Patients are right to expect high risk procedures to be performed by regulated professionals

Guest blog by Amanda Casey, Chair of the Registration Council for Clinical Physiologists

Imagine I told you that you needed to go into hospital for a heart bypass. You’d know instinctively it was major operation, with considerable risks. But no doubt you’d be reassured by the fact that thousands of such procedures take place every year, that a majority of patients make full recoveries, and that you were in the safe hands of qualified and regulated healthcare professionals.

Now imagine I told you the doctors and nurses performing the operation were unregulated. At the very least, your confidence would be shaken. Most likely, you’d be angered and fearful – questioning the ability of the people in whose hands you’re putting your life.

That scenario wouldn’t happen. But tens if not hundreds of thousands of highly sensitive investigations and procedures are performed on patients each year by unregulated practitioners. Yet patients have the same expectations as if they were undergoing a heart bypass. Namely that they’re putting their health in the hands of professionals subject to rigorous regulation and scrutiny.

A recent poll by ComRes, which was commissioned by The Whitehouse Consultancy on behalf of the , found that 81 percent of Britons expect assessments to support the diagnosis of neurological disorders such as strokes and epilepsy to be performed by regulated practitioners. Nearly 80 percent expected pacemaker assessments to be undertaken by staff subject to statutory regulation. And three quarters assumed heart ultrasounds were performed by professionals overseen by an organisation with similar powers to the British Medical Authority.

It’s perfectly reasonable to expect these types of procedures and investigations to be undertaken by staff who can be disciplined or even struck off by a regulator if they do something wrong. Yet, despite whatever the public might think, these and many other interventions are performed by practitioners who are at best subject to only voluntary registration.

There is a fundamental difference. A statutory regulator like the British Medical Association or Health and Care Professions Council can investigate errors and take action to ensure they don’t happen again. That might mean sanctioning or striking off an incompetent practitioner. Quite simply, it confers a far greater level of accountability and ensures the processes are in place to weed out incompetent practitioners.

Voluntary registers have no such powers. They have limited powers, can’t compel practitioners to report incidents or give evidence, and can’t issue sanctions when necessary. Their registrants aren’t even subject to the Government’s much heralded ‘duty of candour’. The result is far less accountability and ability to prevent incompetent practitioners continuing to work with patients.

That’s not to suggest all unregulated disciplines should be regulated, or that standards amongst the majority of practitioners are not extremely high. But there is a need for some professions to be regulated. Clinical physiologists are amongst them. And without regulation we’ve seen examples of patients dying as a result of poor practice, but the individual responsible being able to continue working.

There is an imperative for action, and unless this glaring deficiency is rectified, patients will continue to be put at needless risk. The Government has been reluctant to regulate the unregulated, but in the case of clinical physiologists ministers can and must make an exception. The public clearly expects it, and the NHS and patients will benefit from it.

After all, it’s not unreasonable to expect the person checking your pacemaker is working, is regulated.