Professional Regulatory Bodies Research Articles

Pandemic Impact, Support Received, and Policies for Health Worker Retention: An Environmental Scan

Background and Objectives. The COVID-19 pandemic has brought additional strain to health workers in thePhilippines, leading to a significant proportion of them leaving the workforce. The purpose of this study is to explore the impact of the pandemic on health workers, the support that they received and associated challenges; and identify relevant policies for better workplace conditions. Methods. An environmental scanning method was utilized. Particularly, a literature review and policy scan that were validated through key informant interviews with administrators and frontline health workers from selected urban and rural sites in the three main islands in the Philippines. These were framed into a background note to springboard the discussions during a national policy dialogue participated by representatives from key government organizations, professional organizations of physicians, nurses, and midwives, professional regulatory bodies, hospital administrators, frontline health workers, and donor agencies in the Philippines. Results. Deaths, burn-out, mental health problems, lack of personal protective equipment and poor allocation of vaccines were reported in the early phases of the pandemic. Support varied across settings but included additional allowance, free meals, accomodation, transportation, training and psychosocial services. Furthermore, pre-pandemic issues such as as low salaries and heavy workload continue to be the main reasons for leaving the workforce or the country. The proposed solutions are as follows: (1) creating policies and strategies for appropriate production, recruitment, and retention of human resources for health; (2) allocating regular permanent positions for both the education and health sector; (3) augmenting and continuation of deployment programs; (3) expanding roles of nurses to push for advanced practice nursing; (4) providing fair compensation along with risk allowances, non-financial incentives, and expanded benefits; (5) supportingmental health wellness by providing an appropriate work-rest balance and safe work environment; (6)providing opportunities for professional development and scholarships with accompanying return-serviceagreement; and (7) strengthening the reintegration programs for returning overseas health workers. Conclusion. The pandemic has affected the well-being of health workers and disparities in support were reported due to longstanding workplace issues and policy implementation gaps. Stakeholder commitments require sustained monitoring while policies that are in place and yet to be developed demand stronger support from the government, members of Congress, the private sector, and other key decision-makers.

Post-Dobbs Psychiatric Exceptions in Abortion-Restricting States.

Mental disorders and suicide are important causes of increased morbidity and mortality rates during pregnancy. Since the U.S. Supreme Court's 2022 Dobbs decision, many state legislatures have passed stringent abortion bans and restrictions. These laws define exceptions under which abortion may be legally obtained. Suicidality and other psychiatric symptoms have been excluded from such definitions. In this column, the authors examine how legislatures, courts, and professional regulatory bodies in several abortion-restricting states have defined their medical emergency exceptions. The authors argue that psychiatrists should be concerned about the management of psychiatric emergencies during pregnancy as well as emerging legal intrusions into physician-patient decision making.

Veterinary telemedicine: A new era for animal welfare.

Telehealth is a rapidly developing field of veterinary medicine, particularly during and after the coronavirus 2019 (COVID-19) pandemic. The world and animal owners' expectations are changing to the point where veterinary practice will need to adapt due to information technology advancements. This narrative review describes the status, benefits, technology basics, applications, limitations, and legal aspects of veterinary telemedicine over the globe. Veterinary telemedicine is a service alongside other veterinary services that meets client needs, delivers quality medicine, and improves animal welfare. The most frequently utilized veterinary telemedicine applications include teleradiology, telesonography, teledentistry, telecardiology, telerehabilitation, anesthesia teleconsultation, telehospice and telepalliative care, telecytology, tele-endoscpy, teledermatology, tele-ophthalmology, tele-behavior therapy, and veterinary education and training. Veterinary telemedicine has a bright near future and will impact veterinary medicine and animal welfare due to its numerous advantages. These advantages include its low cost, availability, involvement in veterinary health care, online payment, and effectiveness in many clinical situations such as follow-up after an in-person examination, inspection of surgical sites, or mobility. Nevertheless, veterinary telemedicine should receive more attention from veterinary professional regulatory bodies in all countries. Moreover, it is necessary to conduct more studies to evaluate how telehealth is beginning to improve veterinary care, particularly for underserved regions.

