CHRE Viewpoint #1

CHRE Viewpoint #1

This article is the first in a new fortnightly series called ‘CHRE Viewpoint’, which will discuss topical issues in relation to health professional regulation.

Regulation and managing risk

Regulation cannot eliminate all risk. This is a fact we have to live with. However, good regulation can mitigate risk and at the same time allow professionals to flourish. At CHRE, we refer to this as ‘right-touch regulation’.

This month we publish our report on Managing extended practice, which considers the best way to manage the risks when health professionals extend their practice into other areas. Rather than recommend further regulation, we conclude that professional regulators can manage these risks with the tools they already have, in collaboration with employers and the professionals themselves. We came to this conclusion having evaluated the risk of doing nothing and the benefit of intervening.

This ‘right-touch’ approach was also used to inform our response to the Department of Health consultation on a proposed ‘duty of co-operation’. These proposals would make it a legal requirement for certain organisations to share information on concerns they may have about a healthcare worker. There is no doubt that sharing information contributes to patient safety, but regulation should not be necessary if current safeguards (such as employment checks, tackling poor performance and effective communication with regulators) are deployed effectively.

However, there may be occasions when it is right to regulate. Organisations such as Action against Medical Accidents have long campaigned for a legal ‘duty of candour’. This would require organisations to be open and honest with patients and their relatives when harm has been caused. In this case, we consider that a proportionate way of introducing the legislation in England would be as part of the Care Quality Commission’s regulations. Organisations would then share in the ethical responsibility of health professionals to be open with patients.

Any consideration of regulation requires the problem to be identified and the risk quantified, whilst balancing the rights of patients and professionals. Regulation may be the most appropriate answer to the risks that are identified, or it may not be the answer at all.

John Illingworth, Policy Analyst
16 July 2010