Response to the Department of Health and Social Care consultation on regulating healthcare professionals, protecting the public

16 June 2021

We welcome the opportunity to comment on the Department of Health and Social Care’s consultation ‘Regulating healthcare professionals, protecting the public’.

These proposals serve as an important and timely opportunity to consider how healthcare professionals are regulated. We see reform as a means of modernising ways of working and building more effective, proportionate, and fair means of regulating.

Although there are some areas of the consultation that we feel require further consideration and detail, we support much of what the Department has proposed. It is our hope that the product of these reforms will mean health regulators are able to collaborate more easily to protect the public. Modernising professional regulation also gives new opportunity to assure the public’s confidence in a way that is informed by the professions they oversee, and the perspectives of people whom they treat and support.

We note that Social Work England was not listed as one of the regulators included in the Department’s planned reforms. While we are in a unique position as the newest of the health and social work regulators, some of the proposals may benefit our work and reform offers an opportunity to address aspects of our model that need refinement or improvement. It is also important that we maintain a consistent approach to developing and improving professional regulation, so regulators are best equipped to work coherently and responsively on behalf of the public.

For Social Work England, this means striking a balance between the comparability of our work to the other health regulators in England and maintaining and improving alignment with the social work regulators in Wales, Scotland, and Northern Ireland. As we work to maintain this balance, it is important that the newness of our model does not preclude us from being considered for, or included in, these proposals.  

In the following response, we share our experience of regulating with some of the powers in the consultation, set out our views on the proposals based on our specialist regulation of social work, and explain where we may want to explore how reform could benefit our regulation.

A new way of regulating

As the specialist regulator for social workers in England and the newest professional regulator in the health and care sector, our own journey has been informed by a vision of modern, proportionate, and effective regulation.

We were established by the Children and Social Work Act 2017, and the Social Workers Regulations 2018 set out the detail of our regulatory framework. This legislation provided us with some of the features considered within the ‘Regulating healthcare professionals, protecting the public’ consultation for the other professions.

We are also the first new health and social work professional regulator since the establishment of the General Pharmaceutical Council in 2010. This means we are the first regulator to put into practice some of the proposals from the Law Commissions’ 2014 report on the regulation of health and social care professionals, such as accepted disposal.

This power, alongside other regulatory tools, means that we have been able to offer a process of investigating concerns that is specialised to social work and takes into account the complexities of the social work profession.

What we mean by this is that social work is about people and relationships. Often, social workers are presented with complex legal and ethical dilemmas in the course of their work. The decisions they make can have significant ramifications for the people they support and, even if they are right and lawful, can be difficult and, sometimes, unwelcome.

The uniqueness of the relationship between social workers and the people they support, in contrast to health professions, means that concerns can emerge from the significance, complexity or impact of a social worker’s decision. This can mean that in some instances, concerns are raised about a social worker that do not involve their fitness to practise.

Protecting the public through our specialist model

The changing landscape of social work regulation has meant that social workers in England have, at times, felt confused and disenfranchised from what can feel like a complex system of oversight. This made for a challenging backdrop against which to establish ourselves as the new single-profession specialist regulator. 

We understand that to regulate social work effectively, our oversight needs to be proportionate, effective, and underpinned by the values of the social work profession. To set this intent early, we developed new specialist professional standards, a brand-new digital-first approach to continuing professional development (CPD), and an annual renewal cycle all by the point of our launch.

Since the start of our regulation, we have set the launch for new outcomes-focused education and training standards that will come into effect in September 2021 and accelerated our rate of reapprovals of courses of initial education and training. We’ve seen a full year of CPD recording for the whole profession, and we have been able to receive cases, and engage with people and social workers about concerns in a way that demonstrates empathy and responsiveness.

When we began our work as the regulator, we inherited 1,545 live fitness to practise investigations. Over our first year, we recorded a further 1,982 concerns, 73% of which came directly from members of the public. This is a significant increase in direct referrals compared to the previous regulator the Health and Care Professions Council (HCPC) and has manifested in a c.35% increase in our caseload.

The case examiners may close a case with no further action, issue advice or a warning, issue an ‘accepted disposal’ or refer the case to a hearing. We resolved 41 cases by accepted disposal in our first year and have shared each of these decisions with the Professional Standards Authority for feedback and improvement. 

Our model of fitness to practise, as set out in our regulations and rules, is designed to provide us with options to address concerns with a wider range of outcomes and, in most cases, without the need for a final hearing.

Following investigation, in circumstances where the social worker accepts the concerns and demonstrates that they have taken measures to improve their practice, our case examiners are able to resolve a case without a hearing, also known as ‘accepted disposal’. This process is designed to avoid unnecessary hearings in circumstances where a social worker agrees with the resolution and where public protection has been upheld. This is a new tool in social work regulation, associated with the different powers we’ve been given through our legislation.

COVID-19 response

Just four months into our first year of regulation, the outbreak of COVID-19 brought an unprecedented health and social care crisis that required strong leadership, response and oversight from regulatory bodies of frontline health and social work professions.

The backdrop of the pandemic to the first year of our work, while proving most challenging for the public and profession we oversee, also complicated our understanding of regulatory referrals and why we are seeing more concerns raised to us by members of the public. We also had to adapt our own, newly established processes, by seeking powers for temporary registration, online hearings and sending notices of hearings digitally.

This presented a challenging set of circumstances against which to demonstrate the benefits of our regulatory model. However, we are clear that features such as accepted disposal support our work to uphold a specialist fitness to practise process that sees more proportionate outcomes for social workers and more efficient, decisive, and responsive outcomes for the public.

Building a regulatory approach beyond regulations and rules

Engagement with people with lived and learned experience of social work is core to our work as a regulator. Our culture, regulatory activity, and policy development all rest on the fundamental principal of inclusion.

Engaging with and including people through co-production enables new perspectives in regulation and challenges the status quo. Working in this way means that we are flexible and responsive to the needs of both social workers and those who receive social work support. Our approach values the uniqueness of individuals, builds on knowledge, skills and perspectives, and bridges the gap between regulator, profession and the public. We feel that co-production has also been instrumental to the early successes in our regulation.

We recruited a National Advisory Forum of people with lived and learned experience of social work. The forum acts as a critical friend, they offer advice, challenge and expert experience of social work to our regulation and ensure our work includes the perspectives of social workers and the people they support.

