HPC Listening Event

HPC Listening Event

15 February 2007

Worcester 6-8pm

Panel Members:

Helen Davis – Registrant Council Member (Orthopist)

Jacqueline Ladds – Communications Director, HPC

Morag MacKellar – Registrant Council Member (Dietician)

Marc Seale – Chief Executive, HPC

Annie Turner – Registrant Council Member (Occupational Therapist)

Summary:

Q1. How will the checking of the CPD portfolios be funded? Page 1

Q2. What sort of information should be recorded for a CPD portfolio? Page 2

Q3. How will the HPC evaluate the CPD portfolios of professionals Page 3

working part-time?

Q4. How did the HPC arrive at the figure of 2.5% for CPD audit and how Page 4

will the sample be made?

Q5. What does the HPC deliver in exchange for the fees it receives? Page 4

Q6. Who funds the registration of aspirant groups who come onto the Page 5

Q7. Is there an existing aspirant group of smoking cessation advisors Page 6

and if not how does a group apply to be registered?

Q8. How will the HPC evaluate the CPD portfolios of agency/bank workers? Page 7

Q9. What format should the CPD portfolios take? Will there be a guide? Page 7

Q10. What happens if a CPD portfolio is not accepted? Page 8

Q11. Is a particular profession generating most of the Fitness to Practise Page 9

cases and is there a danger of malicious complaints?

Q1:

Occupational Therapist:

I just wanted to ask how you are going to fund the checking of the portfolios and the information for that element of the CPD, bearing in mind that that is going to be quite costly isn’t it?

Annie:

The current plan is to randomly select 2.5% of registrants at each point that people re-register and then to have two people from the same part of the register evaluating the submissions. The funding of it will come like the funding of whatever the HPC does, through the monies that we receive from registrant members.

Marc:

It goes back to this issue of quality versus cost. The work of the HPC involves processes where you don’t have to be a professional to make the decision, and we have processes where we need professional input to make a decision. So, for example, for a decision to admit an international applicant, approving a university course, sitting on a Fitness to Practise tribunal, we have partners, of whom the vast majority (we have about 450) are registrants. In terms of the portfolio, it is again a professional decision whether it is the appropriate information and CPD. The idea that we are currently thinking of is rather than sending the portfolio out to partners, we will invite a group of partners, half of which will be from an academic background and half practitioners, to come together in one place for them to look over all of the selected portfolios at one time. Then they will collectively as a group come to a decision about whether that information, that CPD is appropriate. So it will be professional input, because it will be professional judgement, and it will be from the same part of the register that you are on.

Q2:

Jacqueline:

One of the questions that has been coming up quite a lot at the listening events is the type of

information that needs to be recorded for the portfolio. Annie gave a very good response to

that in terms of what she was doing at the moment, and I was just wondering if you could

share that with us.

Annie:

I actually went to talk about this to one of the committees at the College of Occupation

Therapists recently and people were asking what it is they have to record. One of the points that came up was that the HPC has produced both a long guide and a short guide to CPD, so you can have a quick look or go into it in more depth. The idea is not for people to jump more hoops. From our understanding 99.9% of registrants are doing CPD all the time anyway. The idea is simply to capture what people are doing, because the issue of CPD is not what you do, not whether you have been on a Masters course, or whether you have sat on X, Y or Z committee, but how the knowledge that you have gained from that has actually impacted on practice.

What we were talking about at the College of Occupational Therapists is how to capture that as you go through you working life. So if you go on a study day do you take that certificate and just write half a dozen bullet points on the back of what you have learned and how that is actually going to impact on your practice. If you are sitting on an audit committee at work, after you have been on it three of four months, can you sit down and perhaps write on the back of some of the minutes what you have actually learned, and what does that mean in terms of your practice? How is that actually going to help you improve your practice? How has it made you think slightly differently?

So it doesn’t have to be anything very fancy. My CPD portfolio at the moment is a box which contains things that I do, like what I have learned from sitting on an HPC committee, what do I do if I go off on a study day? What do I do if I have dealt with a student who has had an issue with conduct and ethics? So if I have dealt with something like that, what has it actually taught me? I pop it in this box and then if my name comes up I will transfer the information to a portfolio that presents in it the way that is appropriate for HPC, and hope that somebody deems my CPD effective. We need to be encouraging staff that we work with, and ourselves, to shift our mindset to looking at CPD as something that we are all doing, but we just need to articulate it, so that when and if we are one of those people, we can easily put a portfolio together.

Morag:

Might I just add one of the other things we talked about was that it’s not just about the study days as Annie said, committee attendance is relevant, but also things that come up in your day to day practise that you have to go and do some literature review or compile some background information for. You might need to go and speak to another professional and then come up with a decision about doing something differently. That is development and that is CPD. So it is capturing that kind of thing as well. You are not going to do that every day but if it is something that you spend a bit of time doing, then that is valid as much as the three or four study days that you have had. So don’t lose sight of these things as well.

Q3:

Physiotherapist:

I work part-time. I only do twelve hours a week in a private practice and so sometimes the

CPD issue concerns me because you have less material to draw upon. Although I go on courses and I try to reflect that within practice I wonder whether if you work part-time that will be considered if you get selected and your portfolio gets looked at.

