This page summarises our findings from reviewing education providers and programmes in recent years.
It provides our view on interprofessional education (IPE), including our regulatory requirements, and what we commonly see in programme delivery.
This information should be considered by education providers when developing new and existing programmes, linked to this area.
Our threshold requirements
- learners are able to learn with, and from, professionals and learners in other relevant professions (SET 4.9).
We expect to see that learners are prepared to work with other professionals and across professions for the benefit of service users and carers.
Good IPE can develop learners’ ability to communicate and work with those outside their own profession, ultimately improving the environment and quality of care for service users.
When we revised our SETs in 2017, we added this requirement and it became effective for all education providers from September 2018. We assessed how education providers had embedded IPE into their programmes via the annual monitoring process in our previous education quality assurance model, and decided that all programmes met our requirements. That review focused on the programme level, in line with the requirements of our previous model. Reviewing through our current model has enabled us to consider IPE at the institution level, which lends itself to better consideration of IPE approach, (which is by nature, cross programme).
IPE in training is integral to the delivery of our standards of proficiency (SOPs), where learners are required to demonstrate knowledge, skills and behaviours such as:
- identify the limits of their practice and when to seek advice or refer to another professional or service (SOP 1.1);
- make and receive appropriate referrals, where necessary (SOP 4.4);
- work in partnership with service users, carers, colleagues and others (SOP 8.1);
- recognise the principles and practices of other health and care professionals and systems and how they interact with their profession (SOP 8.2);
- understand the need to build and sustain professional relationships as both an autonomous practitioner and collaboratively as a member of a team (SOP 8.3); and
- contribute effectively to work undertaken as part of a multi-disciplinary team (SOP 8.4).
Summary reflections
Most education providers have good IPE in place, which positively impacts on learning linked to the SOPs. IPE is generally at its strongest when it is considered as a key part of institution or division strategy, meaning it is properly integrated in programme delivery and quality enhancement. It is generally at its weakest when it is seen as a supplementary initiative added to programmes. Education providers delivering a small number of health or care professions often need to work harder and think differently to embed IPE when compared to education providers delivering multiple health and care professions.
Some education providers are less developed than we would expect, and are not able to sufficiently articulate their approaches in line with our requirements. This can be impacted by education providers finding it difficult to articulate how their IPE functioned, or difficulties in reflecting on developments and challenges in this area.
Where there are gaps in this area, education providers are often aware of these gaps, and were working on developing their IPE to improve, and we will follow up with education providers through future reviews where required.
Education provider approaches
Education providers normally have IPE leadership, policies, and procedures in place, which described the approach and methods used to enable learners of different programmes and from different professions to learn with and from each other.
There are many examples where IPE is well structured into programme delivery and assessment. For example, delivery of sessions about multi-disciplinary teams by staff with different professional backgrounds, multi-professional learner groups discussing case studies, and structured assessments focused on multidisciplinary team situations.
Working with professionals and learners from other professions in practice-based learning can be a part of good IPE, but this only works when the education provider adequately prepares learners and practice educators, and ensures learner reflection about interprofessional engagement.
There are often strong IPE practices at education providers delivering several allied health professions which are sat within the same administrative division. These divisions often have overarching IPE leadership, policies and procedures. Many education providers have a lead role for IPE, and there is lots of good practice such as IPE embedded into learning outcomes.
Education providers delivering one health or care profession need to work harder and think differently to embed IPE when compared to education providers delivering multiple health and care professions. This does not apply to just HCPC-regulated professions – education providers delivering non-HCPC-regulated professions such as nursing, pharmacy, or teaching (as examples) find it easier to embed IPE into programme delivery. This is due to the education provider being able to control engagement activities between different professional groups, such as timetabling and staff deployment.
Portfolio-based routes ensure learning with and from others as part of portfolio requirements, rather than through direct learning. This is acceptable within our standards for this model of learning.
Some education providers refer to external organisations, frameworks and initiatives which enable and support IPE, such as:
- the Centre for the Advancement of Interprofessional Education;
- professional body expectations;
- the Heart and Sole movement, especially relevant to chiropodists / podiatrists and physiotherapists within HCPC professions; and
- Schwartz Rounds which “provide a structured forum where all staff, clinical and non-clinical, come together regularly to discuss the emotional and social aspects of working in healthcare”.
We consider it helpful when education providers use external frameworks and work with other industry bodies, as this shows they are considering good practice when developing their own approaches. This enables new thinking and ideas to inform education provider initiatives.
Education providers for commissioned programmes in Wales are held to Health Education and Improvement Wales requirements that IPE contributes to 20% of the curriculum.
When proposing new programmes, education providers aligned new programmes to existing strategies, policies and processes, and considered how new professional groups could contribute to IPE or other professions they already deliver.
Current sector focus and challenges
A common problem in the delivery of IPE is the logistical challenge of aligning timetables to facilitate engagement.
There are weaknesses in IPE, identified by education providers through internal and external reviews. In these instances, education providers take ownership of improvements. For example, some education providers identified that learners engaging with a broader range of professional groups would be beneficial. In these cases, education providers identified other relevant professions from different divisions within the education provider, which might not be naturally aligned within their school or faculty, for example speech and language therapists working with teachers or educational psychologists.
There are several common pitfalls in education providers’ approaches to embedding IPE:
- ‘chance encounters’, rather than structured engagement, with other professionals or learners without supporting structures to ensure learners are learning ‘with and from’ others, as required by our standard;
- learning about other professions within academic sessions without the involvement of those professions;
- learning about cross professional areas alongside other professions, rather than engaging with them;
- for some education providers, particularly those who deliver one profession, those with portfolio-type routes, or where practice learning is identified by the learner, there can be a reliance on learners identifying their own opportunities for IPE within practice, and this being reflected upon. If properly managed, this could meet regulatory thresholds, but close management is not always a feature of these arrangements – we followed this up with education providers and set further requirements to ensure this area was addressed, where required; and
- perception or presentation by education providers, and / or understanding by learners, that IPE is not a ‘core’ activity – this incorrect assumption is often strengthened by (at least some) IPE activities being optional rather than mandatory.
Some education providers utilise (and help develop) skills of learners outside of health and care professions, such as drama or theatre studies programmes providing actors for role play sessions, film students making films to be discussed by learners in interprofessional sessions. This requires good preparation of others and quality control of materials, to ensure positive impact on the learning of health and care learners. However, this is not an example of interprofessional education in professions relevant to HCPC professions (as required by our standard).
Areas commonly explored further through our assessments
Normally we explored areas further when we IPE practices were underdeveloped. Understanding these difficulties, we were satisfied that all education providers continued to align with our IPE standard, but recognised the planned developments and will consider these moving forward in future assessments.
Where gaps remained, we set expectations for education providers to improve in the short term or as part of their next portfolio submission, and this was considered in review periods we established through assessment outcomes.
We also made suggestions through assessments where it was appropriate for us to do so, for example, where single profession education providers could find collaboration opportunities with other regional education providers.
Proportion of performance review assessments with quality activities / referrals
Interprofessional education:
Quality activities
Referred to performance review
Referred to focussed review
Baseline - all quality activities/referrals:
Quality activities
Referred to performance review
Referred to focussed review