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Plans to standardise regulation of healthcare professions


Regulators will be able to strike off or discipline nurses, doctors and other health workers who cannot communicate clearly in English, under plans announced this week.

A new draft Bill published by the Law Commission will unite the nine bodies currently covering healthcare, allowing them to work from one legislative framework.

At present, organisations including the Nursing and Midwifery Council and the General Medical Council are bound by different rules on what they can do.

New powers would allow regulators to proactively investigate instances of suspected poor conduct and practice whenever they come to their attention.

At the moment, some can only investigate once they have received a formal complaint.

The sanctions regulators can impose will be extended and, for the first time, they will be able to discipline or strike off professionals who are not able to communicate clearly in English.

The Bill also allows regulators to reconsider cases that have been closed following a mistake or error, as recommended by the inquiry into the care failings at Mid Staffordshire Foundation Trust.

A process of revalidation − where professionals undergo “MOTs” to ensure they are still fit to practise − will be extended from doctors to all health and social care professionals.

Schemes could also be introduced to bar unregulated workers from providing services, according to the UK-wide recommendations.

The nine organisations, including the General Dental Council, General Pharmaceutical Council and Health Professions Council, are responsible for around 1.4 million workers across 32 health and social care roles.

“Our recommended reforms place patient protection firmly at the heart of a new legal framework”

Nicholas Paines

Nicholas Paines QC, the commissioner leading the project for England and Wales, said: “The professional regulators of the health and social care field operate within a wide variety of legal frameworks that have been agreed and amended by parliament in different ways, at different times, over the past 150 years.

“Our recommended reforms place patient protection firmly at the heart of a new legal framework,” he said.

“If implemented, they will enhance the autonomy of the regulators, empower them to respond more quickly and effectively to emerging public health concerns and enable them to meet the demands of a modern, devolved health and social care sector,” he added.

A joint letter signed by the regulators calls on the government to support the new plans and asks for “urgent parliamentary consideration” of the Bill.

It said: “The Law Commission was tasked with creating a single, streamlined legal structure covering all nine regulators which would enable us to provide better protection for patients, be more responsive, reduce the burden of regulation and to drive down costs.

“We were, and remain, committed to these aims. Realising them is essential if we are to retain the trust and confidence of the public, healthcare professionals and the health service in which those professionals work.

“The recommendations of Robert Francis QC following events in Mid Staffordshire highlighted the vital importance of effective regulation focused on promoting safe, compassionate patient care rather than, as too often in the past, intervening only after patients have suffered harm.”

“The government is committed to legislate on this important issue”

DH spokesman

A Department of Health spokesman said: “Following the Francis Inquiry, it is important for public and patient confidence that our professional regulation system is fit for the future.

“The government is committed to legislate on this important issue when parliamentary time allows. We welcome the Law Commission’s report and will respond to their proposals in due course.”

The Bill will put all regulators on the same footing when it comes to being able to test the language competency of health workers.

According to the Law Commission, regulators have limited powers to remove workers with poor communication skills once they are registered.

Under the new plans, all regulators will be able to language test any person applying to be on the register if specific issues are raised about their lack of proficiency.

“I would strongly urge the government to include this bill in the timetable for the last parliamentary session”

Jackie Smith

The regulators will also be able to remove from the register or discipline any professional specifically on the basis that their fitness to practise is impaired due to insufficient knowledge of the English language. No additional criteria will be needed.

The GMC is already receiving extra powers in the summer to test the language competency of doctors.

Jackie Smith

Jackie Smith

Jackie Smith, chief executive and registrar of the NMC, said: “We welcome the publication of this potentially revolutionary Bill. However, this is the very first step on a long road to seeing this bill implemented and becoming law.

“The Bill would give flexibility, particularly in our fitness to practise processes which are numerous, time consuming and expensive,” she said. “We need to be able to modernise our approach if we are to meet our target to conclude 90 percent of our cases within 15 months, as we have committed.”

She added: “I would strongly urge the government to include this bill in the timetable for the last parliamentary session. Without it the NMC cannot modernise its ‘outdated and inflexible’ decision making processes.”






Readers' comments (17)

  • This should extend to being about to write clearly in notes - English or not, so many are illegiable. My natural handwriting is bad so i developed a style so that everyone could read it, and I am English born and bred.

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  • Now then, whoa is goan decide if eur regional accent is ok lad? (Yorkshire)

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  • good point. how are they going to set standards and decide what is good English without ruling outside regional accents which in their own area they may consider as foreign!

    The Welsh definitely consider the English as foreign!

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  • how about a plain English policy, to cut down on techno jargon, which can be confusing to everyone particularly patients. and Latin is not English.

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  • Anonymous | 2-Apr-2014 8:51 pm

    I would like to see all the management speak and IT and ambiguous acronyms removed from nursing and medicine which only serve to depersonalise everybody. Patients are not 'targets' and do not have 'outcomes' and nor is 'lessons have been learned' a meaningful apology for errrors made.

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  • Anonymous | 2-Apr-2014 10:07 pm

    I agree with your depersonalised terms for patients who are people not inanimate objects. Outliers and bed blockers also comes to mind.

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  • michael stone

    This seems a very good idea - so if it ever happens, there must be a good chance of them screwing it up somehow.

    The idea that HCPs should be allowed to treat patients without being able to understand English, in England, would seem weird to most people.

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  • I've been saying for years that medical staff would benefit from elocution lessons. When you are a vulnerable patient, there is nothing more terrifying than being cared for by people you can't understand. Many a time I've had conversations with nurses and doctors alike, and come away completely bamboozled, as I haven't had a clue what they have been saying. Even on one occasion I asked my husband to come with me to help me gauge what was being said, and the pair of us came away not really knowing what had been said!

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  • Anonymous | 3-Apr-2014 2:34 pm

    perhaps they need English lessons before the elocution!

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  • Some Latin words are already in situ English, therefore Latin is English QED.

    However I agree with ambiguous abbreviations, STI springs to mind.

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