Database scoping for the Professional Standards Authority
The Professional Standards Authority (PSA), previously known as the Council for Healthcare Regulatory Excellence, is charged with overseeing nine statutory regulatory bodies for health and social care professionals, and for setting standards for and accrediting health and social care organisations holding voluntary registers.
The aim of the PSA is to promote the health, safety and well-being of health and social care service users and the public. This project involved the scoping of information within the PSA database as it relates to regulators’ Fitness to Practice activities.
We set out to respond to the question ‘What interesting/important research questions does the database information respond to that could contribute to an enhanced understanding of, and improvements to, the health and social care regulatory environment?’ The PSA added a second question as a precursor to this: ‘How are we to understand ‘quality’ in relation to the database and, specifically, to the research questions?’
Aims and objectives
We conducted a four phase project from Dec 2014 to Apr 2015:
- Familiarisation with database
- Agreement regarding methodology
- Application of methodology including discussion with PSA staff
- Drawing conclusions and next steps.
The database analysis involved thematic analysis of a sample from 2010-2013 of summaries and full transcripts from the regulators. An analysis of database material and interviews allowed for the inductive identification of other pertinent areas for further investigation.
This analysis focused on two key areas of complaint; dishonesty and professional boundaries/sexual misconduct. Comparisons were made within and across professions during a focus group discussion conducted with six PSA staff members in March 2015.
Head of School of Law, University of Surrey
Seven question areas were identified following an initial trawl of the cases on the PSA database. Exemplars from two areas of misconduct were examined in relation to the seven areas – dishonesty and professional boundaries.
The seven topic/question areas are as follows:
- Process of decision making
- Nature of offending
- Context of offending behaviour
- Mitigation and decisions to review
- Relationship between offending behaviour and organisational factors
- Treatment of acts versus omissions
- Profile of offenders.
- Regulators to devote resources to researching each of the seven question areas.
- In addition to database scoping, consider approaches that capture ‘live’ data from observing Fitness to Practice (FtP) hearings and interviewing participants and panel members.
- The PSA to consider recommending to regulators that there is a consistent approach to database recording particularly in the area if registrant profiles.
- Regulators to be encouraged to collaborate on interprofessional and interdisciplinary research relating to FtP.
- Regulators to liaise with those responsible for the provision of professional education – undergraduate and continuing professional development (CPD) – to research innovative approaches to ethics and professional education with a view to providing evidence-based responses that are upstream to prevent cases of dishonesty, sexual misconduct, boundary violations and other forms of misconduct.
For regulatory practice
- The PSA to consider recommending a standard annual reporting format for FtP data so that regulators and researchers will have an accessible resource that enables them to make comparisons across regulators regarding: nature and number of misconduct issues; practice context; profile of registrant (age, gender, place and dates of education, CPD).
- The PSA to work with regulators to consider how registrants are prepared for the FtP process and to work towards best practice so there is parity of understanding, preparation and representation across professions.
- The regulators to work with education providers to consider how to integrate, most effectively, FtP data within professional education so learning points can be transferred to students and registrants.
For professional education
- Lecturers in professional education to be encouraged to utilise rich resource of database case summaries in activities with undergraduates and within CPD.
- Education providers to work with local health and social care organisations to provide ethics and professional education that draws on learning from the FtP process across regulators.
- The PSA and regulators to consider working with a national education provider and researchers to develop an educational package that integrates what has been learnt from FtP activity into staff induction, undergraduate education and CPD.
The question of ‘quality’, in relation to the PSA database, is very much related to the perspectives, priorities and requirements of the stakeholders who collect, are custodians of and who use the data.
For the purposes of PSA staff, the database must enable them to have the necessary information to review cases to determine whether decisions are unduly lenient and refer to the case as an appeal where necessary to protect the public interest.
For the purpose of researchers, the quality of the database will very much relate to the research questions they are interested to answer. In any case, a framework to consider the significant dimensions of data quality may be helpful.
Research groups and centres
Our research is supported by research groups and centres.