Dr Anna van der Gaag CBE
About
Biography
Anna van der Gaag is a Visiting Professor in Ethics and Regulation. She was Chair of the Health and Care Professions Council from 2006-15 and a member of the Council since it was established in 2001. From 2006- 2008 she was a member of the Council for Healthcare Regulatory Excellence (CHRE) now the Professional Standards Authority for Health and Social Care. Anna has held a number of non-executive roles, including Chair of the Business and Oversight Board at the Law Society of England and Wales, Non Executive Director at Health Education England and Kent Surrey and Sussex Academic Health Science Network. She recently completed two terms as Chair of the Advisory Board for Safer Gambling, working on the National Strategy for Reducing Gambling related Harms and advocating for a statutory levy on gambling companies. She is currently Senior Independent Director at Sussex Partnership NHS Trust. Anna is a founding member of the Health Foundation’s ‘Q’, a connected community of people committed to health improvement.
Prior to her regulatory roles, she taught at undergraduate and postgraduate levels at the University of Strathclyde, was a senior researcher at the University of Oxford and at the Centre for Integrated Healthcare Research at Queen Margaret University, Edinburgh. As a clinician, she worked in acute and community settings in child and adult services. She had a particular interest in improving services to people with learning disabilities and in the importance of making information accessible.
Anna has a strong interest in education and innovation in health care, and has been an advocate of the importance of inter-disciplinary working. She has been involved in quality improvement initiatives with health professionals over four decades, and has published books and papers on user involvement, clinical assessment, clinical audit, skill mix, professional standards, service evaluation, governance and professional regulation. Examples of her work include a standardised communication assessment, a study of professional competence and a national evaluation of healthcare assistants and a study of complaints about health care professionals. Internationally, she has worked with the European and American professional associations on outcome measures and professional competence, and contributed to work on professional regulation in Canada, Australia and across the EU. She has been a member of UK government working groups on learning disabilities, clinical audit, professionalism and regulatory reform. A strong focus of her work has involved looking at professionalism in the healthcare workforce, and exploring what makes and breaks good care. Her current research portfolio includes developing the use artificial intelligence in professional regulation and looking at more compassionate ways to handle complaints for both complainants and practitioners.
She qualified as a speech and language therapist in 1981, has a MSc. from the Institute of Neurology, University of London, and a PhD. from the University of Strathclyde. She holds honorary doctorates from de Montfort University and Birmingham City University, held honorary research fellowships at the Universities of Glasgow and Brighton and is a Visiting Chair at Royal Holloway University of London. In 2015, she was awarded a CBE for services to health and care.
Publications
Within the regulatory community, there has been increasing interest in the issue of proportionality in regulation — that is, using the right amount and right types of regulatory interventions to achieve the primary mandate of the regulatory community in order to serve and to protect. The Health and Care Professions Council (HCPC) in the United Kingdom, one of the largest health-care regulatory bodies in the world, recently commissioned a study examining the disproportionately large number of complaints against paramedics in the UK and social workers in England. The objective of the study was to examine the nature of, and to better understand the reasons behind, this disproportionality, and to identify options and opportunities from a regulatory perspective that could be taken to address this issue. The study involved a systematic multi-methods research approach involving four key interrelated research elements: • A systematic literature review • A Delphi consultation with international experts • Interviews (n=26) and four focus groups (n=23) with UK experts, including service users and caregivers • A review of a random sample (n=284) of fitness-to-practice cases over two years across the three stages of the process (initial complaint, Investigating Committee Panel, and final hearing) Findings from this study highlight the evolving nature of both professions and the influence of a binary model of complaints adjudication that may not be sufficiently nuanced to balance public protection with practitioners’ learning needs. A non-binary option for understanding complaints against practitioners is suggested in this paper, offering a process that involves and engages both employers and practitioners in a more meaningful manner.
