How can we maintain good apples?

The Professional Standards Authority (the Ofsted of healthcare regulators) has commissioned research into professional boundaries and sexual misconduct. It is important to understand the risks in these areas in order to maintain professional standards. GOsC has been working on research into boundaries with the Chiropractic council, recognising this is a high risk area for complaints.  

This article will discuss the PSA reports and as the GOsC boundaries work develops we’ll discuss that in a future newsletter. From recent courses I’ve run it has been highlighted that these are important issues to discuss more openly to help raise and maintain standards so hopefully this might be the start of a useful conversation. 

What has the PSA research found?

This research comes from data from the NMC, GMC and HCPC. 

  • 88% of perpetrators are male 
  • Females tend to have multiple incidents with a single target whereas males have repeated incidents with multiple targets. 
  • Targets maybe patients or colleagues 
  • 49% of cases involve vulnerable patients 

The moral mindset: denial is common and also diffusing responsibility. 

It is suggested that training and raising awareness are important. There may be increased risks for misconduct such as toxic workplace environments, long working hours, under staffing, bullying, hierarchical culture and little supervision. 

What type of apple are you?

Another piece of research recognises three types of perpetrator:

The ‘bad apple’ – an individual operating as a sole agent and motivated by self-gain 

The corrupting barrel – individuals whose moral compass is skewed by working in an organisation where misconduct is seen as the ‘normal’ or accepted way to behave 

The depleted barrel – individuals who are worn down by stress/strain either at work/at home (or both), feel undervalued and overworked and misconduct can then occur through omission/error 

In osteopathy perpetrators of sexual misconduct are also predominantly male and more particularly those who have been qualified more than 10 years. Looking at the apple and barrel descriptions we can see the relevance of the ‘bad apple’ and ‘depleted barrel’. Bad apples may be more the challenging cases to prevent – what could be done? 

Depleted barrels are probably very significant in osteopathy. Many practitioners don’t take enough holidays, working in isolation can lead to a lack of outlet for stress from patient interactions, being self-employed and trying to maintain a thriving practice can be stressful, increasing tiredness and long-term stress can affect your professionalism. 

Local communities of practice are one effort to reach out to depleted barrels – are you a member of yours? What else can be done? 

Do you need a break? Is it time that you took a holiday? Do you need to talk through things with a colleague? What do you think would help you? 

Send me a message or join in the discussion on Facebook.  It would be great to hear your thoughts.

Read the documents here: 

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