One of the
key responsibilities of a professional regulator is to ensure that
professionals are competent when they join the register and remain competent
throughout their working lives. HCPC sets standards of competence (called
proficiency) to do just this, and at the moment we are in a phased review of
these for 15 out of 16 of the professions we regulate. This involves extensive
review, consultation and further revisions in order to ensure that the standards
remain fit for purpose and up to date. Good regulation depends first and
foremost on having robust and credible standards which reflect professional
practice in meaningful ways.
However,
there is much more to maintaining competence than good standard setting. More
than twenty years ago, I worked on a research project looking at the nature of
professional competence in my own profession. Phil Davies and I published a
series of papers describing in some detail the methodology and results of this
work (1). We observed that competence is always more than the sum of its parts,
and it is often if not always context sensitive – that is, influenced by the
context in which practice plays out. It is also as much about the underlying
values of the practitioner as it is about the ‘technical’ knowledge and skills.
I was
therefore particuarly pleased to attend a lecture in Edinburgh last month which reinforced some
of these points, taking a fresh look at competence from the perspective of the
onlooker (2). Professor Zubin Austin from the University of Toronto described
how a patient or service user’s perspective on competence will differ from an
educational or a legal or a professional
perspective. Patients and service users want accessibiity, affability and
acknowledgement. They want kindness as well as knowledge. There has been much
to reinforce this in the recent debates about the training and supervision of care
assistants (3).
Perhaps the
most potent point Zubin made was that, in his view, the opposite of competence
is not incompetence, but disengagement. Professionals become disengaged, not
deliberately or suddenly, but incrementally and often in ways that go unnoticed
for months or even years. The events in Mid-Staffordshire would seem to support
this, too.
The challenge
for us all is how do we address this
engagement issue? How do employers, educators, peers and regulators work
together to help individuals to stay connected? Zubin’s assertion is that
systems and relationships need to reinforce good behaviours not just focus on
bad behaviours. Think of competency in a different way.
Anna van der Gaag
Chair
HCPC
NOTES
(1)
van der Gaag, A. Davies, P. (1992).The professional competence of speech
therapists: IV: Attitude and attribute base. Clinical Rehabilitation 6,4, 325-332.
(2)
Austin Z. (2013) How competent are we at assessing competency?
Keynote,
CLEAR Congress on Professional and Occupational Regulation, Edinburgh, June
27-28, 2013 www.clearhq.org
(3)
Cavendish C. (2013) What the NHS needs is a degree of kindness.The rest can be
taught. Sunday Times, 14.7.13.
