Additional CPD requirements and guidance for new registrants published

Directed CPD: Clinical Governance

The GCC expects all recent graduates to commence their professional life with due regard to the essential elements of clinical governance. These include accountability for providing a safe and effective service, and safeguarding high standards of care.

Therefore, in addition to the directed CPD for all registrants, which for the 2021/22 CPD year will focus on communication skills, the GCC will also be directing the CPD of recent graduates, ie. those who have qualified within the last two years and who have registered with the GCC for the first time from 1 July 2021, to include a focus on clinical governance. The introduction of this additional directed CPD will help to support the GCC's aims of developing professionalism.

GCC expectations for new registrants

Dependant on the date of registration (Details here), the GCC will expect new registrants to:

reflect on their skills and understanding on a range of key areas of clinical governance as specified by the GCC, and
address any aspects that require development.

These additional CPD activities will continue to form part of the expected 30-hour CPD requirement for the year (not in-addition to).

There are six areas of directed clinical governance:

Standards-based care
Using evidence to inform practice
Clinical audit
Safety incident reporting and learning
Patient recorded outcomes / patient satisfaction measures
Reflective practice

GCC requirements with regard to each of these areas are explained below. Participation in the Royal College of Chiropractors' ‘PRT’ postgraduate training programme is the most straightforward way to address these requirements.

1. Standards-based care

Understanding which standards/guideline components are relevant to chiropractic practice and applying them in your practice is a vital part of ensuring that you are working in the best interests of patients and providing the best care. For this element of clinical governance CPD, the GCC expects you to reflect on:

your familiarity with published clinical standards that relate to chiropractic practice, such as the RCC Chiropractic Quality Standards and relevant NICE guidelines, and
your understanding of how these can be applied to your practice as a key element of evidence-based practice.

Plan and undertake appropriate CPD activity that helps you identify relevant practice standards and understand how to apply them. The Standards-Based Practice module (ref ‘SBP1’) of the RCC PRT programme is designed to address this requirement.

2. Using evidence to inform practice

Principle C of the GCC Code requires all chiropractors to select and apply appropriate evidence-based care. This helps to ensure that the most effective care available is provided with the aim of improving patient outcomes. For this element of clinical governance CPD, the GCC expects you to reflect on:

your familiarity of the principles of evidence-based practice, and
your understanding of how an evidence-based approach impacts on patient care.

Plan and undertake appropriate CPD activity that develops your ability to apply an evidence-based approach in your care planning. The Using Evidence to Inform Practice module (ref ‘EBP1’) of the RCC PRT programme is designed to address this requirement.

3. Clinical audit

Clinical audit evaluates existing practice against best practice with the aim of providing best quality care. Carrying out clinical audit involves identifying a particular area of interest/concern (often based on a published standard or guideline), collecting data to compare current practice to the standard; identifying shortcomings and making changes and, finally, re-auditing after a time period to close the loop and assess improvements. For this element of clinical governance CPD, the GCC expects you to reflect on:

your understanding of the process of clinical audit, and
your experience of applying clinical audit in improving your practice since you joined the chiropractic register.

Plan and undertake appropriate CPD activity that addresses/consolidates your understanding of clinical audit and its application, and/or outline the outcomes of a clinical audit you have undertaken in your clinic. The Clinical Audit module (ref ‘CA1’) of the RCC PRT programme is designed to address this requirement.

4. Safety incident reporting and learning

All chiropractors are encouraged to adopt incident reporting as part of a blame-free culture of safety, and a routine risk management tool. Sharing incidents locally helps to ensure that the practice provided in your clinic is safe and effective. Sharing safety incidents nationally and internationally using the Royal College of Chiropractors’ CPiRLS system allows all chiropractors to learn from the collective experience, thus contributing to improvements in safety and effectiveness across the whole profession. For this element of clinical governance CPD, the GCC expects you to reflect on:

your understanding of the process and importance of patient safety incident reporting and learning, and
your awareness of local and national systems of reporting.

Plan and undertake appropriate CPD activity that furthers your understanding of, and ability to apply, patient safety incident reporting and learning in the best interests of patients. The Safety Incident Reporting and Learning module (ref ‘SIRL1’) of the RCC PRT programme is designed to address this requirement.

5. Patient recorded outcomes (PROMS) / patient experience measures (PREMS)

Actively collecting feedback data from patients and directly involving them in measuring clinical outcomes are important aspects of assuring the quality of the services you provide. For this element of clinical governance CPD, the GCC expects you to reflect on:

your understanding of the importance of collecting patient reported outcome and experience data, and
your familiarity with the commonly-used, validated tools and means employed to collect and evaluate them.

Plan and undertake appropriate CPD activity that helps you identify/addresses any gaps in your understanding in this field. Consider participation in PROM and PREM data collection to help you drive improvement in your services to patients. The PROM/PREM learning module (ref ‘PRD1’) of the RCC PRT programme is designed to address this requirement.

6. Reflective practice

Reflecting on your sense and understanding of a topic or situation allows you to identify areas for further learning and professional development. Reflective practice is all about active reflection on your experiences, and then putting changes or improvements into action in your everyday practice. For this element of clinical governance CPD, the GCC expects you to reflect on:

your understanding of the process and value of reflective practice, and
your understanding and application of the tools available to facilitate routine reflective practice.

Plan and undertake appropriate CPD activity that helps you identify/addresses any gaps in your understanding of reflective practice and its application. The Reflective Practice learning module (ref ‘RP1’) of the RCC PRT programme is designed to address this requirement.

Guidance on recording your Clinical Governance CPD activities

Guidance on how to complete the clinical governance elements of you CPD return using the online portal is provided, here.

When to undertake Clinical Governance CPD

As graduates join the GCC register at different times throughout the year, the clinical governance CPD requirements are required for recent graduates’ within their first two annual CPD returns.

Those who joined the register for the first time between 1 July 2021 and 31 August 2021, inclusive, must report completion of the clinical governance CPD requirements as part of their CPD return for 2021/2022.

Those joining the register for the first time from 1 September 2021 onwards, need to report completion of the clinical governance CPD requirements within their 2021/22 or 2022/23 CPD returns.