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Quality assurance and enhancement systems

Health professionals’ education occurs in a range of contexts, carried out by a variety of institutions and professional bodies.  The locus of control in these areas depends on whether the health professional is a student, trainee or independent practitioner.  Although each healthcare profession has its own unique set of educational structures and processes, there are similarities across the disciplines.

The university context

Students preparing for professional registration are generally enrolled in university programmes which, though relying on practicing clinicians for much of the teaching, remain under the control of universities and through them to the agencies that have a mandate for audit.  These agencies are primarily concerned with assuring governments that taxpayers are getting ‘value for money’ and that graduates are ‘fit for purpose`.

Degree programmes and other awards are quality assured internally by universities or other degree-awarding bodies. Funding is provided by governments (national or regional) through some type of funding council which sits under the Department of Education and/or Employability. In the UK, each of the devolved countries has its own council:

  • England – Higher Education Funding Council for England (HEFCE)
  • Scotland – Scottish Funding Council (SFC)
  • Northern Ireland – Department for Employment and Learning Northern Ireland (DELNI)
  • Wales – Higher Education Funding Council for Wales (HEFCW)

 

Governments need to assure that they are receiving value for money in relation to the funding they provide. This is typically quality assured by an ‘arms-length’, independent body which works at institutional or programme level. In the UK this is the Quality Assurance Agency for Higher Education (QAA), which is contracted by the funding councils to safeguard standards and maintain the quality of UK higher education (http://www.qaa.ac.uk). The standards it applies are in the Quality Code which sets out the expectations of all UK higher education providers under a set of headings covering academic standards, academic quality and information about HE provision.

An increasing number of metrics are also used to measure the ‘quality’ of education, including widening participation, attrition rates, pass marks, degrees awarded and employability or further study statistics for graduates.  Universities therefore need good data management systems to collect and analyse data.  HESA (the HE Statistics Agency) is the UK body that collects and analyses all statistics about publicly funded higher education (https://www.hesa.ac.uk).

Professional and regulatory bodies

In addition to the quality assurance processes relating to universities, regulatory and professional bodies also have a responsibility for defining standards against which health professional programmes, the graduates those programmes produce and practising health professionals are measured, reviewed, judged, accredited or approved. Another form of quality assurance is often carried out in relation to the funding provided for the clinical education provided for health professions programmes and students. This QA is typically (although it varies depending on the profession) devolved by the four Departments of Health to Workforce Deaneries, Local Education and Training Boards (LETBs) or other bodies.

Table 2: UK health professions regulatory bodies

Profession(s)

Council

Standards frameworks

Further information

Nurse

Midwife

Nursing and Midwifery Council

These exist for pre-registration, include a set of defined competences and specialist standards http://www.nmc-uk.org/Educators/Standards-for-education/

Much guidance on CPD and fitness to practice is also provided

http://www.nmc-uk.org

Arts Therapist

Biomedical Scientist

Chiropodist/ Podiatrist

Clinical Scientist

Dietitian

Hearing Aid Dispenser

Occupational Therapist

Operating Department Practitioner

Orthoptist

Paramedic

Physiotherapist

Practitioner Psychologist

Prosthetist/Orthotist

Radiographer

Social Worker (in England)

Speech and Language Therapist

Health and Care Professions Council

Whilst some professions (e.g. physiotherapy) have been regulated through registration and licensing for many years (including re-registration and CPD recording) others are in much earlier stages of development. See below for programme approval processes

http://www.hpc-uk.org/education/ and the main site for guidance re revalidation etc. for each profession

http://www.hpc-uk.org

Doctor

General Medical

Council

Approval processes for programmes at all stages of regulation including undergraduate (basic medical) training http://www.gmc-uk.org/education/index.asp

UK Foundation Programme works with GMC on developing standards for Foundation doctors (GMC quality assures programmes).

Postgraduate specialty training programmes are responsibility of Medical Royal Colleges, faculties and specialty associations, quality assured through GMC standards http://www.gmc-uk.org/education/postgraduate/standards_and_guidance.asp

http://www.gmc-uk.org/

 

Dentist

Clinical Dental Technician

Dental Hygienist

Dental Nurse

Dental Technician

Dental Therapist Orthodontic Therapist

General Dental Council

Approval processes for programmes http://www.gdc-uk.org/Aboutus/education/Pages/Education-sector.aspx

Guidance on CPD http://www.gdc-uk.org/Dentalprofessionals/CPD/Pages/default.aspx

Standards for the Dental Team http://www.gdc-uk.org/Dentalprofessionals/Standards/Pages/standards.aspx

http://www.gdc-uk.org/Pages/default.aspx

Psychotherapist

Counsellor

British Association of Counselling and Psychotherapy

Holds professional register; sets standards for counsellors, psychotherapists and supervisors; is membership organisation and provides information

http://www.bacp.co.uk/accreditation

http://www.bacp.co.uk/

 

Professional, regulatory and statutory bodies have a key role in the approval and accreditation of undergraduate programmes offered by universities to assure fitness for purpose of graduates. In the UK and in many other countries, each profession has its own council responsible for assuring the public and other stakeholders that programmes meet defined ‘threshold’ standards in terms of curriculum outcomes and delivery methods, and that the provider institution has resources, systems and governance arrangements to ensure appropriate delivery of the approved programme.  Initial approval and accreditation of programmes leading to a professional qualification and/or registration on a professional register is followed up with a cycle of reviews and audits. The main councils responsible for assuring that undergraduate health professional programmes meet the standards are set out in the table above. Most councils have responsibility for assuring the quality undergraduate and postgraduate training as well as licensing, maintaining a professional register and regulating individual professionals (e.g. through CPD and fitness to practice processes).

In terms of continuing professional development and revalidation, quality assurance processes have been influenced by a number of policy shifts geared around ensuring public and patient safety. These include further formalising revalidation, recertification and licensing; a shift towards specification of competencies at all levels; a greater emphasis on educational and clinical supervision and formalising staff and educational development.  For many professions, new professional standards frameworks for teachers and supervisors are being introduced, adding another layer to the quality assurance processes.

Thinking point

Whether you work in undergraduate, postgraduate or continuing education (or a mixture of each), quality assurance is key to both maintaining and improving standards.

Do you feel you are fully familiar with the external quality assurance processes that impact on your teaching and learning?

If not, take some time to explore the quality assurance context within which your teaching occurs and, if time allows, offer to become involved in these quality assurance processes.

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