New Entrant WCA Learning Journey – Welcome Document

MED-NEWCALJ~001(ag) Sept 2019

New Entrant WCA Learning Journey – Welcome Document

Welcome

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Foreword

This training has been produced as part of a training programme for Healthcare Professionals (HCPs) who conduct assessments for the Centre for Health and Disability Assessments on behalf of the Department for Work and Pensions.

All HCPs undertaking assessments must be registered practitioners who in addition, have undergone training in disability assessment medicine and specific training in the relevant benefit areas. The training includes theory training in a classroom setting, supervised practical training, and a demonstration of understanding as assessed by quality audit.

This training must be read with the understanding that, as experienced practitioners, the HCPs will have detailed knowledge of the principles and practice of relevant diagnostic techniques and therefore such information is not contained in this training module.

In addition, the training module is not a stand-alone document, and forms only a part of the training and written documentation that the HCP receives. As disability assessment is a practical occupation, much of the guidance also involves verbal information and coaching.

Thus, although the training module may be of interest to non-medical readers, it must be remembered that some of the information may not be readily understood without background medical knowledge and an awareness of the other training given to HCPs.

Welcome

MED-NEWCALJ~001(ag) Page 3 of 27

Document control

Superseded documents

Version history Version Date Comments

1 Final 9th Signed of by DWP September 2019

1e draft 4th Updated post DWP review September 2019

1d draft 2nd Formatting September 2019

1c draft 30th Further update August 2019

1b draft 30th Updated with amended learning journey slides August 2019

1a draft 21st Initial draft August 2019

Changes since last version

Appendix B added to refer learners to additional learning resources

Outstanding issues and omissions

Updates to Standards incorporated

Issue control Authors: Clinical Training Team

Owner: Department for Work and Pensions

Signature: Date:

Distribution:

Welcome


Contents Document control 3

Superseded documents 3

Version history 3

Outstanding issues and omissions 3

Updates to Standards incorporated 3

Issue control 3

Contents 4

1. Introduction to your Learning Journey 8

2. Overview of your Learning Journey 9Summary of New Entrant Learning Journey 11Modules within relevant Blocks of Learning (Where applicable- Blocks 1, 3, 5 & 7) 12

3. Summary of Clinical Content of Learning Blocks 16 Block 1 – Introductory Modules 16Module A – Introduction to Disability Analysis (IDA) and the Work Capability Assessment (WCA) - including Process, Forms and Quiz 16Module B - Introduction to the Clinical History (Physical and Mental Function) in the WCA and MCQ 16Module C - Introduction to the Typical Day History (Physical and Mental Function) in the WCA and MCQ 16Module D - Introduction to Anatomical Terms, Joint Range Movement and Musculoskeletal Overview for Registered Nurses, including competency test 16Module E – Neurological Anatomy and MCQ 16Module F – Introduction to LIMA 16Module G – Functional Clinical Examination 16Module H – Mental State Examination 16 Block 2 – Physical Clinical Examination Skills (For Registered Nurses) 17Day 1 17

Welcome


Session One – Introduction and Welcome 17Session Two - Consolidation of Block 1 Learning 17Session Three - Musculoskeletal Examination and Observations 17Session Four – Neurological Examination 17Day 2 17Session One – Neurological Examination Consolidation 17Session Two - Functional Examination of the Cardiorespiratory System and Peripheral Vascular System 17Session Three – Functional Examination of the Special Senses 17Session Four – LIMA Examination Data Input 17Session Five – Physical Clinical Examination Skills using Professional Role Players 17Session Six – Closure 17Day 3 17Session One – Introduction and Neurological Condition Discussion 17Session Two - Physical Clinical Examination Skills using Professional Role Players 17Session Three – Further Physical Clinical Examination Skills using Professional Role Players 17 Block 3 – Physical and Mental Function learning (For Registered Physiotherapists) 18Module I – Physical Conditions (Base location) – 3 days 18Module J – Mental Function Conditions (Classroom) - 3 Days 18 Block 4 – Mental Function Assessment Skills (For Registered Nurses and Registered Physiotherapists) 18Day 1 18Session One – Introduction and Welcome 18Session Two - Overview to Mental Function Aspects of the WCA 18Session Three - Mental State Examination 19Session Four - Practical Exercise in Mental State Examination and Disorders of Thought and Perception 19Session Five – Role Play and LiMA Data Input 19

