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Appendix 3: Principles underpinning the 'Regulation of Healthcare Support Workers' project
Core principles
The wider approach towards the regulation of HCSWs reflects the five principles of good regulation set out by the UK government's Better Regulation Commission (formerly Better Regulation Task Force). These are outlined in 2.1.2 below.
These principles are considered relevant to the HCSW project in that regulatory effort, in areas reserved to Westminster, is required to reflect these principles. The 4-country steering group for the project has voluntarily signed up to these as part of the evidence base for good regulatory practice. They have been used therefore, in this project, as guiding principles.
- Transparency The existence of a centralised occupational register provides the transparency required by prospective employers and members of the public.
- Accountability The approach calls for clear employer and employee accountability in facilitating and maintaining defined standards.
- Targeting The project targets employees who are neither regulated nor subject to regulatory plans, yet who have direct contact with or who influence in other ways the patient's outcomes. 9
- Consistency Consistency in the application of standards is a feature of the approach. Identified inconsistencies in current arrangements was a key reason behind the decision to pursue nationally negotiated standards that could be applied throughout Scotland across all sectors, the achievement of which could be captured in a centralised, independently maintained register.
- Proportionality The approach of employer-led or service-led regulation reflects the role and accountability of employers in applying staff governance and clinical governance standards. The approach therefore is proportionate to the risk associated with the employment of HCSWs and with the role/s carried out by this group of staff.
Principles identified by the National (Scotland) Group
In addition to the above, the National (Scotland) Group (see section 1.1) also defined principles which underpinned their preferred option. These reflected the need for:
- Action Acknowledging that stakeholders had opted overwhelmingly for some form of regulation.
- Public protection Finding a solution that protects the public.
- Fitness for practice Building on the development agenda for staff by promoting a positive approach to regulation that could enhance the quality of patient care, while acknowledging that threshold standards for healthcare support workers should relate to public protection and not to the continuing development standards necessarily required for more advanced roles.
- Partnership Articulating work on a UK-wide basis while not delaying progress in Scotland.
- Cost effectiveness Finding a cost-effective solution for employers and employees.
- Proportionality Balancing financial costs with the need for public protection in a way that is proportionate to the risks involved if there was no regulation.
- Accountability Building on existing governance arrangements and acknowledging the employer's role in regulation and the employee's role in achieving the necessary standards.
- Independence Making sure that, as part of a wider framework of employer-led regulation, any future register is held independently of local and regional employers and that any registration that takes place does so against nationally agreed standards.
These principles have also been used as guiding principles throughout the project.
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