Protecting the Public? An Analysis of Professional Regulation—Comparing Outcomes in Fitness to Practice Proceedings for Social Workers, Nurses and Doctors

Abstract

The regulation of professional activity in the Health and Social Care sector in the UK is carried out by a number of statutory bodies that hold legal mandates to manage the risks of professional malpractice. The prime method used to perform this duty, and thereby protect the public, is the construction of a register of the suitability qualified—and creation of appropriate professional standards to establish a benchmark for practice. When registrant’s performance or conduct is felt not to meet these standards, they are placed within a fitness to practice process administered by the regulatory body. This article examines the publicly available data on fitness to practice cases from UK regulatory bodies relating to the professions of social workers, nurses, midwives and doctors. Examining nearly 1,000 cases, the authors run a statistical analysis of the data to establish whether any differences are found amongst and between these professional groupings. We find there are several areas where significant differences arise, namely gender, attendance and representation. Most of these regulatory bodies are, in turn, regulated in the UK by the Professional Standards Authority (PSA), and the article concludes by suggesting ways forward for the PSA in addressing or further examining apparent inequalities. The analysis is placed within a wide range of literature, with an emphasis on the international transferability of the approach to professional regulation.

Social Work England: A regulator worthy of our collective dissent

“…When SWE introduced these rules, it was clear that reform in this area was needed. Research had shown that social workers were more likely to find themselves subject to FtP investigations than other professionals, as well as being more likely to be removed from the register as a result and less likely to be able to engage effectively with the process (Kirkham et al, 2019;Worsley et al, 2020b). However, social work perspectives have once again been marginalised in this process, with no requirement for either case investigators or case managers who are overseeing these investigations to have any experience, or even knowledge, of social work (SWE, 2019a).…”

Admission to undergraduate nurse education programmes: Who should be selected?

“…These serve to protect the public, but also have the effect of enhancing professionalism 13 by 'asserting professional status'. 14 Codes of conduct and expectations of professional behaviour of nurses are determined by nurse regulators such as the UK Nursing and Midwifery Council and the Irish Bord Altranais. However, Code values are not the only values considered relevant to the recruitment process and there is something of a values' framework tsunami for educators, students and registrants to negotiate.…”

“…These processes are in keeping with approaches in relation to the fitness to practise of registered nurses. 14 Unlike the approach taken for registered nurses, however, there is little national or international guidance and approaches vary across universities. 16 Anecdotally, there is frustration amongst some educators that for some small numbers of students that face disciplinary hearings or FTP, there is a competition of 'rights' with, at times, the rights of the student appearing to supersede that of the patient.…”