NHS Education for Scotland

Proportionate Regulation

Proportionate Regulation

The recognition of Advanced Nursing Practice as a separately registered title was in recent times a well debated and discussed topic with strong proponents on both sides of the debate. In 2009 the Council for Healthcare Regulatory Excellence (CHRE), now called the Professional Standards Authority, published their report Advanced Practice: Report to the four UK Health Departments and concluded that: "what is often called 'advanced practice' across many of the health professions does not make additional statutory regulation necessary."

Subsequently CHRE publications advocated strengthening the position for governance rather than increasing regulation.

In 2011 the command paper 'Enabling Excellence, Autonomy and Accountability for Healthcare Workers, Social Workers and Social Care Workers' was presented to the Westminster Parliament by the Secretary of State for Health (February, 2011).  This paper emphasises proportionate regulation for healthcare workers that is 'accountable, consistent, transparent and targeted.' It outlines the need to reduce the bureaucratic and cost burden of regulation while continuing to safeguard the public and maintain professional standards. Any future requests for statutory regulation of the healthcare professions will be subject to a robust business case on the grounds of risk. For groups of staff that are not currently regulated the paper proposed employers take local responsibility through governance processes.

Further developments by the Nursing and Midwifery Council (NMC) have focussed on systems of assurance utilising greater involvement of employers and peer reviewing of Nurses and Midwives through Revalidation. This endorses the view that good governance occurs closer to practice and that employer and professional supervision have a vital role to play in ensuring public safety.