Continuing Professional Development Review - Update
What’s in this section?
· Reviewing the current system
· What have we done so far?
· How long will the review process take?
· What were the GCC's proposals for the future of CPD?
· How we worked with the profession
· What was the purpose of the CPD pilot 2016-17?
· What were the outcomes from the CPD Pilot?
· What are the next steps?
· Does the review affect the CPD I have to do now?
· Contact us
Reviewing the current system
In February 2014, the General Chiropractic Council put the development of a revalidation system on hold, suspended the Revalidation Working Group and tasked the Education Committee with leading on the review and development of the Continuing Professional Development (CPD) scheme.
The Government in its January 2015 response to the Law Commission’s proposal on the Regulation of Health Care Professionals stated:
“because of the differing nature and size of each profession, the Government believes a one-size-fits-all approach assuring the continued fitness to practise is not appropriate. Regulatory bodies need flexibility around how they seek assurance of the ongoing fitness to practise of their registrants and the type and level of evidence needed to achieve this. Our proposed approach to a future Government Bill is to impose a duty on each regulatory body to seek assurance of the continued fitness to practise of their registrants and to give regulatory bodies the flexibility to develop their own models to discharge this obligation that are proportionate to the risks associated with their professions. … The models being developed by the regulatory bodies share the underlying principles of the GMC medical revalidation process but are based, in the main, around registrants providing assurance they are meeting the standards set in their respective professional codes, in particular standards of continued professional development.” (paras 4.25 – 4.26)
In January 2015 a review of the current system of CPD commenced to ensure it still remained fit for purpose and with the intention of developing a CPD scheme that offers assurance of the continuing fitness to practise of registrants. The principles of the review were framed around:
· A commitment to develop a CPD scheme that was fit for our on-going regulatory purposes and one that made a valid contribution to assuring patients and the public that chiropractors in the UK continue to be up to date and fit to practise
· A belief that an ‘enhanced CPD’ would be a scheme fit for the chiropractic profession in the 21st century offering a proactive way of enabling registrants to periodically demonstrate that they are up to date and continue to practise in accordance with our standards
· An intention to make compliance with an enhanced CPD scheme a mandatory requirement of continuing registration with the GCC
· Recognition of the need to provide clear, accessible and proportionate guidance in support of the scheme.
What have we done so far?
The Education Committee undertook a number of activities to review the current CPD scheme, investigated the broader context and explore the range of ways in which the continuing fitness to practise of registrants might be assured. This culminated in a workshop in January 2015 during which the Committee agreed to recommend to Council that a new CPD scheme be designed to provide assurance of chiropractors’ fitness to practise. In March 2015, the Council agreed to a programme of work for developing the CPD scheme to include assuring the continuing fitness to practise of registrants.
To date the GCC has:
1. Completed a qualitative analysis of CPD records
2. Consulted with the profession and stakeholders by asking them to complete a questionnaire
3. Consulted with the profession and stakeholders by issuing a discussion document.
4. Undertaken research into the CPD market for chiropractors to evaluate how well it supports registrants with their continued learning
5. Reviewed the research and considered the developments being made by other healthcare regulators with their approaches to assuring their registrants’ continuing fitness to practise.
6. Worked with groups of registrant volunteers around the country to identify the best way forward for the profession.
7. Conducted a pilot of proposed elements of the improved CPD scheme with a small group of registrant volunteers.
8. Undertaken an analysis of the CPD pilot.
9. Undertaken a full audit of CPD returns for 2015/16.
What were the GCC's proposals for the future of CPD?
Proposals for a future CPD scheme were considered by Council in March 2015, in the light of enhancements made by other regulators and to provide greater assurances of continuing fitness to practise. A future scheme would be based on the following principles:
· An annual cycle which requires 30 hours of learning of which at least 15 hours is learning with others
· The use of learning cycles as the basis for planning, undertaking and reflecting on learning
· The removal of the requirement for the learning to be categorised as ‘improving patient care’ or ‘developing the profession’ from 2015
· Introducing requirements to take place across a three year cycle which would count against the hour requirements for those three years (90 hours in total) of:
i. an objective activity (e.g. a case based discussion, peer observation and feedback, patient feedback or clinical audit)
ii. a CPD activity in an area identified by the GCC as of importance to the profession as a whole. This might change over time (e.g. from persistent issues in fitness to practise cases or where, for example, new legislation has been introduced).
iii. a peer discussion to demonstrate engagement with learning and development and reflective practice.
· retain a system of annual sampling and audit
· improve the online CPD system so that it makes best use of up-to-date information and communications technology
· The overall approach to be one that is formative and supportive.
How did the GCC work with the profession?
