Regulatory reform: greater say in governance may change the way we work

The proposals to reform the legislation under which we operate have now been issued by the Government. Here our Head of GDC Policy and Research Programme, Rebecca Cooper, unpacks what the governance and operating framework proposals may mean for the way we work. 

Those of us who work in regulation have been talking about regulatory reform - what it will look like, what it will mean for us, and when it will arrive - for several years.  

So many of us were excited by the prospect of the Department of Health and Social Care’s (DHSC) consultation, which was published recently, and have spent a lot of time since then reading (and re-reading) it to understand which bits we welcome, which bits we need more information or detail on, and which bits we would like to see change. We’re preparing a response to the DHSC that will set all that out. But we thought it might be helpful to those who haven’t been watching this quite as closely as we have if we set out some of the key proposals and how we think they will affect us.  

Overall, the proposals, which set out the principles to be applied across all healthcare professional regulators, are designed to offer greater flexibility in how we use our powers. We have made no secret of the fact that we feel constrained by our legislation in respect of some of our processes, and that change is necessary to enable us to be proportionate, agile and responsive. 

This post looks at the potential implications of changes to the governance and operating frameworks of the regulators. We will be publishing similar pieces on the education, registration and fitness to practise elements of the proposals. 

So what do we mean when we talk about governance and operating frameworks? Well this is really about what the organisation is required to do and how it works.  

There are no fundamental changes proposed to what we do: our purpose and objectives remain clearly focused on public protection. The proposals do seek to place us under new duties, of co-operation, transparency and proportionality, when carrying out our functions. Although we don’t yet know much about how these duties will work in detail, we don’t expect to change much of what we do in practice, since they are principles which public bodies, such as GDC, should apply in any case.  

In terms of the way we work, lots of detail about our current structures and processes is set out in our statute, and this limits our ability to change them. That includes things like the committees, which the Council is required to establish and, how many lay and registrant members the Council should have. 

Some of that is now expected to change. The proposals that are currently under consultation seek to offer greater flexibility by giving the Council powers to set its own structures and procedures (by, for example, enabling the Council to establish the committees it needs). 

Changes to how the Council is constituted are also being proposed. Currently, the Council, which makes key strategic decisions for the organisation, is made up only of non-executive members, and the legislation sets out the required balance of lay and registrant members. The DHSC is proposing a unitary board structure, with a maximum of 12 members, made up of both executive and non-executive members, but with no minimum number of registrant members on the board.  

Alongside the proposals for legislative reform, the DHSC has used the consultation to signal its intention, following its report on bureaucracy within the health system, to commission two reviews. The first of these will consider whether there is a need to reduce the number of regulators in order to provide a clearer and more efficient system for the public. We don’t yet know who will carry out this review. And while we fully support initiatives which aim to bring clarity and efficiency, we believe it’s important that organisational reform doesn’t mean that changes to our legislation are delayed further.

The second planned review will be carried out by the Professional Standards Authority, and will look at whether the health professions currently regulated in the UK are the right ones.

More detail on all of this is contained within the DHSC proposals, and I expect many of you will have strong views on some of these matters. That is what consultation is for. This one closes on 16 June, so we encourage you to take the time to read, digest, talk to your peers, and respond.