harry cayton chief executive best value in regulation: know more, do less healthgov, sydney 15 april...
TRANSCRIPT
![Page 1: Harry Cayton Chief Executive Best value in regulation: know more, do less HealthGov, Sydney 15 April 2014](https://reader036.vdocuments.mx/reader036/viewer/2022081519/56649e625503460f94b5ef32/html5/thumbnails/1.jpg)
Harry CaytonChief Executive
Best value in regulation:know more, do less
HealthGov, Sydney 15 April 2014
![Page 2: Harry Cayton Chief Executive Best value in regulation: know more, do less HealthGov, Sydney 15 April 2014](https://reader036.vdocuments.mx/reader036/viewer/2022081519/56649e625503460f94b5ef32/html5/thumbnails/2.jpg)
Reflective practice
‘The unexamined life is not worth living.’
SocratesQuoted in Plato’s Apology, 4thC BC
![Page 3: Harry Cayton Chief Executive Best value in regulation: know more, do less HealthGov, Sydney 15 April 2014](https://reader036.vdocuments.mx/reader036/viewer/2022081519/56649e625503460f94b5ef32/html5/thumbnails/3.jpg)
Three purposes of regulation
• Public protection
• Upholding standards
• Maintaining confidence in regulation
![Page 4: Harry Cayton Chief Executive Best value in regulation: know more, do less HealthGov, Sydney 15 April 2014](https://reader036.vdocuments.mx/reader036/viewer/2022081519/56649e625503460f94b5ef32/html5/thumbnails/4.jpg)
Public protection derives from multiple factors; regulatory force is different for each of these
• People
• Places
• Products
• Processes
• Prices
![Page 5: Harry Cayton Chief Executive Best value in regulation: know more, do less HealthGov, Sydney 15 April 2014](https://reader036.vdocuments.mx/reader036/viewer/2022081519/56649e625503460f94b5ef32/html5/thumbnails/5.jpg)
Right touch regulation
‘Right touch regulation is based on a proper
evaluation of risk, is proportionate and outcome focussed;
it creates a framework in which professionalism can
flourish and organisations can be excellent. Excellence is
the consistent performance of good practice combined with continuous improvement.’
Harry Cayton CHRE Review 2009
![Page 6: Harry Cayton Chief Executive Best value in regulation: know more, do less HealthGov, Sydney 15 April 2014](https://reader036.vdocuments.mx/reader036/viewer/2022081519/56649e625503460f94b5ef32/html5/thumbnails/6.jpg)
The first law of right-touch regulation
Use only the regulatory force necessary
to achieve the desired effect.
![Page 7: Harry Cayton Chief Executive Best value in regulation: know more, do less HealthGov, Sydney 15 April 2014](https://reader036.vdocuments.mx/reader036/viewer/2022081519/56649e625503460f94b5ef32/html5/thumbnails/7.jpg)
Five agents of quality
Regulators
Service users
Service providers
Professionals
LawRegulators - Includes pro-fessional, system and product regulatorsService users - Includes their carers, families, advocates and representative organisa-tionsService providers - Includes NHS, local authorities, private and voluntary employers and commissioners of servicesProfessionals - Includes peer groups, teams and profes-sional organisationsLaw - Includes all legislation, case law and common law
![Page 8: Harry Cayton Chief Executive Best value in regulation: know more, do less HealthGov, Sydney 15 April 2014](https://reader036.vdocuments.mx/reader036/viewer/2022081519/56649e625503460f94b5ef32/html5/thumbnails/8.jpg)
Elements of the right-touch approach
• Identify the problem before the solution
• Quantify the risks
• Get as close to the problem as possible
• Focus on the outcome
• Use regulation only when necessary
• Keep it simple
• Check for unintended consequences
• Review and respond to change
![Page 9: Harry Cayton Chief Executive Best value in regulation: know more, do less HealthGov, Sydney 15 April 2014](https://reader036.vdocuments.mx/reader036/viewer/2022081519/56649e625503460f94b5ef32/html5/thumbnails/9.jpg)
![Page 10: Harry Cayton Chief Executive Best value in regulation: know more, do less HealthGov, Sydney 15 April 2014](https://reader036.vdocuments.mx/reader036/viewer/2022081519/56649e625503460f94b5ef32/html5/thumbnails/10.jpg)
