Exploring public views on the implementation of regulatory reform

Why did we commission this research? 

We commissioned this research alongside our consultation on the proposed rules, standards, and guidance for regulating physician associates (PAs) and anaesthesia associates (AAs). We knew that the consultation was, by necessity, detailed and complex and this could mean certain voices were less likely to be heard as part of the consultation process – specifically, patients and the public.

Therefore, this research explores the public’s views on the upcoming changes to the way in which doctors, PAs and AAs will be regulated. It also explored views on the introduction of regulation for PAs and AAs.

What did the research involve? 

The research involved focus groups and 1-1 interviews with 58 people from a broadly representative sample across the four countries of the UK. Because the consultation was technical and detailed, we used real-life scenarios to take participants through a registrant’s journey with us. Discussions covered several scenarios, including education, joining the register and what happens if a fitness to practise concern arises.

What were the key findings?

Participants broadly supported the proposed changes to how we regulate. The majority felt that the processes and procedures described had improved, appearing more efficient and less bureaucratic. Some raised concerns and suggestions about the proposals. Key findings include: 

1. Understanding of PAs and AAs

• Members of the public had low levels of awareness of PAs and AAs despite the information provided. But there was consensus across age groups that GMC regulation was appropriate, and these roles should be regulated similarly to doctors.  

2. Education

• Participants were generally positive towards the proposed approach to quality assuring education. They agreed that regular checks of both content and teaching were useful for early detection of issues.
• However, some questioned the GMC’s capacity to carry out checks of education providers in any depth. There were also some concerns about exam burden for students, additional admin work for universities and replication of higher education regulators’ work. 

3. Joining the register 

• On standardising checks on international applicants, participants considered this fair and felt this would contribute to greater confidence in those joining the registers from overseas. A minority of participants felt that those applying from certain countries should be subject to fewer checks where those countries have similar education systems to the UK. 

4. Leaving and rejoining the register 

• Groups generally agreed that registrants should be able to leave the registers quickly and efficiently, with support for streamlining this process. However, a small minority felt the proposed approach is less stringent. They highlighted how lower-level concerns from employers might be overlooked and a few perceived a risk of “bad apples” leaving unnoticed.
• Some recommended that the level of evidence needed to rejoin the register should depend on time spent away and what registrants were doing. 

5. Complaints and concerns 

• Most supported the proposed approaches in fitness to practise, viewing them as logical, fair, and progressive. Participants were positive that reforms would lead to concerns being resolved more quickly and with less stress for those involved in GMC investigations. However, a minority were sceptical about this being an internal process and felt that the GMC would tend to find in favour of registrants. 
• Some participants called for stronger punishments for the most serious cases. This was seen as integral to the GMC’s role and was part of being “fair” and providing “justice”. 

6. Challenging the GMC’s decisions 

• At first, the proposal for how people can request changes to GMC decisions was seen as fair and suitable. However, many participants grew critical after reviewing an example, perceiving a lack of impartiality and felt the GMC would favour registrants over patients.

Report

Download research: Exploring public views on the implementation of regulatory reform