09 February 2018

Speaking up when things go wrong: Discussing the Dr Bawa-Garba case

Michael Guthrie, HCPC’s Director of Policy and Standards talks about how the HCPC encourages registrants to discuss mistakes.

The case of Dr Hadiza Bawa-Garba, who was struck off by the General Medical Council after she was found guilty of mistakes in the care of a six-year-old boy who died of sepsis, has received widespread media coverage.

Health secretary Jeremy Hunt has since ordered an urgent review of medical malpractice cases, stating: "The only way we can reduce mistakes in the NHS is to learn from every single one, and the tragic case of Dr Bawa-Garba raises many important questions about how the health system supports staff to be open and transparent when things go wrong."

The HCPC recognises that cases like this can cause concern amongst registrants. However, it is important to remember that discussing when mistakes are made forms a key part of any health and care professional’s practice.

Standard Eight of our Standards of conduct, performance and ethics 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.

The HCPC introduced this standard in 2016, following the introduction of a statutory duty of candour which some organisations in health and social care have to meet. The aim was 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.

The work that health and care professionals do is very often highly pressured and rarely risk free, and the vast majority of our registrants practise safely and effectively - sometimes in difficult circumstances. We recognise that sometimes mistakes happen. Our processes are designed to protect the public from those who are not fit to practise. We will, therefore, only act if a professional is found to have fallen below our standards and there are serious concerns about an individual's practise or behaviour.

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. It is also important to remember that an apology is not an admission of guilt.

Speaking to colleagues, employers and service users about issues or mistakes is an important part of health care, and one which forms a vital part of the continued professional development of any health or care professional.

To learn more about the Standards of conduct, performance and ethics click here. 

Students can see our animated guide on being open when things go wrong here.

To read our response to the urgent review click here.

14 November 2017

Breaking down our Fitness to practise annual report

Acting Fitness to Practise Director John Barwick outlines this year’s Fitness to practise (FTP) annual report and highlights key areas of work and improvement undertaken by our FTP department over the past year.

The Fitness to practise annual report 2017 covers the period from 1 April 2016 to 31 March 2017. It provides information about the way we deal with allegations against our registrant’s fitness to practise their profession.

In 2016–17, the number of individuals on our Register increased by 2.5 per cent. The number of new fitness to practise concerns we receivedincreased by 6.2 per cent to 2,259. The proportion of the Register affected still remains low  with  only 0.64 per cent of registrants (or one in 164) being subject to a new concern.

We have seen a significant increase in hearings activity this year, with 39 per cent more cases being concluded at a final hearing, and a 31 per cent increase in total hearings activity. This reflects the activities we have carried out to improve the time it takes to conclude cases, including our older cases.

Key areas of work undertaken in the past year:
• We have realigned the fitness to practise directorate to provide for greater specialisation in the case management process.
• We have reviewed our approach to assessing risk, including determining whether we should apply for an Interim Order.
• We have continued our focus on improving the time it takes for cases to progress through the process. This has included ensuring that our older cases are concluded at a final hearing. We have also enhanced our arrangements for monitoring performance in this area.
• We commenced the establishment of the Health and Care Professions Tribunal Service (HCPTS) to enhance the independence of the adjudication function. 

Future work in 2017-18:
• Evaluating the impact and improvements achieved following the realignment of our fitness to practise directorate, alongside the continued focus on the timely progression and conclusion of cases.
• Exploring the use and value of case examiners or screeners in the early stages of our fitness to practise process and the use of electronic bundles.
• Taking forward any actions that may emerge from the research the HCPC has commissioned into understanding the prevalence of fitness to practise cases about paramedics and social workers in England.
• We will also be closely considering the outcome of our recent Professional Standards Authority review report and identifying any further improvement activities that may be required.

Read the full fitness to practise annual report 2017 and key information document here.

04 October 2017

Understanding complaints about paramedics and social workers in England

Michael Guthrie, Director of Policy and Standards, discusses recently published research looking at fitness to practise concerns about paramedics and social workers in England.

In 2015-16, social workers made up 27 per cent of the HCPC Register but 55 per cent of all fitness to practise cases we received. Paramedics made up 6 per cent of the Register and 11 per cent of cases.