Welcome


Day 2 19Session One – Mental Function Assessment Scenarios using Professional Role Players 19Session Two – Mental Function Assessment Scenarios using Professional Role Players 19Day 3 19Session One – Mental Function Assessment Scenarios using Professional Role Players 19Session Two – Mental Function Assessment Scenarios using Professional Role Players 19 Block 5 – Core WCA Learning (All Practitioner Types) 19Module K – Physical Descriptors, including competency test 19Module L – Mental Function Descriptors, including competency test 19Module M – The Biopsychosocial Model of Disability 20 Block 6 – Core WCA Consolidation (All Practitioner Types) 20Day 1 20Session One – Introduction and recap 20Session Two – Critical Evaluation of Evidence 20Session Three – Justification in Work Capability Assessments 20Session Four – LiMA Familiarisation and closure of Day 1 20Day 2 20Session One – Introduction 20Session Two – LiMA Practice using Case Scenarios 20Day 3 20Session One – Introduction 20Session Two – LiMA Practice using Case Scenarios 20 Block 7 – Additional WCA Considerations (All Practitioner Types) 21Module N – WCA Special Considerations 21Module O – Risk 21Module P – Providing prognosis or re-referral advice in revised work capability assessments and MCQ 21Module Q – Severe conditions 21

Welcome


Block 8 – Full WCA Completion (All Practitioner Types) 21Day 1 21Session One – Introduction 21Session Two – MCQ Competency Test 21Session Three – Substantial Risk Consolidation and Further Aspects of LiMA 21Session Four – Role Play with Professional Role Players (PM) 21Day 2 21Role Plays – (full day) Role Play with Professional Role Players 21Day 3 22Role Plays – (8.30am to 3.30pm) Role Play with Professional Role Players 22Finalisation and Feedback 22 Block 9 – Clerical WCA Report Completion (Registered Medical Practitioners and Registered Physiotherapists) 22Block 9 – Clerical WCA (Pre-course Learning) 23Session One – Introduction and Welcome 23Session Two - Recording Information on the Clerical ESA85 Form 23Session Three – Domiciliary Visits 23Session Four – Practice Case Scenarios 23Session Five – Closure 23

Appendix A - Additional Mandatory Reading 24

Welcome


1. Introduction to your Learning Journey

The New Entrant Work Capability Assessment (WCA) Learning Journey provides relevant learning for Registered Nurses, Registered Physiotherapists and Registered Medical Practitioners to achieve competency in WCA report completion through a blended approach to learning.

The overall aim of your learning journey is to enable you to understand how to complete a Work Capability Assessment report to a satisfactory standard using LiMA computer software.

Prior to the start of your learning journey, you will have completed several pre-employment modules and had an introduction to the operational side of the company.

Your journey is structured in terms of Blocks of learning. Blocks can consist of digital/e-learning or face to face classroom learning. Where the learning is digital or e-learning, these blocks comprise Modules. Classroom blocks are comprised of sessions comprised of face to face facilitation, physical examination skill practice and role play sessions. Role play usually involves Professional Role Players but may be with other learners.

All the case scenarios you will be completing during the Learning Journey, whether through Role Play or from clerical scenarios, are fictitious and have been solely designed to support learning activities.

This document outlines the various components of the learning journey; the location where the learning block takes place (Base location or Central ‘Classroom’ Venue) and the duration of each learning block. This document also provides an overview of the core clinical content at each stage of the learning journey along with highlighting the points in the journey where competency must be demonstrated.

You will be provided with a tablet to use during your initial New Entrant WCA Learning Journey.

Throughout your learning journey there are various documents that you must read in detail. A list of this additional reading with the timescale for completion can be found in Appendix A of this document.

The timings of the Classroom based modules are usually 8.30 am to 5.15 pm (although some days may finish earlier allowing facilitators time for documentation). A 60 minute lunch break and also coffee/tea breaks are planned throughout the classroom days.

