On Thursday 23rd November, Jennie Jones presented at the Westminster Health Forum on regulatory reform in healthcare. Throughout the morning the speakers shared their perspective on the failings and harm caused by the current regulatory system. Record numbers of concerns bringing patients and healthcare professionals into draconian and adversarial FTP processes that were designed at the time of Call the Midwife. With the reforms set out in the Healthcare Act coming over the horizon, we will first see change at the GMC and the regulation of Anaesthesia Associates & Physician Associates, and new statutory 3 state process with the ability to adopt and flex the detailed rules to meet the paramount need for public protection and the needs of the registrant population.
Agreeing with many colleagues at the Forum, critical requirements are consistency for multidisciplinary teams, compassionate and agile regulation to protect the public while also protecting fundamental rights of fairness & equality to retain good healthcare professionals in fast paced evolution of healthcare delivery.
As she shared at the Forum, our experience in working with the GOC delivering the OCCS complaint mediation service highlights another critical factor – the need to ensure the right concerns are handled in the right way. The GOC led the way in 2014 in identifying the potential impact of an effective yet proportionate resolution pathway for low level concerns which in turn has strengthened and increased the pace of screening/triage decisions. Following the remodelling of the initial assessment phase of FTP and the OCCS contributing to the implementation of Acceptance Criteria, by 2022 we have seen the proportion of enquiries leading to a formal investigation reducing from 68% to 24%. Alongside this, we see more than 20% of referrals to the GOC, being referred on to the OCCS in a clear but streamlined way.. The safety net of an ADR provider with the unique capability to identify potential FTP issues and monitoring ensures the right concerns enter the right ‘funnel’. The OCCS uses mediation techniques which involve looking for the win/win. This must be the focus and approach taken to progressing and inplementing regulatory reform. As was said throughout the forum discussion and presentations – if we keep doing what we have always done, we will get the same outcomes.
From our experience in optics, mediation has a key role to play not only in the initial assessment phase of FTP but also within the process . The other key role for mediation within regulation is qualitative insight to support upstreaming and supporting healthcare professionals to understand, meet and manage patient and societal expectations of the future. We are seeing unregulated areas of healthcare utilising mediation and resolution services to bring impartiality, compassion and proportionality and de-escalation into complaints and concerns. A plea from me is to ensure the reforms enable regulators to look at different approaches that meet the needs of their respective professions and areas of healthcare and deliver that win/win!