Report on Qualitative Consultation amongst Users

5 th Floor, Holborn Gate, 330 High Holborn, London WC1V 7QG Tel: 020 7861 3080 Fax: 020 7861 3081 email: enquiries@opinionleader.co.uk Report on Qualitative Consultation amongst Users Prepared for Health Professions Council April 2002

Table of Contents 1 Background... 3 2 Objectives... 3 3 Methodology... 4 4 Key Findings... 5 Contact with the CPSM... 5 Views on Administration... 6 Interfacing with Users... 6 5 Findings Amongst Specific Audiences... 8 Registrants... 8 Employers...10 Professional Bodies...11 Other Registration Bodies...12 6 Summary...14 OPINION LEADER RESEARCH 2 HPC USERS SURVEY

1 Background SHPC/HPC will adopt new procedures for the way users interface with its registration system due to changes brought about by the OIC. In addition, an IT review is likely to result in a radical change to HPC s operational procedures Therefore, the Shadow Health Professions Council (HPC) is keen to seek the views of its users when they interface with its existing CPSM registration system The survey has been conducted in a way that is transparent and open As well as presenting the findings to the Council, the final findings will be made publicly available This report presents findings from the qualitative phase of research Interim findings from the quantitative survey are available in a separate document 2 Objectives The principle objective of the qualitative research was to gauge levels of satisfaction amongst users using the CPSM existing system Developing recommendations and setting a benchmark for new systems of interface between HPC and registrants and other users Additional objectives include To find out where users feel the CPSM perform well To chart areas where users feel improvements could be made and to illicit practical suggestions for change To test specific operational suggestions for change eg, opening hours To identify the views of registrant sub-groups e.g. different professions, regions, overseas registrants To feed into IT strategy and website redesign e.g. what queries could be referred to the website Record usage of different interfaces e.g. phone, mail, email, office visit OPINION LEADER RESEARCH 3 HPC USERS SURVEY

3 Methodology The users for this survey fall into 4 categories: 1) Registrants Broken down into different profession cells - each proportional to their numbers in the CPSM Not to specifically include the professional bodies 2) Employers e.g. NHS Trusts, agencies 3) Professional bodies e.g. CPSM s existing twelve boards 4) Other providers of registration systems eg, GMC, Qualitative research was undertaken with these groups, as follows: Audience Registrants Employers of Registrants Professional Bodies Other providers of registration systems Methodology 4 mini groups of CPSM s health professionals Held in England, Scotland, Wales and Northern Ireland 5 telephone depth interviews lasting between 20 30 minutes each 6 telephone depths with professional bodies lasting between 20 30 minutes each 5 telephone depth interviews with the relevant people from the liberal professions Qualitative fieldwork was conducted between 7 th March 18 th March 2002 OPINION LEADER RESEARCH 4 HPC USERS SURVEY

4 Key Findings Contact with the CPSM Many participants have minimal contact with the CPSM For a majority, contact is limited to registration and renewal of registration, and thus occurs on an annual basis only Where registrants use direct debit, there may be no contact at all, since renewal happens automatically Once a year, piece of paper through the post, fill it in, sign it, put a cheque in the post and return it. (Belfast Registrant) There is some confusion amongst participants about the role of the CPSM Few understand that its primary function is protection of the public interest Hence, many feel under-served Very few participants are aware of the range of professions regulated by the CPSM They do not understand how the particular professions were decided upon Some feel dental technicians, ambulance technicians and pharmacists should be included However, participants with more knowledge of the CPSM see it playing a useful role in coordinating the professions Though some feel this role could be further improved they point to differences amongst the professional bodies and feel that the CPSM could be doing more to redress these differences and create a level playing field amongst the professions The limited contact participants have with the CPSM makes it difficult for them to assess its strengths For the most part, it is only when something goes wrong and problems arise that the CPSM becomes visible OPINION LEADER RESEARCH 5 HPC USERS SURVEY

