Continuing Professional Development (CPD) National Podiatry Survey

1. Continuing Professional Development (CPD)National Podiatry Survey Keith G McCormick

2. Introduction

3. Clinical Governance • Development and implementation of clinical guidelines and protocols • Evidence based clinical practice • CPD for all staff • Developing clinical leadership skills and managing the performance of colleagues • Risk management • Accreditation of hospital and community departments • Learning from complaints

4. CPD and AHPs • An initial qualification is not enough to maintain competence over a lifetime of practice (Fraser et al 2000) • In a survey of 192 podiatrists 94% considered regular professional updating important (Pavey 1998) • The most significant individual element of lifelong learning is CPD (BMA 2000) • CPD activities within the PAM are uncoordinated, uni-disciplinary and not accredited (NHS Executive 1998)

5. Pushing the Boundaries • Developing new skills and new roles (Partnership for Care 2003) • Extended roles based on competence and qualifications (e.g. Diabetes and Surgery) • Documented and accredited CPD • Protocols for standards and reporting of adverse events (National Patient Safety Agency NPSA) • Improving Safety for Patients in Scotland (Quality Improvement Scotland (QIS) 2003) • The only limit to clinical practice is competence and political barriers

6. CPD and State registration • Health professions Council (HPC) aims to link CPD with registration (DoH 2001) • Learning Together (1999) set a deadline of Dec 2000, for roll-out of Personal Learning Plans (PLPs) • Courses must ultimately make a difference to patient care and improve outcomes • Interactive workshops are more likely to improve clinical practice than Lectures (Thomson, O’Brien et al 2001)

7. CPD and State registration • Doctors have a periodic evaluation of their registration • SALT - 10 sessions of CPD p.a. • Dietitians - 5 hrs plus an additional activity or an appropriate academic course • Nurses - PREP system (since 1990) 5 days study in 3 yrs to re-register • Physio - no specific requirements • The Institute of Personnel and Development (IPD) suggest 35 hrs of recorded CPD p.a.

8. Who is Responsible and How Much £ ? • IPD places emphasis on individual responsibility for learning • CPD for all staff in the NHS is the responsibility of the employer • Learning Together (1999) recognises that investment varies widely between professions • Fraser et al (2000) suggest that allocation of funding for CPD bears no relationship to the requirements of different professions

9. Aims

10. Aims To evaluate Continuing Professional Development (CPD) activity in National Health Service (NHS) Podiatry in Scotland, and make recommendations for the future post registration training and development of Podiatrists

11. Objectives

12. Objectives • Identify the professional requirements for the post registration education and training of Podiatrists • Identify what CPD is currently undertaken by NHS Podiatrists in Scotland • To evaluate the type, level and appropriateness of CPD in NHS Podiatry in Scotland • Develop guidelines for the future post registration training and development of Podiatrists in Scotland

13. Methods

14. Methods • Local Management Support (FVPC) • Support from PAM CRAG Clinical Effectiveness Project leaders • Funding: Trust Bursary and Learn Direct Scotland • Ethics: Letter from Multi-centre Research Ethics Committee, and successful application to ethics committee (QMUC) • Questionnaire design / Pilot • Distribution of questionnaire to Health Board area via CE representatives

15. Results

16. Results • In total 760 questionnaire were delivered to NHS Podiatrists in Scotland • 259 questionnaires were returned by 28th Feb 2002 (33% return) • Compared to other similar studies, this was deemed to be a reasonable return

17. Qu. 1 - State Registration Median 12 yrs

18. Qu. 2 - Grade

19. Qu. 3 - Age

20. Qu. 4 - Sex

21. Qu. 5 & 6 - Qualifications

22. Qu. 7 - Other Qualifications

23. Qu. 8a - Employment Status

24. Qu. 8b - Health Boards It was agreed with the PAM CRAG Clinical Effectiveness Project Leaders, that information on specific Health Board Areas would not be disclosed in the final report. However this information is available on request.

25. Qu. 9 - Specialist remit

26. Qu. 10 - CPD days N = 238 Mean = 2.16 Median = 1.0 42.2% had 0 CPD Days

27. Qu. 11 - PLP

28. Qu. 12 - Adequate Training

29. Qu. 13 - Podiatric Surgery

30. Qualitative Comments • 22.5% of respondents included comments in the box provided. These comments were divided into 4 key areas, based on their primary theme; Resources (time/money), Podiatric Surgery, General Training and Personal comments to researcher

31. Qu. 14 - CPD Activities • 26.1% did not report any CPD activities in the last 3 years

32. Qu.14a-b - Title & Duration • CPD activities were grouped into like categories • CPD activities were split into short courses (2 weeks or less) and long courses (> 1 month) • 91.4% were short courses • 8.6% were long courses

33. Qu. 14c - Funding Short Courses

34. Qu. 14c - Funding Long Courses

35. Qu. 14d - Time Short Courses

36. Qu. 14d - Time Long Courses

37. Qu. 14e - Assessment • In general short courses were attendance only (83.9%) • Longer courses involved examination (43.9%) and course work (41.5%)

38. Qu. 14f - Accreditation • Short courses were generally accredited by a professional body (49.3%) or by employer (16.2%) • Longer courses had more involvement with the University sector (48.7%)

39. Qu. 14g - Relevance

40. Qu. 14h - Multi-Disciplinary

41. Conclusion & Recommendations • The training & development of NHS Podiatrists, in Scotland, is a priority for all stakeholders • Prepare for the introduction of mandatory CPD • Additional resources will be required to fulfil the requirements of 30hrs CPD p.a. • All Podiatrists should have a PLP • Clinical networking, skill mix and a multi-disciplinary approach are pivotal

42. Specialist Clinicians • Visible career structure for Specialist Podiatrists • Podiatric triage to cut waiting lists • Work based professional qualifications/ exams • Validation by appropriate professional body • Rotation through Hospital departments and a pupilage for clinical specialists

43. Service Re-organisations

44. Podiatric Triage • Direct & open referral system • Podiatric & general assessment • Appropriate access to medical records • Limited prescription rights • Immediate treatment if appropriate • Referral for specialist assessment or community care • Treatment from a foot care assistant

45. Specialist Assessment • Peripheral Vascular disease • Diabetic foot disease • Muscular skeletal service • Podiatric Surgery • Biomechanics • Rheumatology • Orthopaedics • Podo-Paediatrics • Sports Podiatry

46. Quality & Standards

47. Podiatry needs Funky Business!!

48. Develop Us! • If you want to attract and retain the best people you have to train them • What people look for in an employer is a continuous investment in their career • With employee education growing far faster than academia, the workplace is becoming a campus • Leadership is about contaminating and being contaminated with knowledge • It is the job of leaders to create new leaders Ridderstrale and Norstrom (2000)

49. Continuing Professional Development (CPD)National Podiatry Survey Keith G McCormick