PATIENT SKILLS
DEVELOPMENT
PROGRAMME
Guide to Facilitator
Training, Skills and
Assessment
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About this Guide
This Guide is written for people who are responsible for recruiting, managing or supporting
facilitators on the patient skills programme.
The facilitators are the single most important resource for the programme. It is therefore
essential that the right people are recruited and that they are appropriately trained,
supervised and supported to fulfil their role.
This guide sets out:
 the core competencies of a facilitator
 standards for facilitator recruitment
 standards for facilitator training
 standards for running training for trainers
 standards for facilitator supervision and support
 support for self reflection
 ensuring the quality of facilitation
 quality assurance template
It is supported by a series of separate more detailed guides:
 guide for facilitators
 3 Facilitator Manuals each covering the activities for the relevant module (see below)
 guide for programme leads
 guide to quality assurance
 participant Workbook and Handouts
All of the guides and further information about self management and self management
support are available on our Resource Centre at http://www.health.org.uk/resourcecentre/new-sms/. The Resource Centre also includes a wide range of resources that can be
given to people with long term conditions to help them self manage and a wide range of
resources to help those running Patient Skills Programmes.
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Core competencies of a facilitator
This section sets out the core competencies for Facilitators and Trainers of Facilitators.
Those who are providing training to new facilitators should be able to demonstrate the same
competencies, but at a higher level.
Competency
Description
Manage and
make effective
use of time
Because the workshops are interactive with
a flexible number of participants
timekeeping and time management is a
core competence. Sessions start and finish
on time.
Outcome
measure /
assessed by
Observation
on initial
training.
Ongoing quality
outcomes
Participants report that they all had chance
to participate.
Appropriate use
of goal setting
Appropriate use
of problem
solving and goal
follow up
Facilitators are able to adjust activity length
to meet group needs whilst keeping to
overall time
The ability to support participants to set
achievable and appropriate goals is a
fundamental competence for self
management and to enable behaviour
change.
Participants report that they were supported
to set realistic and achievable goals
Helping participants to analyse problems in
their own everyday experience and when
faced with difficulties is a core competency.
For participants, believing that progress can
be made and they have choices are key to
improving perceived self efficacy and
increasing activation.
Observation
on initial
training.
Ongoing
quality
outcomes
Observation
on initial
training.
Ongoing
quality
outcomes
Facilitators should be able to support
participants to identify barriers to change
and facilitate them to identify solutions
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Understanding
of the biopsychosocial
model of health
Use a solutionfocussed
approach
Create and
maintain a safe
and inclusive
environment
Group
facilitation and
active listening
skills
Facilitators should have a basic
understanding of the theoretical models
underlying the workshops. This will enable
them to understand the importance of
facilitation and coaching role. They should
have a understanding of why the enablers
are important and their application to all
areas of a person’s life.
It is important to have the skill and insight to
recognise when it is appropriate to work
one-to-one as well as in a group. This
approach may involve facilitating the group
to focus on each issue as required. The
focus should be on analysis and action
planning mixing in ways that enhance wider
learning. Participants supported in this way
regularly achieve good outcomes.
Involves being non-judgemental and
inclusive by ensuring all participants have
time to be involved and no single person is
allowed to dominate the group. The ability
to challenge inappropriate behaviours and
speech in a way that is respectful. Results
in participants willing to recommend PSP to
others and low attrition rates
Management of group dynamics is a key
skill. It includes many of the other
competencies within it and skills such as
managing group energy, group discipline
according to agreed rules, being aware of
emerging dynamics between group
members and the affects of these upon the
individuals involved and others, being aware
of individual moods and the effects of these
on group feeling and progress.
Observation by
trainers in
delivery of
core modules
PAM/increase
d self efficacy
HEIQ quality
domain/attritio
n rates.
Observation of
practice
Attrition rates
Observation by
trainers on
initial training.
All outcomes
The competence to manage the group is
based upon valuing each individual and
ensuring that they have equal access to the
resources within the group.
Skills in observation and listening can be
taught and learned.
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Support and
encourage
behaviour
change by using
motivational and
coaching skills
during goalsetting and goalfollow-up
This is the ability to listen to the tone and
inflection of a person during goal setting and
knowing when it is appropriate to encourage
raising or lowering of confidence levels,
adjustment of the goal and linking the goal
to importance and relevance to the person’s
life. Participants supported in this way will
be able to make positive life changes
Demonstrated
over 24 hour
training and
workshop
delivery.
