23 April 2012

Service user involvement in the design and delivery of approved programmes

In 2011, we asked researchers at Kingston University and St George’s (University of London) to undertake some research for us looking at the involvement of service users in the design and delivery of education and training programmes approved by the HPC. The research included a literature review; a survey of education providers; and focus groups with students, educators and service users. The final research report is now available to download from our website. I would like to thank all the educators, service users and students who participated in the research.
Most previous research on this topic is about medicine, nursing and social work education, so we hope that this work will make a positive contribution to this area. The research should be useful for education providers thinking about how they might involve service users in their programmes.

Q. Why did we commission research in this area?

Our standards of education and training guidance already encourage education providers to provide evidence of service user involvement in their programmes. However, involvement is not currently an explicit part of the standards, so it is possible we could approve a programme which did not involve service users at all.

In August 2012 we will become responsible for regulating social workers in England. Service user and carer involvement is a particular focus in social work education. There are existing regulatory requirements that service users and carers should be involved in all aspects of social work programmes – including in selection, teaching, assessment and quality assurance.

We have been considering whether we might strengthen our requirements in this area by amending our standards of education and training to require service user involvement for a programme to be approved with us and commissioned the research to help us in making that decision. We wanted to find out more about good practice in involving service users in education and training programmes; the extent and types of involvement activities already undertaken by education providers whose programmes we approve; and to learn more about the drivers, benefits and challenges of involving service users.

Q. What were the research findings?

There were no programmes that did not involve service users in some way in how they were designed (e.g. monitoring and evaluation of programmes) and/or delivered (e.g. selection, teaching, assessment). Service user involvement was most common in the area of programme planning. There were no notable trends between different professions or between different types of programme or education provider.

Most involvement activity is piecemeal rather than systematic. There was limited evidence to demonstrate a clear, causal link between service user involvement and outcomes such as improvements in the quality of treatment and care. However, overall, the research indicated that service user involvement is likely to, or is perceived to have a number of positive effects, including programmes which better reflect the needs and wishes of users of services, resulting in practitioners who are able to involve service users in decisions about their care or services.
One challenge was the definition of service users. A variety of different potential service users were identified, including patients, clients, carers and colleagues. The term was used differently in the literature and by stakeholders involved in the research and it was acknowledged that some professions do not have direct patient or client facing contact. The term ‘end recipient of a service’ was suggested as a means to define the scope of the term. A variety of facilitators and barriers to involvement were identified including funding, leadership and the representativeness and vulnerability of service users. There was general support for amending the standards of education and training, with some caveats and concerns about the need for a standard; the scope of the standard; and the practicalities of meeting it.

Q. What have we concluded?

The research was discussed by our Education and Training Committee at its meeting in March 2012. The Committee agreed that service user involvement in approved programmes was important and, in principle, that an additional standard of education and training could act as a driver for education providers to involve service users in their programmes, sending out a strong message that service user involvement is important for public protection.

The research revealed general support for a standard but with some concerns and caveats. We want to develop a proposed standard which is enabling and meaningful. It needs to be applicable across the diversity of professions and programmes we approve, allowing for flexibility whilst setting an appropriate threshold benchmark for all.

If we were to agree a new standard, we would propose that education providers should have a longer than normal lead-in period so that we can communicate our requirements clearly to education providers, for example, via ‘Education update’ and in our annual seminars with education providers. This will also allow education providers the time to make any changes to their programmes which might be necessary.

Q. What happens next?

We will be considering the wording of a proposed standard and supporting guidance at our next Education and Training Committee meeting in June 2012. Subject to Committee and Council approval, we currently anticipate that a public consultation on the proposed standard and guidance might take place from September 2012.

Michael Guthrie
Director of Policy and Standards

02 April 2012

Crafting strategy: HPC’s strategic intent 2012 to 2015

I remember reading from the economist JK Galbraith’s writings about economic regulators, in which he observed: ‘...regulatory bodies, like the people who comprise them, have a marked life cycle. In youth they are vigorous, aggressive, evangelistic, and even intolerant. Later they mellow, and in old age - after a matter of ten or fifteen years - they become, with some exceptions, either an arm of the industry they are regulating or senile.’(1)

HPC celebrates its 10th anniversary this year, hardly a lifetime, but long enough to look back and ask – have we remained true to our central objective - to protect the public? One of the ways we address this question is to reflect on our strategic intent document on a regular basis. This document, above all others, should articulate that central objective. It should set out clearly who we are, what we do and how we do it.

The strategic conversations that we have on the Council range from conversations that aim to make sense of new policies and changes in health and social care from a regulatory perspective, to those that focus on organisational priorities and outcomes. Creating strategy is not a science; it is a craft, one part of an organisation’s way of responding to internal and external influences whilst maintaining a clear focus on what it is there to do. This ‘crafting’ is inextricably linked to the organisational culture and the quality of working relationships which allow the conversations to flow into actions.

The revised strategic intent document that you will find on our web pages is, therefore, our current statement on how we think we should deliver public protection in health and social care. It describes our values – the underlying principles and ethical basis for what we do, our vision – how we would like to be seen in the future, and our key objectives. We aim to deliver efficient and effective regulation, maintaining our ‘can do’ culture of continuous quality improvement, tackling difficult decisions in an informed way, collaborating, anticipating and being proactive in our approach. The ways in which we deliver this must change as we do. As we grow in size and complexity, working with new groups and new stakeholders, we must maintain clarity of purpose and fidelity to our values and vision. This is the strongest defence against Galbraith’s sound and salutary observations. Complacency is surely the enemy of excellence, and the seedbed of senility.

Anna van der Gaag


(1) Galbraith, John Kenneth (1954). The Great Crash, 1929.