Feedback from our National Advisory Forum

Yaz Abdul Rahim and Isaac Samuels, who are members of Social Work England’s National Advisory Forum, have written this contribution specifically from the perspective of those with lived experience of social work:

We would like to see more emphasis on the involvement of people with lived experience of services in regulation.

Involving people with lived experience helps to shape services in a more personal way, rather than them being overly professional and inaccessible. People with lived experience often feel mistreated due to a lack of understanding and involvement.

By working with Social Work England, we are able to speak up and say “this is how I want to be treated”, rather than how people expect to treat us. I can express “I am more than a care plan” and bring a person-centred approach to the thinking behind policies and decisions on an organisational level.

We aim to contribute to a better experience and service for ourselves and others who receive social work support. Often when you have a physical disability people put you in a learning disability category and the staff treat you like you have limited capacity. You have full capacity. Without a voice, those misconceptions will go unchallenged. Advising Social Work England has also given me the confidence to speak about my own experiences to affect change.

We would like to see a greater emphasis and requirement on lived experience being involved at all stages of regulation, including education and training providers co-producing and co-delivering their courses. There should also be a greater responsibility on regulators to involve the public in their regulation and they should increase public understanding of their work. This includes presenting work in an accessible way. Professional language makes it hard to understand for people who do not work in that world.

To get all this right requires time, commitment, shared values and understanding, support for those you are involving, and good facilitation to make that accessible. Ultimately, co-production involves asking who is affected by this work and ensuring that they have a say in how it is designed and implemented.

Consultation questions

Governance and operation

1. Do you agree or disagree that regulators should be under a duty to co-operate with the organisations set out above? Please give a reason for your answer.

We have a duty to cooperate with the organisations set out in the consultation. We see cooperation, including the legal, proportionate, and appropriate sharing of data, as an important feature of regulators being able to respond effectively to risks to the public.

2. Do you agree or disagree that regulators should have an objective to be transparent when carrying out their functions and should have these related duties? Please give a reason for your answer.

We uphold the transparency of our work and commit to consulting and co-producing our work with those who have an interest in social work. As highlighted in 'Our Corporate Strategy 2020-2023', ‘transparency’ is one of our six organisational values.

As a non-departmental public body, we also have specific duties that contribute to the transparency and accessibility of our work in line with our remit. For example, The Social Workers Regulations 2018 set out specific points during our fitness to practise process where we must disclose information and where decisions must be published.  The Regulations also require us to publish information and advice, and the Children and Social Work Act 2017 requires us to publish an annual report and accounts.

Transparency of regulatory activity is fundamental to the accessibility and accountability of our work on behalf of the public. It is an important feature of the public’s trust in what we do and in the broader system of health and social care. We support the principle of transparency in regulation and see much of what the department has proposed to mandate already in practice for many regulators.

3. Do you agree or disagree that regulators should be required to assess the impact of proposed changes to their rules, processes and systems before they are introduced? Please give a reason for your answer.

Assessing the impact of proposed changes to our work is embedded in the principles of public law, regulatory practice and our organisational values. As a non-departmental public body, we are also required to consider the impact of any of our proposals on people with protected characteristics under the Public Sector Equality Duty. We agree with the proposal, but there may be little practical difference between what we do now and what we will need to do in the future, if this requirement already applies to us.

We consider it unlikely that any regulator would not consider the impact of proposed changes to their work. However, we are interested to know exactly what this duty will require. The consultation document refers to assessing the costs to ‘patients, service users and the public’. Does ‘cost’ refer to a potential change in fees, or could it also be interpreted more widely to refer to general detriment? In the case of the latter, this might be quite difficult to assess in some circumstances.

We would assume that, should the proposal be implemented, there would be supporting guidance that addresses, for example, what an assessment should look like, how assessments should be published or shared, how compliance will be monitored and by whom, and the consequences if the requirement is not met.

4. Do you agree or disagree with the proposal for the constitution on appointment arrangements to the Board of the regulators? Please give a reason for your answer.

This proposal appears to reflect our unitary board structure, which we believe has been effective for our work. In our experience a unitary board structure allows scrutiny of our work while not being so cumbersome that it delays appropriate and needed change, especially when such change is needed urgently, as has been the case in the last year.

However, our arrangements are not set out in our rules as it is in the proposal. We would also point out that Schedule 3 of the Children and Social Work Act 2017, which sets out the provision for our regulation, does not meet the requirements proposed in paragraph 68 of the consultation document.

5. Do you agree or disagree that regulators should be able to set their own fees in rules without Privy Council approval? Please give a reason for your answer.

We have the power to set our own fees, which we set out in our fees rules, although the Secretary of State has the power to object. We think it is appropriate for regulators to set their own fees as they are in the best position to determine what they will need to do in the year(s) ahead. However, this should be carried out through the process of a required public consultation, including associated equality impact assessments.

6. Do you agree or disagree that regulators should be able to set a longer-term approach to fees? Please give a reason for your answer.

We are not prohibited from setting out a long-term approach to fees, but Regulation 17(2) of The Social Workers Regulations 2018 means that we would only be able to do so if we had a reasonable expectation of what our income would be in coming years.

Our Regulations also say that our fees "must be set with a view to ensuring that, so far as possible, the regulator’s fee income in any year does not exceed the regulator’s expenses in the same year". This means a careful balance needs to be found between the benefits of a longer-term approach and the difficulty anticipating events further into the future that may mean a regulator needs to deviate from pre-set fee structures to effectively manage resources and meet demands.

Regulators would also need to be able to hold reserves and make internal plans to secure the viability of their services if their predictions on fee income were not realised. For example, we are currently not able to hold reserves, which would make planning longer term more difficult.

7. Do you agree or disagree that regulators should be able to establish their own committees rather than this being set out in legislation? Please give a reason for your answer.

We already have this flexibility and would recommend this for other regulators. Requiring legislative change can delay necessary changes and the flexibility needed to regulate effectively.

8. Do you agree or disagree that regulators should be able to charge for services undertaken on a cost recovery basis, and that this should extend to services undertaken outside of the geographical region in which they normally operate? Please give a reason for your answers.

We can charge fees in relation to education, which is the focus in the consultation, but Regulation 20(1) of The Social Workers Regulations 2018 only relates to courses in England. However, we think the power to charge for accreditation of overseas providers could be useful. Conducting the necessary checks to be assured that a course meets a requirement requires significant resource, which will be increased if the provider is based overseas.

9. Do you agree or disagree that regulators should have the power to delegate the performance of a function to a third party including another regulator? Please give a reason for your answer.

