Final Report > Chapter 25: Competent Healthcare Professionals > The systems for assuring competence

The systems for assuring competence

29 Just as we are concerned with the patient's journey, we are also concerned with the journey taken by the person who seeks to be a healthcare professional. At each step in that journey, in the interests of patients and the public, systems must be in place to ensure that the aspiring professional (and subsequently the qualified professional) has and maintains the requisite competence.

30 We turn now to the question of regulation. As we have said, this is a broad term. It is not merely concerned with discipline and poor performance. To be effective in the service of patients, professional regulation should be understood as encapsulating all of the systems which combine to assure the competence of healthcare professionals: education, registration, training, continuing professional development and revalidation, as well as disciplinary matters. It should be concerned to promote good practice at all stages of a professional's career. It should include control of access to relevant professions through setting educational standards and ensuring that they are met. It should assure competent performance, through the setting of professional standards. It should require measures such as appraisal, continuing professional development and revalidation. It should also include the capacity to deal with poor performance and misconduct, although if appropriate efforts are made to assure good performance in the course of a professional's working life, the incidence of poor performance requiring some form of disciplinary action should be significantly reduced. There are clear indications that the body which currently regulates some aspects of a doctor's career, the GMC, is moving towards this notion of regulation as a more comprehensive and active process. The proposals to reform the regulation of nurses and midwives, and the regulation of the professions allied to medicine are also moving in this direction. [14] In addition, we do not overlook the role of the employer-employee relationship in the overall framework of regulation: it must complement other mechanisms of regulation by fostering good performance. Thus, the employer should have in place systems and resources to enable and support healthcare professionals to maintain and develop their competence, as well as systems to identify and act on failing or poor performance as early as possible.

31 In the paragraphs which follow we consider in greater detail the systems for assuring competence. We do so against the background of the need which we have identified to create an independent council for the regulation of healthcare professionals, at arm's-length from government. The task of this council will be to co-ordinate and integrate in the interests of patients the activities of the various bodies currently involved in what we call Professional Regulation. We will return to this overarching professional regulatory body once we have examined the various elements which together constitute professional regulation. We start with the system which applies at the outset of professional life when young people are first selected to be educated as healthcare professionals, and later we look at the systems in place to assure competence during a professional's working life.

Footnotes

[14] See: `The New Nursing and Midwifery Council: A consultation document', August 2000. www.doh.gov.uk/nmconsult; and `Establishing the New Health Professions Council', April 2001. www.doh.gov.uk/hpcorder