During 2015, development groups made up of registrant volunteers around the UK worked with the GCC to:
· identify and clarify good practice in the current CPD scheme;
· produce examples of good practice in the current CPD scheme that could be shared with others in the profession;
· explore and refine the elements of a new CPD scheme consistent with the broad principles agreed by the GCC Council;
· produce draft guidance on how the new scheme assures the continuing fitness to practise of chiropractors;
· advise the GCC on areas of concern which would need further consideration.
The work of the development groups formed the proposals for change to the CPD scheme. Essentially the groups proposed three additions to the current scheme:
· a mandatory subject (chosen by the GCC mandatory subject as part of a three year cycle in order to address persistent issues which frequently arose in fitness to practise cases).
· an objective activity (observation by a peer, patient feedback, clinical audit) and
· a structured discussion about CPD (supportive discussion with a peer to reflect on practice, learning and development as a whole, to identify learning objectives, how they will be achieved and evaluated.
What was the purpose of the CPD pilot in 2016-17?
Following the outcome of the development group work, the GCC undertook a CPD pilot of suggested changes to the scheme with the purpose of exploring:
· how feasible it is for registrants to undertake the three additional aspects of the scheme;
· the benefits that registrants find in undertaking additional CPD activities;
· any issues encountered by registrants in trying to carry out these additional aspects;
· the amount of time and the costs incurred in carrying them out;
· how useful and user-friendly the guidance and recording forms are and where they need to be improved.
· whether there are any specific issues raised for some registrants by these
· proposals, such as those who act as locums on a long-term basis,
· researchers, educationists, those who are registered as non-practising or those with specific forms of exceptional circumstances
· any implications for the GCC’s own work which the pilot raises (such as how best to identify the mandatory subjects and any additional work this involves).
All registrants who took part in the pilot were asked to have a Structured Discussion about CPD with a peer. Beyond that, registrants had the choice to undertake an objective activity, the mandatory subject or both. Registrants, were however also encouraged to trial at least one of the other two elements to will help appreciate the extent of what was being asked in undertaking the additional components and help the GCC to better develop a system that would work best for the profession.
What was the outcome of the CPD Pilot?
While the final number of CPD submissions received as part of the pilot was disappointing, they were however, considered to be of rich quality and provided exemplars of how the requirements of the scheme should be met and recorded.
In addition to the CPD submissions, the GCC issued an end of pilot questionnaire to all registrants who had contributed to the CPD review since 2015. The responses to the questionnaire can be found in the Developing the General Chiropractic Council’s Continuing Professional Development Scheme for Continuing Fitness to Practise – Learning points and outcomes of the 2016-17 CPD pilot.
The report recommends that new CPD guidance for 2018/19 guidance incorporates some of the elements of the proposed future scheme and that registrants are encouraged to voluntarily adopt some of the elements of the pilot.
We wanted to ensure that any recommendations and decisions about future requirements reflected good practice in CPD. They also needed to be workable and avoid unnecessary paperwork for registrants and for the GCC. CPD requirements are set out in legislation and the GCC recognised early in the review process that proposed change to CPD may require legislative change. It was envisaged that we would consult with the profession at the beginning of 2018, prior to its implementation. Unfortunately, following discussions with colleagues at the Department of Health and Social Care, while recognising the restriction of the CPD rules, were unable to commit to parliamentary time to consider a change to legislation governing CPD, given the potential of the UK exiting the EU.
What are the next steps?
Given the legislative and IT barriers, which for the present prevents the implementation of a new CPD scheme, the GCC are keen that the learning from the pilot is not lost and have continued to explore what may be possible within the current legislation, and encourage registrants to consider taking on some of the CPD pilot elements. In support of this objective the GCC, as part of our five year strategy (launched in 2018), includes a strand to promote standards and we have committed to ‘Develop and implement a proportionate approach to Continuing Professional Development (CPD) submissions and audit by September 2019’. In the light of the findings from the CPD pilot, we took the decision to review our approach to CPD and looked to see where changes could be made which still meet legislative requirements.
We have looked at the CPD summary and thought carefully about what constitutes acceptable learning, in particular, learning with others. The task we have is to balance assurance that registrants meet required standards, and at the same time to stimulate improvements in the quality of care provided by chiropractors, building trust and confidence in the profession. We have set out our proposals in our consultation ‘A fresh approach to Continuing Professional Development’ which runs from 1 May 2019 – 12 June 2019. We believe that the result is both proportionate and right-touch, providing assurance that registrants are updating their knowledge to ensure they maintain the necessary skills to practise safely and competently for the benefit of patients. The results of the consultation will be analysed and considered by the Education Committee in July, when they will decide whether to go ahead with the proposed changes. We will keep registrants informed by notifying them shortly after. If the changes are adopted the requirements, along with guidance, will be published covering the 2019/ 20 CPD year.
Does the review affect the CPD I have to do for 2018-19?
You will find details of the CPD requirements for 2018/ 19 [here].
Your comments about CPD are valuable to us and will help us develop our future proposals. Please email any questions or comments about the CPD review and your CPD experiences to [email protected]