Royal College of Anaesthetists’ response to the Department of Health consultation, ‘Promoting professionalism, reforming regulation’

• We agree with the proposals to reduce the number of regulators, as long as decisions are based on comprehensive analyses of the cost and workload created by regulating new groups of healthcare professions.  The ‘right’ number of regulators should, not only result in more streamlined and efficient processes, but also allow the regulatory system enough breadth to avoid conflicts of interest and incorporate a broad range of expert and independent views, especially if small regulators are incorporated into larger ones.

• While we accept that the PSA will play an important role in the reform of regulators, as proposed by the Department of Health, we recommend that the Authority increases public awareness of its work and remit and engages better with healthcare professionals, not just their regulators, in order to gain their trust and confidence that it will apply a balanced and transparent approach in the way it works with regulators.
• We are encouraged by the range of policy factors that the PSA proposals take into account, specifically consideration of the scale of the risk and the proposals to create a ‘risk profile’ for each professional group, including those that are not currently regulated. We call on the PSA and the DH to establish full statutory regulation of all Medical Associate Professions, in particular Physicians’ Assistants (Anaesthesia) who currently perform high risk anaesthetic procedures with only local clinical governance safeguards in place and resulting in inconsistency of standards and supervision.
• We oppose prohibition orders as an appropriate alternative for those healthcare professions not subject to statutory regulation and we call instead for full statutory regulation of all healthcare professions who carry out procedures with a significant element of risk of harm to patients (i.e. Physicians’ Assistants (Anaesthesia)).
• We support the proposals to review fitness to practise investigations and relevant changes in legislation towards a more proportionate and less adversarial system, which allows for the identification of the causes of malpractice and encourages learning from mistakes. We strongly believe that regulators have an important role in supporting the professionalism of healthcare professions which goes beyond their regulatory remit.
• Any changes to regulation and the way regulators operate will need to be unequivocally supported and adopted by the PSA, so that the right balance is struck between protecting the public and unnecessarily removing doctors from practice. 

If you have any questions regarding our submission, please contact Elena Fabbrani, Policy & Patient Information Co-ordinator, at efabbrani@rcoa.ac.uk or on 020 7092 1694.