Production Cost Forecasting for a Given Volume of Output in Organizations: Case Study Based on Regression Model

Purpose: The objective of this study is the analysis and forecasting of Enterprise Production Cost for a given volume of output on the basis of historical data. Theoretical framework: The theoretical framework of the study includes studies conducted by various researchers and professional regulatory bodies (ACCA) related to the the Production Cost forecasting in organizations. Design/methodology/approach: The authors use trend analysis to determine a regression equation for the organisaton under investigation. Having the planned volume of production , it gives the opportunity to calculate the projected amount of production costs. The financial and managerial accounting reports (from 2015 to 2022) provided by “Effect Group” CJCS were used to study the topic. Findings: Using the revealed dependences and the trend equation, the forecasting of Production Cost of the organization under investigation is obtained for the next two reporting periods. Research, Practical & Social implications: The main findings of the article can be useful in the practical management of businesses, for financial analysis and forecasting. In addition, the results of this research can be used in scientific and teaching activities in covering the issues of financial management and analysis. Originality/value: The value of the study is the contribution it makes to the literature on the cost analysis issues. Therefore, the article can be of benefit to the scientific community with an interest in the study of the subject.

A75Strengthening simulation quality assurance through the ‘Sim QA bundle’

The All Wales Simulation-Based Education and Training Strategy 2022 – 2027 specifies as one of its aims to promote quality assured simulation-based education and training across healthcare in Wales underpinned by standards and evaluated to ensure best practice in safe learning environments [1]. The Simulation Team at Health Education and Improvement Wales (HEIW) has been working closely with the simulation community in Wales to identify their needs through iterative consultation during meetings, focussed discussions and webinars. In 2021 stakeholders agreed that HEIW would promote the application of the Association for Simulated Practice in Healthcare (ASPiH) standards [2] and professional regulatory and statutory body standards relevant to SBET. Since then, a number of quality assurance tools as well as faculty development opportunities have been developed in order to embed these standards into simulation faculty development programmes and cascade their routine inclusion into everyday SBET practice. Quality assurance (QA) resources developed by the Simulation Team at HEIW between August 2021 and February 2023 were packaged as the ‘Sim QA Bundle’ ( HEIW Simulation Quality Assurance Bundle The ‘Sim QA Bundle’ consists of four components: Faculty development and continuous professional development (CPD): available resources include free access to the Essential Faculty Development Course, regular webinars, workshops and conferences. Content development: guidance provided includes a standardized scenario scripting template, with links to relevant literature. Content delivery: a standardized approach to debriefing has been developed which is supported by education opportunities and cognitive aids. Evaluation tools: generic evaluation forms have been designed to assess the learners’ experience, faculty perspectives and adherence to standards. The Simulation Quality Assurance Bundle provides a wide range of resources available to simulation practitioners in order to promote and support the delivery of high-quality simulation-based education and training across the healthcare workforce in Wales. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.

FINAL REPORT FROM THE FORUM ON NURSING PRACTICE REGULATION IN THE REGION OF THE AMERICAS MARCH 15-16, 2023

There are nearly 7 million nursing professionals in the Region of the Americas, representing more than 56% of human health resources. The regulation of professional practices promotes and protects professional integrity, ensuring professionals are competent and well qualified. The Forum on Nursing Practice Regulation in the Region of the Americas aimed to present the regulatory frameworks for the professional practice of nursing; discuss strategic actions to support professional regulatory bodies; analyze requirements for licensing and renovating licenses; and share successful experiences in nursing regulation. The Forum counted on the participation of 83 guests in-person, with representatives from 17 countries from Latin America and the Caribbean. The COFENplay platform registered the participation of 6,906 spectators. The debates in the event led to the proposal of the following recommendations: promote a national discussion with key-actors, including the Ministries of Health, Education, and Work and Employment, to advance regulation in the countries; recommend an intersectoral articulation with the topic of Human Health Resource regulation; generate a common base for the identification of information on regulation; and broaden the research about these topics, as well as the ability to generate and analyze data.

