Response to the Professional Standards Authority's consultation on its new 3-year strategic plan

23 February 2023

Dear Alan,

We welcome the opportunity to comment on the Professional Standards Authority’s new three-year strategic plan.

I hope the Authority finds this feedback helpful.

Yours sincerely,

Colum Conway

Chief Executive

Consultation feedback

General

Question 1: How would you describe your organisation (or your own role if more relevant)?

Health or care statutory regulator

Question 2: Please provide the name of your organisation.

Social Work England

Question 3: Are you content for us to use your comments in any published reports? If so, are you happy for us to include your name and, if relevant, your organisation?

Yes

The context for the strategy

Question 4: Are there any factors we should consider in addition to those we have identified in the strategic plan that will affect the regulatory landscape in the next three years?

We think there are, and are likely to be further, factors that affect only social work regulation or present challenges for us that are distinct from those facing the other regulators. The policy landscape is very different for us than it is for the other health and care regulators. We are sponsored by the Department for Education. However, our responsibility for adult social care, which makes up a third of our registrants and includes our two existing advanced practice annotations (mental health and mental capacity), is held by the Department for Health and Social Care. Policy developments can therefore affect us differently, and we have recently seen a number of major reports (the Independent review of children’s social care, the House of Lords adult social care committee report A gloriously ordinary life, and others) which have substantially more impact on us than on any other professional regulator.

We also urge the Authority to be mindful of contextual factors for all the health and care regulators. For instance, we are identifying that the severe financial, time and resource pressures confronting all public services—both social work but also health, police, probation and courts services—can make it difficult for us to acquire the necessary evidence to progress fitness to practise investigations. This is beyond the remit or control of the regulator but presents a challenge to effective regulation.

Question 5: Which of the four themes in Safer Care for All do you think are most important for us to focus on? [tackling inequalities; regulating for new risks; facing up to the workforce crisis; and accountability, fear and public safety]

Our view is that the order of priority should be:

1. Tackling inequalities
2. Facing up to the workforce crisis
3. Accountability, fear and public safety
4. Regulating for new risks.

This order is, for us, a reflection of two things: firstly, that equality, diversity and inclusion should not be a separate priority but must run through all regulatory activity, including the other three priorities in this list; and secondly, the present economic and social climate makes tackling the severe workforce challenges the prime concern among the others. We would welcome the Authority setting out with regulators the role that regulation can play in relation to workforce issues in light of this; the seriousness of these challenges presents a risk to standards across all sectors, and regulators are engaged as one of the parties who hold responsibility for finding, sharing in, and supporting solutions.

Question 6: Are there any recommendations and commitments in Safer Care for All that you think we should prioritise for action? Please indicate which you think are the top three priorities for us and others to work on in the immediate term.

Broadly, those commitments and recommendations that relate to workforce or bias should be prioritised (2 to 6 in particular). However, we do have a concern around how recommendation 11 (and, to a lesser extent, 13) would affect us. While most of the other regulators hold a UK-wide remit, we do not. Further to this, social care is a devolved matter and each UK government therefore works alongside its own care regulator. In social care, even registration arrangements are different across the constituent countries. In relation to social care, therefore, this recommendation is unlikely to be workable and we hope the Authority will be explicit in recognising this and determining how we can engage with the underlying policy objectives in recognition of this practical difference in relation to our sector.

Question 7: Are there other activities not included in the draft Strategic Plan that you think the Authority should prioritise in the period 2023 to 26?

We think there is space for innovation and creativity in regulation (regulatory sandboxes), but would welcome the Authority recognising that regulators can and should take the lead in identifying new ways of meeting our regulatory objectives and statutory duties, where possible and appropriate. As mentioned above, we would welcome recognition of, and help to consider and address, the issues around gathering information and working with third parties in relation to evidence in order to ensure efficient and effective regulatory processes.

The vision and mission

Question 8: Do you agree that our vision (safer care for all through high standards of competence and conduct in health and social care professionals) is appropriate for the work of the Authority?

Yes, we feel that the vision and the mission are appropriate for the Authority and are able to sit above the other commitments and directions set out in the rest of this strategic plan coherently. They reflect the rest of the strategy but also allow for regulators to have the space and authority to exercise their own judgement and expertise in developing regulatory solutions relevant to their respective sectors, identifying and responding to the differences and similarities between us as we work.

