Approving education providers and programmes

We assess education providers and new programmes to ensure they are properly organised to deliver education, and train learners to be safe, effective and fit to practice.

We focus on whether education providers and programmes meet our standards of education and training (SET). The SETs are outcome focused, to ensure those who complete programmes meet our standards of proficiency and standards of conduct, performance and ethics on completion of programmes. This means that we do not set specific ‘inputs’ such as the academic entry requirements for programmes, or the number of practice hours required. We instead ask education providers to justify why their programmes are set up in the way they are, and how their approaches enable them to meet our education standards.

We undertake two-stage assessments, firstly assessing the institution, and then the programme(s). Our education standards are packaged to enable this approach, with 31 standards set at the institution level, and 21 at the programme level. Where an education provider’s new programme proposal aligns to existing HCPC-approved programmes, we do not ask education providers to evidence institution level standards through the assessment. We make this judgement by reviewing ‘baseline’ information established by the education provider, against initial information provided through their approval request.

We designed our assessments in this way to reduce burden for education providers, ensuring we consider the context and history of an education provider when deciding how to assess. We ran 64 approval assessments across the two years, and for 59 of these assessments, we made the judgement based on risk that we did not need to re-assess institution level standards through stage 1. When compared to our previous quality assurance model, this reduces the burden for education providers by about 60 per cent whilst enabling proportionate assessment against our standards, as 60 per cent of the standards sit at the institution level.

Programmes considered

In the key statistics section, we have included a breakdown of new programmes considered in the two years, with analysis of the types of programmes and number of learners.

Programmes were proposed across three of the four UK nations, and for all professions except biomedical scientists, clinical scientists, and prosthetists / orthotists.

Key findings

Broadly, the key challenge for the sector was growth in the total capacity of approved programmes, and the impact of this growth on practice-based learning, and education provider resources (including staffing). This was particularly prevalent in England, where most new programmes were developed. Even considering innovations in practice-based learning, there is a finite pool of practice opportunities. We increasingly hear from sector stakeholders, including NHS England’s Workforce, Training and Education directorate, that capacity is being reached, but through our assessments, education providers were able to show us how they have secured capacity for additional learners.

Securing adequate staffing numbers can also be challenging. It takes time to grow and develop the academic staff workforce, and stakeholders have noted there are challenges with attracting potential staff into academia. Although there are efficiencies to be gained with developing staffing models, there is a tipping point where existing staff numbers are not able to support proposed learner numbers.

Through individual assessments, there were common themes where further development was required by education providers for us to take assurance that our standards were met. Education providers were able to address shortfalls in the following areas, through further development of proposals:

• Capacity of practice-based learning – linked to the paragraph above, recognising challenges within the sector, we tested the intentions to ensure that all learners would be able to undertake practice-based learning to support delivery of learning outcomes.
• Collaboration with partner organisations to support delivery of programmes – considering how education providers were actively collaborating with their partners, both at strategic and operational levels. Commonly, this area included ownership of policies and process (such as learner support), and formal arrangements to manage relationships.
• Education providers securing appropriate resources for proposed programmes – this area included education provider resources (such as physical learning space, and resources to support learning) and staff resources (such as availability of teaching and support staff, and practice educators).
• Design and delivery of the curriculum – this covered a wide range of areas from delivery of the standards of proficiency, to how curricula were designed to integrate theory and practice.

We have provided detailed findings linked to how education providers have met our standards, and the challenges experienced, in appendix 1.

We aim to conclude assessments within a 6-9 month period of the initial application for approval. We found that more complex proposals led to a longer assessment period. Examples of more complex assessments were when:

• education providers did not already deliver HCPC-approved programmes (and therefore had a full submission and assessment through stage 1); or
• where proposals were particularly innovative or outside of established norms (such as non-alignment with the level of qualification for registration (SET 1)).

Education providers and others should be aware that complexity of assessment influences the time taken through the process, and that good forward planning is required to ensure intended start dates can be met.

Quality activities, conditions and referrals

During approval assessments we sometimes need to explore in more detail whether or not a proposed programme meets our standards. These can be where there are gaps, or it can be to identify best practice that we can then share with the sector. We call these explorations ‘quality activities’. We can undertake a range of quality activities, from clarification via email and documentary submissions, to virtual or face to face meetings with various stakeholder groups.

The main areas we explored through quality themes linked to the following areas of the standards of educations and training (SET):

• SET 3 – programme governance, management and leadership
  • Collaboration with practice education partners
  • Availability and capacity of practice-based learning
  • Programme staffing and resources
  • Access to resources for staff and learners
• SET 4 – programme design and delivery
  • Ongoing currency of the curriculum
  • Programme design, including alignment of the programme to our requirements for registration, and integration of theory and practice
• SET 5 – practice-based learning
  • Availability and preparedness of practice educators
  • Structure, duration and range of practice-based learning, enabling support of delivering learning outcomes
  • Assessment of practice-based learning
• SET 6 – assessments
  • Assessment design, to ensure learners meet the requirements for registration
  • Rules for progression through programmes

In most cases, we were confident with education provider approaches through exploration in quality activities. Where we were not, we set conditions (see below). In our previous education quality assurance model, we would often have set conditions on approval for these areas, especially when a further documentary submission was required. In the current model, we were able to work with providers further upstream to fix issues before needing to set formal requirements. This is a good demonstration of our ability to take regulatory action to ensure our standards are met through assessments.

Conditions on approval

Conditions are requirements that must be met before education providers or programmes can be approved. We set conditions when there is an issue with the education provider's approach to meeting a standard. This may mean that we have evidence that standards are not met at this time, or the education provider's planned approach is not suitable.

An explicit aim of our education quality assurance model is to identify and resolve issues as early in the process as possible, working with education providers to support their understanding of regulatory requirements and identify solutions. This engagement resulted in a significant drop in the number of conditions set through assessments, from 85 per cent of assessments in the last year of running the previous education quality assurance model, to 2 per cent across the two years of running the current model.

It is important to note that the same high regulatory standards are applied within our current model – this reduction was achieved by fixing problems further upstream, rather than setting formal requirements towards the end of the regulatory process.

The conditions set were case specific and required to ensure education provider / programme alignment with our standards. Due to the small number of conditions set, there are no themes to note across conditions.

Recommendations

We include recommendations when standards are met at or just above threshold level, and where there is a risk to that standard being met in the future. They do not need to be addressed before programmes are approved, but should be considered by education providers when developing their programmes.

Through future reviews, we refer to recommendations to consider if they have been addressed, although this is not mandatory due to the nature of recommendations.

We set 10 recommendations in the two-year period. Similarly to the conditions section, recommendations set were case specific. Due to the small number of recommendations set, there are no themes to note across recommendations.

Referrals

In addition to conditions and recommendations, we can refer areas to other assessment processes where we consider there to be a risk that we need to pick up through future assessments. This might be a specific planned development of change, or us seeking reassurance that an education provider’s approach works in practice.

Approval assessments consider whether education providers and programmes meet standards. Sometimes, there are areas which require follow up at a later time, such as a specific planned development or change, or us seeking reassurance that an education provider’s approach has worked in practice. We capture information about these areas, and have tools which enable us to pick them up through future assessment processes. We describe these as ‘referrals’. When referring we are clear with what we will be looking for when we next review. This helps education providers to consider and plan continued alignment with our standards. When referring, we are confident that education providers meet our standards at this time, but we consider there is a specific area of risk that we need to consider through future assessment.

We referred three areas through the approval process to the next performance review process. As in the previous two sections, referrals were case specific. Due to the small number of referrals, there are no themes to note across referrals.