Allied Health Professions Accreditation Standards for Work Integrated Learning: A Document Analysis.

A key role of allied health (AH) professional regulatory and professional bodies is to ensure that AH education programs provide work-integrated learning (WIL) opportunities for students. The requirements are outlined via the respective profession's educational accreditation standards. Although a significant component of the AH professional degrees, researchers have not explored how standards specific to WIL are developed, nor how WIL might be conceptualised through the standards. This study explored how WIL is conceptualised through comparing the WIL education standards across Australian AH professions. Using a non-experimental explanatory mixed-methods research design, a document analysis of Australian education program accreditation standards (and associated documents) for 15 AH professions was undertaken. Data analysis included inductive textual and thematic analyses to compare AH professionals' conceptualisation of WIL. This study found a high degree of variation in how AH professions describe WIL. While there was a common requirement for students to demonstrate competency in WIL, requirements for WIL quantity, assessment and supervision varied. Four key themes were identified regarding the contribution of WIL to curriculum and student learning: (1) the relationship between WIL and the program curriculum; (2) WIL as a learning process; (3) learning from diverse WIL contexts; and (4) developing competence through WIL. Overall, the diversity in the standards reflected differing understandings of what WIL is. Thus, in the absence of frameworks for designing accreditation standards, the risk is that some AH professions will continue to perpetuate the myth that the primary purpose of WIL is to provide a bridge between theory and practice.

An exploration of simulation-based education from other health professionals, to create an informed and effective simulation delivery in a new diagnostic radiography programme

IntroductionThe recent validation of three Diagnostic Radiography programmes in the south of England involved a rigorous approval process with multiple Professional and Statutory Regulatory Bodies (PSRB's). Part of the validation process was evidencing that approximately 50% of each programme is spent undertaking practice-based learning. As well as clinical placements, practice-based learning includes simulation-based education (SBE). MethodologyFrom May 2022 to June 2022, a questionnaire was sent to all 22 simulation education facilitators from health courses belonging to the University School Simulation Group. Ethical approval was reviewed and approved by the Learning and Teaching Hub Research Ethics Panel. ResultsOf the initial 22 participants invited, the response rate was 59% (13 participants). The main themes arising from the analysis was the use of a theoretical or conceptual framework, a breakdown of the simulation session components and the role of simulation training. ConclusionThis questionnaire study demonstrated that there was a need for a standardised guide on how to deliver SBE. There is also a lack of feedback, training, and reassurance for facilitators. However, facilitators would welcome training or further training and HEE and the University have taken steps to prioritise SBE. Implications for practiceThe study highlighted how health professionals are delivering SBE within their subjects in innovative and creative ways. These ideas have helped to structure SBE within the new diagnostic radiography courses at the University.

Profiling UK injectable aesthetic practitioners: A national cohort analysis

The United Kingdom (UK) injectables market has been growing rapidly with a lack of robust regulation and to date, no information regarding the profile of practitioners has been published. We aim to provide a descriptive and qualitative analysis of the advertised practitioners in the United Kingdom. We performed a systematic search using the internet search engine Google to perform a qualitative descriptive analysis of aesthetic practitioners in the UK. For each contiguous country in the UK: England, Scotland, and Wales, five searches were performed. The list of practitioners was then cross-referenced with professional regulatory bodies, with extraction of registration number, date of registration and presence or absence from the Specialist Register or General Practitioner Register. 3000 websites were visited and evaluated. 1224 independent clinics with 4405 practitioners were identified. 738 were identified as those in business support functions and the remaining 3667 practitioners were undertaking injectable practice. The profile of professions were doctors 32%, nurses 13%, dentists 24% and dental nurses 8%. Of the 1163 doctors identified 481 were on the specialist register (41%) and 219 were on the GP register (19%). 27 specialties were represented in this cohort analysis. Plastic Surgery formed the majority of those who were on the specialist register at 37%, followed by Dermatology at 18%. This paper is the first to describe the range of practitioners, their professional backgrounds and experience who perform non-surgical aesthetic interventions. The range of backgrounds may have an impact on the potential risks to patients and will be an important consideration in proposed legislation to introduce licensing to the industry.

