Wrong touch regulation: the limits to effective regulation of approved mental health professionals

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All-Party Parliamentary Group on Social Work and the British Association for Social Work. (2019). Social workers and a new Mental Health Act: Final report. https://production.basw.co.uk/sites/default/files/resources/Inquiry%20Report%20-%20APPG%20on%20Social%20Work%20-%20Social%20Workers%20and%20A%20New%20Mental%20Health%20Act..pdf Allan, H. T., & Westwood, S. (2016). English language skills requirements for internationally educated nurses working in the care industry: Barriers to UK registration or institutionalised discrimination? International Journal of Nursing Studies, 54, 1–10. https://www.sciencedirect.com/science/article/pii/S0020748914003368 Asif AMHP. (2017, June 26). Guest blog: Are we the invisible health professionals? Social Work with Adults Blog. https://socialworkwithadults.blog.gov.uk/2017/06/26/amhps-the-invisible-health-professionals Atkinson, C., & Lucas, R. (2013). Policy and gender in adult social care work. Public Administration, 91(1), 159–173. https://doi.org/10.1111/j.1467-9299.2011.02017.x Ayres, I., & Braithwaite, J. (1992). Responsive regulation: Transcending the deregulation debate. Oxford University Press. Baldwin, R. (2005, Autumn). Is better regulation smarter regulation? Public Law, 485–511. Baldwin, R. (2010). Better regulation: The search and the struggle. In R. Baldwin, M. Cave, & M. Lodge (Eds.), The Oxford handbook of regulation. Oxford University Press. https://doi.org/10.1093/oxfordhb/9780199560219.003.0012 Baldwin, R., Cave, M., & Lodge, M. (2011). Introduction. In R. Baldwin, M. Cave, & M. Lodge (Eds.), Understanding regulation: Theory, strategy, and practice (2nd ed., pp. 1–17). Oxford University Press. Baldwin, R., Cave, M., & Lodge, M. (2011). Regulatory strategies. In Understanding regulation: Theory, strategy, and practice (2nd ed.). Oxford University Press. https://doi.org/10.1093/acprof:osobl/9780199576081.003.0007 Baldwin, R., & Black, J. (2008). Really responsive regulation. The Modern Law Review, 71(1), 59–94. https://doi.org/10.1111/j.1468-2230.2008.00681.x Better Regulation Task Force. (2003). Principles of good regulation. Regulatory and Quality Improvement Authority. https://www.rqia.org.uk/RQIA/media/RQIA/Resources/Better-Regulation-Task-Force-Principles-of-Good-Regulation.pdf Better Regulation Task Force. (2005). Regulation—Less is More: Reducing burdens, improving outcomes (Annex A, p. 47). Cabinet Office British Association of Social Workers. (2024, July 29). What to expect from the fitness to practise process. Professional Social Work Magazine. https://basw.co.uk/about-social-work/psw-magazine/articles/what-expect-fitness-practise-process Broadbent, J., & Laughlin, R. (2002). Public service professionals and New Public Management: Control of the professions in public services. In K. McLaughlin, S. Osborne, & E. Ferlie (Eds.), New public management: Current trends and future prospects (pp. 95–108). Routledge. Cabinet Office. (1997, July 3). Better regulation – not deregulation (News Release CBA 46/97) [Press release]. Cabinet Office. (2000). Principles of good regulation. Better Regulation Unit. Cabinet Office. (2003). Better policymaking: A guide to regulatory impact assessment. Cabinet Office. Care Quality Commission. (2018). Mental Health Act: Approved Mental Health Professional services. https://www.cqc.org.uk/sites/default/files/20180326_mha_amhpbriefing.pdf Care Quality Commission. (2024). Monitoring the Mental Health Act in 2022/23. https://www.cqc.org.uk/publications/monitoring-mental-health-act/2022-2023 Cayton, H. (n.d.). Right-touch regulation. Retrieved October 20, 2024, from https://www.harrycayton.net/righttouch-20 