THE SS2Q TRAINING
FRAMEWORKS
June 2016
A training and support framework for Tutors and Trainers delivering
Stanford University interventions
This document sets out the detailed training and support frameworks to be used
by providers of Stanford University interventions working within the Ss2Q quality
assurance system.
www.qismet.org.uk
© QISMET 2016
The Ss2Q Training Frameworks
The Ss2Q Training Frameworks
Contents
1
Foreword
2
2
Ethos behind training and accreditation process
4
3
The revised training and support frameworks
6
4
Appendices
Aims and objectives of Ss2Q Revision Steering Group
Glossary
18
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The Ss2Q Training Frameworks
1. Foreword
Background to Ss2Q
‘Stepping Stones to Quality’ – Ss2Q for short – is a straightforward and practical self-assessed quality assurance tool.
Its purpose is to ensure that all lay led self management programmes covered by Stanford licenses are implemented consistently and
effectively to benefit of people living with long term conditions.
It was created by a cross sector coalition of organisations and people living with long term conditions to support the expansion of lay
led self management programmes within a set of agreed minimum requirements of good practice.
Ss2Q is a structured self-assessment tool and is the first step towards gaining independent verification through the QISMET
Certification process http://qismet.org.uk/certification/
Ss2Q is built on the four stepping stones to success for a Stanford self-management programme:
STEP 1: Adhere to the core values and principles of lay led self management programmes
STEP 2: Generate support for your programme within your organisation and the communities you serve
STEP 3: Identify a self management coordinator
STEP 4: Recruit, train and support people living with long term conditions, and those who care for them, to deliver lay led self
management programmes
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The Ss2Q Training Frameworks
Updating the training and support frameworks
The process for training and accreditation of deliverers (referenced within Step 4 of Ss2Q) was originally developed by Arthritis Care in the
mid 1990’s; building upon the basic licensing and training requirements of Stanford University.1 The training frameworks were further
enhanced by the NHS Expert Patients Programme, which provided independent capacity building support to Stanford providers from 2001
– 2007. It was anticipated that the training frameworks would continue to be updated by an independent capacity building body. This
expectation failed to materialise after the establishment of the Expert Patients Programme Community Interest Company (EPP CIC) in
2007.
An update of the training and support frameworks to reflect changes in practice largely driven by the post-recession commissioning
environment was needed.
A Steering Group, led by Talking Health Taking Action was established by QISMET during 2015 with the task of updating the training
and support frameworks (see appendix one for Steering Group aims and objectives).
This report contains the updated training and support frameworks and should be used as a companion
document when completing the Ss2Q self-assessed quality assurance framework, which can be
downloaded at http://qismet.org.uk/certification/ss2q-certification/
Acknowledgements
Thank you to everyone that contributed to the production of the revised training and support
framework including QISMET, Talking Health Taking Action, members of the Steering Group, members
of the Reference Group and everyone that participated in the online survey.
1
http://patienteducation.stanford.edu/licensing/
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2. The training and accreditation ethos
The Ss2Q training and accreditation frameworks are based upon an
apprenticeship model which means that training and support is
provided by someone who has already been through the process.
They are designed to provide training and support to people living
with long-term conditions who are, for the most part, delivering in a
voluntary rather than a professional capacity.
To understand the ethos behind the training processes within Ss2Q,
one needs to understand the rationale underlying the initial
development of lay led self-management programmes within the UK
voluntary sector. For Arthritis Care, the originators of the training
framework, use of the Stanford course was primarily to provide an
opportunity for people living with long-term conditions to gain
important skills and to experience feelings of self worth, dignity and
validation by supporting others in a similar position to make changes
to the way in which they manage their condition on a daily basis.3
Well resourced recruitment, training, accreditation and support
process were considered a long-term worthwhile investment to