HEIQ/PAM
and other
outcome
measures
Work in equal,
supportive
partnership with
co-facilitator
The workshops are designed to run with two
facilitators working with the group at all
times. Their relationship must potentially
add value by modelling all the behaviours
and skills being developed in participants
through the programme, in particular
modelling a equal partnership between a
health professional and lay person and
between them create a effective learning
environment
Demonstrated
over 24 hour
training HEIQ
quality domain/
observed by
trainers
Working
understanding
of social
learning and
selfdetermination
theory
Be responsive
to the needs of
the group
Participants will see that the skills of lay
people and health professionals are
complementary with one not more important
the other.
Ability to frame participant and group
responses within a framework that enables
the facilitator understand how to move
people to a point of action
Demonstrated
over 24 hour
training
Observed by
trainers
Ensures that participants feel engaged and
the content of the workshop is relevant to
them. Underpinned by agenda setting.
Participants report that the workshops were
relevant to them
HEIQ quality
domain
Make effective
use of the
materials
Facilitators should be able to adapt the
materials to their own style whist adhering
to the core processes and content. A person
observing a session should be able to follow
where the facilitator is in the lesson plan.
Observation
on initial
training and
first workshop
Recognise and
safely challenge
unhelpful health
A key feature of making changes to health
behaviour involves working with participants
on recognising beliefs that may act as a
On 24 hour
training
Observation by
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beliefs
barrier to change. This learned skill is a key
competence when trying to establish if the
lack of engagement in exercise or dietary
control is due to poor confidence, lack of
knowledge or skill or a belief that it may
aggravate their condition
trainers
This is not about challenging clinical advice
but gently working with the participant to
understand why they may not be willing to
take on a new behaviour without blaming or
undermining them in the group.
Model/support
effective selfmanagement
Facilitators should model a self managed
life with a long term condition, whether this
is turning up on time, creating a safe and
comfortable environment to work, being
aware of the wellbeing of others, addressing
and tackling unexpected situations,
managing momentum and direction in the
work together, reflecting on progress and
willingness to learn etc.
Guide to Facilitator Training, Skills and Assessment
On 24 hour
training
Observation by
trainers
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Standards for facilitator recruitment
 There is an open and fair recruitment process for facilitators
 There is a Recruitment Pack provided to everyone who expresses an interest
 It is preferable, but not essential, that those selected to become facilitators have
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themselves attended the programme.
Those expressing an interest are required to provide relevant information that enables
short listing to take place
Those short-listed are interviewed against required competencies
References are taken up
All candidates are sent a letter informing them of whether they have been accepted as a
facilitator
Those accepted receive an induction to organisation
An Enhanced Criminal Records Bureau (CRB) Check is undertaken
Each person is provided with a named supervisor who will support them
Standards for facilitator training
Training:
 potential facilitators attend a minimum of 24 hours training to fulfil their role
 through the training, potential facilitators demonstrate competence in core self care
skills, including goal setting, goal follow up, problem solving
 in the training, potential facilitators Practice delivery skills and receive and act on
feedback given
Assessment of competence:
 facilitators must deliver their first patient skills workshop within 3 months of initial training
 facilitators are observed on first course they deliver and receive feedback against core
self care competencies
 of needed, additional training and support is provided
 facilitators are accredited to deliver the course following the successful delivery of their
first 3 workshops and proof of satisfactory quality outcomes.
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Standards for the on-going monitoring and development of facilitators
On-going monitoring and development
 facilitators keep a personal learning log on an on-going basis
 ongoing monitoring based on attrition rates and participant feedback and outcomes
 there is regular monitoring of quality outcomes and attrition rates
 facilitators receive annual skills development and update
 facilitators receive regular supervision
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Standards for running training for trainers
Not only is high quality facilitation key to the effectiveness of the programme for participants,
but also facilitator training is a form of intervention in its own right and can have a significant
impact on the lives and health of the trainees. It is therefore vital to the quality and integrity
of the programme that those who are providing training to facilitators, providing supervision
and signing facilitators off as competent to deliver, themselves have sufficient skills,
knowledge and expertise in self management.
Trainers of facilitators and those carrying out supervision, observing and supporting new
facilitators should have extensive experience of programme delivery themselves.