Delegation powers can be complex. There would need to be careful safeguards in place to avoid compromising the specialist regulation that Social Work England was set up to provide.

Delegation powers can work well for the regulation of specialisms. In our case, this could refer to our oversight of approved mental health professionals (AMHPs). This is demonstrated in paragraph 83 of the consultation document which specifically refers to one regulator approving a course that will then be recognised by other regulators whose registrants can qualify as AMHPs.

However, we would query the definition of a “third party”, which is not set out in the consultation document. Could this extend to private contractors, for example? It would need to be clear what the limits are on this power and how we would consider what is most appropriate for social work.

10. Do you agree or disagree that regulators should be able to require data from and share data with those groups listed above? Please give a reason for your answer.

We agree that regulators should be provided with broader powers, but we would welcome safeguards on their use. We are currently reviewing our own data sharing powers, and it would make sense for us to have the same powers as the other regulators, since data-sharing relates to common regulatory functions.

Consideration would need to be given to the extent of the powers, and whether and how they enable us as a regulator to carry out our statutory functions and most crucially to protect the public. For instance, we would value the ability to share and require information to facilitate identification of themes, patterns or correlations in our own data relating to fitness to practise. Being able to share data is also likely to be necessary to support any proposals for delegation of function (question 9).

We recognise however that we hold very sensitive personal data and there may be a general risk that people could be apprehensive about the level of data-sharing that may result from this proposal. We are of the view that with a clear legal basis this is likely to support effective regulatory action.

11. Do you agree or disagree that regulators should produce an annual report to the Parliament of each UK country in which they operate? Please give a reason for your answer.

No comment.

12. Do you agree or disagree that the Privy Council’s default powers should apply to the GDC and GPhC? Please give a reason for your answer.

These powers are similar to the powers given to the Secretary of State in part 7 of our Regulations. We think it would be helpful to ensure consistency across all the regulators.

Education and training

13. Do you agree or disagree that all regulators should have the power to set:

• standards for the outcomes of education and training which leads to registration or annotation of the register for individual learners;

• standards for providers who deliver courses or programmes of training which lead to registration;

• standards for specific courses or programmes of training which lead to registration;

• additional standards for providers who deliver post-registration courses of programmes of training which lead to annotation of the register; and

• additional standards for specific courses or programmes of training which lead to annotation of the register?​

Please give a reason for your answer.

We agree that all of these powers are important for regulators to ensure that those training and joining registers have the skills and knowledge they need and are able to demonstrate that they meet the professional standards set by the regulator. In particular we support the proposals at paragraphs 106 and 107 of the consultation document.

At present, we are reviewing how we operate our powers to annotate the social work register, with a view to ensuring that annotation is a meaningful regulatory process which has a clear purpose in supporting our ultimate aims of public protection.

14. Do you agree or disagree that all regulators should have the power to approve, refuse, re-approve and withdraw approval of education and training providers, qualifications, courses or programmes of training which lead to registration or annotation of the register? Please give a reason for your answer.

We have the power to approve, refuse, re-approve and withdraw approval of courses or programmes of training which lead to registration or annotation of the register, but not of education and training providers. We agree that these powers are important for regulators to ensure that those training and joining registers have the skills and knowledge they need and are able to demonstrate that they meet professional standards.

We see the proposals around annotation of the register with specialist areas of practice as an important means of demonstrating to the public the specialist and advanced areas of practice a professional may be qualified to operate in. This is especially important where a specialist area of practice affords registrants with specific duties and powers, for example the right to deprive somebody of their liberty.

15. Do you agree that all regulators should have the power to issue warnings and impose conditions? Please give a reason for your answer.

We have the power to attach conditions to the approval and re-approval of courses of initial education and training, tests of knowledge of English, and AMHPs courses where:

1. the relevant institution fails to respond to a request for information made under Regulation 20(5) of The Social Workers Regulations 2018 within the period specified in the request; or
2. the regulator is satisfied on the basis of evidence obtained under Regulation 20 of The Social Workers Regulations 2018, or following an inspection, that the course, or test, does not meet the criteria for approval.

We find conditions to be a useful way of working with course providers to make necessary changes while still providing students with a strong social work education. While we are not necessarily opposed to a warnings power, without careful consideration this could become a combative process between the regulator and the course provider, which we would want to avoid. If such a power were given, we consider it should be done with a clear process and criteria for when a warning should be given. This would ensure warnings are only given in way which ensures good quality education, which in turn protects the public.

16. Do you agree or disagree with the proposal that education and training providers have a right to submit observations and that this should be taken into account in the decision-making process? Please provide a reason for your answer.

We already have this right set out in our legislation and agree with the proposal.

17. Do you agree that:

• education and training providers should have the right to appeal approval decisions;

• that this appeal right should not apply when conditions are attached to an approval;

• that regulators should be required to set out the grounds for appeals and appeals processes in rules?

Please provide a reason for your answer.

We are not clear on how allowing a right of appeal against approval decisions would improve public protection differently to the existing right of a provider to seek judicial review. Handling such an appeal would be hugely resource-intensive and expensive for regulators, diverting resources away from other core work, and is unlikely to result in a satisfactory outcome. Our approach is to work with providers to help them reach the point of approval, so the withholding of approval until standards are met is a regulatory lever to enable progress rather than a point-in-time, pass-or-fail assessment. We would like to understand in more detail the issue this proposal is seeking to address.

18. Do you agree or disagree that regulators should retain all existing approval and standard setting powers? Please provide a reason for your answer.

We agree that all regulators should retain their current powers and these powers should be provided to all where those powers support the regulators to protect the public.

19. Do you agree or disagree that all regulators should have the power to set and administer exams or other assessments for applications to join the register or to have annotations on the register? Please provide a reason for your answer.

We agree that all regulators should retain their current powers and these powers should be provided to all where those powers support the regulators to protect the public.

20. Do you agree or disagree that this power to set and administer exams or other assessments should not apply to approved courses or programmes of training which lead to registration or annotation of the register? Please provide a reason for your answer.

We consider that it would be disproportionate for Social Work England to set the exams required for students to complete their social work qualification, as this is the remit of the course providers. However, we would be in favour of a power to require some form of additional assessment for applicants to demonstrate their competency before joining the register.

21. Do you agree or disagree that regulators should be able to assess education and training providers, courses or programmes of training conducted in a range of ways? Please provide a reason for your answer.

There already appears to be a discretion for regulators to determine a variety of ways in which the approval scheme can be undertaken, and we agree that this should continue.

