Managing Professional Competence & Behaviour

1. Workshop Managing Professional Competence & Behaviour

2. Provide professionals with the opportunity to improve practice • Deal swiftly & fairly with concerns & complaints 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)

3. ‘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)

4. 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

5. 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)

6. Managing Performance Continuum Overview • Ongoing support for growth in professional competence and performance ‘normal interventions’ • An individual experiencing or displaying difficulty ‘additional interventions’ • An individual whose performance continues to fail or is defined as ‘poor’ ‘more substantial interventions/capabilityprocess’

7. 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

8. Managing Performance ‘Normal Interventions’ ●Induction●Preceptorship●Appraisal/ Development Review●Supervision● Rotas:Skill / Competency mix●Use of Team/staff/other meetings●L&Dactivities: planned/adhoc; formal / informal Relevant Policies & Statutory Requirements ●Code of Conduct ●PREP ●Appraisal Policy ●Supervision Policy ●Absenteeism Policy ● Capability Procedure ●Disciplinary Procedure ●NMC guidance reporting lack of competence Existing Processes

9. 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%

10. 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 Existing Processes

11. Managing Performance • Should also consider • additional support • mentoring, shadowing, buddying • behavioural coaching, • possibly limit scope of practice • Preceptorship • Supervision • Rotas: Skill/Competency mix • L&Dactivities: planned/ • adhoc; formal/informal ‘Additional Interventions’ Relevant Policies & Statutory Requirements Existing Processes • Triggers • Frequency/Intensity • Occupational Health

12. 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 Existing Processes

13. Managing Performance • Should also consider • additional support • mentoring, shadowing, buddying • behavioural coaching, • Likely to limit scope of practice • Preceptorship • Supervision • Rotas: Skill/Competency mix • Mentoring • L&Dactivities: planned/ adhoc; formal/informal • Stages within capability process ‘More Substantial Interventions’ Existing Processes • Triggers • Frequency/Intensity • Occupational Health May consider additional support eg mentoring, shadowing, buddy, likely to limit scope of practice

14. Discussion Do you recognise the continuum? Would it be useful to consider each stage and identify if further focus would benefit managers?

15. 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

16. INTRODUCTION • Managing poor performance – Development Framework project 2003-2006 (capability procedures)

17. 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

18. INTRODUCTION • Managing poor performance – Development Framework project 2003-2006 (capability procedures) • Interest increasing significantly but focus still mainly at “poor performance”

19. Managing Performance Continuum ‘Stars! ‘ ‘More challenging/ capability’ Main Body of Staff ‘Routine’ CONTINUUM

20. Managing Performance Continuum Level of manager’s interventions CONTINUUM ? ? ?

21. Today's challenge - Examine the topic and identify if anything more needs to be done, and if so what and how?