The Authority reports that the regulators have generally continued to fulfil their statutory functions and are focused on public protection. All of the regulators are performing well or adequately against most of the 24 Standards of Good Regulation.
Three of the regulators have met all 24 of the Standards of Good Regulation. All regulators are more engaged with patients, registrants and the wider debate on public protection.
Several improvements made by the regulators have been noted since last year’s report and details of those are set out in the individual section of the report for each regulator. The Nursing and Midwifery Council’s performance for example now meets four more Standards than it did in 2013/14.
Continuing concerns have been identified about the performance of some regulators regarding their fitness to practise functions. Our concerns include:
- Two of the regulators did not meet the Standard requiring them to ensure that their fitness to practise process is transparent, fair, proportionate and focused on public protection.
- Three of the regulators did not meet the Standard that requires them to ensure their fitness to practise cases are progressed without undue delay.
- Three of the regulators did not meet the Standard that requires them to ensure that all fitness to practise decisions are well reasoned, protect the public and maintain confidence in regulated professions.
Findings will be followed up and it will be expected that regulators will demonstrate in next year’s review that they have remedied their performance in the areas highlighted in the report.
Harry Cayton, Chief Executive of the Authority said, “We are pleased to report that the regulators are generally protecting the public well. It is especially pleasing to see the overall improvement in the NMC’s performance since our Strategic Review over two years ago. We urge the regulators to continue to improve, especially in fitness to practise and registration and we look forward to reporting on their progress and further improvements next year.”
Responses:
A focus on patient-first regulation - the GDC
“A major change programme is already delivering real improvements in the protection of dental patients”, said the General Dental Council (GDC) following the publication of the annual review of performance by the Professional Standards Authority (PSA).
The plan that the GDC has developed is designed to maintain the high level of confidence in the profession amongst patients.
The PSA report confirms that in the areas of guidance and standards, education and training, and registration the GDC is performing well. However, we also recognise that the PSA has identified a number of areas within the Fitness to Practise (FtP) category where reform is required. The PSA has reported on data collected between September 2013 and September 2014, which confirms what was already known, namely that in this period the GDC was faced with an increased number of complaints and a significant pressure on resources. The transformation programme we have put in place is already yielding results in this area and we are confident that it will continue to deliver improved performance.
The GDC is currently preparing its response to the PSA’s review of its methodology. As the report highlights, providing commentary on data that can be as much as 18 months out of date, is clearly not helpful in scrutinising regulators’ performance and helping them to protect patients. The GDC welcomes reforms that will enable the PSA to define what good, risk-based regulation looks like.
GDC Chief Executive & Registrar, Evlynne Gilvarry, said:
“The GDC has set out a clear vision that puts the patient at the heart of its work. The PSA report recognises much of the excellent work being done by the GDC on a daily basis. We are not complacent however, and are fully focussed on the need to see through our current reforms and deliver improvements in the area of Fitness to Practise.
“Whilst some of this can be delivered through the measures we have put in place, we still need the government to bring about a wholesale redesign of the blueprint under which we operate. We are committed to fulfilling our mandate to protect patients and are keen to use the additional time before the 2016/17 Parliamentary session to work with the Department of Health, other regulators, commissioners and patient groups to develop fresh legislation.”
Notes on four areas examined by the PSA report:
Guidance and Standards:
Following a two year programme of research, consultation and analysis, the GDC revised its key professional standards document in 2013, publishing the Standards for the Dental Team in September 2013. Compared with the guidance it replaced, the revised Standards place a greater focus on communication skills and personal behaviour.
Education and Training:
The GDC quality-assures education and training so that DCPs, dentists and specialists provide the highest quality and standards of patient care, and that all individuals have the relevant language skills appropriate to the clinical setting.
Registration:
The GDC has enhanced its registration procedures to guard against fraudulent entry to the register and to ensure that all applicants, wherever they qualified, have the necessary requirements to practice dentistry safely. In this area, four out of five standards were met, an improvement from the previous year. The GDC has a robust plan in place to improve the processes and controls of its register and have communicated this to the PSA.
Fitness to Practise:
The GDC accepts that it has challenges in the area of Fitness to Practise. It has taken a number of steps to address this issue, including appointing a new director to run the team, who has undertaken a fundamental review of the whole Fitness to Practise process. The most recent data shows that progress is being made in all stages of the FtP process:
- At the end of Q1 2015, 87 cases were in the initial triage stage of the FtP process and 56 of these were dealt with within the 10 day KPI. This compares with 340 cases at the same period in 2014, of which only 56 cases were within the KPI.
- At the beginning of October 2014, the average number of assessments completed each month by Casework managers was 45 assessments per month, per team. At the end of March 2015 this number had increased to 65 assessments per team, per month. The number of teams had reduced from 6 to 4 as part of a rationalisation of resources.
- At the end of Q1 2015, the median time taken from receipt of initial complaint to final hearing determination decreased from 100 weeks to 93 weeks.
- At the end of Q1 2015, the median time from final Investigating Committee decision to final hearings decision decreased from 46 weeks to 39 weeks.
- At the end of Q1 2015, the data showed that the Investigating Committee had had its most productive March in the last three years, with 80 per cent of listed cases securing an outcome.
- In 2014, 194 initial Conduct Committee hearings were heard compared to 133 in 2013. Arrangements have been made to hold 375 hearings in 2015; an increase of 93 per cent.
Voicing concerns - the BDA
The British Dental Association (BDA) is concerned that the General Dental Council (GDC) has come bottom of the league in an assessment of the performance of nine healthcare regulators, published on June 26, by the Professional Standards Authority (PSA).
The PSA highlights that the GDC failed to meet a total of seven of its standards of good regulation.
On fitness to practise, the GDC fully met only one of the 10 standards, and failed to meet six others, representing what the PSA describes as a significant decline in its performance compared to an assessment it carried out in 2013/14.
The BDA notes that the jury couldn’t decide on whether the GDC had met two additional standards on fitness to practise pending an ongoing inquiry by the PSA.
The PSA has yet to comment on whether it considers the GDC’s activities in this area are “transparent, fair, proportionate and focused on public protection”.
Commenting on the PSA report, BDA Chair Mick Armstrong, said:
“Sadly this report makes familiar reading. Yet again GDC registrants must acknowledge that they are being regulated by the worst health regulator in the UK. What is worse is that, as far as dentists are concerned, it is now also the most expensive by a country mile.
“The findings in relation to fitness to practise come as little surprise as stories of waste, mismanagement and unreasonable practices abound.
“It is difficult to understand how badly the GDC has to perform before someone actually intervenes.”