Managing Professional

Competence & Behaviour

Workshop

Review of Professional Regulation

• Regulation of non-medical healthcare professionals (Foster, 2006)

• Good Doctors, Safer Patients (Donaldson, 2006)

• White Paper Trust Assurance and Safety – Regulation of Health Professionals in 21st Century (2007)

Provide professionals with the opportunity to improve practice

Deal swiftly & fairly with concerns & complaints

‘Handling Concerns'• Support timely & effective

management of individuals’ performance concerns -

• Good practice in handling performance difficulties

• Foster a consistent & fair approach • Provide clear information for those

who have a concern or have difficulty (DoH & NCAS, 2006)

Definitions• Competence

– knowledge, skills, attitudes, values & judgements which result in performance that satisfies a range of expected competencies

• Performance – What is actually done that can be

influenced by capacity, willingness & opportunity to perform

NIPEC (2006) Competency Profile Foundation Paper

Definitions• Poor Performance

– A significant failure or series of failures to satisfy one or more competencies Performance (NIPEC,2004)

• Lack of Competence– Lack of Knowledge, skill or judgement

of such a nature that the registrant is unfit to practise safely & effectively in any field which the registrant claims to be qualified or seeks to practise

(NMC,2004)

Managing Performance Continuum

Overview1. Ongoing support for growth in professional

competence and performance ‘normal interventions’

2. An individual experiencing or displaying difficulty

‘additional interventions’

3. An individual whose performance continues to fail or is defined as ‘poor’

‘more substantial interventions/capability process’

Handling Concerns about the Performance of

Healthcare Professionals(DoH & NCAS, 2006)

• Good practice in preventing problems (selection & induction)

• Early recognition & support• Effective collection of evidence &

documentation• Understanding why certain groups

of practitioners get into difficulty

Managing Performance‘Normal Interventions’

Relevant Policies & Statutory Requirements

Existing Processes●Code of Conduct●PREP●Appraisal Policy●Supervision Policy●Absenteeism Policy● Capability Procedure●Disciplinary Procedure●NMC guidance reporting lack of competence

● Induction ● Preceptorship ● Appraisal/ Development Review ● Supervision ● Rotas:Skill / Competency mix ● Use of Team/staff/other meetings ● L&Dactivities: planned/adhoc; formal / informal

Managing Performance‘Normal Interventions’

Existing Processes – what is working? NIPEC 2005 Survey•Induction•Preceptorship•Appraisal/Development Review – •Supervision –

•Rotas: Skill/Competency mix•Use of Team/staff/other meetings•L&D activities: planned/adhoc; formal/informal

56%(49%fairly/beneficial)

33% (69%fairly/beneficial)

–Organisations funded most/all = 70%

Existing Processes

Managing Performance‘Additional Interventions’

Relevant Policies & Statutory Requirements

•Code of Conduct•PREP•Policies: Appraisal, Supervision, Absenteeism •Capability Procedure•Disciplinary Procedure•NMC guidance reporting lack of competence

Managing Performance‘Additional Interventions’

Relevant Policies & Statutory Requirements

Existing Processes •Triggers

•Frequency/Intensity•Occupational Health

•Preceptorship•Supervision•Rotas: Skill/Competency mix•L&Dactivities: planned/adhoc; formal/informal

Should also consider Should also consider additional support additional support

•mentoring, shadowing, buddyingmentoring, shadowing, buddying•behavioural coaching, behavioural coaching,

•possibly limit scope of practicepossibly limit scope of practice

Existing Processes

Managing Performance‘More Substantial Interventions’

Relevant Policies & Statutory Requirements

•Code of Conduct•PREP•Policies: Appraisal, Supervision, Absenteeism •Capability Procedure•NMC guidance reporting lack of competence•Disciplinary Procedure

Managing Performance‘More Substantial Interventions’

May consider additional support eg mentoring, shadowing,

buddy, likely to limit scope of practice

Existing Processes •Triggers

•Frequency/Intensity•Occupational Health

•Preceptorship•Supervision•Rotas: Skill/Competency mix•Mentoring•L&Dactivities: planned/ adhoc; formal/informal•Stages within capability process

Should also consider Should also consider additional support additional support

•mentoring, shadowing, buddyingmentoring, shadowing, buddying•behavioural coaching, behavioural coaching,

•Likely to limit scope of practiceLikely to limit scope of practice

Discussion

Do you recognise the continuum?

Would it be useful to consider each stage and identify

if further focus would benefit managers?

Group Discussion

• Identify what aspects of each stage of the Managing Performance Continuum could be done better?

(one stage each table)

• Prioritise the aspects that need addressed

• Identify the 3 most important/urgent and how they may be addressed & by whom

INTRODUCTION• Managing poor performance –

Development Framework project 2003-2006 (capability procedures)

Definition of Poor Performance

Poor performance is defined as “a significant failure, or a series of repeated failures to satisfy

one or more competencies”.

The degree of poor performance can be a result of a variety of factors which could be linked to

capacity, willingness or opportunity.

Capacity can include variables such as health, knowledge and skills, intelligence, level of education, stamina and motor skills.

Willingness can include variables such as motivation, anxiety, attitude, norms and values, perceived role expectation, job status.

Opportunity can include variables such as tools, equipment, materials and supplies, working conditions, leader behaviour, time and pay

INTRODUCTION• Managing poor performance –

Development Framework project 2003-2006 (capability procedures)

• Interest increasing significantly but focus still mainly at “poor performance”

CONTINUUM

Managing Performance Continuum

‘Stars! ‘ Main Body of Staff‘Routine’

‘More challengin

g/ capability’

CONTINUUM

Managing Performance Continuum

? ? ?Level of manager’s

interventions

Today's challenge -

Examine the topic and identify if anything more

needs to be done, and if so what and how?