The new Accredited Voluntary Registers scheme offers anyone employing, recommending or using a practitioner in an unregulated occupation greater confidence, choice, quality and protection, says Harry Cayton

Anne Burge’s article “Tepid Francis response won’t guarantee patient safety” paints a negative picture of oversight for unregulated healthcare practitioners and an overly optimistic one of the value of statutory regulation.

Real patient safety and high quality care is never achieved merely by regulation. It is the commitment and professionalism of individuals and teams and the attitudes and values of organisations that make the difference.

‘To suggest that counsellors and psychotherapists are not capable of quality because they are not regulated is unfair and untrue’

The new Accredited Voluntary Registers scheme goes with the grain of a professional commitment to improvement and quality by the tens of thousands of people who work in health and care, everywhere from hospital wards to the high street, who are not regulated. People working in these unregulated occupations have come together and formed their own organisations in the name of high quality care and developed standards, encouraging their colleagues to meet them. The new scheme builds on this work by providing oversight of those organisations and making sure they are well run and effective.

To suggest that counsellors and psychotherapists, or sports rehabilitators or acupuncturists or healthcare assistants, are not capable of quality because they are not regulated is unfair and untrue.

So far 10 organisations have been accredited and more have submitted applications. Even the best run voluntary registers have had to up their game to meet the Professional Standards Authority’s requirements for good governance and standards in personal behaviour, technical competence and business practice. These standards make a difference to clinical practice and public confidence.

Professional endorsement

Anyone employing, recommending or using a practitioner in an unregulated occupation now has the option to choose one from a register that has been vetted by the authority. It is important that they do so.

‘One member of the public said that the Accredited Voluntary Registers scheme had given them “the confidence to complain”’

Organisations outside the NHS are already choosing from accredited registers. The armed services, for example, use British Association of Sports Rehabilitators and Trainers registered practitioners at their rehabilitation units. When hospices provide massage or aromatherapy they can now choose a practitioner from an accredited register. When members of the public look for complementary therapies they value the consumer protection offered by the scheme’s purple logo.

Complaining about a practitioner on a voluntary register is easier and more transparent than ever before. One member of the public said that the Accredited Voluntary Registers scheme had given them “the confidence to complain”.

That confidence is well placed. In its first year, the scheme was able to protect people from harm in a very tangible way by following up on complaints. A number of complementary therapists on the Complementary and Natural Healthcare Council register were found to be potentially in breach of the Cancer Act, following complaints from the Nightingale Collaboration, which challenges misleading claims in healthcare advertising. These therapists were referred to Trading Standards for investigation and will be prosecuted if they are found to be in breach of the act.

Oversight by the PSA ensures that voluntary registers have the authority, resources and processes to identify and address incompetence and harmful practices.

Commitment to high standards

As the scheme has grown, more and more practitioners are choosing to demonstrate their commitment to high standards by joining an accredited register, extending the reach of the new framework of assurance.

We cannot compel practitioners to join an accredited register, but we can ask why any NHS organisation would employ, commission services from or refer to a practitioner who has chosen not to join one. We cannot prevent people from seeking services where they may be exposed to harm, but we can help them to choose practitioners on accredited registers and protect them when they do so.

‘It’s true the Accredited Voluntary Registers scheme does not provide a “guarantee” of safety. But neither does statutory regulation’

Making that choice is easier now that 45,000 practitioners in more than 20 occupations belong to an accredited register. The list of accredited registers is growing, but the standards expected of those who are on it will remain high.

It is true that the Accredited Voluntary Registers scheme does not provide a “guarantee” of safety. But neither does statutory regulation; the failings at Mid Staffordshire and other trusts show us that.

The world of healthcare outside professional regulation is not the Wild West. The Accredited Voluntary Registers scheme offers greater confidence, choice, quality and protection. People now have a choice: to take advantage of this offer and require practitioners to be part of an accredited register; or to do nothing and grumble about the need for statutory regulation of everything that moves.

Harry Cayton is the chief executive at the Professional Standards Authority