Professional regulation and patient safety: parallel systems or purposeful partners?

Summary

Martin Fletcher, hub topic lead for professionalisation and regulation, has been part of transformational change in professional regulation through his tenure as Chief Executive of the Australian Health Practitioner Regulation Agency (Ahpra).

In a new blog for the hub, Martin asks:

• How do we better connect the work of professional regulation with a systems focus on improving patient safety?
• And how do we navigate this interface in a health and societal context which is rapidly changing?

Content

Zubin Austin writes eloquently about the challenges of the ‘chaotic tumult’ of the many wicked problems that face professional regulators and, indeed, our health system more widely.[1] These form both the context and scaffolding for our work in years to come.

The rise of entrepreneurial and profit-driven models of care, telehealth, unregulated medicines for sale online, the role of social media and AI-driven therapeutics are disruptors which have introduced new risk profiles.

Traditional regulatory frameworks and approaches to patient safety must adapt. These shifts demand new thinking around safety, accountability, transparency and equity.

Traditionally, professional regulation has more narrowly focused on the conduct, competence and performance of individual health practitioners, with an emphasis on public protection. However, we know that the safety of patients is shaped by a wider range of inter-related factors, including clinical governance, team dynamics, design of systems and processes, technology and organisational safety culture.

There can be no healthcare without a health workforce. And an ethical, safety-conscious, competent and accountable health workforce is critical for a safe, high quality healthcare system.

I have previously written for Patient Safety Learning on the need to more closely link the work of service, product and system regulators, and patient safety improvement bodies. 

Shared goals, role clarity, information flows and aligned actions are critical. When we operate in silos, we risk missing the bigger picture. Without coordinated action across agencies, patients remain vulnerable.

The rapidly growing cosmetic practices sector illustrates these challenges vividly. In both Australia and the UK, reviews have shown that regulating practitioners alone isn’t enough.[2] [3] Products, procedures, facilities, social media, information asymmetry, service licensing arrangements and weak professional ethics all contribute to the potential risk of harm to patients.

More widely, there are significant opportunities to better use and share data and intelligence to both anticipate and understand risks of patient harm. The legalisation of medicinal cannabis in Australia powerfully illustrates this need. Incident reports, notifications and complaints are often lag indicators—we need to get ahead of emerging risks of harm to patients, especially in the face of the many healthcare disruptors we face.

I hope the hub community is a vehicle for sharing ideas, strategies and real-world examples of how to build foundations and bridges between professional regulation and patient safety improvements more widely.

New thinking and approaches are needed. And despite many differences in the way that health systems are organised and funded across the world, there are many common challenges.

References

1. Austin Z, Haji A. Regulation of wicked problems: opportunities, responsibilities, and threats. J Med Regulation. 2023;109(3):6–11. doi:10.30770/2572-1852-109.3.6.
2. Brown A, Duggan A, Kirkland A, McCausland R. Independent review of the regulation of medical practitioners who perform cosmetic surgery: Final report. Melbourne: Australian Health Practitioner Regulation Agency; August 2022.
3. UK Parliament. The regulation of non-surgical cosmetic procedures in England. House of Commons Library, 10 September 2025.

Further blogs on the hub from Martin

• Professional regulation and patient safety systems: parallel planets or partners in improvement?

About the Author

Martin Fletcher was the Chief Executive of the Australian Health Practitioner Regulation Agency (Ahpra) for 15 years, finishing his appointment in December 2024. Prior to joining Ahpra, Martin was Chief Executive of the NHS National Patient Safety Agency. From 2004-2007, Martin worked with the World Health Organization (WHO) to establish a global patient safety programme. 

Martin holds a Master of Management degree in public sector management, an Honours degree in behavioural sciences and an undergraduate degree in social studies.

Martin holds an honorary appointment as adjunct Professor with the School of Health and Biomedical Science at RMIT University. He was also a co-Director of the WHO Collaborating Centre for Health Workforce Regulation in the Western Pacific Region hosted by Ahpra.