Question 9: Do you agree that our mission (to protect patients, service users and the public by improving the regulation and registration of health and social care professionals) is appropriate for the work of the Authority?

Please see our response to question 8.

The strategic aims

Question 10: Do you agree with our proposed Strategic Aim 1: To protect the public by delivering highly effective oversight of regulation and registration; and how we plan to deliver this aim and monitor progress?

Yes, this aim seems reasonable.

Question 11: Do you agree with our proposed Strategic Aim 2: To make regulation and registration better and fairer; and how we plan to deliver this aim and monitor progress?

Some of the specific points sitting beneath this strategic aim have the potential to increase work for the regulators (1.11 and 1.12 in particular). We would need to be clear what plans there are for us in these areas, and the consequences, before we are able to support any new obligations or requirements being placed on us and our performance.

We have some related queries around the relationship between some of the outcomes and indicators that sit beneath Standard 3 in the Authority’s draft evidence matrix. We encourage the Authority to give greater detail about how specific outcomes and indicators contribute to the achievement of individual standards and, ultimately, strategic aims, since this is not always explicit. Without clarity about this relationship, there is an inherent risk of driving activity that fails to support the overall standard. We are also mindful that, across all professions but for social work in particular, impact can take a long time to become apparent; expectations must allow for the different sector landscape confronting each regulator, and the maturity and resource of each regulator in being able to generate, collect, analyse and act on relevant data.

We will be submitting detailed feedback on the proposed evidence matrix for Standard 3 separately, but these general points relate to the queries we raise elsewhere in this response.

Question 12: Do you agree with our proposed Strategic Aim 3: To promote and support safer care for all; and how we plan to deliver this aim and monitor progress?

We encourage the Authority to think broadly about its remit beyond performance monitoring and review, and we think this (and the other strategic aims) allows space to do that. We would encourage the Authority to explore ways of facilitating the regulators to consolidate, develop and share excellence in our regulatory practice.

However, we are not sure Health and Social Care Commissioners would be the most effective mechanism. Because of its particular regulatory history, the landscape for social work is already complex, and there are a number of professional and system regulatory bodies, a children’s commissioner, patient safety commissioner and various stakeholder and patient representative bodies that already have a stake in this. Any move towards introducing a Health and Social Care Commissioner must have at its heart a mission to simplify and streamline this complexity in order to create the right incentives.

We would also welcome further clarity on what the Authority envisions by regulatory strategies that support national workforce strategies. For example, who would be involved in this work (regulators, employers, training providers), and how would they fit together to create a strategic approach in what is, for us, a particularly complex landscape, notwithstanding the workforce and resource challenges currently facing all the regulated workforces.

The Authority's future role

Question 13: How do you think the role of the Authority should evolve in the future, particularly in the context of the reform of professional regulation in health and social care?

We hope that the Authority will feel increasingly empowered to set out for government, the sectors we regulate and more generally how regulation is a helpful, supportive and essential tool for driving the kind of improvement that people want to see across the regulated professions. At a time of ongoing challenges at all levels of the public sphere, we are keen for the Authority to be bold in making the case for professional regulation.

Impact

Question 14: Please set out any impacts that the proposals set out in the draft Strategic Plan would be likely to have on you and/or your organisation, or considerations that we should take into account when assessing the impact of the proposals.

Again, we would hope that the Authority would recognise the uniqueness of our position – in the context and environment in which we regulate, in our position as a non-departmental public body, and in the stage of organisational establishment that we are at. At only three years old we do not yet, for instance, have any pre-pandemic performance to use as a benchmark for future evaluation. Another feature of our sector that other regulators may not face is the dearth of consistent data across the whole of our workforce; one of our distinctive challenges is building a data landscape effectively from scratch, including EDI data.

Question 15: Are there any aspects of these proposals that you feel could result in differential treatment of, or impact on, groups or individuals based on the following characteristics as defined under the Equality Act 2010?

Not as they stand. However, as the Authority gives more detail around specific functions, requirements or expectations then we may find that particular impacts might arise.