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Tuesday 15 November 2011, Romanian Authorities Study Visit




The Health Professions
Council
Contents

• Welcome and Introduction
• The HPC and the role of a UK regulator
• Policy at HPC
• Fitness to practise
• Stakeholder engagement


• Registration at HPC
   Mutual recognition and EEA processes
   IMI / Security verification
   Continuing professional development (CPD)
Health Professions Council


• Independent UK statutory regulator of 15 professions
• One of nine health regulators
• Derives powers from Health Professions Order 2001
• Purpose is “to safeguard the health and well-being of persons using
  or needing the services of registrants” – Article 3(4)
• Separate role from professional bodies and trade unions
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                                                                                                                 HPC Register 2011




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                                                                       219,000 registrants from 15 professions




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Processes and standards




                          The Register
Professional and lay input


• 507 ‘Partners’ working across 677 partner roles
 – Our professions and lay persons
 – Provide expertise for good decision-making
 – Approval of education and training programmes
 – Registration decisions (applications and CPD audits)
 – Fitness to practise decisions
• Council and Committees
• Professional Liaison Groups (PLGs)
Tuesday 15 November 2011, Romanian Authorities Study Visit




Policy at the HPC
About the Policy and Standards Department


 Develop policy and strategy




                           Policy
                            and
                         Standards




                                        Consultations
Our standards



•    Standards of conduct, performance and
     ethics: behaviour and attitudes expected
•    Standards of proficiency: professional
     knowledge, understanding
•    CPD standards: requirements for ongoing
     learning
•    Standards of Education and Training: we use
     these to approve education programmes
Guidance



• Explains our policies in more detail
• Advises registrants and/or students on
  how they can meet our standards
• Formal guidance is published
• Informal guidance (advice):
    •   Website
    •   Email
    •   Phone
    •   Meetings
The way policy works



• Responsible for reviewing standards, updating/writing new guidance,
  or undertaking work on policy change
• Write papers for Committees and Council to advise them on options
• Require Committee and Council approval of proposals before
  consulting – plus legal approval
• Meet with stakeholders on projects relevant to HPC policy
• Provide advice on HPC policy to registrants and members of the
  public
• Organise and coordinate professional liaison groups to work on policy
  change as needed
Consultations



• Normally consult for 3 months
• Information posted online in dedicated ‘consultations’ section of
  website
• Also sent to consultation list of over 400 interested organisations.
• Certain consultations go out to all registrants
• Respond to external consultations
Responses to external consultations



• Respond to public consultations relevant to our work and our
  registrants
• Respond positively where possible, constructively where we disagree
  with proposals
• Recent consultations we have responded to:
   • European Commission Green Paper on Modernising the
     Professional Qualifications Directive
   • House of Lords European Union Committee call for evidence on
     the Professional Qualifications Directive
Tuesday 15 November 2011, Romanian Authorities Study Visit




Fitness to Practise
Fitness to practise: An overview of the process

• Allegation made
                                               Allegation
• Investigate allegation
• Interim order imposed                    Investigation
• Hearing convened
                               Interim Order                Mediation
• Case considered by final
 hearing panel                                  Hearing
• Sanction imposed
                                               Judgement
Fitness to practise: when we will take action


• Serious or persistent failure to meet standards
• Improper relationships with service users
• Failure to respect the autonomy of service users
• Sexual misconduct
• Misuse or abuse of drugs and alcohol
• Failure to provide adequate care
• Poor record keeping
• Theft from a service user
Tuesday 15 November 2011, Romanian Authorities Study Visit




Stakeholder engagement
Stakeholder engagement


• AURE (Alliance of UK regulators in Europe): Meetings 6x annually,
  communicating HPC position, debates , contributing to joint
  statements and consultation responses
• BMA EU forum: Bi-annual meetings, wide range of organisations
  represented, debates, communicating HPC position
• BIS (Department for Business, Innovation and Skills): Developing
  working relationships, supporting events eg EU Commission London,
  coordinating HPC responses, data gathering
• CLEAR (The Council on Licensure, Enforcement and Regulation):
  Supporting CEO, attending as delegate (London 2011), speaking slot
  (CPD)
Stakeholder engagement