O161 Profiling UK injectable aesthetic practitioners: a national cohort analysis

Abstract Introduction The United Kingdom injectables market has been growing rapidly. The lack of formal, robust regulation has led to the UK Government seeking to evaluate methods of regulating the industry, as very little information or evidence is available regarding practitioners. We aim to provide a descriptive and qualitative analysis of the advertised practitioners in the United Kingdom. Methods Between June-December 2022, we performed a systematic search using the internet search engine Google to perform a qualitative descriptive analysis of aesthetic practitioners in the UK. For each contiguous country in the UK: England, Scotland, and Wales, five searches were performed. The list of practitioners was then cross-referenced with professional regulatory bodies. Results 3,667 practitioners were identified as those undertaking injectable practice. Doctors formed the majority of practitioners at 32%. Dentists and dental nurses formed 24% and 8% respectively of practitioners, and trainee dental nurses–2%. Of the 1,163 doctors identified, a total of 481 were on the specialist register (41%) and 219 were on the GP register (19%). A total of 27 specialties were represented in this cohort analysis. Plastic Surgery formed the majority of those who were on the specialist register at 37%, followed by Dermatology at 18%. Conclusion This paper is the first to describe the range of practitioners, their professional backgrounds and experience who perform non-surgical aesthetic interventions. The range of backgrounds may have an impact on the potential risks to patients and will be an important consideration in proposed legislation to introduce licensing to the industry.

Professional bodies

AbstractOrganization structures and processes of UK-based professional associations and regulatory bodies (professional bodies) are analyzed across all professions and over the long term. These are successful, long lived, and important organizations which have been neglected in the sociological and organizational literatures. Numbers have been growing and on average these organizations have enjoyed consistent financial success. They have been changing, reacting in part to external challenges, but also in response to internal challenges arising from growth and strains due to reactions to changes from their primary stakeholders, their members. We trace substantial changes in their staffing, governance, and education activities. We evaluate whether these changes amount to corporatization, as has been found in other public and third-sector organizations. We evaluate whether the changes confirm the charge that these organizations demonstrate the iron law of oligarchy. We find corporatization has been substantial but limited and that the changes represent shifting toward strategy rather than oligarchy, though democratic weakening has occurred. We find organization responses to member confusion, concerns, and criticisms to be influential in driving these changes and contributing to the sustainability of these organizations.

Attrition and Retention of Rehabilitation Professionals: A Scoping Review.

Attrition is defined as a permanent departure from one's profession or the workforce. Existing literature on retention strategies, contributing factors to the attrition of rehabilitation professionals and how different environments influence professionals' decision-making to stay in/leave their profession, is limited in scope and specificity. The objective of our review was to map the depth and breadth of the literature on attrition and retention of rehabilitation professionals. We used Arksey and O'Malley's methodological framework. A search was conducted on MEDLINE (Ovid), Embase (Ovid), AMED, CINAHL, Scopus, and ProQuest Dissertations and Theses from 2010 to April 2021 for concepts of attrition and retention in occupational therapy, physical therapy, and speech-language pathology. Of the 6031 retrieved records, 59 papers were selected for data extraction. Data were organized into three themes: (1) descriptions of attrition and retention, (2) experiences of being a professional, and (3) experiences in institutions where rehabilitation professionals work. Seven factors across three levels (individual, work, and environment) were found to influence attrition. Our review showcases a vast, yet superficial array of literature on attrition and retention of rehabilitation professionals. Differences exist between occupational therapy, physical therapy, and speech-language pathology with respect to the focus of the literature. Push, pull, and stay factors would benefit from further empirical investigation to develop targeted retention strategies. These findings may help to inform health care institutions, professional regulatory bodies, and associations, as well as professional education programs, to develop resources to support retention of rehabilitation professionals.

