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
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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
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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?