the regulatory perspective on service user involvement in education anna van der gaag, chair, hcpc...
TRANSCRIPT
The regulatory perspective on service user involvement in education
Anna van der Gaag, Chair, HCPC
CAIPE Conference, LONDON, 20 June, 2013
Outline
• Overview of HCPC
• Research
• Changes to the current standards of education and training
The Health and Care Professions Council
• Independent UK statutory regulator
• Derives powers from Health and Social Work Professions Order 2001• Purpose: “to safeguard the health and well-being of persons using or
needing the services of registrants” – Article 3(4)
• Separate role from professional bodies and trade unions
• Work overseen by Professional Standards Authority for Health and Social Care
• Registered to ISO standards
HCPC: who do we regulate?310,000 registrants from 16 professions
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HCPC’s professional and lay input: Partners and Working Groups
Council and Committees
• Strategic role• 629 Partners working across six partner roles
• Professionals and lay persons• Provide expertise for good decision-making
• Professional Liaison Groups (PLGs)• Short-term expert group, eg consultation on standards of
conduct, performance and ethics
Standards
Standards of education and training
• Standards against which we assess education and training programmes
• Students that complete a programme that meets the SETs will meet the SOPs
• We produce guidance for education providers
• 901 approved programmes
• 150 education providers running approved programmes
• 67 visits 2011–12
Standards of proficiency
• Threshold standards for entry to Register
• Safe and effective practice
• Generic and profession-specific elements
• Expectations, skills and knowledge
• Recognise that scope of practice will change
• Currently under review (for 15 professions)
Standards of conduct performance and ethics
Describe the behaviours that we expect our registrants to adhere to:
Act in the best interests of service usersKeep high standards of personal conduct
Behave with honesty and integrity
• Apply to current and prospective registrants
• Guidance on SCPE for students• Currently under review
Standards of continuing professional development
• Requirements for on-going learning
• Outcome based approach
• Statutory requirement for all HCPC
registrants
• Computer-generated random
sample from 2.5% of each
profession
Resistance to service user involvement in education
• Tokenism
• Cost
• Relevance
• Expertise
Dr Freddy Patel, Pathologist in Tomlinson case
Tribunal considered Dr Patel had a ‘deep seated attitudinal problem’
“you failed to recognize any contrary view to your own…even when robustly challenged by 3 pathologists…”
The centrality of ‘professionalism’
Rise in complaints in the UK
2007 2008 2009 2010 20110
2000
4000
6000
8000
10000
5168
8781
1624
4211
424925
General Medical Council Nursing and Midwifery CouncilHealth and Care Professions Council
Social networking and confidentiality - recent fitness to practise concerns at HCPC
Dietitian – posted information about a patient’s diagnoses, care, medication, and personal circumstances, and published information about colleagues and their place of work on their personal blog
Paramedic – uploaded a patient’s x-ray to a social network
Clinical scientist – posted unfounded derogatory comments about a colleague’s practice using an alias on a professional forum
HCPC’s response
• Research
• Dialogue with the professions
• Review of the standards
• Increase service use involvement in what we do (visitors, research)
1. Research on professionalism
• Qualitative study with students and educators
• Explored perceptions of professionalism
• Three professions – paramedic, occupational therapy and podiatry
• Focus groups and interviews (n=115)
• Second part of the study looking at measurement of professionalism
Study Outcomes
Themes• Professionalism = a judgement
• A holistic concept
• A set of behaviours determined by context
No differences between professions
2. Consultation on Service user involvement in education
297 responses(47% individuals, 53% institutions)
4 questions1.Change to the standard2. Appropriate to all programmes3. Definition of service user4. Lead in period
Results of the consultation
88% agreed to the change in the standard
71% agreed that the standard was appropriate to different types of programme
71% agreed with our approach to definition (service user and carer)
67% agreed with the lead-in period proposed
Benefits of involvement
• A link between theory and the real world• Consistent with a partnership approach• Consistent with user expectations• Linked to professional values• A way of breaking down barriers, dispelling myths and stereotypes• Students like learning from service users• Involvement increases the accountability of programmes to those
who receive services• Involvement seen as a right• Linked to keeping the curriculum up to date and relevant to the reality
of practice
Perceived disadvantages
• Involvement does not work for all HCPC regulated professions• New standard creates a ‘one size fits all’ approach• Access to service users a problem for some education providers• Service users ‘have their own agenda’• Payment issues• How representative are the service users?• Limited added value (based on previous experience)
Themes from the Francis Report
• Put patients first
• Take concerns seriously
• Be more transparent
• Publish information on performance
• Improve regulation and inspection
• Review fundamental standards
Berwick Review“Better care, better health, lower cost”
The future• Team based care• New uses of technology• A new workforce• A new role for the patient
“You cannot have a safe environment without openess”
What needs to change?
• More conversations about professionalism (and unprofessional behaviour)
• New mandatory standard on involving service users in education
In the future• A new standard on inter-professional learning?
References
HCPC (2011) Fitness to Practise Annual Report. www.hcpc-uk.org
HCPC (2011) Professionalism in healthcare professions. www.hcpc-uk.org
HCPC (2013) Service user and carer involvement in education www.hcpc-uk.org/committees
Contact details
www.hcpc-uk.org
Twitter: @AnnavdG