Welcome


2. Overview of your Learning Journey

The duration of the Learning Journey will vary depending on your practitioner type (Registered Nurse, Registered Physiotherapist or Registered Medical Practitioner):

• Registered Nurse - Duration 19 Days

• Registered Physiotherapist – Duration 21 Days

• Registered Medical Practitioner – Duration 13 Days

An overview of the learning journey for each type of practitioner can be found on the following pages.

Attendance at every day of the course is mandatory

HCP approval

The Healthcare Professional (HCP) WCA Approval Process consists of 4 stages. These stages are consecutive and each must be successfully completed before moving on to the next stage.

Stage 1

Completion of the learning blocks appropriate to your practitioner type.

Stage 2

Successful completion of the Final MCQ and all competencies appropriate for your practitioner type.

Stage 3

Return to base location to complete your New Entrant Learning Journey. During stage 3 you have further opportunity to consolidate your learning under the supervision of local mentors. You will complete live supervised WCA during stage 3 as well as consolidation work. It is recommended that you complete a minimum of 7 cases during live stage 3 before proceeding to stage 4. The stage 3 mentor will supervise every case until competence is achieved.

Welcome


Stage 4

After stage 3, the aim is for you to consolidate your experience in completing WCA reports. All your reports will be supported by audit and mentoring until the relevant manager requests Approval status. Attaining approval in the completion of WCA completes your Learning Journey.

Welcome


Summary of New Entrant Learning Journey

Key: Learning Blocks at Local level Learning Blocks in Central “Classroom” venue

Registered Nurse

Registered Physiotherapist

Registered Medical Practitioner

Summary


Modules within relevant Blocks of Learning (Where applicable- Blocks 1, 3, 5 & 7)

Block 1(All Practitioner Types)

Block 3 (Registered Physiotherapists Only)

Block 5 & 7 (All Practitioner Types)

Summary


Summary


Summary


Summary


3. Summary of Clinical Content of Learning Blocks

Block 1 – Introductory Modules

This Block is made up of 8 modules A – H comprising of a mixture of E-Learning and Digital format and will take between 12 hours – 17.5 hours to complete at local level.

You will complete the modules relevant to your learning journey. Registered Nurses, Registered Physiotherapists or Registered Medical Practitioners will be required to complete different modules within this block as indicated:

Modules A – C are to be completed by all Practitioner Types:

• Module A – Introduction to Disability Analysis (IDA) and the Work Capability Assessment (WCA) - including Process, Forms and Quiz

• Module B - Introduction to the Clinical History (Physical and Mental Function) in the WCA and MCQ

• Module C - Introduction to the Typical Day History (Physical and Mental Function) in the WCA and MCQ

Modules D and E are to be completed by all Registered Nurses:

• Module D - Introduction to Anatomical Terms, Joint Range Movement and Musculoskeletal Overview for Registered Nurses, including competency test

• Module E – Neurological Anatomy and MCQ

Module F is to be completed by all Practitioner Types:

• Module F – Introduction to LIMA

Module G is to be completed by all Registered Medical Practitioners and Registered Physiotherapists:

• Module G – Functional Clinical Examination

Module H is to be completed by all Registered Medical Practitioners

• Module H – Mental State Examination

Before continuing your learning journey, you must have completed all the required modules and demonstrated competency in the relevant modules where appropriate.

Summary


Block 2 – Physical Clinical Examination Skills (For Registered Nurses)

This Block is a 3 day Classroom course for Registered Nurses and covers the following topics:

Day 1

• Session One – Introduction and Welcome

• Session Two - Consolidation of Block 1 Learning

• Session Three - Musculoskeletal Examination and Observations

• Session Four – Neurological Examination

Day 2

• Session One – Neurological Examination Consolidation

• Session Two - Functional Examination of the Cardiorespiratory System and Peripheral Vascular System

• Session Three – Functional Examination of the Special Senses

• Session Four – LIMA Examination Data Input

• Session Five – Physical Clinical Examination Skills using Professional Role Players

• Session Six – Closure

Day 3

• Session One – Introduction and Neurological Condition Discussion

• Session Two - Physical Clinical Examination Skills using Professional Role Players

• Session Three – Further Physical Clinical Examination Skills using Professional Role Players

Summary


Throughout Block 2, the facilitators will be observing learners and assessing their competency in the physical examination skills.