This project aimed to develop an artificial intelligence (AI)-based tool for improving the consistency and efficiency of decision making in the nursing complaints process in three jurisdictions. This article describes the tool and the overall process of its development. The AI tool was not designed to replace human judgment but rather to perform three data-driven decision support tasks: (a) an independent risk prediction of the case, (b) a comparison with previous similar cases, and (c) a cross reference to relevant parts of the regulatory standards or rules in each jurisdiction. Three nursing regulatory bodies in the United States, the United Kingdom, and Australia provided anonymized data from 5,700 cases for tool design and testing. Regulatory staff were involved in each stage of development and supported the potential role of an AI-based tool such as this in improving the efficiency and effectiveness of decision-making in disciplinary processes in nursing regulation nationally and internationally.
Additional publications
SELECTED PUBLICATIONS
This sample of publications provide evidence of work in developing national and international professional standards, skill mix, professional competence, regulation, devising clinical audit mechanisms for use by health professionals, as well as work aimed at increasing patient and public involvement in healthcare service delivery.
Books
van der Gaag, A, Glass, K, Reid, D. (1993) Audit: An Introduction for Speech and Language Therapists London; College of Speech and Language Therapists.
-1994 (Ed) Research and Development in Occupational Therapy, Physiotherapy and Speech and Language Therapy. London: Department of Health.
-1996 (Ed, second edition) Communicating Quality: Professional Standards for Speech and Language Therapists London: Royal College of Speech and Language Therapists.
- 1998 (Ed) Clinical Guidelines by Consensus for Speech and Language Therapists. London: Royal College of Speech and Language Therapists.
van der Gaag, A, McCartan, P, McDade, A, Reid, D, with Roulstone, S. (1999). A Talking Toolkit: The Early Communication Audit Manual London: Royal College of Speech and Language Therapists.
Anderson, C., van der Gaag, A (2005) Speech and Language Therapy: Issues in Professional Practice. Chichester: Wiley.
-1988 Communication Assessment Profile for adults with learning disabilities (CASP) London: Speech Profiles. www.speechprofiles.co.uk
Chapters in edited books
van der Gaag, A, Cooper, C. (1995) The Profession at Work
in Leahy, M. (Ed) Communication Disorders: The Science of Intervention (Second Edition) London: Whurr Publishers
Byng, S, van der Gaag, A., Parr, S. (1997) International Initiatives on Outcome Measurement: A Perspective from the United Kingdom in Fratelli, C (Ed) Outcome Measurement in Speech Language Pathology p558-578. New York:Thieme Medical Publishers.
Van der Gaag, A, Mowles, C (2005) Understanding Values in Anderson, C., van der Gaag, A (2005) Speech and Language Therapy: Issues in Professional Practice. Chichester: Wiley.
van der Gaag, A, Anderson C. The Geography of Professional Practice. In Anderson, C., van der Gaag, A (2005) Speech and Language Therapy: Issues in Professional Practice. Chichester: Wiley.
Major Reports
van der Gaag, A, McCartan, P, McDade, A, Reid, D. (1999) A multi-disciplinary audit of GP, health visiting and speech and language therapy services to preschool children with speech and language delays. Report to the Department of Health, London
van der Gaag, A, Symon, S. (2003) The Glasgow Allied Health Professions User Involvement Project. Report to Glasgow Primary Care Trust.
van der Gaag, A Jahoda, A, Symon, S (2004) A pilot investigation of the impact of the Care Aims Model within the Learning Disabilities Partnership. Report to West Glasgow Mental Health and Learning Disabilities Trust
Law, J van der Gaag, A, Symon, S. (2005) Improving communication in primary care:an examination of the feasibility of introducing Health Talk: Count me in in two Primary Care Practices. Report to Forth Valley and Ayrshire and Arran PCTs
van der Gaag, A, Mowles, C (2007) NHS Grampian Speech and language Therapy Review. Final Report to the NHS Grampian Board.
van der Gaag A. (2010) An independent review of the implementation of Care Aims in NHS Lanarkshire. Report to the NHS Lanarkshire Board.
van der Gaag, A. (2015) The making of a multi professional regulator: the HCPC,2002-15.
http://www.hcpc-uk.org/publications/research/index.asp?id=1115
van der Gaag, A. (2017) People like us? Understanding complaints about paramedics and social workers.
http://www.hcpc-uk.org/publications/research/index.asp?id=1401
Journals
van der Gaag, A. (1988) Joint assessment of communication skills: formalising the role of the carer. British Journal of Mental Subnormality 35(1) p22-28.
