A Consultation on Statutory Professional Regulation

The ACP-UK submitted a response to the consultation on statutory professional regulation on the consultation website on 22nd January (closing date: 23rd January). We are grateful to the 167 ACP-UK members who responded to our questionnaire. We summarise their views in what follows:

1. We consider it imperative that all clinical psychologists are registered with an appropriate statutory body. We have concerns that the underlying intention of the consultation is to reduce the number of registered professions, and that psychological practitioners such as clinical psychologists may not be considered “high risk”. We are critical of the classification and criteria for risk offered by the Professional Standards Authority. We argue that clinical psychology is a high-risk profession on the grounds that invariably clinical psychologists are clinically responsible for individuals who, at least at the time of consultation, have impairments of thinking and/or judgement, and many of whom lack capacity. Many of our service users are at risk of suicide or selfharm. Informed consent and the competence to enable understanding are crucial aspects of a clinical psychologist’s practice. The Mental Capacity Act 2005 specifically mentions clinical psychologists as having the power and responsibility to determine capacity. This is an important and onerous responsibility requiring specific competence in determining cognitive impairment and mental state. Incompetence in these areas is likely to have serious consequences for vulnerable service users. Many of our members argue for even greater statutory oversight than at present including revalidation.
   
2. There is concern about clinical psychologists who are struck off, who then practise under another title, and concern about non- psychologists offering psychological treatment they are not qualified to provide.
   
3. Practitioners also need protection when employing organisations such as NHS trusts and their managers seek to damage the reputation and livelihood of a practitioner because he or she has been critical of the organisations action’s or policies or has “blown the whistle”, by reporting the practitioner to the regulatory body. We are strongly against proposals to reduce profession-specific advice in favour of greater representation of employers. We oppose the proposal to give employers greater influence on boards. We are not convinced that employers always have the best interests of the public and service users at heart. They have a conflict of interest in relation to the financial and resource constraints of healthcare.
   
4. There should be demonstrable equity of judgement of competence and training standards on admission to the register, in relation to overseas of EU applicants and also in lateral transfer.
   
5. It is essential that when a clinical psychologist is subject to complaint, that the investigatory panel and tribunal panel ALWAYS includes a CLINICAL psychologist and not another type of practitioner psychologist (this is not presently the case).
   
6. Some further thought needs to be given to which titles are regulated. Some of our members think that the title psychologist needs regulation since most of the public have no concept of the differences between the different types of applied psychologist and imagine they have the same competencies and training, when they do not. There is continuing disquiet at the absence of regulation of the title of clinical neuropsychologist.
   
7. It is essential that the regulatory body includes specific professional clinical psychology advice about competence and fitness to practice.
   
8. We do not agree with the assumption that there is too much regulation. If anything, we think there is not enough regulation and that present regulatory scrutiny particularly in the area of psychological treatment and psychotherapy is insufficient for proper protection of the public. We are concerned that there are many unqualified individuals and even some professionals who are not properly trained or regulated for the services they claim to offer. We are concerned that the present regulatory authority for psychologists is not sufficiently proactive in relation to the regulation of individuals claiming psychological expertise who may lack the appropriate training and who may not be registered with the HCPC. Moreover, because of a lack of specificity in relation to the demonstrable competences of different types of practitioner psychologist, we are concerned that the public are at risk from psychologists who are not properly trained to offer psychological treatment and those who do not have a training as a mental health practitioner.
   
9. When statutory regulation was first introduced for applied psychologists, we were promised that individuals whose advertised role and practice was identical to that of say, a clinical psychologist but who did NOT claim the protected title, would still be liable to prosecution. There is no evidence that this type of infringement is being actively policed by the HCPC.

10. We do not agree with the licensing of specific activities as an alternative to statutory registration. It constitutes a failure of professional regulation and is likely to end up with an extremely complicated system of regulation given all the diverse activities in which clinical psychologists could be engaged. It seems to us that taking responsibility for gaining and maintaining a specific competence, ensuring standards of competence and not practising beyond one’s competence are general features of professional practice. Failure in any of these regards warrants review of fitness to practise in general, not just in relation to one specific skill.
11. We consider that complaint management should involve a less legalistic and adversarial approach with potential for dialogue and mediation between parties, depending on the severity of the complaint. However, this would require clear criteria and pathways for identifying when mediation would be appropriate. There remain many situations and types of complaint where this would be inappropriate.
12. We support the proposal for faster, more streamlined complaint handling. Present timescales and deadlines leaving practitioners without a livelihood for months on end is not acceptable. Naming and shaming of practitioners should be delayed until absolutely necessary with good evidence to substantiate the allegation.

Mike Wang, ACP-UK Chair