Registration Practices Assessment Guide — For Health Regulatory Colleges

Introduction

Purpose

This guide presents registration practices for health regulatory bodies that are subject to Schedule 2 to the Regulated Health Professions Act, 1991 (RHPA). The guide enables staff of the Office of the Fairness Commissioner (OFC) to take a consistent and transparent approach to assessing a regulatory body’s current registration practices and making recommendations for improvement. The guide is also a reference that the regulatory body can use to self-assess its registration practices.

This guide is a key part of the OFC’s continuous improvement strategy. For information about the role that this guide plays in the strategy and an explanation of the regulatory body’s legal obligations under Schedule 2 to the RHPA, see the Strategy for Continuous Improvement of Registration Practices.

NOTE: Due to the differences in the legislation covering health regulatory colleges and the legislation for non-health regulatory bodies, two separate guides were developed. This guide is for assessing health regulatory colleges. For other regulatory bodies, see the Registration Practices Assessment Guide — For Regulated Professions and Trades.

Organization of This Guide

The rest of this guide is organized into sections that each list practices relating to a major element under Schedule 2 to the RHPA.

Practices listed in the specific-duty sections correspond to the regulatory body’s specific duties identified in Schedule 2 to the RHPA. The regulatory body must demonstrate these practices in order to meet the specific duties identified under Schedule 2 to the RHPA.

The general duty is in a distinct section in Schedule 2 to the RHPA and is much broader than the specific duties. The general-duty section in Schedule 2 states that the regulatory body must provide registration practices that are transparent, objective, impartial and fair. The section does not include definitions or interpretations for transparent, objective, impartial and fair registration practices.

In the absence of this information and for the purpose of assessing registration practices in a consistent and transparent way, the OFC interprets the principles of transparency, objectivity, impartiality and fairness as follows.

Transparency: A process is transparent if it is conducted in such a way that it is easy to see what actions are being taken to complete the process, why these actions are taken, and what results from these actions. In the regulatory context, transparency of the registration process encompasses the following:

• Openness: having measures and structures in place that make it easy to see how the registration process operates
• Access: making registration information easily available
• Clarity: ensuring that information used to communicate about registration is complete, accurate and easy to understand

Objectivity: A process or decision is objective if it is based on formal systems, such as criteria, tools, and procedures that have been repeatedly tested during their development, administration and review and have been found to be valid and reliable. In the regulatory context, objectivity of systems encompasses the following:

• Reliability: ensuring that the criteria, training, tools and procedures deliver consistent decision outcomes regardless of who makes the decision, when the decision is made, and in whatever context the decision is made
• Validity: ensuring that the criteria, training, tools and procedures measure what they intend to

Impartiality: A process or decision is impartial if the position from which it is undertaken is neutral. Neutrality occurs when actions or behaviours that may result in subjective assessments or decisions are mitigated. Impartiality may be achieved by ensuring that all sources of bias are identified and that steps are taken to address those biases. In the regulatory context, impartiality encompasses the following:

• Identification: having systems to identify potential sources of bias in the assessment or decision-making process (for example, sources of conflict of interest, preconceived notions, and lack of understanding of issues related to diversity)
• Strategies: having systems to address bias and enable neutrality during the assessment and decision-making process (for example, training policies that address conflict of interest, procedures to follow if bias is identified, and using group deliberation and consensus strategies to come to decisions)

Fairness: A process or decision is considered fair in the regulatory context when all of the following are demonstrated:

• Substantive fairness: ensuring the fairness of the decision itself. The decision itself must be fair, and to be fair it must meet pre-determined and defensible criteria. The decision must be reasonable and the reasoning behind the decision must be understandable to the people affected.
• Procedural fairness: ensuring the fairness of the decision-making process. There is a structure in place to ensure that fairness is embedded in the steps to be followed before, during and after decisions are made. This structure ensures that the process is timely and that individuals have equal opportunity to participate in the registration process and demonstrate their ability to practise.
• Relational fairness: ensuring that people are treated fairly during the decision-making process by considering and addressing their perception about the process and decision.

There is flexibility in how a regulatory body might demonstrate that its registration practices are transparent, objective, impartial and fair. Practices listed in the general-duty sections are to be used as a guideline and are examples or illustrations of the way that regulatory bodies can practically apply the principles of transparency, objectivity, impartiality and fairness. A regulatory body can choose to demonstrate the practices listed or it can choose to explain what it does to ensure that its practices are transparent, objective, impartial and fair.

Use of This Guide

To assess a regulatory body’s practices using this guide, OFC staff record whether the regulatory body is demonstrating a practice and offer comments. They also identify opportunities for improvement and further discussion, and highlight commendable practices. Staff use this guide to generate a Registration Practices Assessment Report.