D eveloping a Registration System for Health Promotion Practitioners in Ireland Findings from a Scoping Study June 2014 Barbara Battel-Kirk on behalf of the AHPI

WHAT IS PROPOSED? A professional registration system for Health Promotion practitioners in Ireland within the IUHPE European Health Promotion Accreditation System AHPI consider managing the registration system

WHY NOW? IRISH CONTEXT Ongoing interest and discussion Support expressed at the 2012 National Health Promotion Conference and in a small scale study with the Health Promotion community (Finnegan, 2012) Funding provided to AHPI by the Health Promotion Department of the HSE to undertake further consultation on the development of a registration system in the context of capacity development for Health Promotion in Ireland.

Established and piloted in 2013 with co-funding from the EU Fully agreed and tested criteria, policies, structures and processes for the approval of National Accreditation Organisations, accreditation of courses and registration of practitioners Based on the CompHP Core Competencies, Professional Standards and Accreditation Framework that were developed through consensus building with the Health Promotion community in Europe. WHY NOW – EUROPEAN CONTEXT

AIM AND OBJECTIVES OF SCOPING STUDY AIM To explore the feasibility of developing a registration system for Health Promotion practitioners in Ireland Objectives To explore the current profile of the Health Promotion workforce in Ireland in the context of developing a registration system To ascertain the opinions of Health Promotion practitioners on the current provision of education and training for Health Promotion in Ireland in the context of registration To explore the opinions of Health Promotion practitioners on developing a registration system.

METHODOLOGY Attempted to engage Health Promotion practitioners in Ireland across all sectors and settings Sample frame – national agencies/organisations Total of 260 questionnaires sent via Snowballing technique with non statutory contacts/questionnaire made available on AHPI website to increase participation 81 responses - Response rate 31% Findings are discussed in the context of the IUHPE European Health Promotion Accreditation System.

WORKFORCE PROFILE AND ELIGIBILITY CRITERIA A majority of respondents are likely to meet the eligibility criteria for initial registration and re-registration within the proposed system based on: Focus of role Educational attainment Length of experience Continuing Professional Development (CPD).

FOCUS OF ROLE Within the IUHPE System the term ‘practitioner’ refers to all those whose main role reflects Health Promotion as defined in the Ottawa Charter (WHO,1986) to promote health and reduce health inequities, including those working in management, education and research directly related to Health Promotion. 59% of respondents indicated that their role was focused 100% on Health Promotion as described in the Ottawa Charter 32% that 75% of their role was so focused 9% that their role focused 50% or less on Health Promotion.

EDUCATIONAL AND EXPERIENCE CRITERIA 1.Graduates or postgraduates of a Health Promotion course accredited within the IUHPE Accreditation System 2. Graduates or postgraduates of a Health Promotion course not accredited within the IUHPE Accreditation System or from a course in another relevant discipline with a minimum of 2 years experience in Health Promotion practice in the past 5 years 3. Until 2019 practitioners who do not meet the required education criteria with a minimum of 3 years experience in Health Promotion practice in the past 5 years.

WORKFORCE PROFILE AND ELIGIBILITY INITIAL REGISTRATION Education 61% of respondents held a Graduate or Post Graduate qualification in Health Promotion 41% held a Graduate or Post Graduate qualification in another disciplines, most of which fit within the ‘relevant disciples’ recognised by the IUHPE System Others 12%.

WORKFORCE PROFILE AND ELIGIBILITY INITIAL AND RE-REGISTRATION Experience 58% have worked in Health Promotion for years 23% for between five and 10 ten years 14% for more than 10 years 5% for 1-5 years None less than 1 year.

RE-REGISTISTRATION EVERY 3 YEARS Criteria for re-registration: A minimum of 1.5 years of experience in Health Promotion practice in the preceding three years 75 hours participation in a diversity of Continuing Professional Development (CPD) activities related to the CompHP Core Competencies and Professional Standards in the preceding 3 years.

WORKFORCE PROFILE AND ELIGIBILITY RE-REGISTRATION CPD 83% of respondents had undertaken some form of CPD in the past 5 years The wide range of topics covered appear to be relevant to the competency based criteria for re-registration.

CURRENT PROVISION OF HEALTH PROMOTION EDUCATION AND TRAINING IN IRELAND 89% of respondents considered that there are insufficient opportunities for CPD for Health Promotion in Ireland and 87% that opportunities for CPD are not easy to find. Comments included: Lack of support to attend education/training (i.e. time off/funding) which has become more evident in past 5 years CPD not valued by employers and, even if valued, cannot be funded in current financial climate Lack of access Difficulties in finding information on opportunities for CPD Gaps in provision, lack of diversity

OPINIONS ON DEVELOPING A REGISTRATION SYSTEM 86% of respondents very likely or likely to register if a system is established, with a majority likely to apply across all sectors 83% considered that developing a registration system was important or very important.

DRIVERS FOR DEVELOPING A REGISTRATION SYSTEM Professional recognition of Health Promotion linked to raising status, pay rates/grading, career progression, professional independence and autonomy Increasing need for specialisation and professionalization Accepted description of/ clarity about who works in Health Promotion Quality /safety of practice through agreeing ‘common practice’ and standardisation across roles, responsibilities and grades Recognition of registration by employers

DRIVERS FOR DEVELOPING A REGISTRATION SYSTEM Commitment from all stakeholders - practitioners, managers, policy makers, academics, employers, Trade unions and the AHPI Leadership in driving the development of the system forward Keeping registration fees low Clarity of purpose about the system/benefits personally and professionally Making the registration system mandatory.

BARRIERS TO DEVELOPING A REGISTRATION SYSTEM Diversity of the workforce linked to potential difficulties in agreeing eligibility criteria/lack of cohesion/identity Apathy among practitioners Lack of recognition of/support for registration by employers The cost of registration fees/time need to apply for registered/CPD Concerns about how practitioners’ experience will be recognised A lack of knowledge and fear of the proposed system Difficulties in finding impartial assessors The fact that the system is not mandatory The current policy context and uncertainty about the position of Health Promotion.

REGISTRATION ORGANISATION 72% of respondents considered that the AHPI was a suitable organisation to manage a registration system, although only 38% were members. AHPI not considered suitable because it lacks: Resources and overall capacity to undertake such a role Experience in relation to registration ‘Standing/status’ ‘If AHPI is aligned to a European body, such as the IUHPE, this strengthens its position.’ Alternative suggestions: CORU and an independent agency comprising representatives from all sectors of Health Promotion

REGISTRATION ORGANISATION ‘Whatever organisation manages the registration system will need wide representation from all relevant stakeholders and very clear governance, with effective, transparent and accountable processes.’

FEES € 150 was the most frequently suggested fee for three year registration period Other suggestions included that fees should be should be benchmarked against those of other similar organisations or practitioners’ income.

SUGGESTED NEXT STEPS Further consultation and information sharing – with the aim of getting ‘buy-in’ from relevant stakeholders Progress on developing the proposed registration system should be a priority for action in the near future.