Global overview of pharmacy support personnel training programmes: a scoping review protocol

IntroductionA global variation in the pharmacy support personnel training programmes has been observed. The objective of this scoping review is to map out global evidence available on the pharmacy support...

A Comparative Model Analysis of Predictors of Community Pharmacists’ Collaborative Practices in Two Southwestern States in Nigeria

Background: In community pharmacy practice, pharmacists are expected to engage in collaborative activities to deliver quality service to clients. However, due to the hybrid nature (social and commercial dimensions) of the practice, certain subjective behavioral norms-competitive and information-sharing behavior may have potential influence on the collaborative behaviors of community pharmacists
 Objectives: Based on the theory of planned behavior framework, the study tests the influence of subjective norms-competitive behavior and information-sharing practices on the collaborative behavior of community pharmacists; and, investigated possible differences in the perception of respondents in two southwestern states in Nigeria
 Methods: A cross-sectional quantitative study with randomly administered questionnaires to 421 community pharmacists from two purposively selected states- Lagos (230) and Ogun (191) in southwest Nigeria. A structural equation model was developed using Analysis of Moment Structures software (AMOS). Group differences were evaluated using the chi-square difference test.
 Results: Competitive behavior and information-sharing behavior are substantial predictors of collaborative behaviors among community pharmacists (R2=0.97, p<0.001). Multigroup analysis revealed differences in perception between respondents in the densely populated and less densely populated settings. Model comparisons revealed insignificant group differences.
 Conclusion: The study confirmed that information-sharing and competitive behavior have a positive and significant influence on collaborative behavior. The findings of the study imply that no link exists between the geographical placement of community pharmacists and differences in their practice behavior. Professional associations and regulatory bodies should provide training and engage in participatory workshops to strengthen the right collaborative attitudes among community pharmacists. The study provides a theoretical framework for further studies in inter- and intra-professional relations among healthcare professionals.

BACCN position statement on non‐medical prescribing in critical care

AbstractBackgroundThe British Association of Critical Care Nurses (BACCN) published its first position statement on non‐medical prescribing (NMP) in critical care in 2009 (Bray et al., Nurs Crit Care. 2009;14:224‐234). Over the years, more nurses and other health care professionals have become non‐medical prescribers, and the BACCN have thus revisited and updated the statement.AimTo update the 2009 position statement on NMP in critical care to reflect contemporary guidance and practice.Study designA working group was established following an expression of interest to BACCN members, and the original BACCN position statement and literature review were updated using key databases. An electronic questionnaire was developed by the working group to describe current NMP practises and the authorization and prescribing of blood and blood components. It was distributed via email to 1861 BACCN members and on BACCN social media in October and November 2021.ResultsTwo hundred and fifty nine health care professionals from the four countries of the United Kingdom completed the survey, and of these 136 (52.5%) respondents were BACCN members. One hundred and five (40.4%) of the respondents described themselves as non‐medical prescribers, and of these, 57 (54.8%) were independent prescribers and 47 (45.2%) were supplementary and independent prescribers, with one respondent not revealing. The remaining 154 (59.4%) respondents were not registered as non‐medical prescribers. Ninety‐one (86.7%) of the respondents who were non‐medical prescribers reported making prescribing decisions on every clinical shift, and 67 (64.4%) of these audited their prescribing practises. Of the 105 who described themselves as non‐medical prescribers, 71 (67.6%) had been in their area of practice for more than 5 years before they became non‐medical prescribers, with 3 (2.8%) being in the practise area for less than 1 year.All seven statements from Bray et al's (2009) position statement were revised and updated following the survey results and review of the literature search.ConclusionsThe updated position statement is based upon new policy documents from a range of sources, including the Nursing and Midwifery Council, the Faculty of Intensive Care Medicine, the Royal College of Emergency Medicine and the Royal Pharmaceutical Society. It takes account of the adult critical care patient pathway before, during and after an admission to critical care.Relevance to clinical practiceNon‐medical prescribing (NMP) should only be implemented to improve the safety and quality of care for the critically ill or deteriorating patient. The requirement for NMP needs to be determined locally by organizations, ensuring that the care of the critically ill and deteriorating patient is the main reason. NMP must not be used as a substitute for unsafe medical practice or poor medical prescribing practice. Non‐medical prescribers must adhere to the current Royal Pharmaceutical Society's Prescribing Competency Framework and must be registered with their professional regulatory body. Non‐medical prescribers must audit and evaluate their practice as well as ensuring continuing professional development. Non‐medical prescribers in critical care must consider how their own professional codes of conduct, scope of practice, standards and guidelines impact their prescribing decisions. Non‐medical prescribers must work collaboratively to ensure that continuity and transfer of care between care settings consider deprescribing and medicines reconciliation.

