Service user and carer involvement

In 2014, our education seminars focused on service user and carer involvement in education programmes

• Case study 1

  Situation

  As a result of some poor feedback from an external review a faculty have asked one of their programmes to include service users and carers in the creation of a new curriculum to make sure that the programme is preparing their students for the ‘real world’ of practice in their profession. The programme team have taken this on board and are making changes in line with these requirements.

  To meet this request, the programme team placed advertisements in the local newspaper for suitable experts by experience. The role description asked for experience in an educational setting, as the service users or carers are to be consulted on the content of the programme’s level five modules. The programme team feel that this level is the most appropriate part of the programme for this input to be, as this is where the students are encouraged to link their theory to the ‘real world’ of practice.

  Through meetings held each Tuesday and Thursday morning with the relevant module leaders, the service users have given feedback on the proposed module content, structure and teaching materials, and have also been able to contribute to the development of e-learning materials for students. Travel expenses are paid to the service users and they have been offered payment for their work. However, one of the service users has refused payment, as this would have affected her entitlement to benefits.

  Questions

  1. Does this meet the new standard?
  2. What are the benefits with this form of service user and carer involvement?
  3. What are the potential barriers or issues with this type of involvement? How could you overcome these?

• Case study 2

  Situation

  As a result of some extensive work in the local community an education provider has developed a long standing relationship with Llanelli Users and Carers Association (LUCA), a service user and carer advocacy group. For a particular programme, LUCA has been asked to send a number of service user and carer representatives to work alongside programme team members on the admissions process. Usually this is in the capacity of talking to potential applicants at the education provider’s open day. However this time, the LUCA representatives are being asked to sit on the panels that will be interviewing applicants for places on this programme.

  While this is a new venture for this education provider the association have provided representatives to undertake this role for other education providers in the past. In order to support their members in the activities they undertake in representing service users, LUCA sponsors them to go on courses such as assertiveness training and communication skills. The programme team have also offered to provide a briefing as to the representative’s role in interviewing students on the days prior to interviewing the applicants. To fully fund the training and support that LUCA provides, which includes some part time staff, the education provider pays the advocacy group for the services provided.

  The reason for this change was that the programme team were made aware of informal discussions with the interviewees at other education providers after they had undertaken the admissions process. In these discussions the applicants stated that they felt the experience of being interviewed by service user representatives gave them some ‘hands on’ experience of interacting with service users. The LUCA representatives also said that the involvement with the selection process made them feel valued and that they felt they were giving the candidates a ‘taste of reality’.

  Questions

  1. Does this meet the new standard?
  2. What are the benefits with this form of service user and carer involvement?
  3. What are the potential barriers or issues with this type of involvement? How could you overcome these?

• Case study 3

  Situation

  An education provider has started an institution-wide initiative to include as many external experts in their assessment processes and procedures as possible, in an attempt to become a leading institute in the field of professional education. For its health and care programmes the education provider has a pool of professionals who are in practice and also a pool of service users and carers that they have worked with in various capacities for a number of years.

  To fit in with this new initiative the one programme team in particular has decided to increase the participation of their experts by experience and include service users and carers in the assessment of students on their programme. As such they have offered training to their pool of service users and carers in order for them to undertake this role and mark students appropriately and in line with professional expectations.

  For one module, the service users and carers provide feedback on students’ classroom presentations, which accounts for 50 per cent of the module mark. They also assess students’ written work for several of the modules across all academic levels. This has been backed up by a policy of ensuring that at least one service user must sit on the Examination Board for the programme to provide an additional external view on the decisions that the Board makes. While the service users and carers are paid an hourly fee for their involvement, they do not have their travel and other expenses covered. This is an agreement that was drawn up some time ago and has become established practice.

  Questions

  1. Does this meet the new standard?
  2. What are the benefits with this form of service user and carer involvement?
  3. What are the potential barriers or issues with this type of involvement? How could you overcome these?

• Case study 4

  Situation

  As a result of a professional body encouraging greater service user and carer participation in pre-registration education and training programmes, an education provider allocated resource to its programme teams to facilitate this involvement. This has led to a number of innovations on the programmes, varying from inclusion in teaching and learning, to the completion of surveys to determine how this particular profession is viewed by users of their services.