Views on Administration Many participants are critical of the administrative efficiency of the CPSM Repeated requests are made for information or to get registration information changed Phone calls are said to go unanswered, by either person or machine Those who do answer phone calls are felt not to be sufficiently well trained or knowledgeable to respond to queries Interfacing with Users I once phoned no one answered and there was no answer machine. (Cardiff Registrant) Wide support for improvements in the HPC s overall communication with users is evident In particular, attention to the interface with the HPC would be welcome Many respondents complain that it is currently very difficult to reach the CPSM by telephone And that when the phones are eventually answered, the people on the end of the phone are often unable to answer queries However, there is resistance to an automated system Some respondents suggest a call centre or proper information line would be helpful The 0845 number is thought to be a good idea but it would need to be well-publicised Lengthening the hours during which the HPC can be reached by telephone would help users Currently, they complain that they are working themselves when the CPSM is open Opening hours from 8:00 / 8:30am 5:00 / 5:30pm are suggested Some suggest opening late one night per week and there is also support for Saturday morning opening Changes made to opening hours to accommodate better the needs of overseas registrants are also seen as useful There is great support for improvements to the website and several suggestions aimed at this were made Including a Frequently Asked Questions section Make the tone of the website less legalistic and more chatty Be able to send email queries via the website and know that you will receive a prompt response, even if it is just an automated acknowledgement of the query and the promise of an answer soon OPINION LEADER RESEARCH 6 HPC USERS SURVEY

It should be possible to register by email, using a credit card for payment Respondents also make suggestions regarding communication with users via print media Having a regular HPC slot in professional magazines would help to publicise issues affecting not only their own profession but also other health professions Producing bi-annual information bulletins on issues of relevance to the professions in particular, potted biographies of people seeking election to the Council would be welcome There should be a local office for the HPC which basically is accessible to the public if they do have concerns and also to the registrants. (Belfast registrant) OPINION LEADER RESEARCH 7 HPC USERS SURVEY

5 Findings Amongst Specific Audiences Registrants Knowledge of CPSM Registrants know very little about the CPSM Their comments tend therefore to be focused around registration procedures They share the concerns of other users, noted above, about the difficulties in reaching the CPSM and about the availability of people able to respond to their queries Some respondents suspect the CPSM plays an important role but are unable to identify what this is In the absence of any legislative powers, some see it as a toothless organisation Some see the CPSM as bossy and rather quick to blame registrants if there is a problem with their status This leads them to feel they are getting poor service And some begrudge having to pay any registration fee, since they cannot see what s in it for them If registrants have a complaint, they go to their professional body, not to the CPSM Administration and Registration The registration procedure appears to work smoothly, in general Especially amongst those who pay by direct debit However, anecdotally, many have heard of people for whom the process has worked less well Some have been unable to practise because registration or re-registration has been handled inefficiently There is considerable surprise that there is no automatic reminder sent to people to tell them that their registration is up for renewal Respondents are also critical about the penalties for late renewal / registration which they see as unduly punitive If the registration has lapsed it should be like the TV licence - you get letters telling you or reminding you. (Cardiff Registrant) OPINION LEADER RESEARCH 8 HPC USERS SURVEY

There is frustration amongst some professions that people who aren t registered are able to practise It is seen as part of the CPSM s role to fight to stop un-registered practitioners from using the professional name This is a particular problem for chiropodists, who see podiatry as an internationally recognised profession The status of registered professionals is felt to be jeopardised by allowing unregistered people to practise using the same titles, especially since knowledge of these issues amongst the public is limited Some registrants had received copies of the CPSM Annual Report However, few said they had read it they flicked through Some registrants look to see who has been struck off Looking to the Future The Role of the HPC Most respondents are aware of the CPSM changing its name to HPC Some like the new name though feel it may add to confusion, since the public will probably assume health professions includes nurses and doctors Some commented on the jazzy new logo and say so this is where our fee has gone There is considerable support for the HPC to widen its role and become more practitioner facing Lobbying more visibly on behalf of registrants Providing professional development and training courses Communication Many of the suggestions made for the future of the HPC concern improved communications This is seen as a way of raising the profile of the HPC amongst both registrants and practitioners Many feel that currently, the CPSM only becomes visible when things go wrong Widening awareness amongst the public of what being state registered means is seen as important Especially amongst private practitioners, who feel their status is threatened at times by unregistered practitioners, and the inability of the public to distinguish between the two OPINION LEADER RESEARCH 9 HPC USERS SURVEY