Helen:

I think the important thing is that it is appropriate for your work, and therefore some people who work part-time may actually work in a narrower field than somebody that works full-time. I think we are very appreciative of the fact that everybody’s work is different. It is really the CPD for your practice that counts. That really relates to what Annie is saying. It is what impacts on what you are doing at the moment. If you are only working part-time it may be that the amount of professional development that you require at the moment is reflected by that amount. So you may not be looked at by a part-time physiotherapist, but you will be looked at in regard to the type of work you are doing and the scope of practice you are doing within that time. So it will be taken into account.

Morag:

It may be things that you are doing outside of your day to day physiotherapy practice may give you learning that you bring to the physiotherapy practice. That would be valid if it has helped you develop and improve in your work.

Unknown:

I am the local treasurer for our CSP group so I could reflect upon that?

Morag:

Yes, absolutely.

Q4:

Jacqueline:

Related to that, something else that has come up quite a lot at the listening events is how we worked out the percentage of the audit, and how we came to the figure of 2.5%, and also how that random selection would be made. I am just going to ask Marc to cover that now.

Marc:

Under the guidance of the University of Reading statistics department an effective sample size of 5% was decided upon for use at the start of the process with a view to reducing it to 2.5%. This is based on our working assumptions that the vast majority of health professionals are already doing a good, high level of CPD. We can actually bring it down to a much lower percentage than 2.5% if we find through sampling that people are doing CPD. I think unfortunately that if we brought it down to a very small percentage people actually would criticise us, even though statistically it would stand up to scrutiny. There is another important component in that if we actually discover that people aren’t doing CPD, or that there are certain groups of individuals that aren’t doing CPD, the sampling rate would increase. It is really going to depend on what we find.

The other thing we also expect is that we will have registrants who haven’t undertaken CPD for entirely legitimate reasons. For example they have been looking after an aged relative, or they haven’t actually been working for a set period of time. What we will do in those situations is effectively say “we are not going to look at you now, but in two years time we will look at you”. Effectively that no longer makes the sampling random but that is what we are doing.

Q5:

Jacqueline:

This afternoon one of the questions that did come up which I think is quite relevant, was the idea of whether registrants were getting value for money, and what were the benefits of registration. I’m going to ask Annie again, because Annie came back with a very good answer.

Annie:

This is one of the questions that many students and registrants ask. They say “what are we paying our money for?” Actually what my response usually is, is that what we are paying for is the maintenance of standards. So what tends to happen is that paying money to a regulator is one of those occasions where, unless something goes wrong, you don’t actually see anything happening. So what you are paying for is public faith in the title that you hold.

So if something goes wrong people will know that those issues are picked up and standards are maintained. That if you have a programme that is teaching physiotherapists or dietitians, whoever, that those programmes are actually producing people who maintain a standard that you are happy to belong to. What you are getting is the maintenance of the status quo in terms of standards. You have assurance that if things go wrong, somebody will pick it up and maintain those standards. That was the way that we looked at it earlier on.

Morag:

As a registrant member I can appreciate the situation. Particularly if you are working part-time - then it becomes a more significant part of your earnings. There isn’t a quick and easy answer to it. We are a statutory body. It is a bit like your council tax in a way. There is an organisation to run and manage. I think as Annie says, we really don’t see the day-to-day bits of the HPC, but it is part of being a professional. If you want to be seen as professionals, then that brings with it the things that Marc alluded to about quality assurance and standards and how do we demonstrate that, and how do we manage it. I do sympathise.

Physiotherapist:

Are there a lot of other groups with these layers, because I don’t know if osteopaths pay just their one amount of money which covers everything?

Morag:

I think every profession that is regulated will have a fee to be on that register. Then there is a choice if you wish to be a member of your professional body. Most people elect to do that because it brings with it professional indemnity insurance. I would have thought that most professionals in the NHS have at least two membership fees.

Q6:

Radiographer:

I would just like to ask about the aspirant professions that you were talking about earlier. Who funds them if they join the HPC and do existing registrants help support them?

Marc:

Well it is very straightforward. In fact we were discussing it with the Department of Health a week ago. We put forward the argument that if the government wants to regulate a new profession and they ask HPC to do that, then the existing registrants should not pay for the cost of bringing that new group onto the register. There are two costs. There is the operational aspect: transferring I.T., agreeing new standards, consultations, events etc. Why should existing registrants have to pay for that? The government has agreed with that argument. The other big problematic area is that if you regulate a new group and they have had a voluntary organisation, for example the Operating Department Practitioners, there are normally one or two, in the case of the ODP I think it is about half a dozen, Fitness to Practise cases going on. We strongly argued that existing registrants should not pay for existing Fitness to Practise cases that come onto the books of the HPC. Luckily our legislation says the Department of Health may give us a grant in association with setting up the HPC.

Podiatrist:

Just following on from that, does it follow that if a profession is found to have a good CPD record and very few needs for referral Fitness to Practise issues, that the fees may come down for that profession.