06 June 2016
What does the standard say?
Standard seven says that registrants must report any concerns about the safety or wellbeing of service users promptly and appropriately. They must also follow-up their concerns where necessary. This includes supporting others to report concerns and acknowledging and acting on concerns reported to them.
Why is the standard important?
The reports of inquiries into failings in health and social care services in recent years have emphasised the importance of individuals reporting concerns they have about the safety of service users and the importance that organisations are responsive to these concerns.
The previous version of the Standards already required registrants to protect service users from harm but our specific expectations were scattered throughout the standards. We have created a dedicated standard and revised the language we have used to make our expectations as clear as possible. We have also included a new requirement that in addition to raising concerns themselves, registrants should support others to raise concerns and, where appropriate to do so, should act on concerns raised to them. This is particularly important for registrants who are in management and leadership positions.
We want to contribute to creating a culture that actively encourages registrants to report concerns and take appropriate action where necessary to keep service users safe.
What does this mean for registrants?
We are asking registrants that when they are concerned about the safety or well-being of service users they take prompt and effective action. For registrants who are employed this might include raising the issue in the first instance informally with their immediate line manager or discussing the issue with their trade union, for example. Most employers will have whistleblowing policies that registrants should be aware of and follow where possible.
For very serious concerns and where no or ineffective action has been taken, we would expect registrants to use their professional judgement, by following-up on their concerns (in line with any whistleblowing policy if there is one) and considering escalating them where necessary. This means passing on their concerns to someone who is better able to act on it, for example a more senior colleague or manager. In some circumstances this might also include passing information to us, to another regulator or to the police.
We know that health and care professionals can understandably be reluctant to raise concerns because they are worried about the consequences for others involved or for their own careers. We want the standards to provide positive encouragement for registrants to use their professional judgement in raising and escalating concerns they have for the benefit of service users and the public.
We have published further advice about raising and escalating concerns on our website. This includes a process diagram to follow when thinking about raising concerns, and suggestions of further sources of advice and support.
Further information about the Standards of conduct, performance and ethics is available here.
For more information about Standard 7, or to address any queries you may have, join in our TweetChat on Tuesday 21 June at 6.00pm using the hashtag #my_standards
09 May 2016
May signals the start of a particularly busy period for our Registration Department as we receive an influx of new applications to join the HCPC Register from students who have completed one of our approved education and training programmes.
In order to confirm that the individuals applying to our Register have successfully completed an approved programme, the Registration Department relies on checking that applicants are on pass lists for the relevant programme sent to us by education providers.
So just why are pass lists so important?
Here’s six things that education providers should be aware of…
1. We are unable to process an individual’s application for registration without a pass list.
2. If you do not submit a pass list in a timely manner, students’ registration may be delayed.
3. You should send us a pass list when you are satisfied that all your award requirements have been fully met and conferred.
4. We will only register applicants if their full name and date of birth matches those on the pass list so accuracy of data is very important.
5. We accept pass lists at any time of the year. If a pass list is updated, an updated version should be sent to us.
6. Pass lists should be sent to firstname.lastname@example.org in the format we require.
Without pass lists, we are unable to process applications for registration. This means that failure to submit them will result in individuals experiencing delays in their registration, affecting their ability to use the relevant protected title.
Therefore, we ask education providers to submit their pass lists as soon as practically possible to prevent any delays in registration.
For more information visit www.hcpc-uk.org/education/providers/passlists
05 May 2016
What... is mediation?
Mediation is a confidential process for people who have been involved in a dispute. They can meet, discuss issues and reach a solution with the help of a neutral mediator. It is a voluntary process; both parties must be willing to participate for it to work.
The mediation process is flexible and depends on each situation. Normally, the mediator meets each side separately and asks them to explain how they see the situation, how they would like it to change and how they feel it could be settled. This is then followed by a joint meeting involving both sides. It can take place in person or online.
Where... does mediation fit in with the HCPC’s role as a regulator?
Our role is to maintain high standards in the professions we regulate and to protect the public. As part of this, we want to provide a range of ways to settle disputes.
Mediation is a way of settling cases which promotes understanding between professionals and service users who have been in disagreement. This alternative approach avoids a contested hearing, whilst still ensuring the public is adequately protected.
