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Defined Specialists

Joint Board Statement 2004

Statement by the Joint Board on Defined Registration July 2004

The Voluntary Register Board has considered the report on defined registration prepared by Jenny Griffiths and Rachel Sugarman and has thought it appropriate to issue a short paper summarising the present position to help alleviate some of the existing uncertainties. The Joint Board would like to acknowledge the enormous work that went into the preparation of this excellent report.

At its meeting in March, the Joint Board agreed to proceed with the implementation of the defined category of public health specialists. At its meeting in May the detailed recommendations were debated and considered. It was decided to publish those recommendations which had been agreed and these are listed below (the numbers vary from the original report and some minor changes have been made to the text). Other recommendations will require further consideration and they will be published later (some have wider implications and require more consultation). It should be noted that this paper only refers to the portfolio route to assessment and should be linked to the wider information on the register found on the website.

The Joint Board has set up a steering group to oversee the next stages of implementation and it hopes that the first categories of defined specialists will be open by the end of the year.

Some of the agreed recommendations are essentially statements of principle and will also require further work on their detailed implementation. Some of these details will come from the work of specialists groups over the coming months.

We feel it very important that the process of registration of the defined category of specialists is essentially the same as the generalist category. One or two of the recommendations requiring more consideration will with benefit apply to the generalist category.

It is recognised that the time frame for portfolio assessment is one of the remaining concerns and accordingly, this will be reviewed at the July meeting of the Joint Board, rather than at the end of the year as originally stated.

The Register Joint Board has agreed the following recommendations with respect to the new category of defined registration.

1. The Voluntary Register should be opened for defined registration as soon as possible. Implementation need to be undertaken carefully, and kept under review by the Joint Board, to ensure continuous evaluation, the maintenance of high professional standards, and public protection.

2. Defined registration should have equivalent status to general registration, at a level similar to that of consultants in public health (medicine).

3. There should be overall equivalence status in the depth or weight of evidence of competence; the breadth of general registration should be balanced by the depth of defined registration.

4. The number of different professional groups, for whom competency frameworks for defined registration would be developed, should be limited to a manageable number.

5. The eligibility criteria should be formalised and become part of the assessment process. Once the details have been agreed by the Board these will be published and adequate notice will be given before the changes are introduced.

6. Proposed overall competency framework for defined registration

The competency framework should be based on generalist knowledge and defined application competencies as follows:

Key area 10 (ethically managing self, people and resources to improve health) both knowledge and application (knows/ knows how and shows how).

Plus knowledge (knows/knows how) across all other nine key areas of public health as specified for general registration; no competencies should be omitted.

Plus the application competence(ies) (shows how) necessary to demonstrate specialist competence in the area of expertise, such as health promotion or public health intelligence. These competencies should be derived from the general registration competencies. Some competencies will be at a higher level for the defined area of practice, and others will be at generalist level. Overall the depth and weight of evidence required to demonstrate competence must equate to that required for general registration.

7. Ensuring greater depth of competence in the defined area of practice

Professional groups will be established for each ‘defined’ area. They will work with project teams appointed by the Board to prepare the package of competencies. Each professional group will include stakeholder professionals, representation from professional organisations and relevant standard setting or registration bodies.

Professional groups should have three options when suggesting the overall package of ‘shows how’ competencies. This may include:

a) Specialist level of competence as required for general registration
b) Higher level of competence in defined area(s) of expertise
c) Omitting a competence or sub-competence entirely

The overall package of ‘shows how’ competencies must be equivalent in depth and weight to the ten key areas of practice for general registration.

8. The proposed competency frameworks for portfolio assessments developed by each professional group will be submitted to the Education and Training Committee of the Voluntary Register Joint Board for consideration, and then recommended to the Joint Board itself for approval. The Education and Training Committee will have an important quality assurance role to ensure that specialist standards are maintained, and this will be done in association with the relevant professional standard setting bodies.

9. The competency frameworks for the various professional groups for defined registration, once approved by the Joint Board should be issued to all higher education institutions as a basis for curriculum development, and to workforce development organisations and employers to influence the provision of the necessary support for defined specialists applying to the Register.

10. The registration process for the defined specialist will remain the same as registration of the generalist category of specialist. As defined registration is equivalent to general registration the fees will be the same.

a) At least one assessor should be registered as a public health specialist with the General Medical Council, the General Dental Council, or the Voluntary Register.

b) At least one assessor should come from the professional group of the defined specialist, e.g. health promotion, public health intelligence.

c) As with general registration, applicants for defined registration should be able to ‘bank’ competencies from previous applications. Assessors should have concluded that competence has been demonstrated at the required level across a whole key area.

8. Although it will be relatively uncommon, the Joint Board will explore the advantages of enabling individual specialists to be registered simultaneously as both a general and defined specialist

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