22. Do you agree or disagree that the GMC’s duty to award CCTs should be replaced with a power to make rules setting out the procedure in relation to, and evidence required in support of, CCTs? Please give a reason for your answer.

No comment.

23. Do you agree or disagree that regulators should be able to set out in rules and guidance their CPD and revalidation requirements? Please give a reason for your answer.

Part 7 of the Social Work England registration rules sets out the requirements for a social worker’s registration to be renewed, including the CPD requirements. We agree that regulators should be able to set out in rules and guidance their requirements, with a level of specificity appropriate to the professions they regulate.

Registration

24. Do you agree or disagree that the regulators should hold a single register which can be divided into parts for each profession they regulate? Please give a reason for your answer.

We agree that a single register, divided into parts, is appropriate, as it is a more efficient way of managing multiple professions.

25. Do you agree or disagree that all regulators should be required to publish the following information about their registrants:

• Name

• Profession

• Qualification (this will only be published if the regulator holds this information. For historical reasons not all regulators hold this information about all of their registrants)

• Registration number or personal identification number (PIN)

• Registration status (any measures in relation to fitness to practise on a registrant’s registration should be published in accordance with the rules/policy made by a regulator)

• Registration history

Please provide a reason for your answer.

We already have a requirement to publish some of the listed information, as set out in Regulation 9 of The Social Workers Regulations 2018. However, it is unclear in the consultation document what is meant by “registration history”. Under regulation 9, we are only required to publish the date of registration and the current restrictions on practice. Publishing historic restrictions of practice would mean publishing critical information about a social worker, or registrant of another register, when they are no longer considered to be impaired. To balance the protection of the public with the rights of registrants, if this were to be considered, we would recommend a limit on the length of time for which this information would be published.

26. Do you agree or disagree that all regulators, in line with their statutory objectives, should be given a power allowing them to collect, hold and process data? Please give a reason for your answer.​

We already have this power, as described in our answer to question 25, and agree that it would be appropriate for the other regulators to be given this power.

27. Should they be given a discretionary power allowing them to publish specific data about their registrants? Please give a reason for your answer.

We agree that a discretionary power would be useful.

28. Do you agree or disagree that all regulators should be able to annotate their register and that annotations should only be made where they are necessary for the purpose of public protection? Please give a reason for your answer.

We already have the power to add annotations to our register set out in our legislation and consider public protection when using our annotation powers. We have identified the current annotations based on the nature of the risks and tasks those registrants can undertake.

We see that annotation may be able to add value to our regulatory activity by making clear to the public those practitioners who have qualifications or have attained specialist and/or advanced practice. This can help the public discern which social workers are able to discharge certain duties or powers in a straight-forward and accessible way. We support regulators being able to make use of powers of annotation in this way while retaining the simplicity and accessibility of the register.

29. Do you agree or disagree that all of the regulators should be given a permanent emergency registration power? Please give a reason for your answer.

At present we only have this power through the Coronavirus Act 2020. We do not have a permanent emergency registration power. This capacity has been valuable for our response efforts and proved a useful contingency measure, but as we begin to move out of the pandemic, we would like to see temporary registration come to an end sooner rather than later. We agree that all regulators should be given a permanent emergency registration power.

30. Do you agree or disagree that all regulators should have the same offences in relation to protection of title and registration within their governing legislation?

We agree that this would be an appropriate step as it would improve consistency and public understanding of the purpose of protected titles. 

31. Do you agree or disagree that the protection of title offences should be intent offences or do you think some offences should be non-intent offences (these are offences where an intent to commit the offence does not have to be proven or demonstrated)? Please give a reason for your answer.

We agree it is important to have protected titles, but we also know the difficulties involved when a regulator considers whether to undertake a prosecution. This often requires regulators undertaking extremely expensive private prosecution processes. Such activity needs to be balanced against the risks posed by the misuse of title, and the use of public money where there might be other ways to minimise the risk.

Inclusion of the offences in legislation could act as a deterrent. However, we think the offences should remain intent offences, as someone who has unintentionally used a protected title would most likely desist as soon as they were informed it was an offence. If they didn’t, from that point on it would be difficult to argue that they didn’t have intent. It therefore doesn’t seem necessary to add a strict liability offence to protect the public.

32. Do you agree or disagree with our proposal that regulators should be able to appoint a deputy registrar and/or assistant registrar, where this power does not already exist? Please give a reason for your answer.

Social Work England may appoint a member of staff as registrar. We do not currently have the power to appoint a deputy and/or assistant registrar and would not seek this power for ourselves, as relatively little of our legislative power is devolved to the registrar. However, we would support this option for other regulators.

33. Do you agree or disagree with our proposal that regulators should be able to set out their registration processes in rules and guidance? Please give a reason for your answer.

Though our registration processes are set out in our registration rules and guidance documents, much of our processes are described in our regulations, which make some parts of our rules a recitation of aspects of the regulations. This sets out in the Rules a level of prescription that would be better in guidance.

We would therefore support registration processes being devolved as much as possible into rules and guidance so that regulators have the flexibility to amend their processes to reflect their current situation.

34. Should all registrars be given a discretion to turn down an applicant for registration or should applicants be only turned down because they have failed to meet the new criteria for registration? Please give a reason for your answer.

We do not currently have this discretion, although it is arguable that there is discretion in deciding whether someone is capable of safe and effective practice. In our view, clear criteria for registration should enable regulators to turn down an application within their framework, without the need for discretionary powers that may lead to ambiguity and increased challenge. However, if this power is retained for the GMC, then it should be made available for all regulators.

35. Do you agree or disagree that the GMC’s provisions relating to the licence to practise should be removed from primary legislation and that any requirements to hold a licence to practise and the procedure for granting or refusing a licence to practise should instead be set out in rules and guidance? Please give a reason for your answer.

No comment.

36. Do you agree or disagree that in specific circumstances regulators should be able to sus-pend registrants from their registers rather than remove them? Please give a reason for your answer.

We have the power to suspend only in circumstances where a social worker does not keep us up to date with information relevant to their registration or if they don’t comply with a request for information from the regulator. In the other specific circumstances detailed in section 206 of the consultation document, the only current option open to us is to remove the registrant from the register.

It may be appropriate to consider the additional resource requirements associated with introducing a separate process and we would query what the suspension would achieve in terms of public protection. Regulators would need clear criteria where suspension for administrative reasons would be appropriate, to ensure that it provided additional protection for the public above the current processes, and to prevent confusion for the public with suspension following fitness to practise proceedings.

