Through extensive work in partnership with osteopaths and others we have developed a new scheme which better supports practice, patient care and CPD.
The three underpinning themes of the CPD scheme are about engagement, support and community. By working in partnership with osteopaths and others, we have been able to develop a scheme which supports osteopathic practice and community. Osteopaths have told us that engaging in the new scheme has enabled them to get professional and personal support and reassurance and has strengthened their communities and networks.
The current CPD scheme was introduced in 2006 and since then we have monitored its application in practice, including feedback from osteopaths, osteopathic organisations and CPD providers. In 2011-12 we conducted an extensive formal review. We have also been part of wider Government-led discussions among health regulators and others, concerned that current CPD systems do not offer the public adequate assurance that a health professional is actually keeping all essential skills up to date and is fit to practise.
Working closely with osteopaths and osteopathic organisations across the UK, and testing ideas with patients, we are looking at strengthening the osteopathic CPD system by building on what we know is already working well. The new CPD scheme has many familiar features, but suggests clearer requirements in areas where there is evidence that practice could be improved. Most importantly, the new CPD scheme aims to address professional isolation reported by some osteopaths by fostering a culture of peer support and creating collaborative learning environments.
CPD is an activity that maintains, enhances and develops osteopathic professional practice. CPD includes any learning undertaken by an osteopath and can include discussion of CPD and practice with a colleague, courses, seminars, practical sessions, e-learning, reading, research, individual study, peer discussion review, mentoring and any other activities that can advance practice. Undertaking CPD is an ongoing aspect of professional practice.
Professional practice can include clinical work, education, research or management responsibilities. Over the course of a three-year CPD period, CPD should be appropriately balanced over the whole of an individual’s practice. So, for example, an individual who only undertakes clinical work and holds no management or teaching responsibilities might confine all their CPD to clinical work. However, an osteopath who undertakes one day a week in education will undertake an appropriate proportion of their CPD in the area of education or teaching practice, as well as CPD in clinical practice. Over the course of the three-year period, osteopaths with management responsibilities should be able to demonstrate balanced CPD in this area.
No, there is no exam involved.
The CPD process aims to empower osteopaths to improve their practice, through support, reflection and continuous learning; it is not a pass/fail test.
Osteopaths move into the next three-year cycle by undertaking a Peer Discussion Review with a peer of their choosing (either an osteopath or other health professional) and by showing that they have engaged with the scheme and that they have undertaken the new features.
Research has shown us that giving osteopaths the scope and opportunity to share knowledge and experience, and seek improvement, is likely to produce better outcomes in terms of both safety and enhancing quality of practice.
Although we suggest that the Peer Discussion Review – demonstrating engagement with the scheme with an osteopath or other health professional of your choice happens towards the end of the three-year cycle, some osteopaths may choose their ‘peer’ earlier in the cycle so that they can have that structured conversation throughout their three-year cycle rather than leaving it until the end.
As now, the majority of CPD will stay practitioner-directed and what is of value and interest to the osteopath. The new features of the CPD scheme aim to support osteopaths to broaden CPD across their practice – to review CPD in all the areas of the Osteopathic Practice Standards to get feedback on their practice and to undertake CPD in communication and consent and build on what many osteopaths are doing already. The reasons for this are outlined below:
Free resources available to support osteopaths to undertake all these new features are available on this website.
When working with osteopaths to develop this scheme, they told us that the scheme helped them to get professional and personal support from their colleagues and to build new networks with others. Many osteopaths are continuing to talk about their practice and cases with others – not because the GOsC requires it – but because it continues to benefit their practice.
Osteopaths sometimes tell us that they look for courses to ‘make up’ their hours, and may be doing CPD based on what courses are available, rather than based on what is of most interest and use. There is also an assumption that CPD is just about courses, but there are a lot of different ways to improve and expand knowledge, including for example case-based discussion or journal clubs. We hope that this website will support osteopaths to undertake CPD in a range of ways – not just through courses – that will genuinely support and enhance your practice.
Wherever and whenever you work, the requirements of the scheme will be the same. The GOsC is the UK osteopathic regulator. Those consulting our Register are entitled to expect that all osteopaths are practising to the standards that we publish in the Osteopathic Practice Standards – regardless of where and how they practise.
