PSA recommends streamlining terminology and what constitutes maintaining public confidence across the health professions

Last year (2018), in the light of recent high prolife cases, Professor Norman Williams was asked to carry out a rapid policy review into gross negligence manslaughter in health care.  Given the inconsistencies in addressing such issues across health regulators the Williams Review recommended an investigation into “the extent and reasons for different fitness to practise outcomes in similar cases and, if as appropriate, to recommend changes to ensure greater consistency.”


Exploring this issue further the Williams team has found that there


  • are limited studies investigating consistency in FTP cases – and in particular no academic studies
  • most health regulators have common four-stage FTP process.  However, there are significant variations between regulators in  allegation categories, outcome categories, nomenclature, legal frameworks, decision-making of staff and the nature and type of panel
  • regulators typically have electronic case management systems but the data sets in them contain only a limited range of information about registrants’ socio-demographic details


but concluded that, despite these obstacles, robust and comprehensive research is possible.  It recommends further work examining:  wider influences at a macro level; organisational issues at meso level; and individual factors at the micro level on FTP system.


The Professional Standards Authority (PSA) – the health regulators’ regulator – agrees that there is no apparent consistency in how health regulators measure public confidence and recommends a move towards a more coherent approach in particular that 


  • It will be beneficial for regulators to consider standardising language and using shared wording
  • there needs to be further investigation of whether and why public views differ on the types and seriousness of behaviours which are likely to damage public confidence and why the public has a different view in respect of different professions.


Much of the problem with terminology and process is a result of successive governments not making time to implement the Law Commissions’ Review (2014), but there does now seem to be a concerted effort between the PSA and the regulators to stream-line FTP terminology, definitions and processes.  This may require legislation.


FODO is strongly committed to fairness and proportionality in regulation and already has confidence in the fairness, balance, and judgment of the GOC FTP panel chairs and members. So, we will track any developments closely and seek to shape them on patients’ and the sector’s behalf to ensure these standards are fully reflected in any proposed changes.