Council for Healthcare Regulatory Excellence. (2010). Right-touch regulation. Council for Healthcare Regulatory Excellence. https://www.professionalstandards.org.uk/docs/default-source/publications/thought-paper/right-touch-regulation-2010.pdf Derbyshire County Council. (2024). Approval and re-approval of Approved Mental Health Practitioners. https://staff.derbyshire.gov.uk/site-elements/documents/working-here/adult-care/approval-and-re-approval-of-approved-mental-health-practitioners.pdf Department for Education. (2016). Children’s social care reform: A vision for change. https://assets.publishing.service.gov.uk/media/5a81a89040f0b623026987ef/Childrens_social_care_reform_a_vision_for_change.pdf Department for Education & Department of Health and Social Care. (2018). Social Work England: Consultation on secondary legislative framework. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/713240/SWE_Secondary_Legislative_Framework_Consultation_Response.pdf Department of Health. (2008). The Mental Health Act: Code of practice. https://www.mentalhealthlaw.co.uk/media/MHA_Code_of_Practice_2008.pdf Department of Health. (2015). Code of practice: Mental Health Act 1983. The Stationery Office. https://www.gov.uk/government/publications/code-of-practice-mental-health-act-1983 Department of Health and Social Care. (2018). Modernising the Mental Health Act: Increasing choice, reducing compulsion: Final report of the Independent Review of the Mental Health Act 1983. https://www.gov.uk/government/publications/modernising-the-mental-health-act-final-report-from-the-independent-review Department of Health and Social Care. (2019a). National workforce plan for Approved Mental Health Professionals (AMHPs). https://assets.publishing.service.gov.uk/media/5dbaaf13e5274a4aa55a0a1c/AMHP_Workforce_Plan_Oct19__3_.pdf Department of Health and Social Care. (2019b). Promoting professionalism, reforming regulation: Government response to the consultation. https://assets.publishing.service.gov.uk/media/5d386abfed915d0d0446885f/Promoting_professionalism_reforming_regulation_consultation_reponse.pdf Department of Health and Social Care. (2021, August). Guidance: Liberty Protection Safeguards — The approved mental capacity professional role. https://www.gov.uk/government/publications/liberty-protection-safeguards-factsheets/liberty-protection-safeguards-the-approved-mental-capacity-professional-role#:~:text=The%20approved%20mental%20capacity%20professional%20(%20AMCP%20)%20is%20a%20new%2C,independent%2C%20trained%2C%20registered%20professionals Department of Health and Social Care. (2022). Draft Mental Health Bill 2022. https://www.gov.uk/government/publications/draft-mental-health-bill-2022 Department of Health and Social Care. (2023). The Approved Mental Health Professional workforce in the social care sector. Skills for Care. https://www.skillsforcare.org.uk/Adult-Social-Care-Workforce-Data/Workforce-intelligence/documents/AMHPs-Briefing.pdf Department of Health and Social Care. (2024). Health and social care statistical outputs: Published by DHSC including OHID, NHSBSA, UKHSA, ONS and NHS England. https://www.gov.uk/government/consultations/health-and-social-care-statistical-outputs/health-and-social-care-statistical-outputs-published-by-dhsc-including-ohid-nhsbsa-ukhsa-ons-and-nhs-england#mental-health Department of Trade and Industry. (1985). Lifting the burden (Cmnd. 9571). Her Majesty’s Stationery Office. GJ v Foundation Trust [2009] EWCA 2972 Glover-Thomas, N. (2011). The age of risk: Risk perception and determination following the Mental Health Act 2007. Medical Law Review, 19(4), 581–611. https://doi.org/10.1093/medlaw/fwr023 Grace, J. D. (2015). The experience of being assessed and detained under the Mental Health Act (1983): An interpretative phenomenological