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

HCPCs 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 users Keep 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

Social networking and confidentiality - recent fitness to practise concerns at HCPC Dietitian – posted information about a patients diagnoses, care, medication, and personal circumstances, and published information about colleagues and their place of work on their personal blog Paramedic – uploaded a patients x-ray to a social network Clinical scientist – posted unfounded derogatory comments about a colleagues practice using an alias on a professional forum

HCPCs 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 questions 1.Change to the standard 2. Appropriate to all programmes 3. Definition of service user 4. 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. HCPC (2011) Professionalism in healthcare professions. HCPC (2013) Service user and carer involvement in education

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