Health Profession Councils` National Strategic Plan

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Health Profession Councils` National Strategic Plan
KINGDOM OF CAMBODIA
NATION RELIGION KING
Health Profession Councils’
National Strategic Plan
2015–2020
JUNE 2015
Supported by
Health Profession Councils’
National Strategic Plan
2015–2020
DISCLAIMER
This strategic plan was authored by the health profession Councils in partnership with the USAID ASSIST Project.
The views expressed do not necessarily reflect the views of the United States Agency for International Development
(USAID) or the United States Government.
Table of Contents
Acronyms..................................................................................................................................................................................................... ii
Purpose of the Document.................................................................................................................................................................1
Introduction and Context.................................................................................................................................................................1
Health Profession Councils’ Strategic Intent...........................................................................................................................2
Vision, Mission and Core Values of the Five Councils......................................................................................................3
Vision......................................................................................................................................................................................................3
Mission...................................................................................................................................................................................................3
Core Values.........................................................................................................................................................................................3
Themes and Criteria for High-performing Regulatory Bodies....................................................................................4
Stakeholders and Partners................................................................................................................................................................6
Inputs..............................................................................................................................................................................................................6
Evaluation and Expected Outcomes for Strategic Interventions...............................................................................7
Health Profession Councils’ National Strategic Plan 2015-2020.................................................................................8
Acronyms
vi
ASEAN
Association of South East Asian Nations
ASSIST
USAID Applying Science to Strengthen and Improve Systems Project
CPD
Continuing Professional Development
MRA
Mutual Recognition Agreement
USAID
United States Agency for International Development
Health Profession Councils’ National Strategic Plan
Purpose of the Document
This document has been developed for the five health profession Councils in partnership with the Human Resource
Development Department of the Ministry of Health and with the support from the United States Agency for
International Development (USAID) and its Applying Science to Strengthen and Improve Systems (ASSIST) Project.
The purpose of this document is to communicate the five Councils’ National Strategic Plan for 2015–2020 for
strengthening the system of regulation for all health professionals in Cambodia.
Introduction and Context
The Royal Government of Cambodia progressively
introduced Royal Decrees to establish the five health
profession Councils as follows:
Medical Council of Cambodia
2000
Dental Council of Cambodia
2005
Cambodian Midwives Council
2006
Cambodia Council of Nurses
2008
Pharmacy Council of Cambodia
2010
This legislation and other related legislative instruments,
sub-decrees and prakas currently provide the
framework for the establishment and delivery of health
professional regulation.
The increasing focus on the assurance of both quality
and safety of the public and private health care systems
in Cambodia has resulted in consideration of how
best to strengthen the system of regulating all health
professionals in ways that meet the needs, cultural
context and resources of Cambodia.
Another equally important driver for this reform is the
Royal Government of Cambodia’s membership in the
Association of South East Asian Nations (ASEAN).
One of the primary goals of ASEAN is to improve skill
development for health professionals so they can work in
many different countries in the region.
Three Mutual Recognition Agreements (MRAs) covering
Doctors, Nurses, Dentists are being progressed with the
objectives being to:
• Facilitate mobility of doctors, nurses and dentists
within the ASEAN region
• Exchange information and enhance cooperation in respect
of mutual recognition of doctors, nurses and dentists
• Promote adoption of best practices on standards and
qualifications
• Provide opportunities for capacity building and
education of doctors, nurses and dentists Health Profession Councils’ National Strategic Plan
1
A rapid baseline assessment was conducted in 2014
by the USAID ASSIST Project using a mixed methods
approach that included:
1.A desktop review of key laws, plans, reports and
other documents relating to the regulation of the
health professions
2. Key informant interviews with stakeholders in
Cambodia (at the National, Regional and Provincial level)
3. Gathering data using survey instruments to assess
stakeholder knowledge of regulation
4.The completion of self-assessments by members of
the five regulatory Councils
5.A rapid literature review to identify:
• The key functions of health professional regulation
• The key issues affecting the Cambodian health
sector (including relevant development in the
wider ASEAN region; and
• Smart practices to health professional regulation of
possible relevance to Cambodia.