For people working alone we hope the scheme might support them to interact with their colleagues. We are working with Early Adopters to support them to create networks using virtual meeting rooms rather than face to face, to overcome some of the challenges of geographical isolation.
If you are working in another language this should not be a problem. Your continuing professional development and Peer Discussion Review should be recorded in English as speaking in English is a part of practice in accordance with the Osteopathic Practice Standards. This will also assist if the documentation is reviewed by the GOsC as part of an audit.
It is important that osteopaths reflect on their own physical and mental health and this is a requirement of the Osteopathic Practice Standards. However, it will also be important that you engage with CPD across all four themes of the Osteopathic Practice Standards (communication and patient partnership, knowledge, skills and performance, safety and quality in practice and professionalism).
Ask yourself – can I demonstrate to my peer that I have engaged with the CPD scheme in relation to the full range of my practice? The guidance is outlined in the draft Peer Discussion Review Guidelines and reproduced below for ease of reference:
‘CPD Standard 1:
Demonstrate that activities are relevant to the full range of osteopathic practice (Osteopathic Practice Standards and breadth of practice)
This Standard is met when the activities that the osteopath has undertaken incorporate all four themes of the Osteopathic Practice Standards (communication and patient partnership; knowledge, skills and performance; safety and quality in practice; and professionalism) and appear to cover all aspects of their osteopathic practice (e.g. clinical practice, teaching responsibilities, research, and management).
This Standard may be met if the osteopath has undertaken CPD in all the themes of the Osteopathic Practice Standards, but has minor gaps in relation to their practice (e.g. if they undertake management responsibilities but have very little CPD in this area), so long as the osteopath is advised to undertake CPD in the areas requiring more attention.
This Standard is not met if the osteopath has not undertaken CPD in all the themes of the Osteopathic Practice Standards.’
Please do seek advice from our Professional Standards team if you would like to discuss further.
When discussing any patient case, it is important to ensure that patient confidentiality is maintained and that you comply with the guidance outlined in the Osteopathic Practice Standards in relation to confidentiality.
Your CPD, reflecting and recording can all count towards CPD. But it is for you to define and evidence this and be able to explain to your peer or to the GOsC what CPD you have undertaken, how long you have undertaken it and what you have learned so that you can show that you have met the four CPD standards as outlined in the draft CPD Guidelines and the draft Peer Discussion Review Guidelines.
As a starting point, it is helpful to look at the draft CPD Guidelines for the definition of CPD. Remember the scheme is not about focussing on ‘compliance’ it is based on an ethos of engaging with the scheme, getting personal and professional support and building networks and communities. It is based on you being able to show that you have engaged with the scheme, reflected and recorded your CPD and that you can show this to a peer.
To answer your question, you would need to come up with some estimate of benefit to you.
The new CPD scheme will need osteopaths to demonstrate CPD activities relevant across the breadth of their osteopathic practice. Opportunities for professional development can count towards your CPD, but there should not be an over-emphasis in one particular area.
There are elements in the Osteopathic Practice Standards about professionalism and how to run a practice, but CPD in this area should not be at the exclusion of everything else. The key point is to ensure a balanced approach of CPD appropriate to your practice.
The short answer is potentially yes.
The draft CPD Guidelines for the new scheme advocate a broad approach to what constitutes ‘acceptable’ CPD:
‘CPD is an activity that maintains, enhances and develops osteopathic professional practice. CPD includes any learning undertaken by an osteopath and can include discussion of CPD and practice with a colleague, courses, seminars, practical sessions, e-learning, reading, research, individual study, peer discussion review, mentoring and any other activities that can advance practice. Undertaking CPD is an ongoing aspect of professional practice.
CPD learning with others, additionally must involve interaction (both giving and receiving information to inform learning) with osteopaths, healthcare practitioners or other professionals.’
It goes on to describe professional practice:
‘Professional practice can include clinical work, education, research or management responsibilities. Over the course of a three-year CPD period, CPD should be appropriately balanced over the whole of an individual’s practice. So, for example, an individual who only undertakes clinical work and holds no management or teaching responsibilities might confine all their CPD to clinical work. However, an osteopath who undertakes one day a week in education should undertake an appropriate proportion of their CPD in the area of education or teaching practice, in addition to their CPD in clinical practice. Over the course of a three-year period, for example, osteopaths with research or management responsibilities should be able to demonstrate balanced CPD in these areas.’
