Recommendation F235: Joint proceedings
From Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry, published 6 February 2013.
Recommendation
The Professional Standards Authority for Health and Social Care (PSA) (formerly the Council for Healthcare Regulatory Excellence), together with the regulators under its supervision, should seek to devise procedures for dealing consistently and in the public interest with cases arising out of the same event or series of events but involving professionals regulated by more than one body. While it would require new regulations, consideration should be given to the possibility of moving towards a common independent tribunal to determine fitness to practise issues and sanctions across the healthcare professional field.
In brief (written by this site)
In February 2026, the Department of Health and Social Care and NHS England stated that an independent tribunal set up to take over hearings was abolished in 2012, and individual statutory regulators continue to operate separate fitness to practise processes overseen by the Professional Standards Authority (DHSC and NHS England, Feb 2026). In May 2024, the Thirlwall Inquiry legal team noted that the government had accepted the recommendation in part, recording that the Law Commission had proposed a draft Bill to establish a single regulatory framework (The Thirlwall Inquiry legal team, May 2024). In February 2015, the department stated that the government agreed legislation should empower regulators to work together, reporting that legislation would be brought forward when parliamentary time allowed (Department of Health, Feb 2015).
Sources
AI-generated summary of the record on this page, checked by a second model and automatic checks, 26 Sep 2026. The record below is the sources' own words.
Government response
Accepted in part.
The Professional Standards Authority oversees the work of the professional regulators, but it has no powers to intervene directly in cases (save that where it considers the outcome of a fitness to practise hearing has been unduly lenient it may refer the case for consideration by the high court). The Law Commission is undertaking a review of the legislation applicable to the regulators with a view to producing a draft Bill containing proposals for reform. Within this it has consulted on proposals which would provide powers for joint working between the regulators. We supported these proposals and, subject to the outcome of the consultation, would wish to consider taking them forward at a suitable legislative opportunity. If implemented, it would be for the regulators to determine how they are used but they would potentially enable greater co-operation and, thereby, greater consistency between regulators in cases affecting more than one class of professional. The Law Commission’s consultation also included the possibility that regulators would be able to use these powers to share tribunal services for the determination of fitness to practice cases, although the full implications of this would need to be considered further.
How this response relates to the recommendation
Site note: This is volume two of "Hard Truths: The Journey to Putting Patients First" (Cm 8777-II), the government's response to the Inquiry's 290 recommendations, published by the Department of Health on GOV.UK on 19 November 2013 and dated to that day here. The PDF the row links to is the accessible edition, whose title page reads "January 2014". The Department of Health has been the Department of Health and Social Care since January 2018. The volume says it includes accounts from each of the national organisations the recommendations name, but it does not mark which passage each organisation wrote, so every row is filed under the Department that published it.
Blanket government agreement does not establish acceptance or delivery by each addressee. Some response passages cover groups of recommendations.
Scope of the government response
Government responded via "Hard Truths: The Journey to Putting Patients First" (2014), a single document covering all 290 recommendations with a blanket acceptance. Individual recommendation responses were not broken out.
Delivery
DHSC and NHS England say in progress (27 February 2026)
DHSC established an independent tribunal, the Office of the Health Professional Adjudicator. OHPA was originally set up to take over Fitness to Practice Hearing from the GMC from 1 April 2011. However, it later closed before it became operational. It was abolished in 2012. According to the PSA, each statutory regulator has a ‘fitness to practise’ process for handling complaints about health and care professionals. The most serious cases are referred to formal hearings in front of fitness to practise committees.
The PSA review every final decision made by all those fitness to practise committees. If we decide the decisions do not protect the public properly, we can refer them to Court to be considered by a judge. Our power to do this comes from the NHS Reform and Health Care Professions Act 2002.
Site note: DHSC and NHS England's own account of progress, supplied to the Thirlwall Inquiry in September 2024 and printed in the Inquiry legal team's Review of Implementation of Recommendations from Previous Inquiries into Healthcare Issues (version dated April 2025, published 27 February 2026). It is not a finding of the Inquiry. Their reviewed extent of implementation reads “Not yet actioned”. Table row: section 18.2 No. 235, PDF page 547-548.
Department of Health and Social Care says in progress (11 February 2015)
The Law Commission published their Report and proposed draft Bill containing recommendations for reforming the regulation of healthcare professionals on 02 April 2014. This included a recommendation that any two or more regulators should be able to arrange for any of their respective functions to be exercised jointly. It also recommended that the Professional Standards Authority should be given a general function to promote co-operation between the regulators in relation to the performance of their functions.
The Government agrees legislation should empower regulators to look for ways in which they can work together and make best use of their respective skills and resources to better support public protection. The Government also agrees the Professional Stands Authority for Health and Social Care should have a specific role in promoting best practice in this respect, identifying opportunities for co-operation between the professional regulators and, as part of their annual performance review of each regulator, monitoring progress made towards this.
The Government response to the Law Commission was published on 29 January 2015 and legislation will be brought forward when Parliamentary time allows.
Site note: This is the supporting annex published on 11 February 2015 with "Culture change in the NHS: applying the lessons of the Francis Inquiries" (Cm 9009), attached to the GOV.UK page as "Culture change in the NHS supporting annex". The annex has no title page; that title is GOV.UK's and the PDF's own. Its table has four columns (No., Recommendation, Hard Truths Government response, Progress update), and the row carries the Progress update cell. No column says which organisation wrote an update, so the row is filed under the Department of Health (now the Department of Health and Social Care), which published it.
Site note: The Inquiry addressed this recommendation to the Professional Standards Authority, not to the Department of Health. The annex gives this update in the Department's publication and does not say who wrote it, so the row is the Department's report of the progress made on it.
What other bodies have found
In their own words. These do not change the delivery statement above.
Thirlwall Inquiry legal team (15 May 2024)
This recommendation was accepted in part by the Government.
The Government stated that the Professional Standards Authority had no power to intervene directly in cases (save where it considered the outcome of a fitness to practise hearing had been unduly lenient)
The Law Commission reported in April 2014, producing a draft Bill setting out a single legal framework for the regulation of all health and social care professionals and imposing greater consistency in respect of the conduct of fitness to practise hearings. The Government published its response in January 2015, largely accepting the recommendations.
Site note: The Thirlwall Inquiry legal team's own notes on implementation, from its Review of Implementation of Recommendations from Previous Inquiries into Healthcare Issues (version of 15 May 2024). The review does not colour its Extent of Implementation cell for this recommendation green; it leaves the cell uncoloured where a recommendation was rejected, where evidence of implementation was insufficient, or where steps had been taken but implementation was not yet complete. Table row: section 16.2 No. 235, PDF page 506-507.
Source
Themes and tags
Who has spoken
- Department of Health and Social Care
Response, delivery statement - DHSC and NHS England
Delivery statement - Thirlwall Inquiry legal team
Finding