The current CPSM booklet, which several registrants had seen, is felt to send out the wrong messages It is seen as largely negative, full of what happens if you practice without being registered A more general approach would be appreciated Northern Ireland A Special Case? One registrant in Belfast was very knowledgeable about the CPSM and the forthcoming HPC The following notes are based largely upon issues raised by this person Northern Ireland s history of having observer status, rather than voting rights, is felt to have impacted on its standing within the CPSM Whilst it will have voting rights within the HPC, it is still not seen to have the same level of representation as the other countries There is also some concern that the procedure for nominating people to the HPC does not have a mechanism to ensure that there is at least one person to represent the interests of a country Whilst this is something that applies to all the countries, Northern Ireland is seen as a special case This is due to the different way in which its health services are structured and because of specific issues that are felt to arise from its political history, particularly in relation to complaints or striking-off registrants Employers Like other respondents, employers major concern is with the administrative efficiency of the CPSM They refer to unanswered phone calls, repeated requests to perform the same tasks, gaps between payment and receipt of registration documents Their major request for the future is that the interface between themselves at the HPC is improved Longer opening hours, with an 0845 number, an improved website on which you could check registration, send emails and assurance that HPC staff were able to provide accurate information are the most important issues to be addressed They never actually do anything, or it takes months to get anything organised, or you repeatedly have to ask what you have already asked them several times. (Employer) OPINION LEADER RESEARCH 10 HPC USERS SURVEY

Most people don t remember strengths the only time I come into contact is when I m chasing them up. (Employer) Professional Bodies The CPSM is seen as a good model for bringing together the various professions Communication amongst the professions is felt to have improved as people work together more closely The CPSM provides a good forum for educationalists and an opportunity for sharing information However, some of the professional bodies feel that the CPSM does not co-ordinate the professions well, if at all Having separate boards within the CPSM to represent the different professions is seen as a main strength It allows issues specific to each of the professions to be discussed in detail The facility for the professional bodies to make presentations to the CPSM council is also welcomed, since it is seen to provide an opportunity for a productive flow of information between the two There is some concern about how the HPC will check on competence and what proof of competence will be required when these separate boards no longer exist Weaknesses As with other audiences, administration and problems with the user interface are seen as CPSM s greatest weaknesses In addition to the problems raised by other respondents, professional bodies say that they end up doing what they see as CPSM s work, since registrants unable to get in touch with the CPSM will call their professional bodies instead They feel that professional officers, or administrators who are allied to the health professions should be responding to enquiries, so that they are able to answer them fully A key issue to address is simplifying procedures for getting people who haven t worked for some time back on to the register One professional body said that they had received a large number of letters complaining about the CPSM In particular, about the rudeness of CPSM staff and the inefficiency with which registration is handled OPINION LEADER RESEARCH 11 HPC USERS SURVEY

Some respondents seen committee servicing as poor Paperwork is seen as badly presented and minute writing is felt to be poor Documents are felt to be often poorly produced and not widely circulated Raising the profile of the CPSM and communicating with its users in a language they understand is seen as very important Communication should be directed at registrants, employers, professional bodies and the general public Attention should be paid to opening up a dialogue with the professional bodies and not setting the HPC up as above them People find it difficult to contact them, to get through on the phone and to raise any interest when they do get through. (Professional Body) Other Registration Bodies Respondents come from a range of backgrounds and all face different issues and problems with their registration systems And have different ways of dealing with them However, there are some points shared in common which may be useful for the HPC to learn from Most systems allow registrants to pay by cheque, postal order, direct debit and credit card Most have a personal rather than automated response system However, some use an automated confirmation system for employers wishing to check that an employee is registered Many registration bodies are updating their websites Re-registration, FAQs, useful general information and payment are all seen as useful on a website Respondents from other registration bodies suggest that the CPSM should consult with the people who use the system on a daily basis These are the people who know what s involved, where the problems lie and what might be done to improve things This means registrants and office staff OPINION LEADER RESEARCH 12 HPC USERS SURVEY

Visiting organisations with similar registration needs is also seen as a good way of not repeating others mistakes One respondent was quite willing to have their name passed to the HPC Speak to sister registration bodies. What systems are in use? Find a good supplier for software development and avoid off the shelf packages. (Other regulator) Don t try to run before you walk listen to your users and do what they want, not what you want. (Other regulator) OPINION LEADER RESEARCH 13 HPC USERS SURVEY

6 Summary Contact with the CPSM is very limited It is mostly concerned with registration and re-registration There is considerable dissatisfaction with current levels of efficiency at the CPSM Phones are not answered, staff appear insufficiently knowledgeable to answer questions, renewals of registration forms appear to be sent out only to some participants There is wide support for greater access to the new HPC An 0845 number, longer opening hours, wider use of website for registration and payment Participants feel the profile of HPC should be raised, in particular amongst registrants and the general public A regular column in professional magazines would help to introduce a wider registrant audiences to the HPC and keep them up to date with issues of concern to the health professions Clarification and strengthening of the HPC s role as the co-ordinating body for the professions would be welcome Ensuring that standards are uniform across the 12 professions OPINION LEADER RESEARCH 14 HPC USERS SURVEY