37. Do you agree or disagree that the regulators should be able to set out their removal and readmittance processes to the register for administrative reasons in rules, rather than having these set out in primary legislation? Please give a reason for your answer.

We already have this power and would support it for the other regulators. In reference to the reasons for removal set out in paragraph 208 of the consultation document, we do not support removal or suspension for non-payment of fees. This confuses the purpose of the register as a means to ensure that registered social workers are able to practise safely and effectively. The cost of returning to the register is not disproportionate to the cost of chasing down debts, and so we would prefer that social workers who do not pay fees to simply seek restoration, rather than having a power as a regulator to seek payment of debts.

38. Do you think any additional appealable decisions should be included within legislation? Please give a reason for your answer.

We already have the discretion in our regulations to add further appealable decisions in rules and agree that this power should be made available to the health regulators.

39. Do you agree or disagree that regulators should set out their registration appeals procedures in rules or should these be set out in their governing legislation? Please give a reason for your answer.

Our legislation allows us to set these procedures out in rules, and we see this as the appropriate part of our framework for such procedures. We are therefore of the view that this approach should be adopted for the health regulators.

40. Do you agree or disagree with our proposal that the regulators should not have discretionary powers to establish student registers? Please give a reason for your answer.

We are pursuing a specialist, single profession approach to social work regulation, which includes the potential for student registration. This is one area in which we have distinct policy considerations from the other healthcare regulators and will need to consider the alignment of all four UK social care regulators (Social Care Wales, the Scottish Social Services Council and the Northern Ireland Social Care Council each of which have student registration).

The General Social Care Council held a student social work register before 2011 and there have been calls for us to consider reintroducing student registration from some cohorts of students and the education sector. We are exploring the relative benefits to the public of registering students, but feel this is an important discretion to retain in order to offer an effective and consistent system of regulatory social work oversight across the UK. We would also support other regulators in their own decision as to whether student registration is appropriate for their professions.

41. Do you agree or disagree with our proposal that the regulators should not have discretionary powers to establish non-practising registers? Please give a reason for your answer.

We do not currently have discretion to establish a non-practising register. Our view is that non-practising registers do little to protect the public and may confuse the public as to what these individuals can do. Unless there are specific considerations for other professions, we would agree that there should not be discretionary powers for non-practising registers.

42. Do you agree or disagree that the prescriptive detail on international registration requirements should be removed from legislation? Please give a reason for your answer.

We don’t have overly detailed international registration requirements set out in our regulations. We are able to set out the detail in our rules, and we would support this flexibility for the other regulators.

Fitness to practise

43. Do you agree or disagree with our proposal that regulators should be given powers to operate a three-step fitness to practise process, covering:

• 1. initial assessment

• 2. case examiner stage

• 3. fitness to practise panel stage

Please provide a reason for your answer.

We agree that the three-stage process proposed would allow regulators sufficient flexibility to operate a suitable fitness to practise process.

Social Work England effectively operates a four-stage process with a triage stage followed by a more substantial investigation stage. This has proved to be essential to ensure we do not deploy unnecessary time and resource in lengthy investigations for referrals where there is no prospect of impairment.  It is not our view that the proposals would preclude other regulators for establishing a similar process.  

44. Do you agree or disagree that:

• All regulators should be provided with two grounds for action – lack of competence, and misconduct?

• Lack of competence and misconduct are the most appropriate terms for these grounds?

• Any separate grounds for action relating to health and English language should be removed from the legislation, and concerns of this kind investigated under the ground of lack of competence?

• ​This proposal provides sufficient scope for regulators to investigate concerns about registrants and ensure public protection?

Please provide a reason for your answers.

We do not agree that regulators should be provided with only two grounds of action but do agree that the number of grounds available could be reduced to provide further clarity.

Social Work England currently has a wide range of grounds available to us including lack of competence or capability and misconduct, which are the predominant grounds used in our regulatory proceedings. However, we do consider the availability of additional separate grounds, particularly conviction and adverse physical and mental health, to be helpful in clearly reflecting the nature of the fitness to practise concerns being investigated.

We have concerns about the loss of health as a separate ground of impairment and find the wording unclear. We recognise that proceeding with fitness to practise proceedings under the ground of health can present challenges. However, we do not think it is appropriate, or in keeping with a modern understanding of how health may affect practice, to consider health in the same way as other grounds of impairment. We consider that keeping health as a separate ground would better allow regulators to handle concerns about health fairly and sensitively.

We do agree that English language can effectively be investigated under the ground of lack of competence.

45. Do you agree or disagree that:

• all measures (warnings, conditions, suspension orders and removal orders) should be made available to both case examiners and fitness to practise panels

• automatic removal orders should be made available to a regulator following conviction for a listed offence?

Please provide a reason for your answers.

On the first proposal, we agree that regulators should have all these measures available to both case examiners and fitness to practise panels and would welcome the addition of the removal order for our case examiners, which was the original intention when drafting our Regulations.

Social Work England has had the opportunity to operate an enhanced case examiner process, which has had all the measures above available, with the exclusion of the removal order power. We consider this enhanced process has allowed us to have a more efficient and responsive fitness to practise process, allowing resolution of cases at an earlier stage, whilst still effectively protecting the public. While it was originally intended for case examiners to also have the removal order available as an option, the current wording of our regulations has prevented case examiners from exercising this power. We consider the addition of this power would be beneficial to our process and contribute to an efficient and effective fitness to practise process, for both Social Work England and other regulators.

On the second proposal, we agree that regulators should have the automatic removal order power available to them. Social Work England already has this power available and believe it is an effective and efficient means of achieving public protection. This maintains confidence in the profession and regulator, with respect to convictions for the most serious criminal offences.  The absence of this power means that these cases would otherwise have to proceed through the entire fitness to practise process, which immediately adds delay in resolving cases, which are in practise more likely than not to result in a removal order.

However, we would note that, given the extreme seriousness of the convictions for which automatic removal is an option, and that our legislation only allows automatic removal for offences committed on or after 2 December 2019, this power will be used extremely rarely. 

46. Do you agree or disagree with the proposed powers for reviewing measures? Please give a reason for your answer.

We agree with flexibility being provided to regulators as to how and when to undertake a review of a final order, as outlined in paragraph 279 of the consultation document. Social Work England currently has this flexibility and while reviews are currently being undertaken by adjudicators, we welcome the opportunity to potentially delegate this function to other appropriate parties in future, such as case examiners.