• EU Commission: Annual meetings with CEO & Policy, developing
  close working relationships, attending & supporting Commission
  events eg Modernisation of the Professional Qualifications Directive
• Supporting International regulators: Cypriot Ministry of Labour,
  Norwegian government, Hong Kong
• European Parliament: MEP meetings with CEO, attending IMCO
  Committee (Internal Market and Consumer Protection Committee),
  supporting MEP’s assistants
Tuesday 15 November 2011, Romanian Authorities Study Visit




Registration at the HPC
Role of the registration department

• Maintain and publish a Register of health professionals
• 36 full time staff
• 100,000+ telephone enquiries per year
• 20,000+ email enquiries per year
• UK approved courses – over 10,000 applications per year
• Readmission and return to practice process
• Bi-annual renewal process
• Audit of continuing professional development (CPD)
• Verification checks for identity, education and career history of all
  overseas qualified applicants
Routes to registration – all international applicants


• 180 - 200 International applications received per month (25% are
  EEA applicants).
• Forms downloaded from HPC website
• Applicants advised to read standards of proficiency before applying
• Incomplete forms returned to applicants with advice
• Character declarations sent to fitness to practice before assessment
• Background checks carried out to verify applicant’s identity, education
  and good standing
• Use of outside agencies such as UK NARIC and Kroll International
  for background checks
• Service level agreement of 10 working days for assessment decisions
Routes to registration – international (non-EEA)


Applications are sent to two registration assessors from the relevant
 profession (HPC partners)
Assessment based on professional qualification and additional
 education, training and experience
Possible outcomes:
• Accept – applicants meets all standards of proficiency
• Further verification – additional information requested to address
  shortfalls in application
• Test of competence – interview to determine borderline cases
• Reject – applicants have automatic right of appeal
Routes to registration - EEA applicants with mutual recognition

Applications are sent to two registration assessors from the relevant
 profession (HPC partners)
Assessment based on professional comparison and additional
 education, training and experience
Possible outcomes:
• Accept – applicants meets all standards of proficiency
• Further verification – additional information requested to address
  significant shortfalls in application
• Adaptation period – normally additional supervised practice or
  academic module. Applicants have automatic right of appeal
• Aptitude test – can be requested by applicant if they feel adaptation
  period is not required
Role of IMI

• Currently three HPC professions covered:
       Physiotherapists, Practitioner psychologists, Radiographers
• All advisors involved in processing international applications have
  access to the IMI system
• Safe and mostly effective way of receiving information
• Used in both permanent establishment cases (verification process) and
  in decisions on temporary provision of services cases
• Increasing use – 10 requests within last 6 months:
        7 sent by the HPC (Estonia, Greece, Lithuania, Romania, Spain)
        3 received by the HPC (1 from Sweden, 2 from Spain)
IMI - our experience

• Most replies within 1 month, however some take several months to
  conclude – this means delays in the recognition process and
  unnecessary obstacles for the applying professional
• Not all relevant authorities are willing to engage – there is no method
  of enforcing mandatory use
• Unclear which authorities can be contacted in some cases (long list to
  choose from) – lack of explanation who is responsible for what
• Overview of regulatory systems for each profession would be helpful
• Still a limited number of regulated professions covered by the ‘general
  system’
• Good potential for growth and extended use
Assessment process – training issues

• Assessors receive refresher training every two years regarding
  developments in legislation
• All new assessors receive equality and diversity training
• On-going quality monitoring to ensure recommendations are fair,
  appropriate and legally sound
• All refusal and adaptation period recommendations must be approved
  by registration managers
• EU Commission has reaffirmed that systematic language testing is
  ruled out as a condition of recognition
• Speech and language therapy is the only profession that is exempted
  from this part of the directive because knowledge of the language is a
  core competence of the profession
Temporary provision of services