Above all, the new scheme encourages osteopaths to take a balanced approach that ensures your CPD reflects the full range of your osteopathic practice. So if you provide mentoring as part of your practice, then keeping up to date your mentoring skills will be important, but your CPD should also reflect the skills needed to manage the range of patients you routinely see in clinical practice.
As with the existing CPD requirements, osteopaths should continue to complete 30 hours of CPD each year (at least 15 hours of which should be learning with others). However, there would be flexibility for each osteopath to choose when they undertake the activities they need to do to meet the CPD Standards during the three-year cycle.
The Osteopaths Act governs the osteopathic care of human patients and, whether or not your practice involves animals, to remain registered with the GOsC you must meet the CPD requirements in relation to human patients.
The new CPD scheme does encourage osteopaths to take a balanced approach to ensure your CPD reflects the range of your osteopathic work. So, for example, an osteopath with osteopathic teaching responsibilities would include CPD to enhance their professional practice in osteopathic teaching. However it is essential that all registered osteopaths undertake CPD that is applicable to the osteopathic care of human patients.
All osteopaths registered with the GOsC are required to undertake CPD – this includes those osteopaths who may be registered as non-practising. This is to ensure that registered osteopaths continue to maintain their fitness to practise as osteopaths even if they are not currently caring for patients. This could include a range of activity from shadowing other practitioners and discussing case scenarios, to reading relevant materials and attending courses.
Currently, osteopaths are required to undertake a minimum of 30 hours of CPD each year, and the expectation is that this will continue with the move to a three-year 90-hour cycle. If they do not, then they must make a statutory application to us, considered by the Registrar, to reduce hours or carry them forward to the next CPD year if there is ‘good reason’. So, for example in situations of sickness, maternity / paternity leave etc. these kind of applications are made.
In future, when the three-year cycle comes into force, osteopaths will still be expected to do 30 hours CPD per year. However, if they choose not to, they will not need to make a statutory application to us. Instead, they will be provided with advice from us that they need to do ‘x’ in order to comply with the CPD scheme at the end of the three-year period.
If you decided to do all of your CPD in year 1 and then did nothing for two years, we would expect that your peer would explore this with you and discuss how you were ensuring that you were up to date in that period. Engagement is important. It’s not a 3rd year engagement, but engagement over 3 years.
The question of the peer would be ‘would you do this and if so why – what was your narrative and how does that fit with your general obligation under theme B – knowledge and skills standard B4 which states: Keep your professional knowledge and skills up to date’? You may have a good reason for it – for example, you are on paternity leave, caring or not practising.
On the other hand, if your explanation to your peer was ‘well I’ve done my 90 hours’ but with no insight as to how and why things might change in the latter two years and why you might need to keep up to date on a regular basis – well that might be more of a concern or area of development that your peer may suggest you pick up as an area of development in the future cycle.
We expect that osteopaths will declare their CPD at the end of each year, and will get feedback from the GOsC about this. We have tested our approach with patients who felt that it was a proportionate approach and this has also been subject to consultation – see http://www.osteopathy.org.uk/news-and-resources/document-library/consultations/cpd-consultation-analysis-report.
Patients felt that the peer should be independent which is why we enhanced the proposals subsequently consulted on. In relation to our audit strategy we will audit a greater proportion of ‘local’ peer discussion reviews rather than ‘independent’ peer discussion reviews under the auspices of a group or organisation.
This website offers resources developed by osteopaths that are relevant for capturing objective feedback along with completed examples for consideration.
Organisations such as local groups, CPD providers, educational institutions, the National Council for Osteopathic Research and clinical interest groups can all provide help and support to undertake the objective activity aspect of the CPD scheme.
Yes, some CPD providers offer packages to support osteopaths to undertake automated feedback and analysis as well as support.
For example, participating in the National Council for Osteopathic Research PROMs activities can support completion of this feature of the CPD scheme.
This website provides you with resources, and also examples of how osteopaths have used the resources to participate in objective activity.
We appreciate that if you do not have contact with patients, it will not be possible to obtain patients’ feedback and other types of objective activity may be more challenging. However, there are other forms of feedback: for example, someone who is engaged only in teaching or research could invite student or colleague feedback. It is also possible to discuss your approach to hypothetical cases with colleagues.
