Engagement of health and social care employers in professional regulatory fitness to practise - missed regulatory and organisational opportunities?

Abstract

Background: Health and social care professional regulators are organisations that ensure their registrants have the correct qualifications and experience to practise in their profession. There are 13 statutory regulators in the United Kingdom (UK) and 29 voluntary accredited registers. Referrals of serious concerns about registrants' Fitness to Practise (FtP) are investigated by regulators, and can lead to a public hearing. Employers may refer their employee to the regulator, and provide evidence about the concerns about their practice. Communication between the regulator and employer is central to ensure fitness to practise procedures are timely and effective, contributing to patient safety and to the improvement of health and social care professional and organisational practices.

Methods: In this mixed-methods research, semi-structured interviews were conducted with 25 participants who held senior management roles in health and social care organisations in the UK and were responsible for communicating with professional regulators. Descriptive statistics were produced relating to participants' roles and organisations, and qualitative data was analysed using Template Analysis methodology.

Results: Four themes relating to communication between employers and regulators were identified: Process of regulatory investigation, Point of contact with employers, Local level/informal resolutions, and Organisational learning. Employers frequently described the processes as protracted and stressful for all concerned, and communication with regulators as sporadic and unidirectional during investigations. This style of communication hampered organisational learning from Fitness to Practise cases. Regulators' employer liaison officers, where they existed, improved communications.

Conclusions: Fitness to Practise processes create the opportunities for not only the determination of whether an individual professional is fit to practise and the supportive measures that might need to be taken if they continue to practice, but also for health and social care organisations to prevent occurrence and re-occurrence of misconduct, thereby improving their services. Regulators' communication patterns resulted in these employers' organisational opportunities being missed. It may also lead to over-referral thereby leading to burden on employers, registrants and regulators. Improvements in communication by regulators such as via dedicated employer liaison functions could help organisations access these opportunities as well as promote the objectives of regulators to uphold trust in regulation.