Strategic Leadership and Performance of Health Care Workers in the Northeastern Counties of Kenya

The Kenya Constitution in 2010 devolved health services provision to counties. Under the county governments, the provision of the health services have faced many challenges relating to human resource management, remuneration, service delivery and turnover hence begging the question as to whether counties have the capacity to manage the health function. Hence, the study sought to establish the relationship between strategic leadership and performance of health care workers in North Eastern Kenya counties. The study was anchored on the upper echelons theory. A descriptive cross sectional research design was used. The study target population was 3,000 Health care workers and 10 health managers in the counties. The sample size for the health care workers was 353 obtained using Yamane Formular. Besides, a census approach was undertaken for the health managers in the counties. The number of the health managers are few and manageable. Questionnaire was used to collect the data. Both descriptive and inferential analysis was done on the collected data. The study findings indicated that strategic leadership (idealized influence, vision development, inspirational motivation and contingent reward) is positively and significantly related performance of health care workers in North Eastern Counties of Kenya. The study recommended the management within the counties (health managers) need to exercise strategic leadership and all health professions be registered with a professional regulatory body. The health workers should be encouraged to remain in North Eastern regions despite the circumstances. The authorities mandated with quality health provision to coordinate and harmonize the development of health policies and laws that are effective and applicable to all. Keywords: Strategic leadership, performance, health care workers, northeastern counties, kanya

A Scottish university prescribing team's experiences and reflections during the COVID-19 pandemic

The onset of the pandemic and associated restrictions led to the closure of university buildings across Scotland in March 2020. This was immediately followed by the introduction and embedding of online learning, teaching and assessment from previous class or blended delivery modules across all curricula. Academics were required to structure and develop quality student materials from their own homes. In addition, approved programmes of study, such as the prescribing module, had to ensure governance and teaching and learning aligned to Professional Statutory and Regulatory Bodies requirements for students and staff now working and studying at home. There was a recognition that NHS stakeholders and clinical practitioners required support with continuing professional education incorporating robust awareness of critical practice needs and the safety of patients and staff in clinical areas.

Differential attainment and recruitment to Intensive Care Medicine Training in the UK, 2018–2020

