Ongoing failure to meet key standards – The Professional Standards Authority’s review of the HCPC

The Professional Standards Authority (PSA) recently published its review of the Health and Care Professions Council (HCPC) for the year 2021/2022. The PSA has a statutory duty to report annually to Parliament on the performance of the ten regulators that it oversees and does so by reviewing each regulator’s performance against the PSA’s ‘Standards of Good Regulation’. Performance reviews are carried out on a three-year cycle and for the HCPC, 2021/2022 was a monitoring year, with a more intensive periodic review scheduled to take place next year.

This year, as with previous years, the HCPC only met 13 out of the PSA’s 18 overall standards and only met 1 out of the 5 standards in respect of fitness to practise. The HCPC had to accept that, in respect of fitness to practise, this is not good enough. 

The regulator published its response to the review on 29 June 2022, stating:

“We have made significant improvements in fitness to practise (FTP), which we believe will allow us to meet additional PSA standards at the next performance review. We must acknowledge, however, that we only met one out of five FTP standards this year”.

The regulator’s Chief Executive, John Barwick, went on to say: “Our hard work since the last PSA review in 2021 has set us firmly on the right track, but we must invest in and implement further improvements and upgrades in order to ensure we continue to provide effective public protection”.

During the recent review, the PSA noted the following positive steps that had been taken by the HCPC:

• The introduction of a new case management system, a risk assessment tool and case plans (all designed to improve timeliness).

• The introduction of senior decision makers and legally qualified chairs for Investigating Committee Panels (aimed at improving the quality of decision making). 

• Piloting of front-loaded investigations (to reduce the time between consideration by an ICP and a hearing).

• Training for staff in ‘becoming a compassionate regulator’ (to increase support for registrants).

The PSA stated that they had seen a noticeable improvement in the quality of panel decision making in the cases that had been reviewed when considering whether the decisions were sufficient to protect the public. This hopefully marks a real and lasting improvement and will be reassuring to registrants facing a fitness to practise investigation. 

In terms of other improvements, it was agreed that carrying out an audit of closed cases for the purposes of the current review would not give a reliable indication of whether the changes had been effective. The PSA therefore concluded that although they had seen some evidence of improvement, they could not comment on the effectiveness of the initiatives and 4 out of 5 standards had not been met.

This year was only a monitoring year for the HCPC. Next year will be the real test when a periodic review will take place and an audit carried out of closed cases. The pressure is therefore well and truly on for the regulator to demonstrate some real improvement the next time that the PSA scrutinises its processes.

The PSA has raised significant concerns about the HCPC’s fitness to practise processes for many years, dating back as far as 2014/2015. The concerns raised then are largely the same as those raised now. Over the years, the HCPC has accepted the deficiencies identified and made references to improvement initiatives and investment. The promise of improvement is therefore a familiar one.  

Ultimately, the proof will be in the pudding or, in this case, the periodic review. As someone who represents registrants facing proceedings before the HCPC, the concerns raised by the PSA resonate. Recent experience confirms that it does take too long for decisions to be made, it is difficult to get responses from case managers and to obtain updates and investigations take too long. The impact of such issues on registrants awaiting a triage decision or facing a fitness to practise investigation should not be underestimated. Registrants expect to feel supported by their regulator and for any issues raised to be dealt with in a timely and professional manner. Being left hanging on for a decision indefinitely and receiving no replies to correspondence leaves registrants feeling demoralised and contemplating leaving their chosen profession. Let’s hope for everyone’s benefit that the HCPC delivers on its promises the next time around.

Author: Laura Smith