complement the six-week CDSMC in enabling people take control of
their life while living with a long-term condition.
2
3
Assumptions underlying recruitment, training and
accreditation processes in Ss2Q
1
Apprenticeship model; everyone starts as a Tutor and progresses up the
training ladder
2
Tutors will be recruited from the ranks of people living with long-term
conditions and those who care for them
3
There is active recruitment of people that have had to make significant
life changes due to living with a long-term condition
4
People living with long-term conditions often need to establish new
roles for themselves, will have low self-confidence, may have been
unemployed for some-time and will need support to deal with the
emotional fall out of living with a long-term condition
5
Courses will be lay led. In other words, the people delivering the courses
do so as a person living with a long-term condition, not in any
professional capacity
6
Tutors will be appropriate role models and representative of the group
they are delivering to
7
Well resourced recruitment, training, accreditation and support
processes are essential to supporting people develop confidence and
skills and a journey back into a ‘helper role’ rather than someone who is
always in receipt of ‘help’ from others2
ibid
Thompson, J. MBE. The principles of lay leadership in Jones, F.R. Self-management courses the thoughts of participants, planners and policy makers. Oxford University Press, 2010.
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The Ss2Q Training Frameworks
From Tutor to Trainer of Lead Trainers
There are four levels of competency among Tutors and Trainers delivering Stanford University programmes within Ss2Q:
Each of the above stages must be completed before moving onto the next level of competency.
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The Ss2Q Training Frameworks
3. The revised training and support frameworks
The process which guided the revision of the Ss2Q training frameworks is set out in appendix one.
The training frameworks will provide those tasked with managing, training and supporting deliverers of Stanford interventions with
guidance that we hope is free from ambiguity and fit for purpose for many years to come.
The key difference between the training and support frameworks contained within and their predecessors is that the content is less
focused on the detail of organisational processes and more focused on the number of hours of training and delivery needed by
deliverers to gain and maintain accreditation, and the means by which organisations are able to demonstrate that the specified
requirements have been met.
The new frameworks also follow the Stanford fidelity convention of Must Do’s and Nice to Do’s.
The Ss2Q training and support frameworks should be used in conjunction with the Ss2Q quality
framework and audit tool which can be downloaded at http://qismet.org.uk/certification/ss2qcertification/
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SELF-MANAGEMENT TUTORS
Role Description: To deliver lay led self-management courses
PROCESS
RECRUITMENT
MUST DO
Transparent recruitment process.
NICE TO DO
Attendance at a six-week
course.
DBS checks and induction.
COMMENT
To recruit a diverse and
representative cohort of people
from local communities.
Useful to include
Co-ordinator and experienced
Tutor on recruitment panel.
TRAINING
Attend standardised training course (24 hours
delivered by two Lead Trainers).
Attend as an observer prior to
training.
To be aware of development
and ethos of the Programme.
Feedback to sponsoring organisation.
Tutor details entered on organisational register.
DELIVERY
To gain familiarisation with the
CDSMC Manual.
To develop skills and practice
delivery.
Deliver minimum of two courses in 12 months and
gain accreditation within 18 months.
First course delivered within
three to six months of training.
Unsuccessful assessment requires a repeat
assessment within 12 months of training.
Unaccredited Tutors deliver
with accredited Tutors.
Options for refresher training within 12 months (min
six-hours).
Gain accreditation within 12
months of training.
To build on the initial training
and to gain confidence and
expertise through delivery.
Refresher training to be offered
through supervision or
full/partial attendance at Tutor
training must include observed
practice delivery.
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PROCESS
ACCREDITATION
MUST DO
NICE TO DO
Certificate issued on successful completion of 1st and
2nd assessment by training organisation once
training organisation has received copies of 1st and
2nd assessment.
COMMENT
To build capacity in
communities and ensure
consistent practice.
Sponsoring organisation and Tutor to hold Passport
to Practice (P2P) record.
Name and accreditation details to be recorded by