  Last year, on their three year programme Imran, a service user, was interviewed by a module leader in front of the group, as a one-off. Imran was asked about his experience and was able to provide a number of stories from the service user perspective. The students felt this was a highly valuable addition to the programme, so the programme team responded to the feedback by contacting a variety of different service user and carer organisations, requesting people willing to come and talk to the students about their experiences, on a voluntary basis. This year they ran a short series of talks which were delivered by service users and carers on their lived experience of the service from the profession. The speakers were briefed beforehand by the programme team, on the kind of topics that may be relevant and appropriate to the programme.

  However, as this was outside of regular teaching, the sessions were not mandatory and this resulted in poor attendance. Some of the service users and carers are therefore unwilling to engage with the programme further.

  Questions

  1. Does this meet the new standard?
  2. What are the benefits with this form of service user and carer involvement?
  3. What are the potential barriers or issues with this type of involvement? How could you overcome these?

• Frequently asked questions

  Introduction

  This is a summary of the common questions which delegates asked across our entire service user and carer education seminars delivered in autumn and winter 2013–14. If you require any further information regarding any of the information contained within the document please contact us at education@hcpc-uk.org. 

  Q - Why is there a phased approach to the introduction of the new standard of
  education and training (SET)?

  Our Council agreed that a phased approach should be undertaken to take into account
  that regulatory requirements for service user and carer involvement in programmes
  have previously existed for some of the professions we regulate but not others.
  Therefore transitionally approved mental health professional (AMHP) programmes due
  to be visited over the 2013–14 and 2014–15 academic years will be assessed against
  the new standard at the visit.

  However, they recognised the 16 professions may need a longer lead-in time to make
  any necessary changes, share best practice and develop appropriate systems and
  processes to support service user and carer involvement. Therefore the vast majority of
  currently approved programmes from the 16 professions will be assessed against the
  new standard through their annual monitoring audit submission in the academic years
  2015–16 or 2016–17. Only programmes which make significant changes to their
  programme and which require a visit to assess how the programme continues to meet
  the standards, may be assessed against the new standard earlier than this.

  This timescale allows all education providers to build service user and carer
  involvement in their programme in their own way. It allows education providers sufficient
  time to develop their approach and if necessary, put in place the resources to support
  this and affect any cultural or strategic changes that may need to take place within an
  institution.

  Q - The standard and guidance are very broad. Why have they been developed
  this way?

  Our remit is to protect the public and part of the way in which we do this is by setting
  standards for education and training (SETs) and using these to approve and monitor
  education and training programmes. These standards ensure that graduates from these
  programmes can meet the professional standards we set (SOPs) in order to be eligible
  to apply for registration. Our SETs are generic across the professions we regulate,
  flexible and set at a threshold level.

  We needed to ensure the standard and guidance we set is appropriate to professions
  which have regular contact with ‘end recipients of services’ and carers, including groups
  such as patients, as well as to professions such as biomedical scientists where the
  nature of their contact with individual end recipients of services and their carers can
  sometimes be much more indirect. Therefore based on the responses we received to
  the consultation we undertook, and the research we commissioned in this area, we
  concluded that a more prescriptive requirement across all the professions would be
  unreasonable at this stage.

  Q - Why does the standard and guidance not provide specifics about the required
  resources, including funding, to implement service user and carer involvement?

  As mentioned above, all our standards are flexible and generic across the 16
  professions we regulate. We are conscious that all education providers will be at
  different stages on their journey of involving service users and carers in their
  programmes and that implementing this standard will require resourcing, possibly of
  time and money.

  We also recognise the funding available for this varies across the professions and
  education providers, and as such we have not set any requirements in the standard or
  guidance that you must put a certain amount of resources into this; in the same way
  that we do not say how many resources should be put into our other standards, for
  example training of practice placement educators. The amount of resources needed are
  entirely dependent on your chosen approach to meeting the standard, and we leave this
  decision to you as the education provider responsible for designing and delivering the
  approved programme.

  When assessing this standard we will want to see the rationale underpinning your
  chosen approach to service user and carer involvement and that appropriate resources
  are available to you to support this approach. We are aware that what you provide us as
  evidence on the first assessment, whether that is through an approval visit or annual
  monitoring submission, may be your first steps in involving service users and carers in
  your programme. We acknowledge that, as institutions become more attuned to the
  new regulatory requirement and as it becomes integral in your education and training
  provision, service user and carer involvement will be developed further.

  Q - What other sources of guidance / information are available to education
  providers?

  Please find below further sources of information which may be of use. These are in
  addition to the sources of guidance we provided in the seminar. A copy of the
  presentation can be on our website here.

