Professional regulation

CAMERA is a leading centre in health professions regulation research, with our work including research on a range of regulatory policies and processes, including Fitness to Practise, registration, licensing and revalidation. We engage with key stakeholders to inform policy development and implementation and to understand the impacts of regulation on professional practice.

Our research in this theme also links to work across other CAMERA themes, as professional regulators play a key role in setting educational standards and quality assuring professional education, and are also taking an increasing interest in workforce issues.

Fitness to practise

Fitness to practise processes are a central feature of professional regulation, and our work in this area explores: the complaints and referrals which prompt fitness to practise proceedings; the functioning of fitness to practise procedures themselves; and quantitative analyses of trends within fitness to practise data.

CAMERA’s fitness to practise research includes studies commissioned by the General Dental Council, the Nursing and Midwifery Council, and the General Medical Council.

Recent work has focused on ‘seriousness’ in fitness to practise, exploring how the concept is understood and applied within professional regulation. In 2018, we undertook a literature review on this topic, commissioned by the General Dental Council, and we are currently carrying out further funded research on FtP processes and how to optimise learning from FtP for the benefit of the profession and patients.

As well as work on regulatory fitness to practise procedures, we also undertake research into local and organisational performance management and disciplinary processes for healthcare professionals.

Revalidation

Since 2010, CAMERA has undertaken research into the development and introduction of medical revalidation, a relicensing process which aims to ensure that doctors remain up-to-date and fit to practise through engagement in appraisal processes. Our team took part in two major national evaluations of the implementation of this flagship regulatory policy, between 2015 and 2018, funded by the General Medical Council and the Department of Health Policy Research Programme. This programme of work explored the impacts of revalidation for the medical profession and for healthcare organisations.

Registration and licensing

Our research covers policies and processes for the registration and licensing of healthcare professionals, including a focus on understanding the implications of Brexit for the UK healthcare workforce.

Brexit carries major implications for the migration of healthcare workers into the UK from the EU, including in relation to the recognition of international professional qualifications. Our recent work has included mapping standards for basic dental training across the EU to support the development of new recognition processes.

The introduction of a national medical licensing assessment in the United Kingdom is a major change in medical education in the UK, and CAMERA was commissioned by the General Medical Council to synthesis the evidence base on the impact of these types of assessments internationally.

Publications

Fitness to practise 

Tazzyman, Bryce M, Boyd A, Walshe K. 2019. ‘Identifying and managing concerns about general practitioners: an interview study and case series analysis.’ British Journal of General Practice, 69/684, e499-e506, https://doi.org/10.3399/bjgp19X703733

Bryce M, Archer J, Brennan N, Burns L, O’Brien T, Price T. 2018. Fitness to Practise: Impairment and serious misconduct – a narrative synthesis review. General Dental Council.

Revalidation

Price T, Tredinnick-Rowe J, Walshe K, Tazzyman A, Ferguson J, Boyd A, Bryce M. 2020. ‘Reshaping clinical governance: a qualitative study of reforms to professional regulation and their effects on clinical accountability in the NHS in England.’ Health Policy, 124/4, 446-453 https://doi.org/10.1016/j.healthpol.2020.01.004

Tazzyman A, Bryce M, Ferguson J, Walshe K, Boyd A, Price T, Tredinnick-Rowe J. 2019. ‘Reforming regulatory relationships: the impact of medical revalidation on interactions between doctors, employers, and the General Medical Council.’ Regulation & Governance, 13: 593-608, https://doi.org/10.1111/rego.12237

Baines R, Zahra D, Regan de Bere S, Bryce M, Archer J. 2019. ‘A “futile exercise”? Psychiatrists’ perceptions and experiences of patient feedback for relicensing purposes in the UK.’ Academic Psychiatry, 43(6):570-576, https://doi.org/10.1007/s40596-019-01088-w

Tazzyman A, Ferguson J, Boyd A, Bryce M, Tredinnick-Rowe J, Price T, Walshe K. 2019. ‘Reforming medical regulation: a qualitative study of the implementation of medical revalidation in England, using Normalisation Process Theory.’ Journal of Health Services Research and Policy, https://doi.org/10.1177%2F1355819619848017 

Wakeling J, Holmes S, Boyd A, Bryce M, Cameron N, Marshall M, Tredinnick-Rowe J, Archer J. 2019. ‘Reflective practice for patient benefit: an analysis of doctors’ appraisal portfolios In Scotland.’ Journal of Continuing Education in the Health Professions, 39/1, 13-20, https://doi.org/10.1097/CEH.0000000000000236

Bryce M*, Luscombe K, Boyd A, Tazzyman A, Tredinnick-Rowe J, Walshe K, Archer J. 2018. ‘Policing the profession? Regulatory reform, restratification and the emergence of Responsible Officers as a new locus of power in UK medicine.’ Social Science & Medicine, 213, 99-105. https://doi.org/10.1016/j.socscimed.2018.07.042

Walshe K, Boyd A, Bryce M, Luscombe K, Tazzyman A, Tredinnick-Rowe J, Archer J. 2017. ‘Implementing medical revalidation in the United Kingdom: findings about organisational changes and impacts from a survey of Responsible Officers.’ Journal of the Royal Society of Medicine, 110/1, 23-30. https://dx.doi.org/10.1177%2F0141076816683556

Registration and licensing

Gale T, Bryce M, Burns L, Hanks S & Zahra D (2021) Review and mapping of basic dental training in EU member states: final report. General Dental Council

Price TJ, Lynn N, Coombes L, Roberts M, Gale T, Regan de Bere S & Archer J. 2018. 'The International Landscape of Medical Licensing Examinations: A Typology Derived From a Systematic Review.' International Journal of Health Policy and Management, https://dx.doi.org/10.15171/ijhpm.2018.32

Archer J, Lynn N, Coombes L, Roberts M, Gale T, Price T & Regan de Bere S 2016 'The impact of large scale licensing examinations in highly developed countries: a systematic review.' BMC Medical Education 16/1, https://dx.doi.org/10.1186/s12909-016-0729-7

Who's involved