sponsoring organisation.
ONNGOING
Deliver minimum of one course annually.
Monitoring visit every 18 months.
Attend one Tutor supervision delivered by a Lead
Trainer every 18 months.
Deliver minimum of two
courses annually.
Cement skills in further
delivery of courses.
Monitoring visit every 12
months.
Use Tutor training and
experience as a stepping stone
to other opportunities
including Assessor and Lead
Trainer (Note: Not all
sponsoring organisations have
capacity to progress Tutors to
Assessor, Lead Trainers).
Attend Tutor supervision
delivered by a Lead Trainer
every 12 months.
Attend internal training and
support sessions within
sponsoring organisation when
available.
Discuss alternative options
with sponsoring organisation.
Supervision is required with
group of peers for minimum of
six-hours which includes skill
update and practice delivery.
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SELF-MANAGEMENT ASSESSORS
Role Description: To carry out assessments leading to Tutor accreditation and Standards Monitoring Visits to assist
Tutors in maintaining their accreditation
PROCESS
RECRUITMENT
MUST DO
NICE TO DO
COMMENT
Transparent recruitment process.
Advertise among accredited Tutors demonstrating
suitable aptitude who have delivered minimum of
four courses post accreditation.
Advert must clearly explain minimum requirements:
 Applicants hold a valid Passport to Practice
(P2P)
 DBS checks and induction.
TRAINING
Attend standardised training (12 hours delivered by
two Trainers of Assessors).
Feedback to sponsoring organisation.
Step 1 - Shadow Assessment
Observe the practice of an accredited Assessor
(including completion of shadow assessment
paperwork).
Shadow assessment within six
months of initial training.
Repeat process if unsuccessful at
Step 1.
Step 1 Shadow
Assessment:
Observe an assessment
and complete test
assessment form
Receive verbal & written
feedback
Submit test assessment
form and written
feedback form from
observed Assessor to the
trainer of Lead Trainers
(who delivered the
standardised Assessor
training) for Step 1 sign
off.
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PROCESS
DELIVERY
MUST DO
Step 2: Solo Assessment:
Carry out solo assessment within 12 months of
training and receive verbal and written feedback
from accredited Assessor.
NICE TO DO
If unsuccessful at Step 2 offer retraining at standardized Assessor
training and repeat Step 1 and Step
2.
Step 2: Solo
Assessment:
Conduct observed
assessment
Submit completed
assessment form and
written feedback from
accredited Assessor to
the Trainer of Assessors
for Step 2 ‘sign off’.
If unsuccessful after retraining, a development
plan can be created for
Tutors should they wish
to re-apply for the
Assessor role.
Attend supervision every 12
months.
Accredited Trainers of
Assessors are not
required to attend
supervision as they
facilitate supervision
(Note: Not all sponsoring
orgs have capacity to
progress Assessors to
Lead Trainers).
Is unsuccessful at Step 2 discuss next step with
Trainer of Assessors.
ACCREDITATION
COMMENT
Certification issued by the training organisation upon
successful completion of Steps 1 and 2.
Assessor’s name entered on database of accredited
Assessors by sponsoring organisation.
ONGOING
Carry out minimum one assessment each year
Attend one Assessor supervision delivered by
Trainer of Assessors every 18 months.
Provide copies of assessments for audit at
supervision.
Audit of assessment forms.
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PROCESS
MUST DO
NICE TO DO
COMMENT
Discuss with sponsoring
organisation – it may be
that a change of
organisation is required
in order to continue
progression.
Supervision to be
minimum six hours with
peers including skills
update and opportunity
for practice.
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SELF-MANAGEMENT LEAD TRAINERS
Role Description: Have overall responsibility for training and assessing Tutors
PROCESS
RECRUITMENT
MUST DO
Transparent recruitment process.
Advertise among accredited Assessors.
Advert must clearly explain minimum
requirements:
 Applicants hold a valid Passport to Practice
(P2P)
 DBS checks and induction.
NICE TO DO
COMMENT
Accredited Assessor for at
least two years post
accreditation.
To provide transparent
processes for recruiting Lead
Trainers.
Have successful monitoring
visits with ‘good’ or ‘very
good’ on monitoring form.
Standard letter must be clear
on full process to allow trainees
to make informed decision of
continuing role (Note: Not all
sponsoring organisations have
capacity to progress Assessors
to Lead Trainers).
Discuss with sponsoring
organisation – it may be that a
change of organisation is
required in order to continue
progression.
TRAINING
Attend standardised training event (12 hours
delivered by two T-trainers).
(Note: Lead Trainers follow an apprenticeship