• Temporary and occasional nature of the provision of services
  (Directive 2005/36/EC, Article 52)
• Proof of nationality or citizenship
• Attestation(s) of legal establishment (or proof of 2 years professional
  experience)
• Evidence of professional qualification
• Decision in 1 month
• Registration for 1 year (possible to renew)
• Typically approx. 40 declarations per month
 Once the declaration has been processed and accepted they
 professional may begin to practice using the professional title from
 the Member State in which they are established e.g. 'Fizjoterapeuta'
 in place of 'Physiotherapist' for a Polish registrant.
Post-registration and renewal

• Name and registration number displayed on the online Register
  available to the public
• Registration renewed every two years with declarations of current
  practice, character, health and CPD
• £76 fee payable per year
• Registrants lapse from the Register if they do not renew successfully
  – must pay and sign
• Requirement for registrants to keep personal information up to date
• Registrants must advise of any changes in health or character
• Over 60% of registrants now renew using online portal
• Over 95% of registrants successfully renew each cycle
Continuing professional development



• A statutory requirement for all HPC registrants since July 2006
• Audits began in May 2008
• Flexible outcome based approach (not points / hours)
Questions from HPC



• Point of contact for regarding for professions regulated by the HPC in
  Romania
• Certified/official translators – process for verification
• For professions currently regulated in Romania which HPC regulates
  - is there one agreed curriculum? Who is the owner?
• Status / role of Radiography Nurses - Nurses or Radiology
  Technicians?
Finding out more and getting in touch

www.hpc-uk.org

ftp@hpc-uk.org

0800 328 4218

        Find us on www.facebook.com/hcpcuk

        Follow us on www.twitter.com/HPC_news

        Follow us on www.linkedin.com

        Sign up for our RSS feeds www.hpc-uk.org

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The Health Professions Council

