What is important to you about being regulated?
05.04.23
In March we highlighted that the DHSC was seeking views on regulating physician associates (PAs) and anaesthesia associates (AAs), and that the new legal framework would set the scene for the reform of the other regulated healthcare professions – including chiropractors.
We are continuing to develop our formal response to the consultation and, while we hope you will consider submitting your views as well, we are committed to understanding and reflecting the views of chiropractors in our formal response.
Broadly, the new legislation seeks to standardise how healthcare is regulated in the UK, and the reform will cover the key areas of regulation:
- education and training
- registration
- fitness to practise
As we review the legislation and the consultation, a number of themes have emerged for us, which we are keen to understand your views on.
Please complete our five minute consultation survey or read on to consider the themes in more detail.
Achieving the best outcomes for patients and chiropractors in Fitness to Practise cases
The GCC has a legal duty to investigate every complaint received and take every complaint to an investigating committee. There is no discretion over the investigation, and the resulting process is, by necessity, often adversarial, lengthy and involved – with complainants disengaging and registrants complaining it is stressful and bureaucratic.
Our primary purpose as regulator is to protect patients, and to that end we have permanently removed a small number of unsafe individuals from the register; and suspended or sanctioned others. But in many cases, patient safety could be better served by a different approach.
The proposed legislation could give regulators discretion over how the Fitness to Practise process is run, but equally patients and others might be concerned that their complaints may not be heard.
- How important to the safety of patients do you consider the current Fitness to Practise (FtP) process to be?
- How important to the safety of patients do you consider it is for the regulator to have discretion within the Fitness to Practise process?
- Do you have any other comments on reform of the Fitness to Practice process?
Statutory Regulation
The GCC is one of the 10 statutory health and care regulators in the UK, overseeing 32 (soon to be 34 with PAs and AAs) healthcare professions. If you want to practise as a chiropractor in the UK, Isle of Man or Gibraltar you have to be registered with the GCC – and if someone calls themselves a chiropractor without being registered with us they are breaking the law.
In contrast some other healthcare professions are voluntarily regulated not statutorily regulated – while acupuncturists are encouraged to register voluntarily with the British Acupuncture Council (BAcC), anyone can practise as an acupuncturist without any training or experience (though they may be subject to regional legislation).
- How important is it to you that you belong to a statutorily regulated profession?
- Any other comments on whether statutory regulation of chiropractors should continue?
The Annual Registration Fee
The annual regulation fee covers the costs of running the register, inspecting and overseeing education standards and investigating the complaints in the fitness to practise process. The annual retention fees were last set around five years ago (when they were reduced from £1250 to £800) and they have not increased since (nor do we have any ambition to despite the increase in costs we all see).
The rules that govern the General Chiropractic Council do not allow us to offer pro-rata fees. This means that applicants must pay the full fee before joining, transferring, rejoining or retaining their name on the register. This also means we are unable to offer payment plans (e.g. direct debit) for the current year – though registrants are able to pay for the following year in advance installments.
The fact we cannot offer pro-rata fees is of concern to some registrants – in particular part-time chiropractors, those taking a short career break or new graduates. It is something we can do little about as the fee structure form part of our rules which we have been unable to change as it requires government support.
- How important is it to you that your regulator has flexibility over setting of annual registration fees?
- Any other comments on the regulators ability to set fees and charges?
Sharing a regulator
Chiropractors are unusual in that they have a single regulator concentrating on their profession. Other regulators are responsible for many professions (the Health and Care Professions Council (HCPC) regulates 15 different professions) and while some people feel this could bring “economies of scale” and consistency across regulation, other people value the in-depth understanding and personal approach of a smaller regulator.
- How important is it to you that there is a regulator exclusively for chiropractors?
- Any other comments about whether there should be one or multiple healthcare regulators?
Developing the profession
Unlike many healthcare regulators, the GCC currently has a duty in law to develop as well as regulate the profession.
We do this by emphasising the importance of professionalism: setting The Code and Educational Standards for chiropractors to meet, by creating guidance, backed up with toolkits and resources for the profession and by ensuring registrants are demonstrating lifelong learning through continuous professional development.
- How important is it to you to have a regulator responsible for promoting professionalism within chiropractic?
- Any other comments about the role of a future chiropractic regulator?