Registered Nurses must have completed and demonstrated competency in Block 2 before continuing with their learning journey.

Block 3 – Physical and Mental Function learning (For Registered Physiotherapists)

This Block is made up of 2 modules, Module I is in Digital format and will take approximately 3 days to complete at local level. Module J is both Digital and Classroom based - duration of 3 days.

• Module I – Physical Conditions (Base location) – 3 days

You will review information on various topics from mandatory and optional reading sources. An MCQ is required to consolidate learning for each topic (with the exception of blood pressure measurement).

• Module J – Mental Function Conditions (Classroom) - 3 Days

You will review information on various topics from mandatory and optional reading sources and complete a MCQ to consolidate learning for each topic.

Registered Physiotherapists must have completed and demonstrated competency in Block 3 before continuing with their learning journey.

Block 4 – Mental Function Assessment Skills (For Registered Nurses and Registered Physiotherapists)

This Block is a 3 day Classroom course for Register Nurses and Registered Physiotherapists and covers the following topics:

Day 1


• Session Two - Overview to Mental Function Aspects of the WCA

Summary


• Session Three - Mental State Examination

• Session Four - Practical Exercise in Mental State Examination and Disorders of Thought and Perception

• Session Five – Role Play and LiMA Data Input

Day 2

• Session One – Mental Function Assessment Scenarios using Professional Role Players

• Session Two – Mental Function Assessment Scenarios using Professional Role Players

Day 3

• Session One – Mental Function Assessment Scenarios using Professional Role Players

• Session Two – Mental Function Assessment Scenarios using Professional Role Players

Throughout Block 4, the facilitators will be observing learners and assessing their competency in mental function clinical skills.

Register Nurses and Registered Physiotherapists must have completed and demonstrated competency in Block 4 before continuing with their learning journey.

Block 5 – Core WCA Learning (All Practitioner Types) This Block is made up of 3 modules K - M in Digital format and will take approximately 2 days to complete.

• Module K – Physical Descriptors, including competency test

• Module L – Mental Function Descriptors, including competency test

Summary


• Module M – The Biopsychosocial Model of Disability

All Practitioners must have completed and demonstrated competency in Block 5 before continuing with their learning journey.

Block 6 – Core WCA Consolidation (All Practitioner Types)

This Block is a 3 day Classroom course for all practitioner types and covers the following topics:

Day 1

• Session One – Introduction and recap

• Session Two – Critical Evaluation of Evidence

• Session Three – Justification in Work Capability Assessments

• Session Four – LiMA Familiarisation and closure of Day 1

Day 2

• Session One – Introduction

• Session Two – LiMA Practice using Case Scenarios

Day 3


• Session Two – LiMA Practice using Case Scenarios

Throughout Block 6, the facilitators will be observing learners and assessing their competency in WCA understanding and report completion.

Summary


Block 7 – Additional WCA Considerations (All Practitioner Types)

This Block is made up of 4 modules N - Q in Digital format and will take approximately 2 days to complete.

• Module N – WCA Special Considerations

• Module O – Risk

• Module P – Providing prognosis or re-referral advice in revised work capability assessments and MCQ

• Module Q – Severe conditions

All Practitioners must have completed and demonstrated competency in Block 7 before continuing with their learning journey.

Block 8 – Full WCA Completion (All Practitioner Types)

This Block is a 3 day Classroom course for all practitioner types and covers the following topics:

Day 1


• Session Two – MCQ Competency Test

• Session Three – Substantial Risk Consolidation and Further Aspects of LiMA

• Session Four – Role Play with Professional Role Players (PM)

Day 2

• Role Plays – (full day) Role Play with Professional Role Players

Summary


Day 3

• Role Plays – (8.30am to 3.30pm) Role Play with Professional Role Players

• Finalisation and Feedback

Throughout Block 8, the facilitators will be observing learners and assessing their competency in WCA report completion continued from Block 6.