  The Higher Education Academy (HEA) - the aim of the HEA is to 'add value' to the
  vocational training of health care professional and support educators within universities
  and student placement settings. The HEA understands health care education and
  training is unique within further and higher education and the reliance on partnerships
  between educators and health care practice assures the provision of a quality workforce
  for health care delivery throughout the UK. The Health and Social Care Cluster team
  within the HEA are shaping and developing a specific project around Patient and Public
  / Service User (SU) and Care involvement in Higher Education. There is a recently
  convened national network of individuals with a special interest in Service Users’
  involvement.

  It may be appropriate for you to contact the following organisations to possibly engage
  with service users and carers.

  • The Patients Association
  • The National Development Team for Inclusion
  • Shaping Our Lives
  • National Allied Health Professions Patients' Forum
  • A full list of the organisations who responded to our consultation can be found in the
    Education and Training Paper in June 2013.

  Q - How will HCPC ensure consistency across programmes and visitors when
  evaluating this new standard?

  It is important to remember that as our standards are generic and flexible across the 16
  professions we regulate, education providers can meet them in many different ways.
  However there are a number of ways in which we ensure there is parity across the
  professions. All newly appointed visitors are required to attend two days of training and
  from then on, refresher visitor training every two years. This ensures all visitors have
  received appropriate training on the new standard. Each approval visit has a dedicated
  education executive attached to it who is an expert in the processes of the HCPC. They
  are there to aid the visitors and ensure that any condition or recommendation which is
  set is within our remit; as well as ensuring the visitors approach all the standards from a
  threshold perspective. All our Education Executives have received detailed training on
  the new standard.

  It is important to note that our visitors do not make the final decision on the
  programme’s approval or ongoing approval; they make a recommendation to our
  Education and Training Committee (ETC). It is our Education and Training Committee
  (ETC) whose role it is to scrutinise the recommendations of our visitors and, if
  appropriate, approve or grant on-going approval to a programme. ETC can change the
  visitors recommendation or elements of their report if, for example, they felt a condition
  or recommendation was inappropriate or was asking over and above the threshold level
  required for safe and effective practice.

  Q - How many service users and carer visitors will you have as part of the HCPC
  panel?

  In June 2013, our Education and Training Committee (ETC) agreed that service user
  and carer perspectives should inform the decision making processes for the approval of
  education and training programmes. As a result, the HCPC approval panel will be made
  up of three visitors; two registrant visitors, at least one whom is from the same
  profession with which the programme is concerned, and a lay visitor with a service user
  and carer experience. Lay visitors will be involved in the approval process from the
  2014–15 academic year.

  Q – How flexible are the HCPC in regards to the practice placement standards?

  All our standards of education and training (SETs) are designed to be flexible, nonprescriptive
  and robust. This includes our standards that relate to practice placements.

  This means that education providers can meet the SETs in many different ways.
  However, every education provider must meet all the standards at a threshold level in
  order to gain approval and retain on-going approval. It is the role of our visitors to
  determine whether the threshold level has been met and make a recommendation to
  our Education and Training Committee.

  Q – What sort of activities could be considered as service user and carer
  involvement? For example, could practice placements or social media /
  television programmes play a role?

  We use the term ‘involvement’ as a broad phrase; we do not prescribe the exact areas
  of a programme in which service users and carers must be involved nor do we say that
  service users and carers must be involved in every aspect of the programme.

  Within session one of the seminar we provided suggestions about where service users
  and carers could be involved in an education or training programme such as selection,
  teaching and learning activities, developing materials, feedback and monitoring. We
  also highlighted this was not an exhaustive list and the involvement of service users and
  carers could be involved in any or all aspects of your programme.

  We do not provide a clear definition of what the involvement of a service user or carer in
  an education or training programme should be because there will be different ways of
  involving service users and carers for each profession. Therefore, providing any further
  definition may be suitable for one professional group but not for another.

  When our visitors are assessing your programme they will want to see evidence that
  service users and carers are involved and you can explain and justify where and how
  involvement takes place as appropriate and relevant to your programme.

  ‘Practice placements’ as an overarching title would not in themselves constitute
  involvement of service users and carers. However, if the service users and carers at a
  practice placement provided feedback which led to programme development, this could
  constitute involvement. Television programmes and social media could play a part in
  delivering learning outcomes however, for both these examples, you would need to
  explain and justify why and how this involvement is appropriate for your programme.

  The presentation from the seminars is available here.