The Law Commission report ('the report') recommends standardising the types of registration each regulator grants. This piece provides some of the background to the proposal for the new legal
The Law Commission report ('the report') recommends standardising the types of registration each regulator grants. This piece provides some of the background to the proposal for the new legal framework other than 'full' registration.
NB – the Law Commission bill was not included in the Queen's speech and is therefore unlikely to become law before the next election. The GMC has pledged to work with the government to make urgent amendments to the Medical Act to protect patients but the extent to which the reforms suggested by the Law Commission will be implemented is very much in question. We will keep this under review and provide updates in due course.
Temporary Registration:
Temporary registration enables regulators to register overseas practitioners who are coming to the UK to provide services for a short period of time. The GMC is currently accepting applications from medical professionals visiting the UK for a temporary period to provide particular medical services to teams at the Commonwealth Games. The HCPC records details of visiting European health and care professionals providing their services in the UK on occasional/temporary bases in line with the relevant EU directive. The ability to register specialists on a temporary basis will be retained by the GMC and could be extended to other regulators under the draft bill. It is noted in the report that this will be more appropriate for some regulators than others but does not consider it necessary to exclude specific professions.
Provisional Registration:
Provisional registration allows individuals to be registered while they complete the general professional training requirements. The initial consultation proposed that all regulators would be given powers to introduce provisional registration if they wish to do so.
A majority of the responses to the consultation supported the proposal. Others considered that additional safeguards should be put in place before introducing a system for provisional registration. As a result, the report proposes that provisional registration is to be in the hands of the Department of Health rather than the regulators and that any provisions should be tailored for professions as appropriate. Existing systems of provisional registration such as that of the GMC will continue to operate under transitional arrangements until the new regulations are made. The GMC is currently consulting on draft regulations which seek to impose a time limit for provisional registration of doctors to three years and 30 days, at which point registration will expire. These arrangements would be linked with proposals around student fitness to practise (to be covered in a future blog).
Conditional Registration:
Conditional registration allows a Registrant to work subject to certain conditions, such as a restriction on the type of practice or a requirement for them to undergo further training. Individuals can be registered with such conditions following findings of impaired fitness to practise. A failure by the professional to fulfil the requirements of conditions within a specified time or a breach of the conditions imposed may lead to further action being taken on their registration.
The GMC previously had a general system of conditional registration enabling them to impose certain conditions on the practice of international medical graduates but this was abolished in 2007. It was queried during the Consultation process whether the reference to conditional registration extended beyond fitness to practise cases. It was also highlighted that the General Chiropractic Council's and General Osteopathic Council's conditional registration schemes had been a convenient method of bringing experienced but not formally qualified practitioners onto the new statutory registers when the regulators were established, but were no longer in operation.
While the report considers that conditions should be limited to fitness to practise cases, it recommends that the government should have regulation-making powers to add further types of registration in such circumstances as it considers necessary.
Emergency Registration:
One of the recommendations in the report is that regulators should have power to register practitioners on a temporary basis if the Secretary of State advises that it is necessary to deal with an emergency. At present, some regulators are empowered to make certain temporary changes to the register in such circumstances which allows groups or individuals deemed fit, proper and suitably experienced to deal with emergencies such as the outbreak of a disease or a pandemic. Additionally, the GMC also has specific powers to register specialists on a temporary basis.
The majority agreed with the proposals relating to emergency registration, but it was felt that further clarification would be required on the meaning of an 'emergency' and how long temporary registration would last. Most of the legislation refers to the Civil Contingencies Act 2004 and the Law Commission intends to follow that approach. However, setting a specific duration for emergency registration was not considered appropriate and the draft Bill provides that the Registrar must revoke any changes when the Secretary of State advises that the emergency is over.
Requirements for Registration
The paper also considered the various requirements for registration [recommendations 34 and 35] which included having the appropriate qualifications, fitness to practise, adequate insurance/indemnity arrangements and payment of prescribed fees. The language checks for practitioners from overseas were also raised during the consultation as a crucial issue for clarification. The proposed provisions would allow for the registration of all 'exempt persons' with the responsibility placed on regulators to ensure that the individual has sufficient proficiency in terms of their English language skills before they are permitted to practise. This information may be recorded on part of the register or a supplementary register specifically for this purpose. The individuals would therefore be registered but unable to practise until the relevant checks or tests are completed successfully. The plans in relation to the GMC are to undertake checks relating to effective communication and language skills during the registration process and to withhold the licence to practise where any concerns are identified. Although the doctor would be registered they would be prevented from treating patients until the requirements are met.
