From compliance to risk: A paradigm for nursing and midwifery regulation in Ireland

Healthcare regulation is essential for protecting the public and maintaining professional standards, yet traditional compliance-based models are often rigid and resource intensive. Risk-based regulation (RBR) has emerged as an additional tool that can assist regulators in focusing on preventing harm rather than eliminating all risk. This article examines the application of RBR to nursing and midwifery with a focus on healthcare assistants, who deliver substantial patient care but are frequently unregulated. Using responsive regulation theory and right-touch assurance models, this article considers how intrinsic and extrinsic risks can guide proportionate oversight. Although RBR enhances efficiency, adaptability, and patient safety, challenges include data limitations, varied perceptions of risk, and political pressures. It is asserted that proportionate mechanisms, including delegation frameworks, can contribute to public safety without imposing unnecessary burdens. Thus, RBR offers regulators a flexible framework to support workforce optimization and ensure safe, high-quality care.