  • 1. Tuesday 15 November 2011, Romanian Authorities Study Visit The Health Professions Council
  • 2. Contents • Welcome and Introduction • The HPC and the role of a UK regulator • Policy at HPC • Fitness to practise • Stakeholder engagement • Registration at HPC Mutual recognition and EEA processes IMI / Security verification Continuing professional development (CPD)
  • 3. Health Professions Council • Independent UK statutory regulator of 15 professions • One of nine health regulators • Derives powers from Health Professions Order 2001 • Purpose is “to safeguard the health and well-being of persons using or needing the services of registrants” – Article 3(4) • Separate role from professional bodies and trade unions
  • 4. Ph O ys cc io up th at er 10,000 15,000 20,000 25,000 30,000 35,000 40,000 45,000 50,000 5,000 0 io ap n al i st th s e ra R pi B ad s io i og ts m ra ed ph ic er al s Pr sc ac ie Sp nt ee tit Pa is io ts ra HPC Register 2011 ch ne an rp m ed d sy ic la ng ch s O C ua ol og pe hi ra ro ge is tin po th ts g di er de st ap pa s is rt /p ts m od en ia tp tr ra is ts ct iti on 219,000 registrants from 15 professions er D s C ie lin tit ic ia al ns sc ie H A nt ea rts is r in th ts g er ai ap d is di ts sp en Pr se os O rs th rt ho et is pt ts is /o ts rt ho tis ts
  • 5. Processes and standards The Register
  • 6. Professional and lay input • 507 ‘Partners’ working across 677 partner roles – Our professions and lay persons – Provide expertise for good decision-making – Approval of education and training programmes – Registration decisions (applications and CPD audits) – Fitness to practise decisions • Council and Committees • Professional Liaison Groups (PLGs)
  • 7. Tuesday 15 November 2011, Romanian Authorities Study Visit Policy at the HPC
  • 8. About the Policy and Standards Department Develop policy and strategy Policy and Standards Consultations
  • 9. Our standards • Standards of conduct, performance and ethics: behaviour and attitudes expected • Standards of proficiency: professional knowledge, understanding • CPD standards: requirements for ongoing learning • Standards of Education and Training: we use these to approve education programmes
  • 10. Guidance • Explains our policies in more detail • Advises registrants and/or students on how they can meet our standards • Formal guidance is published • Informal guidance (advice): • Website • Email • Phone • Meetings
  • 11. The way policy works • Responsible for reviewing standards, updating/writing new guidance, or undertaking work on policy change • Write papers for Committees and Council to advise them on options • Require Committee and Council approval of proposals before consulting – plus legal approval • Meet with stakeholders on projects relevant to HPC policy • Provide advice on HPC policy to registrants and members of the public • Organise and coordinate professional liaison groups to work on policy change as needed
  • 12. Consultations • Normally consult for 3 months • Information posted online in dedicated ‘consultations’ section of website • Also sent to consultation list of over 400 interested organisations. • Certain consultations go out to all registrants • Respond to external consultations
  • 13. Responses to external consultations • Respond to public consultations relevant to our work and our registrants • Respond positively where possible, constructively where we disagree with proposals • Recent consultations we have responded to: • European Commission Green Paper on Modernising the Professional Qualifications Directive • House of Lords European Union Committee call for evidence on the Professional Qualifications Directive
  • 14. Tuesday 15 November 2011, Romanian Authorities Study Visit Fitness to Practise
  • 15. Fitness to practise: An overview of the process • Allegation made Allegation • Investigate allegation • Interim order imposed Investigation • Hearing convened Interim Order Mediation • Case considered by final hearing panel Hearing • Sanction imposed Judgement
  • 16. Fitness to practise: when we will take action • Serious or persistent failure to meet standards • Improper relationships with service users • Failure to respect the autonomy of service users • Sexual misconduct • Misuse or abuse of drugs and alcohol • Failure to provide adequate care • Poor record keeping • Theft from a service user
  • 17. Tuesday 15 November 2011, Romanian Authorities Study Visit Stakeholder engagement
  • 18. Stakeholder engagement • AURE (Alliance of UK regulators in Europe): Meetings 6x annually, communicating HPC position, debates , contributing to joint statements and consultation responses • BMA EU forum: Bi-annual meetings, wide range of organisations represented, debates, communicating HPC position • BIS (Department for Business, Innovation and Skills): Developing working relationships, supporting events eg EU Commission London, coordinating HPC responses, data gathering • CLEAR (The Council on Licensure, Enforcement and Regulation): Supporting CEO, attending as delegate (London 2011), speaking slot (CPD)
  • 19. Stakeholder engagement • EU Commission: Annual meetings with CEO & Policy, developing close working relationships, attending & supporting Commission events eg Modernisation of the Professional Qualifications Directive • Supporting International regulators: Cypriot Ministry of Labour, Norwegian government, Hong Kong • European Parliament: MEP meetings with CEO, attending IMCO Committee (Internal Market and Consumer Protection Committee), supporting MEP’s assistants
  • 20. Tuesday 15 November 2011, Romanian Authorities Study Visit Registration at the HPC
  • 21. Role of the registration department • Maintain and publish a Register of health professionals • 36 full time staff • 100,000+ telephone enquiries per year • 20,000+ email enquiries per year • UK approved courses – over 10,000 applications per year • Readmission and return to practice process • Bi-annual renewal process • Audit of continuing professional development (CPD) • Verification checks for identity, education and career history of all overseas qualified applicants