In 2016, we commissioned a team at the University of Surrey to understand better, why we appear to receive disproportionately more fitness to practise concerns about these professions than for other professions we regulate, and what we might be able to do about this trend.  Amongst the different regulators of health and social care professions in the UK there is an increasing recognition that we need to try to rebalance our energies, away from reactively dealing with instances of poor practice and conduct, towards an approach that focuses more on prevention.

The research included a review of the published literature; interviews and focus groups with paramedics, social workers, employers and service users; and a review of 10 per cent of fitness to practise cases in these professions over two years. Our thanks go to all those who participated.

Overall, the research found a number of common themes, which appear to be behind complaints including changing public and societal expectations; challenging practice; pressurised work environments; and the evolving nature of both professions. The case review found that a cohort of concerns we consider about social workers are from members of the public raising issues that at their heart are about disagreements with decisions and a desire to see them changed. Many of these cases concerned disputes between family members over place of residence and contact with children. For paramedics, the case review found that the rate of self-referral (where a registrant reports a potential fitness to practise matter about them to us) was much higher than for other professions and that some of these self-referrals may be unnecessary. The Standards of conduct, performance and ethics says that registrants must let us know if, for example, they are convicted, receive a police caution or are dismissed by their employers.

The above can only be an incomplete discussion of the research. We are at a very early stage of thinking about how we might respond to and take forward the findings. Some initial actions are likely to include using the insights from the research to engage further with the public, employers and registrants on when to refer and self-refer a fitness to practise concern.  We will also want to consider how we might use fitness to practise case studies developed as part of the research to develop teaching and learning materials for educators.

The research is an interesting read and is now available on our website. It’s important that we (professionals, employers and regulators alike) constantly strive to learn from the concerns we receive and use the learning positively to improve. However, whenever we talk about this area we always need to remind ourselves that although the fitness to practise process is an important part of our work, it affects only a minority of registrants in any one year (in the last financial year 1.23% of paramedics and 1.33% of social workers). The vast majority of health and care professionals are hardworking, dedicated professionals doing their best day-in-day out for service users.

04 September 2017

How to use social media and meet HCPC Standards

Policy officer Olivia Bird discusses the HCPC’s new Guidance on social media, and how it can help registrants ensure that their use of social media is both professional and effective.

Social media is a key communication tool of the modern world, and is popular amongst many of our registrants. The HCPC is aware that the vast majority of our registrants who use social media already do so responsibly, in line with our standards, and with no difficulty at all. The HCPC believes there is no reason why these registrants shouldn’t keep on using social media with confidence. However, as a regulator we often receive queries from registrants wanting to ensure that the way they access these platforms meets our standards.

As a result we have launched our new Guidance on social media. The guidance focuses on issues registrants and other stakeholders told us they come across most frequently, and aims to provide reassurance and confidence that they are meeting the HCPC’s Standards of conduct, performance and ethics when using social media.

The guidance is complementary to other guidance, such as that produced by some professional bodies to support their members in getting the most from this technology.

The guidance is divided into four sections which includes top tips and using social media in line with HCPC standards.

Some of the top tips are:
• Think before you post. Assume that what you post could be shared and read by anyone.
• Think about who can see what you share and manage your privacy settings accordingly. Remember that privacy settings cannot guarantee that something you post will not be publicly visible.
• Maintain appropriate professional boundaries if you communicate with colleagues, service users or carers.
• Do not post information which could identify a service user unless you have their permission.
• When in doubt, get advice. Appropriate sources might include experienced colleagues, trade unions and professional bodies. You can also contact us if you are unsure about our standards. If you think something could be inappropriate or offensive, do not post it.

You can download the HCPC’s Guidance on social media, and learn more about using social media in line with our standards here.

The HCPC will be holding a tweetchat focusing on the new guidance from 6.30pm on Tuesday September 12, 2017. Join in by following @The_HCPC and using the hashtag #my_guidance.

27 July 2017

Changes to our Standards of Education and Training

Policy Officer Hollie French breaks down the newly released revised Standards of Education and Training and Guidance, highlighting additions and changes.

Our Standards of Education and Training (SETs) are the standards against which we assess education and training programmes.  A programme which meets the SETs allows learners who successfully complete that programme to meet the standards of proficiency for their profession, and are eligible to apply to the HCPC for registration.

A number of changes and additions have been made to the SETs after consultation with key stakeholders including education providers, practice educators, HCPC visitors, professional bodies, newly qualified professionals and service users and carers.