When... can fitness to practise cases be referred to mediation?
Criteria have been set to ensure that only suitable cases are referred to the mediation process.
A case can be referred to mediation at the following stages of the fitness to practise process:
a) When a no case to answer decision is made by the Investigating Committee Panel where there is a realistic prospect of the facts being proved, but not the grounds or impairment.
b) When a case to answer decision has been made but there is a reasonable chance that mediation may resolve the concerns. The Committee can include a timeframe for attempting mediation and direct that the case be referred back should mediation be unsuccessful.
Why... can mediation be beneficial?
Mediation can have a number of benefits, including:
- In instances where there is no case to answer, it can provide a way of dealing with issues that were not considered serious enough to form part of the allegation, but still need to be settled.
- In instances where there is a case to answer, it can provide an alternative way to settle a case.
- It can help the professional understand why a concern was raised, what led to it and whether there are things that can be done to prevent fitness to practise investigations in the future.
- It can help both sides understand the situation from another point of view.
- It can help everyone involved in a disagreement reach a solution together.
- It can make both sides feel more involved in the decision-making process. This can mean that both sides are satisfied with the outcome.
Who... is the mediator?
We provide independent and experienced mediators who are trained and qualified. These individuals are not employed by HCPC.
The mediator listens to both sides and helps to manage the discussion. They do not take sides, give advice or make decisions - their role is to help all those involved reach an agreement which is acceptable to all.
A word from Council
“I am so pleased that the HCPC is providing mediation as one way of resolving cases. It fits well with our responsibility to both maintain standards and safeguard the health and wellbeing of service users. I have worked as a mediator in the past, so I know from experience how helpful mediation can be for all those involved.”
Jo Mussen, HCPC Council Member
For more information about the mediation process visit www.hcpc-uk.org/complaints/mediation
04 May 2016
1. 2014-15 marked the third and final year of the 93 scheduled approval visits to social work programmes in England following the transfer of regulatory functions from the General Social Care Council (GSCC) to the HCPC in 2012. We also undertook the final year of the 20 scheduled approval visits to post-registration programmes for approved mental health professionals (AMHP) following the introduction of the approval criteria for this entitlement in 2012-13. As a result, we have seen an anticipated reduction in our approvals work and an increase in our monitoring activity. Moving forward, our monitoring processes – including major change and annual monitoring – will increasingly be the main way in which we continue to assess approved programmes.
2. In contrast to previous years, approval visits continued into the summer months of July and August. Typically it takes three months after an approval visit for the process to finish and for a final decision about a programmes’ approval to be made. Because of this, the timing of summer visits may impact on programmes’ ability to recruit students if they want to start in September. To ensure there is sufficient time for any conditions on approval to be met before a September start date, we prefer to avoid visits in late summer. Education providers should also be aware that we require at least six months’ notice of a visit to a new programme to ensure effective preparation.
3. The most significant increase in approved programmes was in the paramedic profession where there was a 20% increase in 2014-15. This is linked to workforce planning for the profession which led to reactive commissioning, the creation of new programmes and an increase in student numbers for existing programmes. Whilst many programmes engaged with us early and we organised visits in good time, some did not until later in the year. This contributed to the high number of conditions placed on paramedic programmes, and meant that some education providers had to revise their initial estimated start dates.
4. Over the year, 796 conditions were set across the 100 programmes visited; an average of eight per programme. The majority of conditions set related to programme management and resources (SET 3) and practice placements (SET 5). Our guidance document provides further information about how we assess programmes against our standards.
5. We received 416 major change notifications; a 32% increase on last year and more than in any previous year. This indicates that our model of open-ended approval is achieving the task it was set out to do; preventing the need for cyclical re-approval visits where possible.
6. We also considered 653 annual monitoring submissions - more than ever before. However 99% of programmes showed sufficient evidence of continuing to meet our Standards of education and training (SET) in 2014-15. This result demonstrates that our model of approval works and that programmes can continue to demonstrate how they continue to meet our standards via documentary submissions.
7. As part of the 2015-16 annual monitoring process, education providers are expected to provide evidence to meet our new SET about service user and carer involvement. To assist with this, we have amended our communications to emphasise the additional evidence requirement. We will also increase the number of assessment days to enable us to minimise the number of submissions that will be considered via correspondence.