We agree that registrants should be able to request a review of a final order, as set out in paragraph 280 of the consultation document, but we would like to be clear though that the ability to request an early review at any stage should be combined with a power for the regulator to reject such requests. It would not be out of the question for registrants to immediately request an early review or request multiple early reviews when there has been no change in circumstances. If the regulator was obliged to undertake a review in every case, this would be unduly burdensome and divert resources from other functions.

47. Do you agree or disagree with our proposal on notification provisions, including the duty to keep the person(s) who raised the concern informed at key points during the fitness to practise process? Please give a reason for your answer.

We agree that regulators should have the power to set out the process for notifying registrants and the person(s) who raised the concern in rules, as set out in paragraph 286 of the consultation document. Social Work England currently has the discretionary power to set rules about how we undertake any aspect of fitness to practise proceedings and believe this provides us with a greater level of flexibility in dealing with issues such as the matters set out above.

We also agree with the proposal requiring the regulator to inform the registrant whenever a substantive decision is being made. We are unclear however, on the proposal providing a right to registrants to request updates from the regulator. We appreciate that registrants should be kept updated regularly and this should be built into the fitness to practise process, however creating a right to request these updates may create an unnecessary burden on the regulator in responding to multiple or consistent requests for updates. We consider the current requirement to provide updates at key stages of the process is sufficient, in addition to responding to general requests for information from registrants in line with our own internal procedures and policies.

We agree with the proposal set out in paragraph 289 of the consultation document. We already have a general requirement to keep the person who raised the concern informed of the majority of the outcomes of the fitness to practise process. However, there is a discretion to notify them if the case does pass the triage test and to provide them with a copy of the social workers’ submissions.

It is important to note that the complainant is not a party to the fitness to practise process, and a matter that began with a concern may develop into other matters.  For example, there may be a complaint from one service user which results in an investigation into the social worker’s actions regarding other service users.  Alternatively, further investigation may mean there is little prospect of the instant matter raised being taken forward, but other issues are identified.  In these situations, it may not be appropriate for us to share information about all parts of the fitness to practise process with the original complainant.

48. Do you agree or disagree with our proposal that regulators should have discretion to decide whether to investigate, and if so, how best to investigate a fitness to practise concern? Please give a reason for your answer.

We have broken the following response down to provide specific responses to some of the regulatory powers proposed in paragraph 292 of the consultation document:

A power to require information from a third party, and to seek an order from the courts requiring information from a third party should they refuse to provide it:

We agree that regulators should be given the power to require information from a third party at any stage of the proceedings, and we would welcome the addition of this power ourselves. We also agree that regulators should be given the power to seek an order from the courts requiring information from a third party, and we would welcome the addition of this power ourselves.

Unlike some of the other regulators, at present Social Work England does not require information from a third party at our triage stage to ensure the triage process is as quick as possible.  However, this can occasionally negatively impact our ability to resolve concerns at an earlier stage as we are not able to obtain relevant information to assist in our decision making, particularly from employers.  As such we are exploring whether we would wish to require information from third parties at the triage stage.

Social Work England does not currently have the power to seek an order from the courts requiring the information from a third party. Effectively our only means of enforcing a request for information in line with our powers is to pursue a prosecution of a summary offence of failing to provide information. In practice the potential for prosecution is usually sufficient to engage co-operation from reluctant third parties in providing the information requested. However, there are occasions when it is not sufficient. In those instances, pursuing prosecution does not provide an effective means of obtaining the required documentation as it is costly, resource intensive and does not ensure the disclosure of the relevant information. As such we recognise the value of Social Work England having the power to seek an order from the courts in certain circumstances.

A power to require information from a registrant. This power will exclude reflective material:

We agree that regulators should be given the power to require information from a registrant but do not think this should be engaged at the triage stage.

Social Work England is currently content with this power being limited to investigations as opposed to being available at the earlier triage stage. We do already have the power to conduct further enquiries with third parties at the triage stage, which can be used, if considered necessary, to engage with the registrant. We consider this is sufficient at this stage.  In this respect we are particularly conscious of requiring information from a registrant at a stage in the proceedings when we have not yet determined whether the case meets our threshold for investigation.

A power to direct a registrant to undergo an assessment in relation to a fitness to practise investigation:

We understand assessment in this context to include an English language assessment, health assessment and/or competency assessment. We agree that regulators should be given the power to direct that a registrant undergoes an assessment including a health, competency and English language assessment.  We would welcome the addition of this power in respect of health and competency assessments ourselves.

Social Work England case examiners, adjudicators and investigators already have the power to direct English language assessments (Regulation 25(6) of The Social Workers Regulations 2018). We are content with the scope of this power at present.

Social Work England investigators and adjudicators can request a health assessment under rule 36 of our Fitness to Practise Rules, but have no power to direct a health assessment, in the same manner as the English language assessment.  As such there is no specific provision for an adverse inference to be drawn when the social worker does not engage in a health assessment.  The inability to direct such an assessment can, on occasion, hamper our ability to progress cases and therefore effectively protect the public. As such we recognise the value in having the power to direct a health assessment. We do however recognise that this power would need to be exercised carefully and in limited circumstances.

Social Work England does not have the power to direct a competency assessment is undertaken at any stage in our process. While we could request the social worker undertakes such an assessment, we would be relying on voluntary engagement and compliance. This again can hamper our ability to progress cases and therefore effectively protect the public. As such we recognise the value in having the power to direct a competency assessment. We do however recognise that this power would need to be exercised carefully and in limited circumstances and would have resource implications.

The right for a registrant to provide written submissions to the regulator during the course of the initial assessment:

We do not agree that the registrant should have the right to provide written submissions, but rather that there should be discretion to invite submissions during the initial assessment stage.

We recognise that there is value in allowing registrants to provide submissions at an early stage, but we do not agree that this should be as of right. Instead, we agree that the addition of a discretionary power to inform registrants at the initial assessment stage is appropriate and proportionate. Requiring registrants to be informed in respect of every concern that is raised about them would prove overly burdensome to regulators and unnecessarily distressing for registrants in cases where most of the concerns raised do not meet the threshold. It would also extend the triage process, in many cases where it would be of no benefit to do so.

A new power for regulators to decide, if appropriate, that there is no further action to be taken and to close the case at this stage.

We agree with the introduction of this new power for regulators and would welcome the addition of this power ourselves.

Social Work England currently does have the capacity to close cases at the triage stage if the concerns do not meet the requisite threshold for investigation. However, we do not have the specific power to close cases in circumstances where the concerns do meet the threshold for further investigation, but a judgement decision has been made that no further action is required.