The critical issue here is to consider what is the best way in which your work can be enhanced and how you can use the input of others to help you identify your CPD needs?
It depends on what the audit says. It is important that feedback is capable of being applied to both individuals within the same practice, but there would need to be some way of disaggregating what the message from it is. So, depending on the content, the same audit is capable of addressing the requirements of two people, but it might not.
You are welcome to talk this through with our Professional Standards team, so this could be tweaked to ensure it does meet the requirements of the new scheme.
The new CPD scheme needs some flexibility. There are different types of reasons why osteopaths are non-practising. The majority of osteopaths who are non-practising are so for a restricted period of time, for example for maternity or paternity leave. It is unlikely therefore that these individuals will be non-practising over the whole three-year CPD cycle, and could therefore seek objective feedback at some point.
If an individual is non-practising over the three-year CPD cycle they are more likely to have a different type of role, for example in teaching and therefore there are other ways their practice could be assessed, for example through student feedback.
Yes. The CPD resource materials include examples of role-playing case histories and group case-based discussion.
We don’t have a fixed requirement for what a clinical audit should look like. There are lots of resources in place to do clinical audit, including NCOR’s Guide to Clinical Audit.
This is just one way you can gain objective feedback, others include peer observation. For example, one of the osteopathic Pathfinder groups we worked with to develop the initial CPD proposals liked the idea of buddying up with other osteopaths, observing them in practice (with patient consent) and discussing each other’s practice afterwards.
Whatever the CPD activity, take time to consider which themes of the Osteopathic Practice Standards have been covered. Record this on the notes of your activity and retain these in your CPD folder.
Yes. It is important to be able to demonstrate that in every three-year cycle your CPD covers all four themes. However, it is not necessary to link all your CPD activities to the Osteopathic Practice Standards.
No, you do not need to link your CPD to every standard of the Osteopathic Practice Standards.
However, as part of your CPD you should review each of the standards and identify which areas you may need to focus on over the course of the three-year cycle.
Professional isolation is a significant risk factor in any profession.
The Peer Discussion Review process is intended to be supportive, creating for osteopaths the opportunity and secure environment in which to reflect on areas for potential development in their practice, assisted by feedback and advice from a colleague they respect and trust.
Osteopaths are encouraged to choose a reviewer whose opinion you respect and who can bring fresh perspective to your practice. The reviewer could be an osteopath or another health professional. The proposals suggest that these peer-to-peer discussions could be arranged within osteopathic groups, or under the auspices of an educational institution or a clinical interest group. Or, you can choose your own arrangements independently.
Osteopaths working with us developed the peer discussion process, and actively tried it out, in pairs and in small groups. They told us that discussing practice candidly with a colleague seemed quite daunting at the beginning, but the support and constructive suggestions of colleagues had, they felt, produced real benefits both to their practice and to themselves.
More information, along with case studies of osteopaths who have piloted a Peer Discussion Review, is included in the draft Peer Discussion Review Guidelines.
The Peer Discussion Review is not a pass/fail test – it is about continual learning and personal development and support for individuals – both personally and professionally.
Cheating will mean the osteopath loses out on these benefits. The fundamental aim underpinning the new CPD proposals is to offer all osteopaths a supportive environment in which they can explore any concerns they have about practice and gather feedback from a professional colleague whose views and suggestions could add value to practice.
Many osteopaths tell us that they rarely have the opportunity to discuss their practice development with a peer and report feeling professionally isolated. The Peer Discussion Review process aims to make the sharing of expertise an integral part of all osteopath’s professional development.
However, in common with any educational process, quality assurance is important for all concerned. Not only osteopaths but the public, too, should have confidence in the process.
The GOsC will apply an appropriate process for auditing Peer Discussion Reviews between osteopaths to minimise the risk of collusive activity. It is likely that Peer Discussion Reviews offered and conducted under the auspices of educational institutions and other osteopathic organisations will include their own, independent quality assured mechanisms. The GOsC would audit a higher proportion of reviews between osteopaths arranged outside of these more formal networks.
