What is Professional Regulation and why do public health professionals need to be regulated?

Professional Regulation is necessary to protect the public from individuals whose practice is below the required standard (incompetent) or unethical.

The main purpose of the regulation of professionals, including public health professionals, is to “protect, promote and maintain the health and safety of the public”[i]. This is achieved by ensuring professionals are competent, sufficiently experienced and adhere to agreed standards of ethical practice.

 

What is the purpose of the UK Public Health Register?

Protecting and improving health and well being of our communities and ensuring access to good quality healthcare services are objectives that lie at the heart of Public Health.

The purpose of the UK Public Health Register is to provide public assurance for the provision of a competent workforce that contributes to a high quality public health service to deliver those objectives.

 

What is the UKPHR doing to protect the public?

In order to create and maintain a high quality public health service we need a public health workforce that is trained, self confident and professionally skilled. We seek to ensure that the skills they have are consistent across the entire regulated public health workforce.

To achieve this, the UKPHR is committed to

 

  • supporting employers in all sectors - health, local government, the voluntary and private sectors - to recruit and retain an appropriately regulated multi-disciplinary and multi-professional workforce able to address the complex demands and challenges of the public health needs in the 21st Century
  • ensuring that the skills and competencies of all of the regulated public health workforce are fit for purpose and appropriately regulated across all four countries of the UK
  • promoting and ensuring co-operation between regulatory and standard setting bodies to assure employers, commissioners of services and the public that the quality of public health practice is consistent across the breadth of the regulated public health workforce
  • ensuring that standards and training requirements are kept under regular review and updated as necessary
  • investigating complaints about the conduct or performance of any registrant, ensuring that action is taken against their continuing registration in the event of serious shortcomings being identified
  • ensuring robust procedures are in place for the implementation of professional revalidation, which are consistent among the relevant regulators

 

What is the difference between a ‘regulator’ and a professional body?

The difference between a regulator and professional body varies for different professions. These days it is usual to separate the regulatory function from the functions of a membership body that represents a profession. So, while it used to be common for professional bodies to have a regulatory function that is no longer the case. In Public Health, the two are separate and it is necessary to be registered with the regulator but not necessarily to be a member of a professional body, although the latter is considered to be good practice, since professional bodies often offer access to CPD and member networks.

In Public Health, for specialists, there are three regulators, the General Medical Council who regulate public health doctors, the General Dental Council who regulate public health dentists and the UKPHR who regulate the multidisciplinary workforce. However, there are also other regulators for public health practitioners, including the UKPHR, the Chartered Institute for Environmental Health and the Nursing and Midwifery Council.

While there may be a number of regulators for public health what is more  important is that the regulators work closely, together with the professional bodies, to ensure that there is consistency in both standards and practice across all professionals involved in delivering public health services in order to safeguard the public.

 

What is the difference between a voluntary and statutory regulator?

Regulation involves an independent regulatory body, with the aim of:

 

  • Maintaining a register of practitioners
  • Setting educational standards and supporting an independent accreditation system
  • Requiring professional competence among its registrants through a programme of continuing professional development
  • Publishing and enforcing codes of conduct, ethics and practice
  • Having in place a complaints mechanism for members of the public to employ
  • Having in place a fitness to practise procedure that is accessible to the public
  • Including lay representation on the executive council

However, the most important factor for effective regulation is that whoever employs the professionals or commissions their services takes the requirement to be regulated seriously and that they will only look to employ professionals who have demonstrated they have achieved the level of competency required to be on a register.   

The difference for statutory regulation is that the disciplinary procedures and sanctions of the regulator are underpinned by law. This means that if a professional is removed from the register it is illegal for them to continue to practise. A professional removed from a voluntary register would not appear on the register on enquiry and they may not practise where the employer requires its professional staff to be independently regulated.

 

Who is included within the Public Health Workforce?

In recent years the public health workforce has been identified within three groupings although this is currently the subject of a consultation by the Department of Health: 

 

  • Wider workforce:  people who have a role in health improvement, protecting health and wellbeing and reducing health inequalities but who would not necessarily regard themselves as part of the public health/health and wellbeing workforce, for instance, teachers, youth workers, leisure services personnel.
  • Practitioners:  people who spend a major part or all of their time in public health practice.  They are likely to work in multi-professional teams and include people that work with groups and communities as well as with individuals, for instance, Smoking Cessation Advisors. Some of this group may be involved in project delivery.  At a more senior level, they will be providing management and leadership across different organisations.
  • Public health specialists:  this group includes consultants and specialists who work at a strategic level and very senior level.  They will have technical skills, for instance in epidemiology, statistics, environmental health or immunology and be prepared to lead public health action and to support communities to engage with health protection and improvement. , and with health and social care services improvement.

 

What is the difference between a generalist specialist and a defined specialist?

 The UKPHR views the two categories of specialist registration, defined and generalist, as equivalent. Defined specialist registration responds to the need of employers for specialists with a higher level of expertise in particular areas of public health, such as health protection, health improvement or public health information, amongst others.  Defined specialists work at the same very senior level as general specialists.

The UKPHR requires that generalists and defined registrants have exactly the same knowledge base.  Generalists and defined specialist also are required to have the same skills across all the core areas of public health: surveillance and assessment of the population’s health and well-being; assessing the evidence of effectiveness of health and healthcare programmes and services; policy and strategy development and implementation; and leadership and collaborative working for health.

In addition defined registrants must demonstrate high level skills (at a higher level than general specialists) in specific areas of public health.  In these areas, the depth of expertise required for defined registration balances the breadth of general registration. Higher level competence is assessed against a set of criteria which, in essence, require specialists to demonstrate either (or a combination of):

 

  • Providing and being recognised for highly specialised expert advice and professional support to others, reflecting advanced theoretical and practical knowledge
  • Undertaking specialised work in organisationally complex and uncertain environments, with a wide reach, requiring a high degree of independent responsibility for decision-making and partnership working

The overall equivalence between general and defined registrants helps to support a flexible and widely competent workforce at specialist level

[i] This is referred to as the Public Protection Duty. The purpose of regulation of professionals is currently being consulted on as part of the Law Commission review of the regulation of healthcare professionals found at http://lawcommission.justice.gov.uk/areas/Healthcare_professions.htm. The Consultation is seeking to expand the purpose of regulation to include the public protection duty  and also  a duty to maintain professional reputation and ensuring proper standards are applied for safe and effective practice.