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

0

10,000

20,000

30,000

40,000

50,000

60,000

70,000

80,000

90,000

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

anna.vandergaag@hcpc-uk.org

Twitter: @AnnavdG