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Government unveils plans to reform the regulation of health and social care professionals

The health professions in the UK are currently regulated in law by nine different regulatory bodies, including the General Medical Council, the General Dental Council and the Health Professions Council. In addition to this, four care councils separately regulate social workers and social work students in all four parts of the UK.

The regulatory bodies have a statutory duty to protect the public by setting standards of education, training, conduct and ethics. The bodies are responsible for maintaining a register of those professionals who demonstrate that they meet the required standards. They also investigate concerns about registered professionals and take appropriate action against those individuals who might propose a risk to the public. This system therefore ensures high standards of practice and reassures the public that qualified, properly vetted professionals provide their health and social care needs.

However, the coalition government has recognised that the regulatory system is becoming increasingly expensive. It is estimated that the combined cost of the health professions regulatory bodies and the General Social Care Council exceeds £200 million per year, [1] the direct cost of which falls largely on the registrants themselves through the annual retention fees that they pay for their registration. The government believes that regulation is also becoming increasingly complex.

There is often a duplication of effort from local systems of management and clinical governance and regulatory oversight, which carries a risk of confusion about who is responsible for addressing concerns about poor practice.

The government has therefore set out its proposals for a more balanced, proportionate and effective approach to regulation in its Command Paper, “Enabling Excellence – Autonomy and Accountability for Healthcare Workers, Social Workers and Social Care Workers.” Their proposals for reform include the following:

1. Reducing the cost of regulation

  • The government proposes to commission the Council for Healthcare Regulatory Excellence (CHRE) to lead a sector wide review of the costefficiency and effectiveness of each regulator within its remit, with a view to identifying significant cost savings.
  • The government also intends to discourage the health professions regulators from taking on any new responsibilities or roles which would add to the costs of their existing registrants. This is in light of the fact that health and social work professionals are currently facing pay constraints.

2. Increasing independence and accountability

  • At present, the regulators remain dependent on government and Parliament to update their legislative framework, to enable them to adapt to changing circumstances and effectively fulfil their statutory obligations to protect the public.
  • The government has therefore commissioned a simplification review of the legislative framework for professional regulation, with a view to giving greater autonomy to the regulatory bodies to decide how best to meet their statutory duties. It is the government’s intention to create a single Act of Parliament for the regulatory bodies, to reduce the number of complex pieces of legislation. The Law Commission will be conducting this review.
  • An increase in the autonomy of regulated bodies would need to be balanced by a commensurate strengthening of their public and parliamentary accountability for their performance. The government is therefore exploring what formal mechanisms might be established to enable Parliament to hold the regulators to account.

3. Assured voluntary registration

  • The government recognises that a more flexible system is needed to enable employers to assure themselves that prospective employees have met adequate standards of training and competence and to enable individual members of the public who seek care directly from unregulated self-employed professionals to assure themselves about their standards.
  • The government therefore proposes to introduce a system of assured voluntary registration for professionals and occupational groups that are not currently subject to statutory professional regulation. The CHRE will provide strategic oversight and responsibility for the development of a coherent and cost-effective system of registers.
  • The government intends to incentivise employers to use workers on the voluntary register, and in due course local authority commissioners could also give preference to providers using workers on the voluntary registers.

The government’s Command Paper can be viewed in full at:

[1] See Annex A of “Enabling Excellence – Autonomy and Accountability for Healthcare Workers, Social Workers and Social Care Workers” – Government Command Paper


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