Reporting concerns to regulators: A novel analysis of feedback from people harmed by health and social care practitioners

Background Health and social care professionals must adhere to the standards of professional conduct of their professional regulator. Regulators can sanction registrants, including limiting their practice and striking them off, through a fitness-to-practice process. In the United Kingdom, there are 13 professional regulators, the largest of which regulates nurses and midwives. Although anyone can raise a concern about a registrant, members of the public are the largest source of raised concerns. Globally, there is scant research regarding the public raising a concern with a regulator. Purpose This study examined the expectations of, experiences of, and support offered to the public who raised a concern in the United Kingdom. Methods A survey was completed by 64 people who had raised a concern. The resulting cases were either closed by one of seven regulators before a hearing or were still open with one of two other regulators. Open responses were analyzed using thematic content analysis. Results Three overarching themes emerged about participant experiences related to (a) raising a concern, (b) the regulatory process, and (c) the outcome. Serious harm of multiple types was commonly reported by participants. Participants who expressed negative feelings about the process felt that they were not taken seriously or that "justice" was not served. Participants who reported positive outcomes had cases in which a registrant was disciplined in some way or the outcome would prevent repetition of harm to others in the future. Conclusion This study adds to the small body of research that may inform interventions to improve the engagement of the public in regulatory processes, enabling them to give their best evidence, and through this process contribute to public safety. Regulators should recognize the key role public referrers have in regulatory processes by welcoming these concerns, communicating what can and cannot be considered and why, keeping referrers informed, offering a point of contact and support if needed, and communicating outcomes personally. Additional research is needed to evaluate whether these interventions would improve the public's experiences and trust in professional regulation. Clinical trial registration Not applicable.