model the last stage being 12 hours training
(above); this follows 24 hours of tutor training
and 12 hour assessor training plus requirement of
assessed practice hours at each stage).
Attend Tutor training event as
event organiser prior to
attending training.
This is the apprenticeship
model only available for
accredited Assessors.
Be peer reviewed by Lead/Colead.
To develop familiarisation with
Lead Trainer’s Manual.
Feedback given to sponsoring
organisation after above
event.
Degree of involvement at event
will depend on sponsoring
organisation’s policies.
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PROCESS
DELIVERY
MUST DO
Step 1
Peer reviewed by Lead Trainer while co-delivering
at Tutor training within 18 months of attending
training.
Step 2
Be observed and assessed for a minimum of 0.5 day
(by T-Trainer) while delivering as trainee Lead
Trainer (within 18 months of co-delivering).
Trainee Lead Trainer to complete standardised
post-training report (Appendix 11 of the Lead
Trainer Manual) accompanied by participant
feedback forms.
ACCREDITATION
Standard Letter of Accreditation issued by TTrainer.
Certificate issued by training agency signed by the
T-Trainer.
Stanford registration letter provided by T-Trainer
and registration with Stanford completed.
NICE TO DO
If unsuccessful at Step 1 have
one further opportunity.
If unsuccessful at Step 2 have
one further opportunity.
Be observed and assessed for
a minimum of half a day by a
T-trainer while delivering as a
trainee.
Become accredited Lead
Trainer within 12 months of
co-delivering at a Tutor
training event.
COMMENT
Develop skills through
constructive feedback and
demonstrate self-awareness
through report of event.
Observation will be undertaken
by a T-Trainer. The T-Trainer
will confirm days of attendance
to undertake observation with
the sponsoring organisation.
A T-Trainer needs to observe
Tutor’s second practice delivery
and Lead Trainer’s feedback to
trainees after second delivery
practice and audit report and
participant feedback forms.
To build capacity in
communities and ensure
consistent practice.
To comply with Stanford
requirements.
Name entered on Stanford University List Serve and
certificate issued by Stanford.
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PROCESS
MUST DO
NICE TO DO
COMMENT
On-going supervision with line
manager of sponsoring
organisation .
Supervision to be with peers for
a minimum of six hours
including skills update and
practice delivery.
To share experience and help
develop the programme in light
of practice.
Ensure consistency of
approach.
Combat health inequalities.
Opportunity to conduct audit of
process and practice.
Opportunity to progress from
Lead Trainer to Trainer of
Assessors dependent upon the
capacity of the sponsoring
organisation.
Name entered on database of sponsoring
organisation.
ONGOING
Attend one supervision delivered by T-trainer every
18 months.
Every 12 months from accreditation date deliver
either:
 Four-day Tutor Training
 Six-week community course,
 Conversion Training
 Assessor Training
Deliver a minimum of one Tutor training in any
programme (in which they are certified) every two
years.
If no training opportunities available then deliver a
minimum of one Tutor supervision or one Assessor
supervision (if qualified to do so) every 18 months.
Provide feedback on
development of programme.
Engage in further
development of programme.
Deliver a minimum of one
Tutor training event per year.
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SELF-MANAGEMENT-TRAINERS OF LEAD TRAINERS (T-Trainers)
Role Description: Train Lead Trainers, oversee programme integrity
PROCESS
RECRUITMENT
MUST DO
Conduct transparent recruitment process.
DBS checks and induction.
Advertise amongst accredited Lead Trainers who
have also trained Assessors.
Register as trainee T-Trainer with Stanford.
NICE TO DO
COMMENT
A T-Trainer observes potential
trainee T-Trainer as they
facilitate a Tutor training and
gives verbal and written
feedback indicating if the
person is ready to progress to
T-Trainer status.
To provide transparent
processes for recruiting
trainers of Lead Trainers.
To develop sustainability of
national programmes.
Must be able to conduct Lead
Trainer trainings using
paraphrasing and appropriate
personal stories.
Must have conducted at least
three Tutor trainings in the
past two years.
Must have approval from the
organisation for which they
work to offer a Lead Trainer
training outside of their area
for at least one week a year.
To ensure that the individual
has the required knowledge
experience and commitment to
become a T-Trainer.
To ensure their organisation is
also aware of the commitment
required to be recognised by
Stanford as a T-Trainer.
Compliance with Stanford
Fidelity.
Inform UK T-Trainer group
Chair.
PRE-REQUISITE TO
TRAINING
Must have:




Conducted at least three Tutor trainings in
past two years
Approval from organisation employed by to
offer Tutor training outside of area once a
year
Demonstrable opportunities/need to run
Tutor training to maintain accreditation
Meet the Stanford requirements for TTrainers.
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PROCESS
TRAINING
MUST DO
NICE TO DO
COMMENT
Co-train with a T-Trainer at one Tutor training, one
Assessor event and one Lead Trainer event within
12 months of completion of apprenticeship.
The option is open to travel to
Stanford to become accredited
as a T-Trainer.
Or must have apprenticed for a full 4.5 day Lead
Training under the supervision of a Certifying TTrainer.
Attendance at a Stanford
training does not guarantee
sign off as a T-Trainer The
guidelines for this are very
clear on the Stanford website.
Must be signed off by a certifying T-Trainer.
The 12 month completion of
apprenticeship and signing off
is required, unless this is
negotiated with special
additional training if outside of
the 12 months.
DELIVERY
Deliver one Lead Trainer training within 12 months
of completion of apprenticeship/’sign off’.
To establish role as main
contact supporting
development of other
regional/national programmes.
Ensure sustainability of
programmes within the ethos
and values of the training
framework.
To gain personal development
opportunities with peers.
Share good practice via peer
support.
Be available to deliver to
external organisations.
ACCREDITATION
Return the T-Trainer Agreement and Certification
Form to Stanford.
To build capacity in
communities and ensure
consistent practice.
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PROCESS
MUST DO
NICE TO DO
COMMENT
Certificate issued by Stanford University.
Name entered on Stanford Register.
ONGOING
Must deliver at least one 4.5 day master training, or
equivalent not less than every two years.
Presenting at national and
international conferences.
During years when no Lead Trainer training is
delivered, must deliver at least one of the following:
 Tutor training
 Lead Trainer supervision day
 Assessments for Lead Trainers and/or
Assessors accreditation
Link to Stanford University and
peer support.
Ensure adherence to the licence requirements when
delivering for any provider organisation.
Attend national meetings of TTrainers
Develop and influence national
health care policy in support of
the ethos and values of lay led
self -management.
When conducting Lead
Training the T-Trainers are
responsible for ensuring:
 Organisation has
appropriate licence
 Any fees due for Lead
Trainers trained is paid
Ensure any trained Lead Trainers details are sent to
Stanford.
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4. Appendix One
Aims and Objectives Ss2Q Revision Steering Group
The Steering Group [SG] has been established by the Quality Institute for Self-Management Education and Training [QISMET] the body that holds the copyright of the Training and
Quality Framework Stepping Stones to Quality [Ss2Q] to update the Training Frameworks.
The focal point of Step 4 of Ss2Q is on recruitment, training, accreditation and ongoing support for Tutors and Trainers. However, in relation to the specific steps that deliverers
move through to accreditation, and maintenance of their accreditation the minimum requirements within Ss2Q states that:
‘Tutors move through identified steps to become accredited, as outlined in the training frameworks.’
The Steering Group has been established to:

Develop the detailed process and oversee the updating of the training and support framework

Consider suggested revisions/additions to develop a draft framework

Disseminate the draft framework to members of the wider Reference Group

Decide upon the final content of the training framework
Aims:




Review and revise Training Frameworks Appendix 1 for Ss2Q Step 4
Produce up to date Training Frameworks, free from ambiguity that will be ‘fit for purpose to support all Stanford Programmes from 2015 and beyond
To maintain the integrity of The Fidelity Manual and UK Quality Frameworks
Adhere to the principles and ethos underlying recruitment, training and accreditation processes in Ss2Q
Responsibilities/objectives:
All Steering group members:

To work in partnership within agreed timescales

Ensure they are prepared for all meetings/webinars

Be an active member on at least one work steam sub group

To engage in sub-group meetings/webinars/conference calls and follow through on agreed actions

Present drafts in a timely manner to co-ordinator to ensure dissemination prior to scheduled meetings.
Steering Group will in conclusion:

Suggest a process for review and future updating of the training and support framework

Make recommendations about future ‘guardianship’ of the framework
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Glossary
Accredited Tutors – people who have been trained, successfully gained and maintain their Passport to Practice.
Assessors – accredited Tutors trained and accredited to monitor the quality of course delivery by other Tutors, and to accredit them
when found to be satisfactory.
Audit – a systematic review to determine whether agreed requirements are being met.
Best practice – the generally agreed best possible way of doing something.
Coordinator – the person(s) or their equivalents who have day-to-day management responsibility for the programme.
Evaluation – a process of collecting information and feedback to determine the effectiveness of the intervention.
Fit for purpose – meeting adequate standards for the defined purpose.
Lay led – the programme is delivered by lay people.
Lay people –people who deliver the programme in their capacity as someone living with, or caring for people living with, long term
conditions.
Lead Trainers – accredited Assessors who are trained and accredited to have responsibility for training and assessing Tutors.
Long term condition – an illness that continues for a long time, which needs to be managed on a long term basis.
Monitoring – collecting information on the delivery of the intervention.
Monitoring and evaluation framework – an agreed plan or protocol for monitoring and evaluation.
Monitoring and evaluation tools – instruments for measuring the delivery and effectiveness of the programme.
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Passport to Practice (P2P) – certification given to accredited Tutors that enables them to deliver and carry their accreditation
across organisational boundaries.
Programme – the interventions and infrastructure used to support the development of self-confidence and skills among people living
with long term conditions, or those who care for them, to help them to live life to the full.
Provider organisations – organisations delivering lay led self management to people living with long term conditions and those who
care for them.
QISMET Certification – the formal procedure through which QISMET assesses and verifies the quality of an organisations’ selfmanagement programme in accordance with established standards.
Self management – the tasks that individuals living with one or more long term conditions, or those who care for them, must
undertake to live well.
Stanford University – the University in California, USA, where the concept of lay led self management was first developed.
Stanford Manual – the licenced material that must be followed when delivering the intervention.
Stepping Stones to Success – the collective name for the agreed best practice among UK providers of Stanford University lay led self
management programmes.
Stepping Stones to Quality (Ss2Q) – the quality assurance framework and audit tool for Stanford self-management programmes.
Supervision – management by overseeing the performance or operation of a person or group.
Toolkit of self management skills – the skills people gain from lay led self-management, such as goal setting, action planning and
problem solving, which help them to make informed choices about their wellbeing.
Trainers – see Lead Trainers.
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Trainers of Lead Trainers – trained and accredited Lead Trainers who are responsible for training Tutors, Assessors and Lead
Trainers (see training framework).
Training and support framework – the framework that sets out the required competencies for Tutors, Assessors, Lead Trainers
and trainers of Lead Trainers.
Tutors – people living with long term conditions, or those who care for them, who are recruited and trained to deliver the
programme (see training framework).
Volunteer Tutors – people who deliver self-management programmes without payment, except for reimbursement of out-of-pocket
expenses.
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