The story so far..

1. Public Health Practitioner Portfolio Assessment National Pilot Schemes The story so far The story so far.. www.totalimprove.com

2. A note about this presentation’s author Total Improvement Process was commissioned to research and present an overview of the UKPHR pilot in December 2010, to evaluate the Kent & Medway pilot in 2011 and the Wales pilot in 2011 and 2012. They also undertake evaluations for the Department of Health, United Nations and equalities organisations. Their evaluation director coaches the City of London Health & Wellbeing Board in its shadow form, Public Health practitioner mentors and two Public Health consultants. They facilitated and sponsored the last UK Evaluation Society national conference and will do so this year.

3. The characters in this story 3/10 English SHAs (2/4 SHA “clusters”!) 1 UK country 327 Practitioners 27 with Portfolios verified (88 expected 2012) 93 Assessors & Verifiers “The Board was determined to open the Register…there is such turmoil in England that anything people can hang onto has value…and in Wales we also get an insight into the benefit for the employer…..this way we put it on the table and see if people want it.”UKPHR interview

4. The characters in simple headlines Nearly 1/3 of the old English SHAs (Half of the 4 new Cluster SHAs) 1 UK country 327 Practitioners fully engaged 1/3 expected to be registered by end 2012 93 senior staff and clinicians trained and experienced in using the standards

5. Story-sub-plots: experimentation, emerging evidence base and refinement of: • use of Learning Sets for practitioners • processes for training and supporting assessors and verifiers • provision of mentoring • systems of evidence collection and evidence assessment • models of coordination, • models of marketing, • models of recruitment, • models of CPD provision

6. Story lines… High volume of hours for practitioners, assessors and organisers Very considerable workload for those running it Partnership between practitioners and assessors as they step-by-step master the process Practitioners feeling overwhelmed by amount of paper Using evaluation early to strengthen learning-as-you-go Assessors working on a goodwill basis Frustrations from inevitable first-time-round learning Practitioners gaining confidence from identifying their expertise Assessors feeling strengthened in their main role as public health managers

7. Story authors….leadership of the Pilot Claire Barley Public Health Wales Sylvia Beacham Kent Public Health Joanna Chapman-Andrews NHS South Central Jenny Griffiths UKPHR Sally James NHS West Midlands Lillian Somervaille UKPHR Six of the leaders we encountered and some of their many roles Shared characteristics Visionary Determined (“obstinate!”) Resilient Attention-to-detail

8. Example of a Driver diagram Aim Key Drivers Intervention

9. Drivers Initial driver diagram for this pilot… Formal credible standards that everyone agrees with Organisational buy-in sufficient to support the goal and fund it with time and/or money UK-wide process for the registration of public health practitioners Buy in from individual practitioners Coordinated scheme or programme that accredits individual competence “...I feel strongly that the reputation of Public Health will be strengthened by registering Practitioners: this will drive up standards and give opportunities for career progression, which will in turn encourage good staff to come into/remain in the profession and seek further development where appropriate.” Practitioner in Kent & Medway Buy-in from PH specialists or consultants to act as assessors and verifiers Creating spread

10. Interventions Identify who are most likely to benefit Establish a supportive CPD culture Driver Briefings that attract practitioners and help them make an informed decision Buy in from individual practitioners Offer enough for the more advanced Practitioners Offer enough for the Level 5 and 6 Practitioners Offer enough for the developing Practitioners

11. Interventions Make a well-argued case to senior team Driver Secure outline agreement for time off-the-job for candidates Organisational buy-in sufficient to support the goal and fund it with time and/or money Secure an adequate budget Make a compelling case to key employers Demonstrate success to fund second Cohorts

12. Interventions (1) Have a strong picture of what you seek to achieve Use credibility, local knowledge, professional knowledge and track record to secure active allies Driver Build a workable structure Coordinated scheme or programme that accredits individual competence Create effective support process Recruit sufficient assessors and verifiers Design and run a robust evidence and commentary assembly and assessment system Commit a very considerable amount of personal pioneering energy to sustain a start-up programme Recruit practitioners

13. Interventions (2) Match those recruited to accessible assessment, guidance and support processes Function Purpose Facilitation and Support Target Groups Frequency Number Driver Set up Learning Sets Coordinated scheme or programme that accredits individual competence Define what that is Identify who can best provide it Train/support them to provide it Provide relevant CPD Define what that is Identify who can best provide it Train/support them to provide it Commission training/facilitation events for key topics Set up a Mentoring process

14. Interventions (2) Match those recruited to accessible assessment, guidance and support processes Function Purpose Facilitation and Support Target Groups Frequency Number Driver Set up Learning Sets Coordinated scheme or programme that accredits individual competence Define what that is Identify who can best provide it Train/support them to provide it Provide relevant CPD Define what that is Identify who can best provide it Train/support them to provide it Commission training/facilitation events for key topics Set up a Mentoring process

15. Set up Learning Sets “Number of people were able to complete fairly quickly because of the learning sets Sylvia had been running for all these years. We were prepared!” “…Putting the learning sets on. The organisation was good at letting us have time out to do the learning sets.” “There was a network of people doing fast track, so even when we were not on the learning set, it allowed you to talk to people and bounce ideas off.” “It was the learning sets. I had a colleague on the same team in the same learning set, so we could work together...if I was alone in my team, I would have been less motivated to have finished.” “We had 10 geographically spread learning sets initially with about with 10 practitioners in each – and we had three sessions of each?”