Once a case passes the triage test, the cases must be put before case examiners to make a decision. This process can prove to be overly burdensome to the regulator. The case examiners and the social worker in cases where an investigation has been carried out, and the regulator, is of the view that there is no realistic prospect that a social workers fitness to practise will be found to be impaired. We consider this power would be most appropriately exercised after an investigation has been undertaken, where there is an ability to scrutinise a range of evidence and likely take account of the social workers views before a decision is made.

49. Do you agree or disagree that the current restrictions on regulators being able to consider concerns more than five years after they came to light should be removed? Please give a reason for your answer.

We do not have a 5-year rule, and do not consider it is beneficial to regulators. Like most regulators, our guidance makes recommendations on the handling of historic cases, particularly when having regard to the strength of evidence available.  However, a set time period for concerns is not beneficial and may prevent consideration of important historical matters.

50. Do you think that regulators should be provided with a separate power to address non-compliance, or should non-compliance be managed using existing powers such as “adverse inferences”? Please give a reason for your answer.

We agree that regulators should be provided with a separate power to address non-compliance to assist in those cases where managing non-compliance through existing powers is not appropriate or sufficient, and we would welcome the addition of this power ourselves.

Social Work England has separate non- compliance powers with respect to the registrations process (see regulation 16(2) where we can engage adjudicators to suspend or remove a person for not responding to request for information). However, this power has not been extended to fitness to practise.

At this stage, failure to cooperate with an investigation can be facilitated within the fitness to practise process, by including it as a separate regulatory concern. This does mean that a non-compliance concern must proceed through the ordinary fitness to practise process but also ensures that the engagement/cooperation is seen as part of a wider picture of the other fitness to practise issues. We generally regard this process as an effective means of addressing non-compliance, but this would be strengthened with the addition of the power to direct assessments, as set out above.

We do recognise that the introduction of such a scheme requires setting up new types of hearings, drafting rules to facilitate the process and training the adjudicators and other staff, which could prove burdensome. However, having the ability to run separate non-compliance hearings would be beneficial for those intractable cases where the matter cannot be investigated in a thorough meaningful way without the engagement and cooperation of the registrant.

51. Do you agree or disagree with our proposed approach for onward referral of a case at the end of the initial assessment stage? Please give a reason for your answer.

• If, after an initial assessment, a regulator believes that there is a fitness to practise concern, they will be able to make an onward referral to a case examiner.

• At any time during or after initial assessment, the regulator may consider the use of an interim measure if immediate action is needed to protect the public.

Please provide a reason for your answers.

Once a case passes the initial assessment stage at Social Work England, it is referred to investigators for a more robust investigation before then being referred to case examiners. We consider this to be an effective tool of ensuring all the relevant information and evidence is available to the case examiners to allow them to make a robust decision and consider this to be particularly important considering their enhanced powers under the accepted disposal process.

We agree that regulators should be able to consider a case for an interim measure at any point. We would welcome the introduction of this power to consider cases at the triage stage.

Social Work England is currently limited to considering cases for an interim measure only once the case has passed the initial assessment phase. While we understand the principle of this restriction, namely to ensure only those cases that meet a certain threshold for investigation should proceed to an interim order application, we also recognise that in practice this presents an unnecessary barrier which can make the process less responsive. Given the serious nature of the cases being considered for interim measures and particularly the risk to the public, we think this process should be as streamlined as possible to ensure that the regulator can take prompt and efficient action.

We agree that regulators should be able to make the rules specified in paragraph 300 of the consultation document. We have the discretionary power to set rules about how we undertake any aspect of fitness to practise proceedings and believe this provides us with a greater level of flexibility in dealing with issues such as the matters set out above.

52. Do you agree or disagree with our proposal that regulators should be given a new power to automatically remove a registrant from the Register, if they have been convicted of a listed offence, in line with the powers set out in the Social Workers Regulations? Please give a reason for your answer.

As set out above we have welcomed the addition of this power and would agree with the proposal.

53. Do you agree or disagree with our proposals that case examiners should:

• have the full suite of measures available to them, including removal from the register?

• make final decisions on impairment if they have sufficient written evidence and the registrant has had the opportunity to make representations?

• be able to conclude such a case through an accepted outcome, where the registrant must accept both the finding of impairment and the proposed measure?

• be able to impose a decision if a registrant does not respond to an accepted outcomes proposal within 28 days?

Please provide a reason for your answers.

We have broken the following response down to provide specific responses to the regulatory powers proposed in this question of the consultation document:

Have the full suite of measures available to them, including removal from the register?

We agree with this proposal because as set out above we have had a positive experience of the enhanced powers for case examiners and would welcome the addition of the power to remove.

Make final decisions on impairment if they have sufficient written evidence and the registrant has had the opportunity to make representations?

Be able to conclude such a case through an accepted outcome, where the registrant must accept both the finding of impairment and the proposed measure?

We agree with these proposals. As set out above we currently have these powers and feel that they have positively impacted on our ability to undertake our fitness to practise function.

Be able to impose a decision if a registrant does not respond to an accepted outcomes proposal within 28 days.

We would welcome the expansion of case examiner powers as a responsive measure in circumstances of non-engagement. At this stage case examiners at Social Work England require the engagement of social workers before an outcome can be imposed. We appreciate there will be cases of non-engagement which are not appropriate for accepted disposal. However, the absence of this power in our process can result in cases being referred to hearing only because of non- engagement of the social worker rather than because a hearing would be in the public interest and in circumstances where there is no expectation that the social worker would ever engage in our process. As such we consider that providing case examiners with the discretion to impose outcomes can contribute to a proportionate and more efficient fitness to practise process. 

54. Do you agree or disagree with our proposed powers for interim measures, set out above? Please give a reason for your answer.

We agree with the introduction of consistent powers across the regulators with respect to interim measures as we consider this will assist the public, employers and other third parties understanding of the interim order process (paragraphs 320 and 321 of the consultation document).

We agree that regulators should be able to consider a case for an interim measure at any point and would welcome the introduction of this power to consider cases at the triage stage (paragraph 322 of the consultation document).

Social Work England is currently limited to considering cases for an interim measure only once the case has passed the initial assessment phase. While we understand the principle of this restriction, namely to ensure only those cases that meet a certain threshold for investigation should proceed to an interim order application, we also recognise that in practice this presents an unnecessary barrier which can make the process less responsive. Given the serious nature of the cases being considered for interim measures and particularly the risk to the public, we think this process should be as streamlined as possible to ensure that the regulator can take prompt and efficient action.

