Press Round-Up: Regulatory and Professional Discipline April 2019 - May 2019

Care Quality Commission

• The CQC recently downgraded the Royal Free London NHS Trust’s rating from ‘good’ to ‘requires improvement’.  It also reduced the surgical safety rating in three of the Trust’s hospitals, the Royal Free, Barnet General and Chase Farm. 
  
  The recent downgrade in rating for the Royal Free NHS Trust follows from the inspection the CQC carried out between December 2018 and January 2019. The CQC rated effective, caring and well-led components as good, and responsive and safe as requires improvement. Six of the twelve services inspected were rated as requires improvement.  Detailed findings were published in the CQC inspection report on 10 May 2019.
  
  The CQC inspectors found that some of the issues identified during their previous inspection had not yet been addressed, specifically with regards to the responsiveness and safety of the services.  They also concluded that staff did not consistently follow best practice when describing, giving, recording and storing medicines. Further, services did not always have sufficient numbers of staff with the right mix of skills and qualifications to keep the Trust’s patients safe and to provide the right care. Interestingly, the CQC also identified a culture of bullying within the operating theatres of the Trust which it had not effectively addressed thereby leading to a “very hierarchical working environment”.
• The CQC has commissioned an independent review into how it dealt with concerns raised in relation to the regulation of Whorlton Hall, featured recently in the Panorama documentary exposing abuse of vulnerable people. The review will focus on concerns raised in the CQC draft report from 2015 and how they were addresses by the CQC. The regulator is also commissioning a wider review into regulation of Whorlton Hall between 2015 and 2019.
• On 2 April 2019, the CQC and the Healthcare Safety Investigation Branch (HSIB) published a new Memorandum of Understanding (MoU) agreement.  The agreement confirms that the CQC and the HSIB will share information about the safety and quality of NHS services and evidence of safety risks or emerging themes that may indicate wider safety issues.

Solicitors Regulation Authority

• The SRA conducted a review of how solicitors offer conveyance services, how transparent they are about costs, and whether they are doing enough to make sure buyers understand their potential contractual obligations. The “Residential Conveyancing Thematic Review" found that most solicitors were doing what they should, but it also identified a number of concerns. These included not quoting clients for additional work, which should have been reasonably anticipated at the outset, failing to be transparent about the mark-ups they added to the fee a bank charged for making a telegraphic transfer, and a lack of explanation in respect of the long-term implications of complex contractual clauses. As a result of the review, six law firms were referred to the SRA’s internal disciplinary process.
• The SRA’s thematic review of trust and company service providers has shown that a some firms are not doing enough to prevent money laundering, with some falling seriously short. The report found that the main area of concern was firms’ risk assessment. Further issues related to the lack of appropriate customer due diligence. As a result of the review, 26 firms were put through he SRA’s disciplinary process and published a number of warning notices.

Nursing & Midwifery Council

• The Professional Standards Authority (PSA) published its review of the NMC’s performance for 2017/2018.  The report noted that the NMC has done significant work around its review of education and training and that in respect of fitness to practise, it has made progress to address concerns around how it communicates with families and patients. The report raised concerns about how the NMC handled complaints about registrants who have conducted Personal Independence Payment (PIP) assessments. Additionally, the PSA highlighted some concerns around how the NMC fails to systematically consider all the concerns raised by complainants, instead relying on the views of employers as reasons to close cases without proper scrutiny. The NMC’s response to the report is available here.

Health and Care Professions Council

• The HCPC has welcomed guidance on the role of expert witnesses published by the Academy of Medical Royal Colleges (AMRC) on 16 May 2019. The guidance comes in response to recommendations in the Williams Review published in June 2018. It seeks to underline the important responsibilities of acting as an expert witness.

General Optical Council

• The GOC published its new Standards for Optical Businesses, which will come into effect on 1 October 2019.The Standards will replace the current Code of Conduct for Businesses and are said to set out the GOC’s expectations of businesses more clearly. 

General Chiropractic Council

• The GCC published its annual report on fitness to practice for 2018. The report found that the most common complaints related to substandard treatment, and other allegations included rough treatment causing injury, concerns about techniques and failures to follow up or review the patient. 

General Pharmaceutical Council

• The GPHC has strengthened its guidance for pharmacy owners providing services at a distance. This was done to ensure that people can only obtain medicine from online pharmacies that are safe and clinically appropriate for them. The guidance introduces a number of new safeguards:
  • Making sure medicines are clinically appropriate for patients by ensuring that pharmacy teams can carry our robust patient identity checks and are able to identify requests that are not appropriate;
  • Further safeguards for certain categories of prescription-only medicine including antimicrobials, medicines liable to abuse, overuse or misuse or where there is a risk of addiction, and non-surgical cosmetic medicinal products, to make sure that they are clinically appropriate;
  • Transparency and patient choice by providing sufficient information for people to be able to make an informed choice as to using the online service;
  • Regulatory oversight with regards to prescribers and proscribing services operating outside of the UK, but ensuring that the prescribers based abroad are working within national prescribing guidance in the UK.