The new CPD scheme is a not a ‘soft’ option. If an osteopath fails to engage in the CPD process, or does not undertake all the required activities, they will be removed from the Register of osteopaths and prevented from practising. Meeting the CPD standards is a statutory requirement for registration.
If the Peer Discussion Review process identifies the need for further development, the osteopath will be expected to undertake this CPD to ensure they meet the current standards. We will also be monitoring implementation of the new scheme to ensure that the Peer Discussion Reviews are working properly. More information on how we plan to audit and quality assure the proposed CPD scheme is set out in the draft CPD guidelines.
Yes. This is a good way of encapsulating the safe space we are trying to achieve within the profession.
If you are going to reflect on your strengths and weaknesses and potential areas of development through, probably the last people you would want to share this with is the General Osteopathic Council.
The Peer Discussion Review process is putting a great deal of trust in the profession to do this. It will also rely on osteopaths getting better at giving and receiving feedback. We want to encourage osteopaths to value differences in practice and reflect on this together as a method of improvement.
Yes, the same two osteopaths can review each other.
It is suggested, under these proposals, that such arrangements are more likely to be audited by the GOsC in the interests of quality assurance, and this strategy is outlined in the draft CPD Guidelines. This will help to minimise the risk of collusive activity and will also help us to provide feedback to support those osteopaths undertaking Peer Discussion Reviews more locally. By this we mean those reviews conducted outside the auspices of a local group, educational institution or other CPD provider, for example.
No, this is not a requirement of the proposed scheme, but we can see there are pros and cons of both continuity and change.
Keeping the same reviewer might encourage consistency, but changing peer reviewer might give the osteopath more challenge and encourage development. This might be a factor in any risk-based approach to auditing the scheme.
It is the responsibility of everyone in the profession to develop a supportive learning community, ensuring that osteopathic practice continues to improve for the benefit of osteopaths and patients. This is a feature of a successful and maturing profession.
There are many ways in which a review could take place: osteopaths working with colleagues, osteopaths with an employer, osteopaths who are part of a local or clinical interest group. As a fall-back the GOsC can also conduct the review.
Based on feedback to date from the profession, choosing their own peer reviewer should enable the osteopath to discuss their CPD and practice in an environment in which they feel professionally comfortable. This encourages osteopaths not only to engage with the process of continual learning and development, but help also to focus on safe and effective practice and the overall quality care provided.
This does not mean the GOsC would not be closely involved in monitoring the CPD process. Our proposals relating to quality assurance and audit are set out in the draft CPD Guidelines.
If there were concerns that not all requirements of the new CPD scheme had been met, as a reviewer it is your choice not to sign off the Review, and as the reviewee you could seek another reviewer. We would not penalise either side in this instance.
If somebody fails to find any peer who will sign them off, then this is a discussion we would have with the practitioner.
If serious concerns about osteopathic practice were revealed in the Peer Discussion Review, the process would be exactly the same as set out currently in the Osteopathic Practice Standards. If you think an osteopath is posing a danger to patients, you can raise this first of all with the osteopath concerned, their employer and in some instances you might want to raise this with the police, social services or report your concerns to the GOsC.
No, the reviewer will not be penalised in any way, unless there is clear evidence of collusion.
If we find significant differences, we may provide advice about this to both parties. However, we recognise that this is not a precise science – the key outcome is to help osteopaths to conduct discussions in a way that supports and enhances practice.
The peer is not a ‘judge’. A peer cannot fail an osteopath. The peer is merely confirming engagement with the scheme.
The GOsC will continue to audit a selection of CPD evidence as we do now. But the discussion about CPD will remain in the professional sphere. We think this is important as part of the professionalisation of the profession and achieving goals of patient safety and enhancement of quality of care. This thinking is based on the Gerry McGivern’s research see http://www.osteopathy.org.uk/news-and-resources/document-library/research-and-surveys/dynamics-of-effective-regulation-final-report
Our research and our experience of the revalidation pilot (see http://www.osteopathy.org.uk/news-and-resources/document-library/continuing-fitness-to-practise/kpmg-revalidation-pilot-evaluation-report) showed that osteopaths did not show evidence of reflection to the regulator whereas they were more likely to do so with a peer.
Thus one might argue that providing a space with a peer is more likely to lead to our goal of patient safety and enhancement of quality of care – more likely than the process we currently have in place.
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