Davies, P. van der Gaag, A. (1992) The professional competence of speech therapists: I: Introduction and methodology. Clinical Rehabilitation 6,3, 209-214.
van der Gaag, A. Davies, P. (1992) The professional competence of speech therapists: II: Knowledge base. Clinical Rehabilitation 6,3, 215-224.
Davies, P. van der Gaag, A. (1992). The professional competence of speech therapists: III: Skills and skill mix possibilities. Clinical Rehabilitation 6,4,311-324.
van der Gaag, A. Davies, P. (1992).The professional competence of speech therapists: IV: Attitude and attribute base. Clinical Rehabilitation 6,4, 325-332.
van der Gaag, A, Davies, P. (1994). Following the dolphins: an ethnographic study of speech therapists working with people with learning disabilities. European Journal of Disorders of Communication, 29, (2) 203-216.
Davies, P, van der Gaag, A .(1993). The use and value of speech therapy assistants: summary and conclusions of a twelve month evaluation. College of Speech and Language Therapists Bulletin , 494, p4-6.
McCartney, E, van der Gaag, A. (1996). How shall we be judged? Speech and Language Therapists in educational settings. Child Language Teaching and Therapy,12
van der Gaag, A. (1998). Keynote review: Communication skills and adults with learning disabilities. British Journal of Learning Disabilities, 26, (3) 88-93.
van der Gaag, A, McLoone, P, Reid, D. (1999).Speech and language therapy caseloads in seven districts in the UK. Journal of Management in Medicine 13 (1) 23-32.
Anderson, C, van der Gaag, A. (2000) An examination of the pattern of preschool referrals to speech and language therapy. Child LanguageTeaching and Therapy 16, (1)59-71.
Van der Gaag, A, Anderson, C. (2001) Reviewing the review process; examining decision making in practice. International Journal of Language and Communication Disorders 36, 258-63.
Mitchell, J, van der Gaag, A. (2001) Through the eye of the cyclops: an evaluation of a multi-sensory programme for people with complex disabilities. British Journal of Learning Dsabilities, 29, 131- 137.
van der Gaag, A. (2007) Regulation – no fire in the belly. Royal College of Speech and Language Therapists Bulletin 646,
van der Gaag, A, Smith, L, Davies, S, Moss, B, Mowles, C. (2005) Connect therapy and support services for people with long term stroke and aphasia and their relatives; a six month follow up study. Clinical Rehabilitation, 19, 372-81.
van der Gaag, A, Brooks, R. (2008) How much does the service cost? An economic evaluation of a service for people with aphasia International Journal of Disorders of Communication 43, 233.
Mowles, C van der Gaag, A, Fox, J. (2010) The Practice of Complexity: review, change and service improvement in an NHS department. Journal of Health Organisation and Management, 24(1).
van der Gaag, A. (2010) The Health Professions Council and the regulation of counselling and psychotherapy. The Psychotherapist, Autumn, p26-28.
van der Gaag, A. (2010) Regulation, accountability and fitness to practise. New Associations 4 8-10.
van der Gaag, A, Donaghy, J (2013) Paramedics and professionalism: looking back and looking forwards. Journal of Paramedic Practice 1(5) p8-10.
van der Gaag, A., Jago, R., Austin, A., Zasada, M., Banks, S., Gallagher, A., Lucas. (2018) Why do more paramedics report themselves to the UK regulator than other health professionals? Journal of Paramedic Practice 10 (4)
Gallagher, A., Jago, R., Lucas, G., Banks, S., Austin, Z., Zasada, M., van der Gaag, A. (2018) Findings from a Delphi process exploring reasons for fitness to practise complaints & preventative strategies. Journal of Paramedic Practice 10 (4)
Austin, Z., van der Gaag, A., Gallagher, A., Jago, R., Banks, S., Lucas, G. Zasada, M. (2018)Understanding complaints about paramedics in the UK and social workers in England: findings from a multi-method study, Journal of Medical Regulation,104 (3), pp. 19-28.