8. The percentage of programmes subject to concerns has remained below 1% in 2014-15. This is positive and highlights the fact that there are very few approved programmes that people have concerns about. It also emphasises the role our approval and monitoring processes play in ensuring that programmes continue to meet the SETs.
9. In 2014-15, following receipt of all the required documentation regarding a major change submission, it took on average just over two months for the process to be completed and the education provider notified of the outcome. This means that education providers were given a clear, unambiguous answer regarding their programme’s ongoing approval within a short timeframe, appropriate to the changes they had made.
The 2015 Education Annual Report is now available to download here.
For more information about our approval and monitoring processes for UK education and training programmes visit www.hcpc-uk.org/education
01 April 2016
What does the new standard say?
Standard eight says that registrants need to be open and honest when something has gone wrong with the care, treatment or other services that they provide. This includes letting service users and carers know; apologising; and taking action to put matters right if they can. The standard also says that registrants need to support service users and carers to raise concerns and be helpful and honest in their responses to complaints.
Why a new standard and why is it important?
The reports of inquiries into failings in health and social care services in recent years have emphasised the importance of organisations and individuals being open and honest when service users are harmed or could have been harmed, as a result of errors or mistakes in the care or treatment they have received. This is sometimes referred to as a ‘duty of candour’. In England, there is now a statutory duty of candour which some organisations in health and social care have to meet, and similar requirements are being introduced in the other UK countries.
The previous version of the Standards already required registrants to be honest and to protect service users from harm. The new standard builds on this to set out clearer and more specific expectations. We do not use the term ‘candour’ because of feedback that this term was not always understood.
The other UK wide regulators of health and care professionals either have or are introducing a similar standard for their registrants. We all want to make a small, but important, contribution to creating a culture that supports professionals being open and honest with service users and carers about mistakes and errors and one which is open to, and acts on, feedback – both positive and negative.
What does this mean for registrants?
We are asking registrants to be transparent in their work and to act appropriately to make sure that service users and carers are not kept in the dark when something goes wrong.
The work that health and care professionals do is very often highly pressured and rarely risk free. The standard isn’t about penalising registrants when inevitably mistakes happen or where outcomes are not as beneficial as they had hoped. But it is about expecting registrants to act appropriately when they identify that something has gone wrong. This includes letting the service user know but also, for example, making sure that any records are completed accurately. For registrants who are employed, this includes making sure that they use their employer’s incident reporting arrangements where appropriate.
The Standard includes an expectation that registrants will apologise when something goes wrong. Service users and carers have fed back to us about the power of apologies – that though simple and easy to give, they make a huge difference to the service user, and to their relationship with the professional, even where the person apologising had not made the mistake. We know that sometimes professionals can be reluctant to apologise for fear of the consequences. We are very clear that an apology is a positive thing and not an admission of liability or wrongdoing.
As with any of our standards, we expect registrants to use their professional judgement. For example, some registrants will work in teams where it might be more appropriate for another professional to inform a service user or to make an apology. We expect registrants to adhere to the principles of these standards and that they are able to justify their decisions and actions if asked to.
Further information about the Standards of conduct, performance and ethics is available here.
For more information about Standard eight, or to address any queries you may have, join in our tweetchat on Thursday 21 April at 6.00pm using the hashtag #my_standards
27 January 2016
In March 2003 I contracted Group ‘A’ Streptococcus, which, after mutating a number of times, ultimately became Meningococcal Septicaemia. This resulted in the amputation of both my legs above the knee, the loss of the muscles in my right forearm, the loss of all my fingertips and the amputation of my little finger on my right hand. I also have significant lung capacity reduction, deafness in one ear and reduced hearing loss in the other.
As a consequence of managing these lifelong and complex conditions, I continue to experience and benefit from the services of a wide variety of allied health professionals (AHPs), including paramedics, prosthetists, orthotists, physiotherapists, occupational therapists and radiographers.
Reviewing the Standards
Health and care professionals must adhere to SCPE as a condition of their continuing HCPC registration. The Standards are important because they outline a minimum quality of service that the public can, or should, expect from their health and care professional. This means that they are equipped with a better understanding upon which to base their expectations for any intervention or service being provided.
