In an effort to hire more professionals to manage the COVID-19 pandemic, the UK government has asked a number of regulators in the health and care sector to recall professionals who had previously left the profession and come off their registers.
The General Medical Council (GMC), Nursing and Midwifery Council (NMC), Health and Care Professions Council (HCPC) and General Pharmaceutical Council (GPhC) have all initiated schemes in an effort to reintroduce ex-registrants into the workforce. The full details of the schemes are provided on the respective websites of the regulators. Broadly, the regulators are allowing professionals who have come off their registers in the past three years, with no fitness to practise concerns or outstanding complaints, to have temporary registration for the duration of the crisis.
Revalidation is an important facet of professionals maintaining compliance with regulation, as it ensures their knowledge and skills are up to date and that they are working to required standards.
Notably, the regulators confirm that professionals who return will not have to participate in revalidation during their temporary registration. Professionals re-entering the workforce will be given induction training and supervision as appropriate.
Professionals may be incentivised to return if they are not subject to the usual appraisal and revalidation mechanisms. The measures also reflect the temporary nature of the work, if the returning professionals are only registered for a few months there may be less of a requirement for appraisals and revalidation.
Complaints and Concerns
Some of the regulators have also stated that, where complaints are raised against professionals on the temporary register, they will not be subjected to the same regulatory processes that professionals registered and active before the crisis (‘pre-crisis registrants’) are subjected to.
The NMC have said that “[if] a concern is raised about a nurse or a midwife while on the temporary register these would not be dealt with by way of any Fitness to Practise proceedings…where there [are] justifiable concerns the NMC Registrar have the power to remove you from the temporary register.”
The HCPC have said that “[if] a concern is raised about a registrant on the COVID-19 temporary register(s), which meets our Triage test as explained in our Threshold Policy, we will remove them from the COVID-19 temporary register(s) with immediate effect”. As outlined in their Threshold Policy, the ‘triage’ test is “a simple assessment as to whether a concern is within [the HCPC’s] remit to deal with” and is “necessarily a low bar”.
In combination, the measures of not requiring revalidation from temporary registrants and more readily removing them from the register without the usual process of thorough investigation of complaints seems to create a space of less regulation and administration. The relaxing of usual regulatory processes in relation to the returning professionals could be justified by their temporary status and prioritising the need for a larger workforce to deal with the crisis. The temporary registrants will not have to comply with the same revalidation requirements, but also could be removed from the temporary registers more easily when complaints are raised, meaning fewer resources are spent holding fitness to practise proceedings.
However, the COVID-19 crisis has no clear end in sight and its duration is indefinite. If the crisis continues for a prolonged period, a situation may develop where temporary registrants and pre-crisis registrants are regulated differently despite doing similar day-to-day work. Issues may arise where pre-crisis registrants have to comply with revalidation requirements when temporary registrant counterparts are not subject to as stringent supervision.
Further, temporary registrants may become entrenched in their employment assisting the crisis, many professionals may have had to quit previous jobs to return to the health and care workforce. In these circumstances, removing them from the temporary register without complaints being investigated as thoroughly would be a devastating blow financially and emotionally and could be unjust.
The crisis presents a near unprecedented challenge to institutions nationally and globally, which includes regulators in the health and care sector. As the situation develops, regulators may have to continue to adjust their practices to ensure all registrants are treated fairly and justly, and public confidence in both the regulators and the professionals is maintained.