23 November 2011

Professionalism in healthcare professionals

What is professionalism?

There has been renewed interest over the last few months in the ‘professionalism’ of health care workers. One YouGov poll reported 41% of those surveyed thought that nurses were ‘less professional than they had ever been’. Whilst today’s wave of interest may be focused on nurses, it is in all our interests to reflect on why health and care workers are currently perceived in this way. The issues which have been a cause for concern – treating patients and service users with respect, communicating clearly, involving people in decisions about their own care, keeping accurate records of treatments and interventions – are all fundamental to good professional practise for all health and care professionals, and they are clearly articulated in the HPC’s standards.

One of the questions worth exploring in this complex arena is: what do professionals themselves think ‘professionalism’ means? As part of our commitment to building the evidence base of regulation, we commissioned researchers at Durham University to take a qualitative look at perceptions of ‘professionalism’. Specifically, we asked them to explore what the concept meant to students and educators in three professions; occupational therapists, paramedics and chiropodists / podiatrists. One hundred and fifteen students and educators participated in twenty focus groups.

What emerged from the research was that ‘professionalism’ was seen not so much as a competency but a judgement, a set of behaviours influenced by context, rather than a fixed, defined characteristic. These behaviours were strongly influenced by the particular care group, peer group, and knowledge and skills of an individual. How peers behaved, for example, could strongly influence how an individual viewed ‘professional’ behaviour, and what was appropriate in one context might not be in another. The use of humour, calling a patient by their first name, and dress codes, were all examples of behaviours which needed to be adapted depending on the context, and the skill of professionalism was in knowing when to do what. The report gives illuminating examples of unprofessional behaviour and why it was judged to be so. Standards and codes were seen as an important, if more remote, influence on behaviour – a baseline level of professionalism that would not be breached.

Why is this research important?

It is the first study of its kind into professions regulated by HPC. There has been a great deal of research on professionalism, but most of it in relation to doctors and nurses, very little specifically looks at the professions we regulate. The findings reveal more similarities than differences between students and educators from the three professions. We hope it will provoke further thinking about the centrality of behaviour, ethics and conduct in delivering good care.

There is a lot of discussion about whether or not support workers and assistants should be registered – mainly arising from reports about poor conduct, abusive relationships, and dishonest dealings with vulnerable people. There seems to be a renewed interest in defining and securing professional behaviours in our health and social care workforce, whether EA trained doctors, healthcare assistants, or paramedics. As a UK-wide regulator, we have an interest in promoting professionalism, stimulating debate and discussion about what part we play, and how this overlaps with the role played by others – systems regulators, employers, peers, patients and carers. I hope that many of you will see this report as an opportunity for debate and discussion about what professionalism means for you, in your context, and how it can be enhanced across the whole workforce. It is through debate and discussion that our individual and collective understanding of this important aspect of practise can develop still further.

Anna van der Gaag
HPC Chair

The research is available to download from the HPC website