We generally agree that the regulators should have the powers listed with respect to interim measures in paragraphs 324 and 325 of the consultation document.

Social Work England currently has all the above powers except for ‘reduction’. We are not clear on what is meant by this term and whether this has the same intended meaning as ‘vary’.  For instance, Social Work England currently has a power at review to vary an interim order conditions of practise order. If reducing interim order measures in this context is meant to include something beyond the current power to ‘vary’, such as reducing the length of time of an interim order, then we would generally agree that providing scope to vary the length of the order would be welcome.

Social Work England’s current interim order process requires that case examiners effectively approve the regulator putting forward an interim order application to adjudicators. However, they do not have the power to propose or make an interim order. The inclusion of the case examiners in this way in our process has proved cumbersome and added on occasion unnecessary delay in progressing cases to adjudicators, without necessarily adding real value.

The enhancement of the case examiners power to allow them to make the initial proposal to the registrant, would in some circumstances remove the need to involve the adjudicators and hold a hearing and therefore lead to a more responsive and efficient process to ensure public protection. However, we do recognise that with the need for agreement by the registrant, this may also have the unintended effect of adding a further layer to a process that should be as streamlined and responsive as possible. As such we recognise that the use of case examiners in this way may not be appropriate in all cases, but we would generally welcome the enhancement of their powers.

We agree that interim measures should come into effect at a time set by the regulator and would welcome this power ourselves (paragraph 330 of the consultation document).

We agree that interim measures should remain in place while an appeal is considered, and we would welcome this clarity in our own regulations (paragraph 332 of the consultation document).

We agree that regulators should be provided with a discretion to inform the complainant about the intention to apply for an interim order and the outcome of an interim order (paragraph 333 of the consultation document).

Social Work England currently has the discretion to notify the person/s who raised the concerns of the outcome of the interim order application, but we do not have the discretionary power to inform them when we are making the application. There are benefits of advising the parties at this earlier stage as we may then be privy to information that would assist the adjudicators in making their decision, particularly in circumstances where the employer’s input may be required in terms of ability to comply with conditions etc. However, the downside to alerting parties at such an early stage is that such an application may not eventuate in an interim order and the complainant’s knowledge of the application itself may potentially prejudice the registrant. As such we agree that this power should be discretionary but not mandatory.

55. Do you agree or disagree that regulators should be able to determine in rules the details of how the fitness to practise panel stage operates? Please give a reason for your answer.

We have the power to make rules in relation to the fitness to practise panel stage.

56. Do you agree or disagree that a registrant should have a right of appeal against a decision by a case examiner, fitness to practise panel or interim measures panel? Please give a reason for your answer.

There is no apparent right of appeal for the social worker to appeal against advice given under Schedule 2, paragraph 12(3)(a) of The Social Workers Regulations 2018 when a finding of impairment has been found. There is also no right of appeal against a decision by the adjudicators to give a warning or advice after a finding of ‘no impairment’ has been made under Schedule 2, paragraph 12(1) of The Social Workers Regulations 2018.

57. Should this be a right of appeal to the High Court in England and Wales, the Court of Session in Scotland, or the High Court in Northern Ireland? Please give a reason for your answer.

No comment.

58. Do you agree or disagree that regulators should be able to set out in rules their own restoration to the register processes in relation to fitness to practise cases? Please give a reason for your answer.

We already have this power and would support the other regulators also having this power.

59. Do you agree or disagree that a registrant should have a further onward right of appeal against a decision not to permit restoration to the register? Please give a reason for your answer.

The applicant already has an onward right of appeal in our legislation, first to our adjudicators and then to the County Court.

60. Should this be a right of appeal to the High Court in England and Wales, the Court of Session in Scotland, or the High Court in Northern Ireland? Please give a reason for your answer.

No comment.

61. Do you agree or disagree that the proposed registrar review power provides sufficient oversight of decisions made by case examiners (including accepted outcome decisions) to protect the public? Please provide any reasons for your answer.

We agree that a registrar review power would be beneficial to regulators, and an appropriate and proportionate way to consider some cases without the need for judicial review. However, we acknowledge that such a power would involve the same organisation both making the original decision and reviewing it. To that end, we consider that regulators will need to provide clear, public guidance and processes on how such review will be undertaken.

62. Under our proposals, the PSA will not have a right to refer decisions made by case examiners (including accepted outcome decisions) to court, but they will have the right to request a registrar review. Do you agree or disagree with this proposed mechanism? Please provide any reasons for your answer.

Under our legislation, the PSA cannot currently review case examiner decisions. There is also no power for a registrar to review any decisions made by the regulator. While the PSA sees a public protection deficit in not extending their section 29 powers, we feel that to propose a section 29 review of this decision is disproportionate when the original decision has been made administratively and on the papers. We consider that the registrar review mechanism would be a proportionate way to ensure checks on accepted outcomes and decisions to refer to a hearing.

63. Do you have any further comments on our proposed model for fitness to practise?

No comment.

Regulation of Physician Associates and Anaesthesia Associates

64. Do you agree or disagree with the proposed approach to the regulation of PAs and AAs? Please give a reason for your answer.

No comment.

65. In relation to PAs and AAs, do you agree or disagree that the GMC should be given a power to approve high level curricula and set and administer exams? Please give a reason for your answer.

No comment.

66. Do you agree or disagree with the transitional arrangements for PAs and AAs set out above? Please give a reason for your answer.

No comment.

67. Do you agree or disagree that PAs and AAs should be required to demonstrate that they remain fit to practise to maintain their registration? Please give a reason for your answer.

No comment.

68. Do you agree or disagree with the benefits identified in the table above? Please set out why you've selected your answer and any alternative benefits you consider to be relevant and any evidence to support your views.

No comment.

69. Do you agree or disagree with the costs identified in the table above? Please set out why you've chosen your answer and any alternative impacts you consider to be relevant and any evidence to support your views.

No comment.

Impact assessment and equalities impact assessment

70. Do you think any of the proposals in this consultation could impact (positively or negatively) on any persons with protected characteristics covered by the general equality duty that is set out in the Equality Act 2010, or by Section 75 of the Northern Ireland Act 1998?

• Yes - positively

• Yes - negatively

• No

• Don't know

Please provide further information to support your answer.

No comments.

Ends.

I hope the Department finds this feedback helpful.

Yours sincerely

Colum Conway

Chief Executive