analysis [Doctoral thesis, University of Staffordshire and University of Keele]. CORE. https://core.ac.uk/download/pdf/43608959.pdf Grabosky, P. (2017). Meta-regulation. In P. Drahos (Ed.), Regulatory Theory: Foundations and applications (pp. 149–162). ANU Press. http://www.jstor.org/stable/j.ctt1q1crtm.17 Gunningham, N., & Grabosky, P. (1998). Smart regulation: Designing environmental policy. Oxford University Press. Gunningham, N., & Sinclair, D. (2012). Regulatory pluralism: Designing policy mixes for environmental protection. Edward Elgar. Gunningham, N., & Sinclair, D. (2017). Smart regulation. In P. Drahos (Ed.), Regulatory Theory: Foundations and applications (pp. 133–148). ANU Press. http://www.jstor.org/stable/j.ctt1q1crtm.16 Health and Care Professions Council. (2019a). Fitness to practise annual report 2019. https://www.hcpc-uk.org/globalassets/resources/reports/fitness-to-practise/fitness-to-practise-annual-report-2019.pdf Health and Care Professions Council. (2019b). Transferring the regulation of social workers to Social Work England. https://www.hcpc-uk.org/education-providers/updates/2019/transferringregulation-of-social-workers-to-swe Health and Social Care Act 2012 Health Education England. (2020). Approved Mental Health Professional (AMHP) national service standards: Evaluation, mapping and planning toolkit. https://www.hee.nhs.uk/sites/default/files/documents/National%20AMHP%20Service%20Standards.pdf Heimer, C. A. (2011). Disarticulated responsiveness: The theory and practice of responsive regulation. UBC Law Review, 44(3), 663–698. Hemmington, J., Graham, M., Marshall, A., & others. (2021, October). Approved Mental Health Professionals, Best Interests Assessors and People with Lived Experience: An exploration of professional identities and practice. Social Work England. https://www.socialworkengland.org.uk/media/4046/amhp-bia-research-report.pdf Hemmington, J. (2024). Approved Mental Health Professionals’ experiences of moral distress: “Who are we for”? British Journal of Social Work, 54, 762–779. https://doi.org/10.1093/bjsw/bcad258 Laing, J. M. (2015). Perspectives on monitoring mental health legislation in England: A view from the front line. Medical Law Review, 23(3), 400–429. https://doi.org/10.1093/medlaw/fwu029 Laing, J. (2023). Independent mental health monitoring: Evaluating the Care Quality Commission in England’s approach to regulation, rights and risks. In B. D. Kelly & M. Donnelly (Eds.), Routledge handbook of mental health law (pp. 44–59). Taylor & Francis. Leah, C. (2020) Approved Mental Health Professionals: A Jack of All Trades? Hybrid Professional Roles within a Mental Health Occupation. Qualitative Social Work 19(5), 987. https://doi.org/10.1177/1473325019873385 Leigh, J. T., Worsley, A., & McLaughlin, K. (2017). An analysis of HCPC fitness to practise hearings: Fit to practise or fit for purpose? Ethics & Social Welfare, 11(4), 382–396. https://doi.org/10.1080/17496535.2017.1293119 Marriott, S., Audini, B., Lelliott, P., Webb, Y., & Duffett, R. (2001). Research into the Mental Health Act: A qualitative study of the views of those using or affected by it. Journal of Mental Health, 10(1), 33–39. https://doi.org/10.1080/09638230124934 Mascini, P. (2013). Why was the enforcement pyramid so influential? And what price was paid? Regulation & Governance, 7(1), 48–60. https://doi.org/10.1111/rego.12003 Mearns, G. (2022). What does the “A” stand for? Exploring the process of AMHP “re-approval” and opportunities for improvement: Themes from a narrative literature review. Practice, 35(5), 389–403. https://doi.org/10.1080/09503153.2022.2129047 the Mental Health Act 1983 as amended 2007 The Mental Health (Approved Mental Health Professionals) (Approval) (England) Regulations 2008, SI 2008/1206 Sch. 1 (UK). https://www.legislation.gov.uk/uksi/2008/1206/schedule/1/made The Mental Health (Approved Mental Health Professionals) (Approval) (England) Regulations 2008, SI 2008/1206 Sch. 2 (UK). https://www.legislation.gov.uk/uksi/2008/1206/schedule/2/made Ministry of Justice. (2023). Tribunal statistics quarterly: January to March 2023. https://www.gov.uk/government/statistics/tribunal-statistics-quarterly-january-to-march-2023 Morriss, L. (2017). Being seconded to a mental health trust: The (in)visibility of mental health social work. British Journal of Social Work, 47(5), 1344–1360. https://www.jstor.org/stable/26612513 National Health Service Reform and Health Care Professions Act 2002 The NHS Act 2006 NHS Digital. (2024, June 21). Mental Health Act statistics: Annual figures 2022–23. https://digital.nhs.uk/data-and-information/publications/statistical/mental-health-act-statistics-annual-figures/2022-23-annual-figures NHS England. (2024). Mental Health Act statistics: Annual figures 2023–24. https://digital.nhs.uk/data-and-information/publications/statistical/mental-health-act-statistics-annual-figures/2023-24-annual-figures Nursing and Midwifery Council. (2015). The code: Professional standards of practice and behaviour for nurses, midwives and nursing associates. https://www.nmc.org.uk/globalassets/sitedocuments/nmc-publications/nmc-code.pdf Osborne, D., & Gaebler, T. (1992). Reinventing government: How the entrepreneurial spirit is transforming the public sector. Addison-Wesley. Parker, C. (2006). The “compliance” trap: The moral message in responsive regulatory enforcement. Law & Society Review, 40(3), 591–622. https://doi.org/10.1111/j.1540-5893.2006.00274.x Professional Standards Authority. (2015). Right-touch regulation revised. https://www.professionalstandards.org.uk/docs/default-source/publications/thought-paper/right-touch-regulation-2015.pdf Professional Standards Authority. (2016). Right-touch assurance: A methodology for assessing and assuring occupational risk of harm. https://www.professionalstandards.org.uk/publications/right-touch-assurance-methodology-assessing-and-assuring-occupational-risk-harm Professional Standards Authority. (2018a). Right-touch regulation in practice: International perspectives. https://cy.professionalstandards.org.uk/sites/default/files/attachments/right-touch-regulation-in-practice---international-perspectives_0.pdf Professional Standards Authority. (2018b). Health professional regulation: A long view, with annual report and accounts 2017–18. https://assets.publishing.service.gov.uk/media/5b46095eed915d39e1b703b5/professional-standards-authority-annual-report-and-accounts-2017-2018-web-accessible.pdf Professional Standards Authority. (2025a). Reviewing right-touch regulation: A PSA discussion paper. https://www.professionalstandards.org.uk/sites/default/files/attachments/Reviewing%20Right-touch%20regulation%20-%20a%20PSA%20discussion%20paper%20%28March%202025%29.pdf Professional Standards Authority. (2025b). Right-touch regulation 2025 (interactive PDF). https://www.professionalstandards.org.uk/sites/default/files/attachments/Right-touch%20regulation%202025%20%28interactive%20pdf%29_0.pdf Reason, J. (2000). Human error: Models and management. BMJ, 320(7237), 768–770. https://doi.org/10.1136/bmj.320.7237.768 Richardson, J. J., Gustafsson, G., & Jordan, A. (1982). Government and the economy: A strategy for regulation. Oxford University Press. Rooke, R. (2020). Facilitating the “least restrictive option and maximising independence” under section 115 Mental Health Act 1983. Practice, 32(4), 269–283. https://doi.org/10.1080/09503153.2020.1782871 Samuel, M. (2024, February 23). Mounting demand for AMHPs and unmet need masked by fall in number of detentions, say service heads. Community