Banks, S., Zasada, M., Jago, R.,Gallagher, A., Austin, Z.,van der Gaag, A. (2019)Social workers under the spotlight: An analysis of fitness to practise referrals to the regulatory body in England, 2014-16 British Journal of Social Work, advanced access, 20 December 2019, bcz145, https://doi.org/10.1093/bjsw/bcz145
Lucas, G., Zasada, M., Gallagher, A., Jago, R., Banks, S., Zubin, A., van der Gaag, A. (2019) Understanding complaints about paramedics: a qualitative exploration in a UK context’ Australasian Journal of Paramedicine, 16, pp.1-7
Jago, R., van der Gaag, A., Stathis, K., Petej, I., Lertvittayakumjorn, P., Krishnamurthy, Y., Caceres Silva, J., Webster, M., Gallagher, A., Austin, Z (2021) Use of artificial intelligence inregulatory decision making. Journal of Nurse Regulation 12 (3) 11-19.
Lertvittayakumjorn,P., Petej, I., Krishnamurthy, Y.,Gao, Y Jago, R., van der Gaag, A., Jago, R., Stathis, K. (2021) Supporting complaints investigation for Nursing and Midwifery Regulatory Agencies
https://aclanthology.org/2021.acl-demo.10/
Biggar, S, van der Gaag, Fletcher, M (2023) Virtually daily grief: Identifying and minimising the risk of distress in health practitioners involved in a regulatory process: a qualitative study in Australia.https://academic.oup.com/intqhc/article/35/4/mzad076/7282442
Selected articles and blog pieces
Davies, P, van der Gaag, A. (1993). The use and value of speech therapy assistants: summary and conclusions of a twelve month evaluation. College of Speech and Language Therapists Bulletin, 494, p4-6.
van der Gaag, A. (2000). Post modernising the evidence. Royal College of Speech and Language Therapists Bulletin, 578, 20.
van der Gaag, A. (2002) Health Professions Council initiates change for professions Royal College of Speech and Language Therapists Bulletin, 602, 18.
van der Gaag, A. (2007) Regulation – no fire in the belly. Royal College of Speech and Language Therapists Bulletin 646,
van der Gaag, A. (2010) The Health Professions Council and the regulation of counselling and psychotherapy. The Psychotherapist, Autumn, p26-28.
van der Gaag, A. (2010) Regulation, accountability and fitness to practise. New Associations 4 8-10.
van der Gaag, A. (2011) Psychotherapy needs regulation like any other profession.The Guardian, 5.1.11.
van der Gaag A. (2012) Why social work students do not need to register with professional regulator. The Guardian Professional, 25 May 2012.
van der Gaag, A. (2013) Drawing new lines in the sand: maintaining standards in the wake of the mid Staffordshire Inquiry. RCSLT Bulletin 729, p16.
van der Gaag, A. (2014) Focus on continuing fitness to practise, not revalidation. Nursing Times 110 (12)7.
Examples of blog pieces on professionalism, regulatory failure, mediation, Law Commissions review at: www.hcpc-uk.blogspot.co.uk. and https://avdgblog.wordpress.com/
A commentary on competence
http://hcpc-uk.blogspot.co.uk/2013/07/what-is-opposite-of-competence.html
The Francis Inquiry
http://hcpc-uk.blogspot.co.uk/2013/02/personal-reflections-post-francis.html
The Berwick Review
http://hcpc-uk.blogspot.co.uk/2013/05/don-berwick-challenging-voice-from-us.html
The Q initative and why it matters
https://avdgblog.wordpress.com
Stewardship of the common good
http://www.health.org.uk/blog/stewardship-common-good
Trust and leadership
https://avdgblog.wordpress.com/
Rehumanising regulation
https://avdgblog.wordpress.com/
The future of AI in regulation
https://ascend.thentia.com/more/podcast/podcast-future-ai-in-regulation/
Kindness in regulation
https://www.ahpra.gov.au/News/2021-05-04-Kindness-in-healthcare-pod-ep…
https://www.ahpra.gov.au/Publications/Podcasts.aspx