BackgroundDifferences exist among doctors in examination performance, clinical and academic career progression, and prevalence of performance assessment by professional regulatory bodies. Some of these differences have been reported in relation to individual characteristics. The purpose of this study is to establish whether any specific individual characteristics are associated with performance in selection for entry into specialty training in Intensive Care in the United Kingdom.MethodsWe evaluated data of 509 candidates from the national recruitment rounds of 2018/19 and 2019/20. The outcome evaluated was “success at interview". Variables reaching statistical significance at univariate logistic regression analysis were fed in the multivariable analysis to identify independent predictors of success, with additional exploratory analyses performed, where indicated.ResultsThe candidates’ median age was 31.5 (interquartile range, IQR 30–33.7) years, 324 (63.7%) were male, 256 (50.3%) not married/in civil partnership, 6 (1.2%) pregnant. The majority (316, 62.1%) were White British, 99 (19.5%) of Asian background, other ethnicities represented less than 20% of the sample. Of the 509 candidates, 155 (30.5%) were Atheist, 140 (27.5%) Christian; most were heterosexual (440, 86.4%); 432 (84.9%) reported no disability, while 4 (0.8%) had a minor and 1 (0.2%) had a major disability; 432 (84.9%) candidates held a UK medical degree; 77 (15.1%) a non-UK degree. At univariate logistic regression analysis (LRA) multiple factors were found to be associated with a lower likelihood of success, the strongest being an international medical graduate (IMG, holding a non-UK medical degree); others were increasing age, male gender, being married, Asian or mixed ethnicity, specific religious beliefs (Buddhism, Islam and Hinduism).After feeding all factors significant at univariate analysis, the only two retained as independent predictors at multivariable regression were Asian ethnicity and holding a non-UK degree. Asian UK graduates success rate was 92.7%, comparable to the national average of 92.3%, the Asian IMGs success rate was significantly lower, at 45.5%.ConclusionsAs the imbalances seen within the candidates of Asian background are explained by considering the country of primary medical training, the variations in performance is likely to reflect differences in training systems and understanding of the UK NHS.

Amalgamation of Professional Regulators: Conflicting Perceptions and Beliefs Among Canadian Regulatory Leaders

<h3>Background</h3> In Canada and the United Kingdom, there is discussion about amalgamating nursing and other professional regulatory bodies to improve efficiency; however, there is a dearth of research on the advantages and disadvantages of amalgamation. <h3>Purpose</h3> To begin to address this gap, this article explores Canadian regulatory leaders' views about professional regulator amalgamation. <h3>Methods</h3> In-depth interviews were conducted with 83 Canadian regulatory leaders (in regulatory bodies, government, and other related roles). Qualitative description analyses were conducted on interview transcripts. <h3>Results</h3> Participants identified several advantages of amalgamation, believing it was valuable for small, under-resourced regulators, as well as for regulators in the same field, such as nursing and oral healthcare. Some participants anticipated improvements in regulatory effectiveness that would benefit regulators, governments, and society. However, participants also raised concerns about amalgamation: prioritizing efficiency over effectiveness, lack of evidence of success, and concerns about inequality. Participants also provided advice to facilitate amalgamation. <h3>Conclusion</h3> Limited evidence and conflicting views on this regulatory change encourage caution among those pursuing amalgamation of professional regulators. It is clear that collaboration is key to successful amalgamation; thus, it should not be forced or mandated.

Positioning Prem Sikka’s academic activism in the third space

PurposeThis paper applies Bhabha’s concept of the third space to frame an understanding of Prem Sikka’s use of digital media to bridge the academic–activist binary. In doing this, the paper makes two contributions. First, it conceptualises Sikka’s engagement, and second, through the lens of the third space, it analyses it to establish whether, in the era of the neoliberal corporatised university, public intervention has the potential to generate new perspectives and new knowledge.Design/methodology/approachSikka’s articles and blogs for the period 20 February 2002 to 15 April 2020 were analysed using Leximancer, a textual analysis software programme that displays the output visually. A discriminant analysis was used to identify where each year of the study is situated in the overall semantic analysis. Netnography, the examination of archived published texts, was then used to analyse the responses by members of the public, academics, accountants and auditors, tax experts, policy makers and regulators to Sikka’s digital media engagement.FindingsAs a third space practitioner, Sikka has overcome some of the shortcomings associated with academic research to challenge the activities of professional accounting firms, regulatory bodies and multinational corporations. Through extending the boundaries of accounting and accountability, he has facilitated new radical alliances aiming to create a just and equitable society. The paper also finds that by opening up a third space of engagement, academic activists’ work can play an essential part in social transformation and emancipatory change framed in terms of social justice and equity.Originality/valueThis is one of the few papers to provide an in-depth examination of the activities of an accounting activist over twenty years.