Welcome to the Allied Health Profession’s webinar: Professionalism: The Big Conversation 29th January 2013 #bigSLTtalk PROFESSIONALISM: THE BIG CONVERSATION Kamini Gadhok MBE CEO, RCSLT CONTEXT First Francis Inquiry into Mid-Staffs (2010) Winterbourne View Hospital Inquiry (2011) Karen Middleton, CHPO, set up working group All AHPs encouraged to provide leadership for the ‘Big Conversation’ on professionalism Second Francis Inquiry Report due for release 6th Feb 2013 Webinar: Opportunity for AHPs to hear from key leaders to support the Big Conversation WEBINAR FORMAT Presentations Karen Middleton Julia Scott Anna van der Gaag Q&A Professionalism and the Big Conversation Karen Middleton Chief Health Professions Officer, England Mid Staffs Public Inquiry: What went wrong? The first inquiry found: • A failure of clinical and managerial professionalism and fundamental human compassion • Patients – especially older people – denied nutrition, hygiene and basic dignity and subjected to degrading and unsafe treatment • A closed culture with a bullying management style that sought to ignore or suppress concerns • Inward looking medical and nursing communities, disengaged from management • FT status and financial savings were pursued at the expense of providing high quality, safe care to its patients • Too few qualified nurses and disproportionate reliance on healthcare assistants • Poorly thought through clinical reconfiguration My personal journey • Where to locate the blame? • Utter horror and shame • How did clinical professionals allow this to happen and how do we prevent it happening again? • Where are AHPs in this? • Winterbourne • Culture and the need to talk • The Big Conversation – possibly the most important thing we’ll ever do. Professionalism: The Big Conversation Julia Scott CEO, College of Occupational Therapists 6 Commonplace Characteristics of Professions 1. A Commitment to serve in the interest of clients, in particular, and the welfare of society in general 2. A body of theory or knowledge 3. A specialist set of professional skills, practices and performances that are unique to the profession 4. The capacity to make judgements with integrity under conditions of technical and / or ethical uncertainty 5. An organised approach to learning from experience and thus of growing new knowledge from the context of practice 6. The development of a professional community responsible for oversight and monitoring of quality in both practice and professional education (Gardner, Howard and Shulma, Lee S “The Professions in America Today” Daedalus 134 (summer 2005) The Distinctive Characteristics of Professional Services? • Professional Services do not have a fixed specification that can be easily judged • Clients often do not know what they want or require, until advised by the professional • The professional tends to know more about the quality of the service provided than the client does • Those on the receiving end of professional services may be considered vulnerable as they have less information than the professional • Users of services cannot judge competency or whether the professional has done a good job. Tensions between the professional and the user create what is known as “Information Asymmetries” PARN (The Professional Associations Research Network) Professionalism debate 29 January 2013 Promoting professionalism Anna van der Gaag, Chair, HCPC Outline • Increased focus on professionalism in UK • HCPC research findings al Ph w or O ys cc ke io up rs th at e ra io pi na st lt s he r R ap ad B is io io ts gr m ed ap ic he al rs sc Pr ie ac Sp nt t ee iti is P ts on ar ch a e m an rp ed d sy ic la ch s ng O C ol pe u hi og ag ra ro is e tin po ts t h g di e de ra st pi s pa st /p rt s m od en ia tr tp is ra ts ct iti on er s D C ie lin tit ic ia al ns sc ie A H nt rts ea is r in ts th g er ai ap d is di ts sp en Pr se os O rs th rt h et op is ts tis /o ts rt ho tis ts So ci HCPC: who do we regulate? 308,000* registrants from 16 professions (*estimated) 90,000 80,000 70,000 60,000 50,000 40,000 30,000 20,000 10,000 0 Rise in complaints in the UK 10000 8781 8000 6000 5168 4211 4000 2000 0 1624 925 424 2007 2008 2009 2010 General Medical Council Nursing and Midwifery Council Health and Care Professions Council 2011 Competence versus conduct HCPC data 2011-12 competence conduct mixed grounds 8% 29% 63% HCPC’s Research on professionalism • Qualitative study with students and educators • Explored perceptions of professionalism • Three professions – paramedic, occupational therapy and podiatry • University based programmes • Focus groups and interviews (n=115) • Second part of the study looking at measurement of professionalism Study Outcomes Themes • Professionalism = a judgement • A holistic concept • A set of behaviours determined by context No differences between professions A tough nut to crack Research from • Sweden • Netherlands • United States Common theme…. Peer led discussion and peer feedback is a key influence on behavior and self awareness Conclusions • Professionalism a judgement, influenced by context • Key influence on your professionalism are your peers • Peer led conversations are an important part of the change References Bergman, D, Arnetz, B, Wahlstrom, R, Sandahl,C. (2007) Effects of dialogue groups on physicians work environment. Journal of Health Organization and Management 21(1) p27-38. HCPC (2011) Fitness to Practise Annual Report. www.hcpc-uk.org HCPC (2011) Professionalism in healthcare professions. www.hcpc-uk.org Hickson, G. et al. (2007) A complementary approach to promoting professionalism. Academic Medicine, 82 (11) p1040-1048. Leistikow, I, Kalkman, C, De Bruijn,. (2011) Why patient safety is such a tough nut to crack. British Medical Journal, 342;d3447. ANY QUESTIONS?