In November 2011, we published a research report exploring what professionalism meant to students and educators in three different professions. Whilst, perhaps unsurprisingly, the research found that there was no one definition of professionalism, participants generally saw professional behaviour as a ‘situational judgement’ – knowing what to do, and what not to do, in a given situation – and it was defined in contrast to behaviour which was considered ‘unprofessional’. The skill of ‘knowing what to do’ included the importance of identifying poor practice and taking appropriate action.
The professionalism of health and care staff certainly seems to be in question in recent, unfortunately repeated, reports about failures in standards of care in hospitals and care homes. These examples will not be repeated here, but, quite rightly, they have led commentators to question not only the role of the regulators involved in monitoring standards, but the responsibility of individual professionals and other staff in speaking-up about poor practice. Last week, the Commission on Dignity in Care for Older People published a draft report for public consultation suggesting ways to ensure that older people are treated with compassion and dignity and receive the services they need. The Commission proposes a number of recommendations to improve the care provided to older people, and of central importance is the concept of responsibility, not just at board and managerial level, but throughout hospitals and care homes. All staff have ‘personal responsibility’ for patient care and ‘should be required to challenge practices they believe are not in the best interests of the people in their care’. These are certainly requirements that are familiar to HPC registrants. They are included in the HPC’s standards of conduct, performance and ethics and we have also published additional information on our website about raising and escalating concerns.
However, I strongly believe it is important in this debate not to focus too much on the negative - the minority who appear before our fitness to practise panels and whose unprofessional behaviour damages public trust. We should not be complacent about poor conduct or poor practice but this means that we need to focus on the majority and our shared responsibility to identify and challenge unprofessional behaviour when it occurs. As one recent report clearly argues, this is important territory. The recently published report (enclosure 08) of a working group established by the Chief Nursing Officer in Scotland to look at professionalism across the nursing, midwifery and allied health professions emphasises the need for professionalism to be clearly articulated throughout the NHS in Scotland in a way which can support all staff to display the behaviours, attitudes and values at the heart of what it is to be a professional. Professionalism is intimately linked with the trust service users place in practitioners and, crucially, with high quality services.
What all these reports indicate is the need for professionals to engage in debates about professionalism. In her February bulletin, Karen Middleton, Chief Health Professions Officer at the Department of Health in England, has recently invited allied health professionals (‘AHPs’) to engage in a ‘big conversation’ about professionalism, but her call to action is surely relevant to all the professions on the HPC Register, in all the various contexts in which they work. The aim is to create an ‘environment where unprofessional behaviour is challenged immediately and constructively on an individual basis’ and we are encouraged to start talking to each other about professionalism and professional behaviour, ‘whenever and wherever’.
So, what do you think is professional or unprofessional behaviour? When is the last time your team had a conversation about professionalism? If you witnessed behaviour that you thought was unprofessional, what would you do?
Have YOU had the conversation yet?
Anna van der Gaag
Chair of the Health Professions Council
