Regulatory Policy and Professional Practice: How to bridge the divide?NIPEC a system solution

Dr Susan HamerUniversity of Leeds UKs.hamer@leeds.ac.uk

Change in context:

Changes in disease burden

Population and workforce demographics

Demand pressures

Cost pressures

Innovation “crisis”

Policy initiatives centred on organisational forms.

Quality initiatives relating to increasing control and regulation, introduction of industrial concepts.

Task substitution and increased specialisation, erosion of generalist roles.

Patient mobilisation, use of market/consumer activity

The responses:

Right type of professionals?

Source: Thomas Plochg, Niek Klazinga, Michael Schoenstein and Barbara Starfield for the OECD.

Supportive environments Right skill mix Effective leadership Expectation of change and authority to act Flexible regulatory environment Clinically attractive (innovation)

When health professionals change fast:

Working with the grain: self regulation to self organising

Encourage annexing of new forms of knowledge. Reduce specialisation. View task substitution as a temporary state. Regulate with extreme caution and introduce

flexibility. Increase expectations of the professions to

organise themselves.

Counter intuitive? ( ?Too scary, so rarely done)

NIPEC a case study:• NIPEC was established in 2002 under the Health and Personal Social

Services Act as a Non-Departmental Public Body (NDPB) sponsored by the Department of Health, Social Services and Public Safety (DHSSPS). The responsibilities for NIPEC, as identified within the Act, are shown in Annexe 1, and are summarised below:

To promote

• high standards of practice among nurses and midwives• high standards of education and learning for nurses and midwives

• professional development of nurses and midwives and provide

• guidance on the best practice for nurses and midwives

• advice and information on matters relating to nursing and midwifery.

Corporate Plan 2013 - 2016

System solutions which work with an understanding of how individual professions change their practice

An expectation of professions acting as professions from policy makers

A better appreciation of how to change professional behaviours and a realistic understanding of time and cost

A honest (and trusted) broker who can create the space for system actors to meet and generate solutions

?????????????????????

Adaptive professionals : what do they need?