16. Interventions (3) Maintain dialogue with counter-parts in other pilots Driver Work towards a succession strategy to ensure it does not remain unsustainably dependent on a particular Coordinator Coordinated scheme or programme that accredits individual competence Go electronic as soon as practicable Link to the "Mother Ship" ie UKPHR Evaluate and learn fast to simplify and reduce demands

17. Interventions (3) Maintain dialogue with counter-parts in other pilots Driver Work towards a succession strategy to ensure it does not remain unsustainably dependent on a particular Coordinator Coordinated scheme or programme that accredits individual competence Go electronic as soon as practicable Link to the "Mother Ship" ie UKPHR Evaluate and learn fast to simplify and reduce demands

18. Evaluate and learn fast to simplify and reduce demands Example from South Central of the changes the pilot team have already made or are considering, taken from a recent evaluation Support Groups • Initial 1:1s • Portfolio development groups facilitated by two • Master classes and learning sequences will be provided to fill knowledge gaps • Better tools, such as time-related project plans and resources • Better IT channels creating one point of email contact • A list of mentors will be provided Assessment process • Development, with other pilots, of an electronic method of recording assessment. • Assignment of an assessor only when progress has been made through the support programme • Limiting assessor feedback to constructive comment • Clear deadline dates for submission of portfolios to assessor • Clear deadline dates for completion of assessment and submission by practitioner to Verification Panel Interim Evaluation of Assessment Processes for the Portfolio Development Programme Viv Speller November 2011

19. How much time did practitioners, assessors and verifiers invest? “ It was time consuming, but it was also a very good exercise to take stock of what projects I have been involved in. “ Example from Total Improvement Process’s Kent and Medway evaluation summary

20. What benefits from being on/involved in this programme did the participants identify? Example from Total Improvement Process’s Wales Public Health evaluation summary Structured professional development Encourages reflection / reflective practice Development of Assessors, Verifiers and Managers “ Structured professional development Encourages reflection / reflective practice When mentors are line managers to other staff it helps the support to these staff too. You start thinking “perhaps I should be doing this also for the • Supports management of other public health staff – give them similar guidance • Supports & encourages reflective practice • Recognise gaps • Reward for taking risks: achieving through supporting others. Recognition of PoD team across UK • Identify achievement • Recognising and assessing competence across the system - knowing who our troops are and where they are • Structured approach • Provides a credible systematic structure for a workforce who have historically never had one • Professional development staff I manage!” The benefits ‘leak out’. “

21. The questions raised by the story Public Health Practitioner Portfolio Assessment National Pilot Schemes The story so far..

22. Questions faced by the characters in this story… How big is the potential pool of public health practitioners you need to - and are likely to - register? What is the consistent message you need to give about the £75 Registration fee? How can you collaborate to build a compelling case for Employers? How do you communicate the measurable impact on confidence and the difference it makes? Are there some emerging ways of supporting the different groups ie experienced and competent practitioners who see the value of recognition and those who are still significantly building their competence? How do you communicate the increased public confidence this process can bring? Is the goodwill model sustainable in most likely scenarios?

23. Public Health Practitioner Portfolio Assessment National Pilot Schemes The next chapter? The story so far..

24. 1. Create and collate credible data that will build a compelling case for spread 6. Lobby key individuals through formal and informal meetings 2. Create a joint spread plan – especially who does what Creating spread? 5. Identify the key publications, journals etc into which you want to input letters, articles and papers about achievement and learning 3. Identify the key bodies and individuals who influence further take-up of the process in their countries, regions or sub-regions 4. Identify the key events and professional conversations into which you need to input and influence

25. Policy-shapers (eg Employers, Local Govt Association nationally, emergent Health & Well-Being Boards regionally) Funders (eg Employers, “Local” Education and Training Boards, Local Authorities) Creating spread 3. Identify the key bodies and individuals who influence further take-up of the process in their countries, regions or sub-regions Potential suppliers (eg Colleges and/or HE Institutions) Potential clinical and professional allies (eg Faculty, RCN)

26. 1. Create and collate credible data that will build a compelling case for spread Assemble the key pilot statistics about achievement Assemble key case-studies and stories of success and impact Clarify the input necessary to replicate successful start-up and maintenance of a programme Creating spread

27. Public Health Practitioner Portfolio Assessment National Pilot Schemes Write on…..! The story so far..

28. “Throughout this evaluation, despite the teething problems with the pilot, the commitment, enthusiasm and professionalism of all involved in the programme has been evident. Its continued success depends on the good will and dedication of many in the public health community, and it is hoped that with the learning from this pilot, and streamlining of processes, the assessment process will continue to be of the highest standards for quality assurance, and will be sustainable within existing resources for future public health practitioners wishing to have their professional contribution to public health formally recognised.” Interim Evaluation of Assessment Processes for the Portfolio Development Programme Viv Speller for NHS South Central November 2011