Key changes include:

• new standards requiring interprofessional education, learner involvement and supporting learners to raise concerns;
• strengthening the link between the SETs and our Standards of conduct, performance and ethics;
• making key terminology broader, inclusive and up to date with current terminology used in the sector – for example using ‘learner’ rather than ‘student’; and ‘practice-based learning’ rather than ‘practice placement’.

Alongside the SETs we have produced detailed guidance. The guidance has been written for education providers who are or will be involved in our approval and monitoring processes, but it will also be useful for practice education providers and others who work with and alongside education providers.

We are confident that the standards are fit for purpose and reflect safe and effective professional practice and would like to thank everybody that took the time to provide us with feedback.

To see the revised SETs and access the guidance, click here: http://www.hcpc-uk.org/education/providers/setsresources/

18 July 2017

Meet the HCPC – Southampton

HCPC Chair Elaine Buckley discusses the importance of our Meet the HCPC events in meeting registrants on a regular basis and our recent visit to Southampton.

Our Meet the HCPC events form are a vital part of our stakeholder activity to get out and meet the health and care professionals that are on our Register. We have been doing these events across the UK since 2004 and they are crucial for us to hear about registrant experiences, issues and challenges. This month we were in Southampton to explain what we do at the HCPC and explore with participants what we can all do to help prevent fitness to practise concerns.

Despite the weather, we were joined by colleagues from 13 of the professions we regulate with the majority being social workers. The energy, enthusiasm and engagement in the room across both sessions and during the workshop on how we all work together to prevent fitness to practise concerns was encouraging. We also have some valuable feedback from all those involved which we can now reflect on as an organisation.

Through the course of the discussions across both sessions there were several take home messages.  With those being that 76% of complaints we receive are about conduct and behaviour and not about competency and that good quality and focused education is key to registrants maintaining effective and safe practice. 

During the discussions, there were themes arising round the fact that we all needed to be alert in recognising the signs when colleagues may be struggling and the need to engage in supportive conversations. Supportive working environments are critical in ensuring practitioners can raise concerns and seek help. Informal peer mentoring through to formal supervision were all other ways to help and support each other. Some of the discussion also highlighted the importance of maintaining professional networks especially when practicing in isolated settings. 

The comments from participants were encouraging in that they felt it was helpful to meet people from the HCPC and they were pleased to hear that fitness to practise is only a small part of the work we do. The opportunity to take publications relevant to their profession was also valuable as were the discussions around the sorts of research we do.

As an evidence informed regulator, it is crucial we commission research into issues relevant to our role. It is the outcomes of the research we do that will help us make better decisions, drive continuous improvement and assist us in engaging with our stakeholders.

We’d like to thank everyone that attended the event and for their valuable contributions at both sessions.

Our next Meet the HCPC event will be in Eastbourne on Wednesday 27 September 2017.

If you’d like any of the publications, reports or research from HCPC, visit our Publications section.

16 June 2017

myHCPC app – how we’re helping you access the HCPC from your pocket

Web and digital officer, Becky Glass shares the latest about the myHCPC app update.

The myHCPC app is designed especially for HCPC registrants and lets you carry everything you need to know about the HCPC in your pocket.

Earlier this year we set out to redesign the app, originally launched in 2014, to make it more practical, useful and modern.

The more registrants use the app, the more they’ll access the information within – so our aim was to ensure the app was both engaging and fit-for-purpose. We invited registrants and HCPC employees to feed back on the app’s structure, design and content. This feedback resulted in several significant fixes and additions, and we launched the new and improved version in March.

A few months on and the app is continuing to help HCPC registrants feel more confident about how they practice their profession. Here are a few key ways the app can help your practice:

• The home screen has been redesigned: it’s visually engaging and now functions as a dashboard, so users have an overview of the app’s content at a glance and can instantly access standards of practice and standards of conduct performance and ethics.
• The app now allows users to identify their profession, which pulls through the standards and guidance relevant to them. No more scrolling through irrelevant professions.
• Navigation options are now icons at the top of every page. Users can also bookmark pages or access our latest newsletter instantly.

However we want to hear more about how you use the app, or what you’d like to see added or improved. The aim is to make our information, standards and news as easily accessible for our registrants as possible, so if you have any feedback please contact web@hcpcuk.org

To download search myHCPC in the app store on Android or Apple.