LLB MA Solicitor Advocate
Specialist Regulation Lawyer and Partner
Veale Wasbrough Vizards
Yvonne has been advising private and public providers of health, social care and education services on regulatory law for more than 10 years. Much of this work includes preparing care homes and independent schools for inspection to ensure they not only comply with national minimum standards, but are able to demonstrate best practice in order to excel in their inspection ratings. Yvonne has a masters degree in human rights law and, as a higher court advocate, has appeared before the High Court and Court of Appeal in cases dealing with regulatory challenges
Consultant Solicitor and Chartered Arbitrator
Veale Wasbrough Lawyers
Derek has a particular interest in the primary healthcare sector, acting for over 250 GP and dental practices throughout the south and western regions of England and Wales over a period of 20 years
The background to the new regulatory framework began with Sir Liam Donaldson's post-Shipman report Good doctors, safer patients.(1) Sir Liam made no less than 44 recommendations, many of which are being introduced at the same time the Care Quality Commission (CQC) is extending the range of its regulatory powers to cover GP/dental practices from April 2012.
It is salutary to note that, even as late as 2001, the General Medical Council (GMC) was saying that it was "unthinkable" that there should ever be "any alternative to professionally led regulation".(2) As in the case of other professions (eg, solicitors), however, the argument that professions should regulate themselves has, as a result of public pressure, reached the point when it is no longer sustainable.
The precursor to regulation by the CQC is the Commissioners and Investments Asset Management Strategy (CIAMS) process. We call CIAMS the "Domesday Book", as it is intended to constitute a comprehensive record of all premises (together with a variety of information about the suitability, condition, quality, etc).
To us, this looks suspiciously like preparation for the CQC's work, in that the CQC will be able to search the CIAMS register to get a first view on how existing surgery premises comply with their requirements!
CIAMS is intended to provide a factual base for strategic evaluation of the primary care sector real estate, and it seems this is something practice-based commissioning (PBC) "clusters" should surely involve themselves with. A further "use" is that practices considering expansion of their surgery premises will have access to considerable detail about the number, sustainability and functionality of neighbouring surgery premises.
Alongside what may be termed "organisational" regulation, all GPs should have taken a Licence to Practise with effect from 16 November 2009. This is expressed to be the "first practical step towards introduction of revalidation".(3)
As far as revalidation is concerned, fresh consultation on the subject is going to take place in early 2010. At the same time, the Department of Health is issuing papers on "Clinical Governance", and the processes for complaints handling were formalised in regulations issued last year.(4)
Ten tips for good preparation
It is beyond the scope of this article to go into the detail of any of these regulations. In any event, much of the detail is yet to be finalised. From the general standpoint of dealing with "the regulators", we offer the following 10 top tips:
1. Department of Health. Good doctors, safer patients: proposals to strengthen the system to assure and improve the performance of doctors and to protect the safety of patients. London: DH; 2006. Available from: http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/Publicati...
2. See http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1120633/
3. Department of Health. Medical revalidation. Available from: http://www.dh.gov.uk/en/Managingyourorganisation/Workforce/Professionals...
4. For more information on the new complaints handling procedures in general practice, see: http://www.managementinpractice.com/
5. NHS Revalidation Support Team. Assuring the Quality of Medical Appraisal for Revalidation. May 2009. Available from: http://www.rcpsg.ac.uk/Education/Revalidation_CPD/Documents/Revalidation...
Care Quality Commission