Care. https://www.communitycare.co.uk/2024/02/23/mounting-demand-for-amhps-and-unmet-need-masked-by-fall-in-number-of-detentions-say-service-heads Simpson, M. (2024). Changing gears and buying time: A study exploring AMHP practice following referral for a Mental Health Act assessment in England and Wales. British Journal of Social Work, 54(2), 797–814. https://doi.org/10.1093/bjsw/bcad18 Skills for Care. (2025). The Approved Mental Health Professional workforce in the social care sector. https://www.skillsforcare.org.uk/Adult-Social-Care-Workforce-Data/workforceintelligence/resources/Reports/Regulated-professions/The-Approved-Mental-Health-Professional-workforce-in-the-social-care-sector-2025.pdf Sparrow, M. K. (2000). The regulatory craft: Controlling risks, solving problems, and managing compliance. Brookings Institution Press. Sparrow, M. K. (2008). The character of harms: Operational challenges in control. Cambridge University Press. Social Work England. (2021). Approved Mental Health Professionals, Best Interests Assessors and People with Lived Experience: An exploration of professional identities and practice. https://www.socialworkengland.org.uk/media/4046/amhp-bia-research-report.pdf Social Work England. (2022). Consultation on new education and training approval standards for Approved Mental Health Professionals. https://www.socialworkengland.org.uk/about/consultations/consultation-on-new-education-and-training-approval-standards-for-approved-mental-health-professionals/#consultationquestions Social Work England. (2023a). Annual report and accounts 2022 to 2023. https://assets.publishing.service.gov.uk/media/64b91ba806f78d00147425d9/Social_Work_England_annual_report_and_accounts_2022_to_23.pdf Social Work England. (2023b). Social Work England’s fitness to practise process: An initial analysis of diversity data. https://www.socialworkengland.org.uk/media/lqlhvazf/an-initial-analysis-of-our-diversity-data-september-2023.pdf Social Work England. (2024, July 10). Approved Mental Health Professionals (AMHP) course guidance. https://www.socialworkengland.org.uk/education-training/amhp-course-guidance/#mapping%20AMHP%20criteria%20to%20the%20education%20and%20training%20standards Social Work England. (2025, January 6). Registration annotations: Guidance for Approved Mental Health Professionals (AMHPs) and Best Interests Assessors. https://www.socialworkengland.org.uk/registration/registration-annotations/#annotations St George’s Healthcare NHS Trust v S [1999] Fam 26. Stone, K. (2019). Approved Mental Health Professionals and detention: An exploration of professional differences and similarities. Practice, 31(2), 83–98. https://doi.org/10.1080/09503153.2018.1541783 UK Parliament. (2015, July 2). HC Deb, vol 597, col 4. https://hansard.parliament.uk Westerman, P. (2012). Pyramids and the value of generality. Regulation & Governance, 6(1), 90–106. https://doi.org/10.1111/j.1748-5991.2012.01155.x Wickersham, A., Hami, R., Marwaha, S., & Morriss, R. (2020). The Mental Health Act assessment process and risk factors for compulsory admission to psychiatric hospital: A mixed-methods study. British Journal of Social Work, 50(3), 642–662. https://doi.org/10.1093/bjsw/bcz143 Wiegmann, D. A., Wood, L. J., Cohen, T. N., & Shappell, S. A. (2022). Understanding the “Swiss cheese model” and its application to patient safety. Journal of Patient Safety, 18(2), 119–123. https://doi.org/10.1097/PTS.0000000000000810 Worsley, A., Shorrock, S., & McLaughlin, K. (2020). Protecting the public? An analysis of professional regulation—Comparing outcomes in fitness to practice proceedings for social workers, nurses and doctors. The British Journal of Social Work, 50(6), 1871–1889. https://doi.org/10.1093/bjsw/bcaa079 Yeung, K. (2004). Securing compliance: A principled approach. Hart Publishing.