Reflecting service user expectations
The revised Standards of conduct, performance and ethics absolutely reflect my expectations. Like most service users with lifelong and often complex conditions, I have changing needs. I therefore feel privileged that I’m able to benefit from the skills, expertise and knowledge afforded to me by my caring AHPs.
Building the relationship between professionals and service users
Importantly, the revised SCPE include a new standard about registrants being open and honest when things go wrong. I would add that this should be a two-way process: if I do something wrong, I would be the first to apologise. This trust and mutual respect is crucial for service users who have to build long-term relationships in order to work constructively with AHPs. Indeed, it can directly impact meeting any goals or on-going needs.
Registrants are also required to report and escalate any concerns they might have about the safety and wellbeing of service users. Clearly, this is essential. News reports often highlight the lessons to be learnt from whatever incident may have occurred, but I believe that prevention is generally better than cure.
Standards of conduct, performance and ethics are, of course, directly relevant to health and care professionals regulated by the HCPC, as well as those aspiring to join the Register. However, they are also of particular interest and importance to service users, carers and the general public. I know and understand, from my own personal experience, the benefit to patients of a skilled and professional workforce. So it is particularly pleasing to have been part of the revision of a set of standards that seeks to support, maintain and encourage that workforce.
More information about the HCPC’s Standards of conduct, performance and ethics is available here.
26 January 2016
On 26 January 2016, we published our revised Standards of conduct, performance and ethics. These Standards have always served to set out what is expected of me as an HCPC registrant. They have provided guidance as I’ve progressed in my career as a physiotherapist, and have assisted me as an educator in articulating these expectations to students as they embark on qualifying in their chosen profession. The Standards are equally as important to the HCPC as a regulator. They help us to determine suitability of character for individuals who apply to our Register, and in cases where concerns are raised about a registrant’s fitness to practise.
As Chair of the working group - called a Professional Liaison Group (PLG) - which assisted with the revision of the Standards, I have been impressed with the thoroughness of the process: particularly in terms of the gathering of evidence to inform any changes and the level of stakeholder engagement. The PLG comprised a variety of stakeholders, including service users and carers, professional bodies, employers and registrants.
The journey to revise the Standards began with a number of commissioned projects capturing the views of a wide range of stakeholders. This included workshops with different groups of service users and carers; focus groups and interviews with registrants and employers; and discussion with Fitness to Practise (FtP) Panel Chairs.
The PLG then reviewed the evidence gathered, debated issues and suggested changes to the previous Standards. This resulted in the development of a robust set of draft Standards, which went out for public consultation UK-wide. The consultation elicited 217 responses from stakeholders including individual health and care professionals, professional bodies, employers and educators. In addition, we benefited enormously from the views of service users and carers at a series of UK-wide events we held during the consultation period. Further changes were made to the Standards in light of the consultation.
The key changes from the previous version of the Standards include a standard about reporting and escalating concerns about the safety and wellbeing of service users. There is also a standard about being open and honest when things go wrong: individuals are expected to tell service users and carers when they become aware that something has gone wrong with the care, treatment or other services that they provide and to take action to put matters right wherever possible. They are also required to consider making an apology and to make sure that the service user receives an explanation of what happened.
It was essential that we refreshed the Standards in such a way that ensured they remained relevant for all 16 professional groups that we regulate. Our registrants work across a range of settings: in the private sector, NHS and in local authorities, to name but a few. This meant that the PLG’s discussions focused as much on format, as on content.
As such, we have made changes to the structure of the Standards to improve their accessibility. We hope that the new concise layout will ensure ease of understanding, not only for our registrants, but also for service users and carers. Despite the new ‘look’ of the Standards, registrants should be assured that the content remains consistent.
I hope that you will find our revised Standards clear and easy to engage with, and that they will continue to guide your practise as you progress through your career.
The Standards of conduct, performance and ethics are now available to download here. The HCPC will be producing a range of communications to highlight what the revised Standards mean for registrants, including regular articles within our In Focus newsletter, blog pieces, live forums and social media messaging.
For more information visit www.hcpc-uk.org/aboutregistration/standards/standardsofconductperformanceandethics