Physio Sandra Harding explains how HCPG helps private clinics on compliance and governance issues
If Sandra Harding worked in the food preparation and presentation field – perhaps along the lines of the larger-than-life TV celebrity chef Gordon Ramsay – she’d probably focus on what goes on in the kitchen rather than on ‘front of house’ matters.
A physiotherapist by background, Sandra co-runs HCPG (Health Care Professionals Governance), a company that helps physios, as well as other practitioners such as osteopaths, chiropractors and sports and massage therapists, running private practices to understand their responsibilities around compliance and governance issues.
HCPG often supports clinics staffed by a range of healthcare professionals, as Sandra states. ‘While there may be nuances and minor differences between the professions regarding the regulatory and professional standards, the fundamentals are the same.’
'Combining passion with patience'
The bold strapline appearing on the HCPG’s website is ‘Helping clinicians to become HCPC compliant’. So, at first glance, it might seem odd that Sandra and business partner Sarah Tribe (another physio) often refer to kitchens and restaurants when setting out their stall to prospective clients. They receive regular feedback from clients, which helps them to ensure their approach on governance issues is relevant, topical and – yes – even fun!
'This area (compliance) can be filled with worry and fear, but Sandra and Sarah, who are so approachable and knowledgeable, have made it an enjoyable experience! I would highly recommend their service [a satisfied customer]
The company’s ethos, Sandra says, is one of ‘radical candour’ which is, underpinned by ‘caring personally, while challenging directly’. The ‘Radical Candour’ concept is borrowed from Kim Scott, author of a bestselling book published in 2017 with that title.
Early on, Sandra and Sarah decided that HCPG would not be a ‘jack of all trades’. ‘We don’t cover health and safety, HR. We don't check PROMS, for example – to us, they are “front of house” activities and plenty of other specialists already focus on them. We are “in the kitchen” doing the basics, making sure it’s “clean”, that no-one will get food poisoning and that the underpinning governance framework is robust and evidenced.
‘Many physios understandably tend to concentrate on the clinical side of things and what the patient sees when they visit their clinic,’ Sandra explained. ‘While that’s clearly important, we focus on what goes on behind the scenes which is as important too. That aspect is crucial in the food sector, where, if you fail a food hygiene test, for example, you might rapidly start losing your customers’ confidence and ultimately could lose your business.
‘In our experience – and we’ve audited hundreds of clinics over the years – many clinicians “don’t know what they don’t know” when it comes to governance and compliance. The standards are often robust, but we find that the evidence and understanding can be less so.'
Moving towards 'unconscious competence'
The term used by Sarah and Sandra to describe this trait is ‘unconscious incompetence’: while people know that the professional standards and regulations exist, their understanding around them is sometimes incomplete.
‘Compliance,’ Sandra explains, ‘needs to become something that’s intuitive. We can help clients move in stages from a state of “unconscious incompetence” towards one of “unconscious competence”. That’s when you don’t even think about it, it’s just a part of what you do.’
Between them, Sandra and Sarah come with 30 years’ healthcare experience under their belts. They segued neatly into roles inspecting and managing therapy services for a large corporation after leaving their NHS posts, and their clinical and managerial backgrounds have proved invaluable since they went their own way and set up HCPG.
Are you unsure if your clinic and team meets all the important standards and regulations? One option is to book an independent, objective HCPG audit, which provides managers and clinical leads with an assurance of where the business is now and a report showing what can be done to address areas of non-compliance.
Too often, HCPG finds that clinics have been delivering an excellent service to patients but have fallen short by failing to log what’s happened in a clear, coherent fashion. As Sandra points out: ‘If it hasn’t been written down and documented, it didn’t happen. How did one thing lead to another? What action did you take, how have you learnt from this, how would you stop it happening again? How did you close the loop? You need evidence if you are challenged to back up what you say.’ This more active approach is being adopted by regulatory bodies e.g., HCPC from September 2023.
Why do people get in touch?
In the past, says Sandra, clinicans tended to seek help when something had gone awry, such as a receiving a complaint; when an untoward incident occurred; or when they were called to a review with the regulatory body. ‘But these days we increasingly hear from clinics saying they want to ensure they will “stand out” from the crowd: that they are fully meeting all the standards and that they are comfortable that they can prove it.'
Sandra continues: ‘While physios are expected to keep their CPD updated, for example, and could be selected to illustrate this by the HCPC, an in-house inspection is currently rarer. Private clinics – unlike NHS facilities – are not inspected by the Care Quality Commission (CQC). We are also finding that members of the public are increasingly seeking reassurances that a clinical service, perhaps sited on their local high street, is meeting all the relevant legislatory standards and is a safe place to have their treatment. They assume that allied health professionals are inspected and so, of course, that it will be safe.'
HCPG now communicates with clients using a ‘blended’ approach, and Sandra and Sarah conduct many audits using Zoom. While perfectly happy to travel to clinics to conduct face-to-face audits, they find many clients welcome the virtual alternative.
HCPG offers various levels of support (see examples below)
If this article has piqued your interest, Sandra suggests you explore HCPG’s website, which offers a wealth of free information in the form of blogs, articles, podcasts and videos www.hcpg.co.uk.
Would you like to find out more about how to run your practice safely? Which policies you must have in place? How to evidence that your governance is robust?
Come along to one of our monthly courses run on Saturday mornings and Wednesday evenings on Zoom.
Do you worry that if you come you will be judged? You won’t! We would love to see you and help you to find out what you do and don’t know.
Working in Private Practice: Compliance refresher. They are 2 parts covering different subjects. Visit the HCPG Store to book.
Far from being ‘bored’, you will discover that ‘governance can be interesting’, engage with your peers and learn how to improve services for patients. There is a special discount for PhysioUpdate readers for the June and July course/s click here on Store | HCPG.
Select the course date that suits you.
Click add to order under refresher course and
Enter the code PhysioUpdateJune23 where it says “Got a discount code? Enter it here” (in the left-hand panel).
You will need to create an account if you haven’t already.
More plaudits from satisfied HCPG clients
'I have been in private practice for over 15 years and thought it about time that I brushed up on my and my clinic's compliance. I must admit that I was surprised by a couple of things that came up that I thought I 'knew' but clearly didn't. I will now implement these changes which will make me, my associate, and the clinic meet the HCPC compliance standards.'
'If we are to continue to be leading professionals in the healthcare industry that peers and patients trust and find effective, it is paramount that we adhere to professional governance guidelines and keep abreast of changes.'
'Thanks to Sandra and Sarah for their well-structured and thoughtful 3-hour session.'
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