The facilitator will advise at the end of Block 8 whether or not the learner is deemed to have met all the required standards to progress to Stage 3 of the learning journey.

(Note: Registered Medical Practitioners will continue onto Block 9, regardless of whether all the required standards have been achieved by the end of Block 8. Further support will be provided as necessary, once block 9 is completed. Individual Registered Physiotherapists will be referred for Block 9, based on business needs, at a later date, after gaining and maintaining approval in LiMA WCA reports.)

Block 9 – Clerical WCA Report Completion (Registered Medical Practitioners and Registered Physiotherapists)

This block is a 1 day Classroom course for Registered Medical Practitioners and Registered Physiotherapists. All Registered Medical Practitioners will move directly onto Block 9 – Clerical WCA - after completion of all the relevant previous learning blocks of the New Entrant HCP WCA Learning Journey. Any Registered Medical Practitioner who has not yet demonstrated competency in all the required standards will receive further support as necessary prior to proceeding to Stage 3. Individual Registered Physiotherapists will be referred for Block 9 - Clerical WCA – based on business needs, at a later date, after gaining and maintaining approval in LiMA WCA reports.

Block 9 covers the following topics:

Pre-course reading

Summary


• Block 9 – Clerical WCA (Pre-course Learning)

Classroom learning


• Session Two - Recording Information on the Clerical ESA85 Form

• Session Three – Domiciliary Visits

• Session Four – Practice Case Scenarios

• Session Five – Closure

Registered Medical Practitioners must have completed Block 9 before continuing with their learning journey.

Summary


Appendix A - Additional Mandatory Reading

Document Timeline for completion

Nurse Physiotherapist Doctor

Work Capability Handbook

Throughout Learning Journey



Mental Illness Current Therapeutics and Management

Evenings of Block 2

Evenings of Block 1 and 3

Evenings of Blocks 1 and 5

Physical and Mental Function Descriptor Choice Further Consolidation Cases

Complete during Block 6 & 7 Submission on Day 1 of Block 8



Personal Summary Statement Scenarios

Block 6 Day 1 evening (cases 6+7) Day 2 evening (case 8)



Substantial Risk Consolidation Cases

Block 8 Day 1 evening



Universal Credit modules

During stage 3 During stage 3 During stage 3

Types of Cancer and their Management self directed learning

By end of stage 4 By end of stage 4 By end of stage 4

Review of Cancer Treatments and their Functional Effects


Improving the Claimants Experience and Avoiding Complaints

Prior to Stage 3 Prior to Stage 3 Prior to Stage 3

Summary


Dealing with Aggressive and Unacceptable Client Behaviour


Block 9 - Clerical WCA (Pre-course Learning)

Before start of Block 9

Before start of Block 9

Summary


Appendix B - Additional Clinical Resources During your initial New Entrant Learning Journey and throughout your time as a Healthcare Professional, you should be assessing your own clinical knowledge in line with your Professional Body guidance to ensure your knowledge is up to date.

To support you in this, CHDA have a wide variety of learning resources on a number of clinical topics more commonly encountered in the Disability Analysis setting.

These include:

A large number of self directed learning modules

A number of “short notes” on various conditions

EBM protocols on a wide range of conditions.

These are all accessible through the online internal knowledge library. You should take time to become familiar with the clinical material available and complete learning activities based on your own self identified knowledge gaps or those suggested by your facilitator or mentor.

Summary


Observation Form Please photocopy this page and use it for any comments and observations on this document, its contents, or layout, or your experience of using it. If you are aware of other standards to which this document should refer, or a better standard, you are requested to indicate this on the form. Your comments will be taken into account at the next scheduled review.

Name of sender: ________________________ Date: _____________ Location and telephone number: ___________________________________ Please return this form to: Centre for Health and Disability Assessments

Clinical Training Team Room 236 2nd Floor Five Ways House Islington Row Middleway Birmingham B15 1SL

Documents

New Entrant WCA Learning Journey – Welcome Document