1. Managing Professional Competence & Behaviour Workshop

2. Review of Professional Regulation Regulation of non-medical healthcare professionals (Foster, 2006) Good Doctors, Safer Patients (Donaldson, 2006) White Paper Trust Assurance and Safety – Regulation of Health Professionals in 21 st Century (2007)  Provide professionals with the opportunity to improve practice  Deal swiftly & fairly with concerns & complaints

3. ‘Handling Concerns' Support timely & effective management of individuals’ performance concerns - Good practice in handling performance difficulties Foster a consistent & fair approach Provide clear information for those who have a concern or have difficulty (DoH & NCAS, 2006)

4. Definitions Competence –knowledge, skills, attitudes, values & judgements which result in performance that satisfies a range of expected competencies Performance –What is actually done that can be influenced by capacity, willingness & opportunity to perform NIPEC (2006) Competency Profile Foundation Paper

5. Definitions Poor Performance –A significant failure or series of failures to satisfy one or more competencies Performance (NIPEC,2004) Lack of Competence –Lack of Knowledge, skill or judgement of such a nature that the registrant is unfit to practise safely & effectively in any field which the registrant claims to be qualified or seeks to practise (NMC,2004)

6. Managing Performance Continuum Overview 1.Ongoing support for growth in professional competence and performance ‘normal interventions’ 2.An individual experiencing or displaying difficulty ‘additional interventions’ 3.An individual whose performance continues to fail or is defined as ‘poor’ ‘more substantial interventions/capability process’

7. Handling Concerns about the Performance of Healthcare Professionals (DoH & NCAS, 2006) Good practice in preventing problems (selection & induction) Early recognition & support Effective collection of evidence & documentation Understanding why certain groups of practitioners get into difficulty

8. Managing Performance ‘Normal Interventions’ Relevant Policies & Statutory Requirements Existing Processes ●Code of Conduct ●PREP ●Appraisal Policy ●Supervision Policy ●Absenteeism Policy ● Capability Procedure ●Disciplinary Procedure ●NMC guidance reporting lack of competence

9. Managing Performance ‘Normal Interventions’ Existing Processes – what is working? NIPEC 2005 Survey Induction Preceptorship Appraisal/Development Review – Supervision – Rotas: Skill/Competency mix Use of Team/staff/other meetings L&D activities: planned/adhoc; formal/informal 56%(49%fairly/beneficial) 33% (69%fairly/beneficial) –Organisations funded most/all = 70%

10. Existing Processes Managing Performance ‘Additional Interventions’ Relevant Policies & Statutory Requirements Code of Conduct PREP Policies: Appraisal, Supervision, Absenteeism Capability Procedure Disciplinary Procedure NMC guidance reporting lack of competence

11. Managing Performance ‘Additional Interventions’ Relevant Policies & Statutory Requirements Existing Processes Triggers Frequency/Intensity Occupational Health Preceptorship Supervision Rotas: Skill/Competency mix L&Dactivities: planned/ adhoc; formal/informal Should also consider additional support mentoring, shadowing, buddyingmentoring, shadowing, buddying behavioural coaching,behavioural coaching, possibly limit scope of practicepossibly limit scope of practice

12. Existing Processes Managing Performance ‘More Substantial Interventions’ Relevant Policies & Statutory Requirements Code of Conduct PREP Policies: Appraisal, Supervision, Absenteeism Capability Procedure NMC guidance reporting lack of competence Disciplinary Procedure

13. Managing Performance ‘More Substantial Interventions’ May consider additional support eg mentoring, shadowing, buddy, likely to limit scope of practice Existing Processes Triggers Frequency/Intensity Occupational Health Preceptorship Supervision Rotas: Skill/Competency mix Mentoring L&Dactivities: planned/ adhoc; formal/informal Stages within capability process Should also consider additional support mentoring, shadowing, buddyingmentoring, shadowing, buddying behavioural coaching,behavioural coaching, Likely to limit scope of practiceLikely to limit scope of practice

14. Discussion Do you recognise the continuum? Would it be useful to consider each stage and identify if further focus would benefit managers?

15. Group Discussion Identify what aspects of each stage of the Managing Performance Continuum could be done better? (one stage each table) Prioritise the aspects that need addressed Identify the 3 most important/urgent and how they may be addressed & by whom

16. INTRODUCTION Managing poor performance – Development Framework project 2003- 2006 (capability procedures)

17. Definition of Poor Performance Poor performance is defined as “a significant failure, or a series of repeated failures to satisfy one or more competencies”. The degree of poor performance can be a result of a variety of factors which could be linked to capacity, willingness or opportunity. Capacity can include variables such as health, knowledge and skills, intelligence, level of education, stamina and motor skills. Willingness can include variables such as motivation, anxiety, attitude, norms and values, perceived role expectation, job status. Opportunity can include variables such as tools, equipment, materials and supplies, working conditions, leader behaviour, time and pay

18. INTRODUCTION Managing poor performance – Development Framework project 2003- 2006 (capability procedures) Interest increasing significantly but focus still mainly at “poor performance”

19. CONTINUUM Managing Performance Continuum ‘Stars! ‘ Main Body of Staff ‘Routine’ ‘More challenging/ capability’

20. CONTINUUM Managing Performance Continuum ? ? ? Level of manager’s interventions

21. Today's challenge - Examine the topic and identify if anything more needs to be done, and if so what and how?