Making sure our processes are fair

We regularly review our policies, guidance and processes to make sure they’re fair and consistent; and to seek out and mitigate any potential biases.

To do this we ask doctors, physician associates (PAs), anaesthesia associates (AAs), patients, and organisations who support them about their experiences with us. We also seek views from our staff and advice from external stakeholders. And we commission independent experts to recommend where improvements can be made. 

The summary below provides an overview on key areas of work.

Enabling more efficient, proportionate investigations and flexible decision making

We’ve updated our investigation plan guidance to better support colleagues carrying out investigations, improving its ability to support the individual complexities of each case.

We’ve given decision makers greater flexibility to reconsider decisions to refer a case to a tribunal if we receive new information that means a tribunal isn’t necessary. We’ve also amended our guidance to permit greater flexibility to cancel tribunal hearings if we assess that they’re no longer required.

We’ve updated our Guidance for decision makers in cases where violence and dishonesty may represent a lower risk to public protection (available on our How we make decisions page). The changes provide greater flexibility and discretion when assessing concerns, allowing decision makers to weigh all the circumstances to assesses the overall risk to public protection, including to public confidence and patient safety, earlier in the process. This means that cases can conclude at the earliest appropriate stage. 

When we instruct Counsel – the barristers who represent us at tribunal hearings – we ask them to advise us on the merits and strengths of a case or if they have any concerns. We also ask them to tell us if there’s enough evidence for a tribunal to decide if a doctor should receive a sanction, or not, before it proceeds any further. 

We’ve strengthened our process for drafting sanction submissions so that sufficient information is provided in all cases and kept under review as the case develops.

Enabling professional curiosity and continuous learning

We’ve introduced a set of escalation principles to enable a culture of professional curiosity, where colleagues feel they can challenge decisions or raise concerns about a case at the earliest opportunity. Our aim is to encourage more empowered teams, who understand the collective responsibility for fair outcomes. 

We’ve rolled out tailored equality, diversity, and inclusion learning for our staff, so it’s more specific to issues they might face in their job. We’re also expanding learning for decision makers, so they have a better understanding of how culture may impact a doctor’s communication, attitudes, and behaviours. This will help make sure that these factors are taken into account when investigating concerns.

We’ve commissioned external training for colleagues on best practice in writing up decisions.

We’re auditing our functions in a more regular and consistent way across the organisation. And we continue to ask for more feedback on our work from people who experience our processes.

Promoting a local first culture and fair employer referrals

Our Outreach team work across the four countries of the UK to improve understanding of our regulatory role and when fitness to practise action is necessary. They discuss concerns and help to address them at a local level, before anything is referred to us.

We regularly promote our guidance to support employers and responsible officers when they’re considering raising a concern with us. It explains that they must tell us:

• about all the steps they’ve taken to make sure referrals are fair and inclusive
• what impartial checks have been carried out and how they’ve considered systemic issues 
• what support they’ve provided locally to the doctor in question
• what induction international medical graduates have received, so they understand what’s expected if things go wrong.

We’ve updated our approach to investigations, so that we no longer open a case, where there’s an ongoing local investigation. Instead, we wait for the outcome of local processes before opening a case.

We’ve strengthened how we share information on the outcomes of investigations between our decision makers and Outreach teams. This is helping to build awareness and understanding with responsible officers and employers about what we can and can’t investigate.

We continue to work with partners to help make sure local investigation processes are fair and consistent. We’re capturing examples of good practice in local complaint handling; and we’re exploring how we can share these to encourage organisations to embed them in their own local processes. 

Being an effective, relevant and compassionate regulator

We’ve called on the UK government to reform the legislation that governs how we regulate doctors, so that we can take a more flexible approach to regulation and embed fairness across everything we do.

Reform will enable us to change our fitness to practise processes so they’re less adversarial and more efficient. It will also enable us be the effective, relevant, and compassionate regulator we want to be, for patients and all our registrants, in the years ahead.

Find out more about regulatory reform.