“We’ll walk readers through the FtP process”

1. Since joining the GOC, I’ve spoken to various groups, including registrants, professional bodies, education providers and witnesses, about their experience of fitness to practise (FtP).

Not much of what I heard was positive. One of the main takeaways from these conversations was that registrants were fearful of the FtP process and consequentially of us as their regulator, so it was clear that we needed to increase awareness of what we do and why we do it. We wanted to make sure we could reach all of our registrants, and that’s how FtP Focus – a learning bulletin published quarterly by the GOC – was born.

From reading FtP Focus, I hope registrants get a clearer understanding of the FtP function and how it fits into our broader role of protecting the public and upholding standards. We’ll walk readers through the FtP process and introduce the various components that come together to ensure that our regulatory function is fulfilled.

2. Our first edition focuses on triage.

This is where we determine if the initial concern could raise an FtP matter. We’ve included three case studies to give registrants an idea of the concerns we receive and the approach we’ve taken in deciding whether to progress the matter to an FtP investigation. We’ve also included reflection points and the relevant standards and CET to help registrants improve their practice and minimise any risks to the public, as well as an introduction to the Optical Consumer Complaints Service, our independent mediation provider.

3. Registrants worry about the punishing nature of the FtP process, and the time it takes to investigate.

I’ve heard this a lot and we’ll be addressing this over the next few editions as we share the work we’re doing to improve our timeliness. One of our biggest challenges was the volume of cases that we were investigating at any one time. It’s important that only the most serious concerns that could have an impact on the health or wellbeing of the public reach the investigation stage. That hasn’t always been the case due to the prescriptive nature of our legislation.

The introduction of our revised acceptance criteria and enhanced triage process in 2019 has helped us filter out concerns that could be better addressed through mediation, for example. As a result, we’ve reduced our caseload by over 40% since August 2019 and have enabled our investigation teams to work more quickly through their cases. We recognise the emotional impact that an investigation can have on parties and are committed to reducing the time it takes us to progress these matters. I hope readers will recognise the steady improvements that are being made.

Registrants were fearful of the FtP process and consequentially of us as their regulator

4. We have been looking at the differential impact of FtP on BAME registrants.

Our volumes at the GOC are quite low to draw any firm inferences from, but we are aware that this variance cuts across many of the healthcare regulators. A group of us are currently working through some options on commissioning some cross-regulatory research to give each of us greater quantitative datasets that we may be able to drill down some local qualitative data from.

We have a quarterly decision review group, attended by an independent FtP representative from another healthcare regulator, to review referred outcomes where concerns such as these may be raised and consider if any lessons can be learned.

Additionally, we commission an annual independent audit of our decisions to determine if we can draw any specific impacts from here and I’m pleased to say that this has not yet indicated any bias in decision making throughout the process.

We have also very recently appointed an Equality, Diversity and Inclusion partner who is currently researching specialised courses on bias awareness that we can include as part of our annual training programme.

5. There are other FtP topics we hope to tackle in 2021.

As well as walking registrants through the end-to-end process, we’re planning a student edition – we are unique across the statutory healthcare regulators in our registration of students and we think there would be a benefit in addressing that fear factor from the earliest stage. We’re also considering doing an inter-regulatory edition to show how similar FtP is across healthcare, as well as sharing some of the positive aspects of what it has achieved.

We aim to publish FtP Focus each quarter, with the next edition focussing on the investigation stage. This is due out in early 2021 and will be followed by editions on our case examiner function and our hearings and fitness to practise committees.

We’re very much open to feedback and suggestions on what registrants want to know more about

6. We hope that by educating registrants about the FtP function they will become less fearful.

Obviously, we want as many people as possible to read FtP Focus, and hope that registrants might take a little something from each edition that they can then use to improve their practice and the service they provide to their customers.

We’re very much open to feedback and suggestions on what registrants want to know more about, so please feel free to email us with your thoughts.

• As told to Lucy Miller.