Recruitment of trainers:
 nominated individuals to have delivered minimum 5 SMP Programmes
 those expressing an interest are required to provide relevant information that enables
short listing to take place
 those short-listed are interviewed against required competencies
 all candidates are sent a letter informing them of whether they have been accepted as a
facilitator trainer
 each person is provided with a named supervisor who will support them
Training for trainers
 each trainer co-delivers a ‘training for facilitators’ course with an experienced trainer
Assessment of competence
 each trainer is the lead in delivering‘training for facilitators’ course, during which they are
observed and assessed against core competencies set out in section 2 above
 if needed, additional training and support is provided
 facilitators are accredited to deliver the course following the successful delivery of their
first course and proof of satisfactory quality outcomes.
On-going monitoring and development
 there is regular monitoring of quality outcomes and attrition rates
 trainers receive annual skills development and update
 trainers receive regular supervision
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Standards for supervision and support
All self management facilitators should have access to regular supervision both one to one
and group, which covers skills development, quality assurance, personal and professional
development and training and which allows the facilitators to reflect on their and continue to
develop core skills.
Group Supervision / Skills Events
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You should provide a minimum of one event a year which facilitators attend as a group. The
event should:
 provide skills development and training based on learning needs
 allow facilitators to compare practice
 include information on programme changes- facilitators should be involved in any
changes
 share evaluation and quality data
Individual Supervision Sessions
You should provide on-going individual supervision, which:
 provides support where there are issues with group participants or group dynamics
 reviews participant feedback with the facilitator to support the identification of further
training
 addresses individual training and development needs, as well as being an opportunity
for two way feedback
 identifies problems that have been encountered on either side and how these might be
resolved
 supports the development of productive relationships with others
 supports time management
Access to supervision is particularly important when the facilitator may have concerns about
difficult behaviour in a group. A named person should always be on-call when workshops
are running, to help the facilitator resolve any issues.
You may find it useful to use the following grid to ensure that you track the training and
support you are providing to your facilitators:
Name
Healthcare
Profession
al or lay
facilitator?
Date
training
complet
ed
Guide to Facilitator Training, Skills and Assessment
Date refresh
training
completed
Date of last
supervisio
n
Leave
date
Average no.
of courses
delivered
per year
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Support for self reflection
Continued learning and development is essential to all facilitators and reflecting on their
experience is an important component in this. Making some key reflective notes following
each workshop can begin to identify areas where progress is being made and where skills
need further development. These reflective notes can then form the basis for supervision and
for identify support needs
This six step process can be a helpful tool:
Experience
What was my experience here- what happened?
Feelings
How do I/did feel?
Evaluation
What was good? What was difficult?
Analysis
Why?
Learning point
What can I learn from this?
Learning process
How do I/did learn it?
Action Planning
What will I do differently
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Ensuring the quality of facilitation
The facilitators and the quality of the facilitators are the most important resource for the
programme. It is therefore essential that the right people are recruited and that they are
appropriately trained, supervised and supported to fulfil their role.
Effectiveness of facilitator recruitment, training and support is a key aspect of ensuring the
quality of the programme. The diagram below shows how ensuring the quality of facilitator
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recruitment, training, supervision and support should form part of a wider approach to quality
assurance.
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Quality Assurance Template
We have set out below a Quality Assurance Template, to help you quality assure the
facilitator aspects of your programmes.
Facilitator training
Ref Question
26
Are the necessary experience and/or
qualifications required of facilitators
clear and used in the recruitment
process
27
Are new facilitators given an induction?
28
During training, do the new facilitators
have the opportunity to observe
programme delivery by a qualified
facilitator?
29
Is all training recorded?
30
Do new facilitators receive written
feedback?
Yes
No
Evidenced by
Facilitator supervision and support
Ref Question
Yes
No Evidenced by
15
Do the facilitators’ have access to regular
supervision?
16
Is there a clear process for facilitator
accreditation?
17
Are those involved in providing training,
accreditation and supervision of facilitators
suitably qualified and experienced in self
management and developing facilitators?
18
Do facilitators have a CRB cheque
19
Do facilitators where volunteers have a
clear volunteer policies in place
20
The model of volunteer/professional co facilitation at the heart of the model. How much of
the course are volunteer facilitators trained to deliver and what is the mechanisms for
supporting this?
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Further Resources
There are a wide range of further resources available through The Health Foundation’s Self
Management Support Resource Centre, at http://www.health.org.uk/resource-centre/newsms/patient-skills-programme/resources/.
The Quality institute for self management education and training has a range of standards for
self management education www.qismet.org.uk.
For further information:
Tel: 0207 257 800
www.health.org.uk
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