded and sustained by effective leadership, management and clinical governance in the organisation.
4. Finally, the professional regulatory bodies and the bodies that regulate providers of health and social care services provide a national framework of assurance.
We currently have a mixed economy of regulation with:
- statutory regulation covering many different professions across nine professional regulators
- other groups with access to voluntary registers, such as clinical perfusionists and clinical physiologists, which are maintained by a professional body
- an employer-managed system that exists, arguably, for the whole workforce not just those who are not subject to additional layers of regulation and registration.
The Professional Standards Authority (PSA) oversees the professional regulators, working with them to improve the way that professionals are regulated. They also have powers to accredit voluntary registers and have produced a standards for members of NHS Boards and clinical commissioning group governing bodies in England.