Evasion & Alienation
Mutual cover-up & collusion
Professional commitment
Ownership & respect
Moral
Compass
ENGAGEMENTDISENGAGEMENT
Human factors in regulation
![Page 11: Harry Cayton Chief Executive Best value in regulation: know more, do less HealthGov, Sydney 15 April 2014](https://reader036.vdocuments.mx/reader036/viewer/2022081519/56649e625503460f94b5ef32/html5/thumbnails/11.jpg)
![Page 12: Harry Cayton Chief Executive Best value in regulation: know more, do less HealthGov, Sydney 15 April 2014](https://reader036.vdocuments.mx/reader036/viewer/2022081519/56649e625503460f94b5ef32/html5/thumbnails/12.jpg)
Cost effectiveness
• The nature of the profession and the work setting have significant impact on cost
• Larger regulators have economies of scale
• Complaints processes consume most cost
• Standard setting is most susceptible to savings
• There was wide variation between regulators
Review of the cost effectiveness and efficiency of the health professional regulators November 2012
![Page 13: Harry Cayton Chief Executive Best value in regulation: know more, do less HealthGov, Sydney 15 April 2014](https://reader036.vdocuments.mx/reader036/viewer/2022081519/56649e625503460f94b5ef32/html5/thumbnails/13.jpg)
UK professional regulators unit operating costs by core function*
Regulator Standards & Guidance
Registration Education & Training
Fitness to practise
Continuing FtP
Governance Overall
GCC £25.18 £104.07 £0.00 £409.75 £73.63 £108.37 £721.00
GDC £6.09 £63.06 £12.60 £179.10 £2.91 £14.61 £278.36
GMC £5.82 £64.48 £20.28 £244.37 £11.50 £21.93 £368.39
GOC £9.77 £31.81 £24.11 £73.30 £19.36 £33.87 £192.22
GOsC £131.65 £141.60 £52.52 £205.53 £75.14 £104.83 £711.28
GPhC £6.39 £33.55 £21.53 £73.43 £10.20 £19.52 £164.62
HPC £2.94 £15.68 £6.87 £45.25 £0.41 £4.43 £75.58
NMC £5.30 £11.18 £2.66 £41.83 £0.54 £5.99 £67.50
PSNI £23.49 £47.16 £56.60 £65.90 £103.78 £43.15 £340.07
Overall £5.68 £27.58 £8.79 £92.97 £4.01 £10.95 £149.98
*adjusted for exceptional and/or non-core expenditure
![Page 14: Harry Cayton Chief Executive Best value in regulation: know more, do less HealthGov, Sydney 15 April 2014](https://reader036.vdocuments.mx/reader036/viewer/2022081519/56649e625503460f94b5ef32/html5/thumbnails/14.jpg)
UK professional regulators share of expenditure by functionFunction Average share of
expenditureRange of share of expenditure
Standards & Guidance 3.77% 1.6%–18.5%
Registration 18.32% 10.3%–22.7%
Education & Training 5.84% 0.00%–16.6%
Fitness to practise 62.14% 19.4%–69.1%
Continuing fitness to practise
2.66% 0.5%–30.5%
Governance 7.27% 5.2%–17.6%
![Page 15: Harry Cayton Chief Executive Best value in regulation: know more, do less HealthGov, Sydney 15 April 2014](https://reader036.vdocuments.mx/reader036/viewer/2022081519/56649e625503460f94b5ef32/html5/thumbnails/15.jpg)
Average share of expenditure 2010/20113.77%
18.32%
5.84%
62.14%
2.66%7.27%
Standards & Guidance (1.6%–18.5%)
Registration (10.3%–22.7%)
Education & Training (0.00%–16.6%)
Fitness to practise (19.4%–69.1%)
Continuing fitness to prac-tise (0.5%–30.5%)
Governance (5.2%–17.6%)
![Page 16: Harry Cayton Chief Executive Best value in regulation: know more, do less HealthGov, Sydney 15 April 2014](https://reader036.vdocuments.mx/reader036/viewer/2022081519/56649e625503460f94b5ef32/html5/thumbnails/16.jpg)
Effective public governance
• Responsibility and accountability
• Personal behaviours
• Roles and relationships
• Dealing with disagreement
• Conflicts of interest
• Transparent decision-making
• Understanding performance
• Acting on organisational complaints
• From representativeness to credibility
![Page 17: Harry Cayton Chief Executive Best value in regulation: know more, do less HealthGov, Sydney 15 April 2014](https://reader036.vdocuments.mx/reader036/viewer/2022081519/56649e625503460f94b5ef32/html5/thumbnails/17.jpg)
www.professionalstandards.org.uk