NB – the Law Commission bill was not included in the Queen's speech and is therefore unlikely to become law before the next election. The GMC has pledged to work with the government to make urgent amendments to the Medical Act to protect patients but the extent to which the reforms suggested by the Law Commission will be implemented is very much in question. We will keep this under review and provide updates in due course.
Temporary Registration:
Temporary registration enables regulators to register overseas practitioners who are coming to the UK to provide services for a short period of time. The GMC is currently accepting applications from medical professionals visiting the UK for a temporary period to provide particular medical services to teams at the Commonwealth Games. The HCPC records details of visiting European health and care professionals providing their services in the UK on occasional/temporary bases in line with the relevant EU directive. The ability to register specialists on a temporary basis will be retained by the GMC and could be extended to other regulators under the draft bill. It is noted in the report that this will be more appropriate for some regulators than others but does not consider it necessary to exclude specific professions.
Provisional Registration:
Provisional registration allows individuals to be registered while they complete the general professional training requirements. The initial consultation proposed that all regulators would be given powers to introduce provisional registration if they wish to do so.
A majority of the responses to the consultation supported the proposal. Others considered that additional safeguards should be put in place before introducing a system for provisional registration. As a result, the report proposes that provisional registration is to be in the hands of the Department of Health rather than the regulators and that any provisions should be tailored for professions as appropriate. Existing systems of provisional registration such as that of the GMC will continue to operate under transitional arrangements until the new regulations are made. The GMC is currently consulting on draft regulations which seek to impose a time limit for provisional registration of doctors to three years and 30 days, at which point registration will expire. These arrangements would be linked with proposals around student fitness to practise (to be covered in a future blog).
Conditional Registration:
Conditional registration allows a Registrant to work subject to certain conditions, such as a restriction on the type of practice or a requirement for them to undergo further training. Individuals can be registered with such conditions following findings of impaired fitness to practise. A failure by the professional to fulfil the requirements of conditions within a specified time or a breach of the conditions imposed may lead to further action being taken on their registration.
The GMC previously had a general system of conditional registration enabling them to impose certain conditions on the practice of international medical graduates but this was abolished in 2007. It was queried during the Consultation process whether the reference to conditional registration extended beyond fitness to practise cases. It was also highlighted that the General Chiropractic Council's and General Osteopathic Council's conditional registration schemes had been a convenient method of bringing experienced but not formally qualified practitioners onto the new statutory registers when the regulators were established, but were no longer in operation.
While the report considers that conditions should be limited to fitness to practise cases, it recommends that the government should have regulation-making powers to add further types of registration in such circumstances as it considers necessary.
Emergency Registration:
One of the recommendations in the report is that regulators should have power to register practitioners on a temporary basis if the Secretary of State advises that it is necessary to deal with an emergency. At present, some regulators are empowered to make certain temporary changes to the register in such circumstances which allows groups or individuals deemed fit, proper and suitably experienced to deal with emergencies such as the outbreak of a disease or a pandemic. Additionally, the GMC also has specific powers to register specialists on a temporary basis.
The majority agreed with the proposals relating to emergency registration, but it was felt that further clarification would be required on the meaning of an 'emergency' and how long temporary registration would last. Most of the legislation refers to the Civil Contingencies Act 2004 and the Law Commission intends to follow that approach. However, setting a specific duration for emergency registration was not considered appropriate and the draft Bill provides that the Registrar must revoke any changes when the Secretary of State advises that the emergency is over.
Requirements for Registration
The paper also considered the various requirements for registration [recommendations 34 and 35] which included having the appropriate qualifications, fitness to practise, adequate insurance/indemnity arrangements and payment of prescribed fees. The language checks for practitioners from overseas were also raised during the consultation as a crucial issue for clarification. The proposed provisions would allow for the registration of all 'exempt persons' with the responsibility placed on regulators to ensure that the individual has sufficient proficiency in terms of their English language skills before they are permitted to practise. This information may be recorded on part of the register or a supplementary register specifically for this purpose. The individuals would therefore be registered but unable to practise until the relevant checks or tests are completed successfully. The plans in relation to the GMC are to undertake checks relating to effective communication and language skills during the registration process and to withhold the licence to practise where any concerns are identified. Although the doctor would be registered they would be prevented from treating patients until the requirements are met.