  • 22. Routes to registration – all international applicants • 180 - 200 International applications received per month (25% are EEA applicants). • Forms downloaded from HPC website • Applicants advised to read standards of proficiency before applying • Incomplete forms returned to applicants with advice • Character declarations sent to fitness to practice before assessment • Background checks carried out to verify applicant’s identity, education and good standing • Use of outside agencies such as UK NARIC and Kroll International for background checks • Service level agreement of 10 working days for assessment decisions
  • 23. Routes to registration – international (non-EEA) Applications are sent to two registration assessors from the relevant profession (HPC partners) Assessment based on professional qualification and additional education, training and experience Possible outcomes: • Accept – applicants meets all standards of proficiency • Further verification – additional information requested to address shortfalls in application • Test of competence – interview to determine borderline cases • Reject – applicants have automatic right of appeal
  • 24. Routes to registration - EEA applicants with mutual recognition Applications are sent to two registration assessors from the relevant profession (HPC partners) Assessment based on professional comparison and additional education, training and experience Possible outcomes: • Accept – applicants meets all standards of proficiency • Further verification – additional information requested to address significant shortfalls in application • Adaptation period – normally additional supervised practice or academic module. Applicants have automatic right of appeal • Aptitude test – can be requested by applicant if they feel adaptation period is not required
  • 25. Role of IMI • Currently three HPC professions covered: Physiotherapists, Practitioner psychologists, Radiographers • All advisors involved in processing international applications have access to the IMI system • Safe and mostly effective way of receiving information • Used in both permanent establishment cases (verification process) and in decisions on temporary provision of services cases • Increasing use – 10 requests within last 6 months: 7 sent by the HPC (Estonia, Greece, Lithuania, Romania, Spain) 3 received by the HPC (1 from Sweden, 2 from Spain)
  • 26. IMI - our experience • Most replies within 1 month, however some take several months to conclude – this means delays in the recognition process and unnecessary obstacles for the applying professional • Not all relevant authorities are willing to engage – there is no method of enforcing mandatory use • Unclear which authorities can be contacted in some cases (long list to choose from) – lack of explanation who is responsible for what • Overview of regulatory systems for each profession would be helpful • Still a limited number of regulated professions covered by the ‘general system’ • Good potential for growth and extended use
  • 27. Assessment process – training issues • Assessors receive refresher training every two years regarding developments in legislation • All new assessors receive equality and diversity training • On-going quality monitoring to ensure recommendations are fair, appropriate and legally sound • All refusal and adaptation period recommendations must be approved by registration managers • EU Commission has reaffirmed that systematic language testing is ruled out as a condition of recognition • Speech and language therapy is the only profession that is exempted from this part of the directive because knowledge of the language is a core competence of the profession
  • 28. Temporary provision of services • Temporary and occasional nature of the provision of services (Directive 2005/36/EC, Article 52) • Proof of nationality or citizenship • Attestation(s) of legal establishment (or proof of 2 years professional experience) • Evidence of professional qualification • Decision in 1 month • Registration for 1 year (possible to renew) • Typically approx. 40 declarations per month Once the declaration has been processed and accepted they professional may begin to practice using the professional title from the Member State in which they are established e.g. 'Fizjoterapeuta' in place of 'Physiotherapist' for a Polish registrant.
  • 29. Post-registration and renewal • Name and registration number displayed on the online Register available to the public • Registration renewed every two years with declarations of current practice, character, health and CPD • £76 fee payable per year • Registrants lapse from the Register if they do not renew successfully – must pay and sign • Requirement for registrants to keep personal information up to date • Registrants must advise of any changes in health or character • Over 60% of registrants now renew using online portal • Over 95% of registrants successfully renew each cycle
  • 30. Continuing professional development • A statutory requirement for all HPC registrants since July 2006 • Audits began in May 2008 • Flexible outcome based approach (not points / hours)
  • 31. Questions from HPC • Point of contact for regarding for professions regulated by the HPC in Romania • Certified/official translators – process for verification • For professions currently regulated in Romania which HPC regulates - is there one agreed curriculum? Who is the owner? • Status / role of Radiography Nurses - Nurses or Radiology Technicians?
  • 32. Finding out more and getting in touch www.hpc-uk.org ftp@hpc-uk.org 0800 328 4218 Find us on www.facebook.com/hcpcuk Follow us on www.twitter.com/HPC_news Follow us on www.linkedin.com Sign up for our RSS feeds www.hpc-uk.org