The baseline assessment findings along with international
experiences and Cambodian stakeholder perspectives
were presented by the Councils at a two-day National
Consultative Workshop in October 2014.
The decision to strengthen the regulatory system
provides a systematic way for all the Councils to work in
partnership with stakeholders and health development
partners to address the identified issues of:
1. Weak and variable effectiveness of health profession
regulation;
2. Limited authority, capacity, structure and powers
of the health profession Councils to regulate health
professionals in Cambodia;
3. Limited connections between health profession
regulation with other quality and safety mechanisms in
the Cambodian health system.
The stepwise interactive process of the National
Consultative Workshop provided the opportunity to
facilitate stakeholders’ understanding of the regulatory
issues and the regulatory situation and to develop the
strategy content. Five key issues were prioritised from
the 20 issues identified. This resulted in 10 key strategic
objectives and 28 strategic interventions to achieve the
strategic objectives.
The health development partners and the Human
Resource Development Department of the Ministry of
Health assisted the Councils to prioritise and finalise the
Councils’ National Strategic Plan 2015-2020.
Health Profession Councils’ Strategic Intent
The Councils’ strategic intent over the next five years
is to strengthen the system for regulation of all health
professionals in Cambodia and thereby protect the
community of Cambodia by:
• Addressing issues that adversely impact on the
effectiveness of regulation of health professionals;
• Improving the authority, powers, capacity and
structure of the five health profession Councils to
regulate the health professions: doctors, dentists,
pharmacists, nurses and midwives;
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Health Profession Councils’ National Strategic Plan
• Working in partnership with the Ministry of Health,
Ministry of Education, Youth and Sports, Ministry
of Justice, health development partners and key
stakeholders to regulate the health professions
effectively;
• Enhancing the connections between health profession
regulation and other quality improvement and safety
mechanisms within the Cambodian public and private
health care systems.
Vision, Mission and Core Values
of the Five Councils
The five health profession Councils continue to remain
independent entities responsible under the law for
regulating their respective health profession. However,
the Councils have made a commitment to work in
partnership together with the Ministry of Health to
achieve the following Vision and Mission and apply
the Core Values to their actions and decisions in
implementing the National Strategic Plan.
Core Values
Vision
•Integrity
A strong and responsive system of health profession
regulation that supports safe, quality health care
services delivered by competent and registered health
professionals in Cambodia.
•Transparency
The core values underpinning the Councils’ actions and
decisions are:
•Collaboration
•Consistency
• Quality and safety
•Fairness
•Accountability
Mission
Provide the leadership and collective voice in
strengthening the system of regulation for all health
professionals (medical practitioners, dentists, pharmacists,
nurses and midwives) in accordance with the legislation
and contemporary regulatory practices and in
partnership with stakeholders.
Health Profession Councils’ National Strategic Plan
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Themes and Criteria for High-performing
Regulatory Bodies
The National Strategic Plan for 2015–2020 is based on four
features or themes identified as necessary for Councils to
become high-performing health professional regulatory
bodies to assure the safety and quality of registered health
professionals and their practice. These themes are:
1. Legislation, advocacy and responsiveness
2. Organisational and internal governance
3. Responsibilities and functions
4. External governance and public accountability
Aspects of each of these four themes have been identified
as the focus of this five-year Strategic Plan. They are
Legislation, Organisational, Responsibilities and functions
and Public accountability. A number of key criteria related
to these themes will allow for the continuous assessment
of the Councils’ performance in implementing the strategic
interventions over the next five years to address the
shortcomings of the current regulatory system.
The five-year Strategic Plan focuses on some of the
key criteria relating to aspects of the four themes that
are considered to be a priority in the next five years.
The aspects of the four themes are underlined and the
related key criteria are identified by an asterisk (*) in the
table below.
Legislation, Advocacy and Responsiveness
Implementing
Legislation
The regulatory body interprets legislation to facilitate and accommodate changing public protection needs*
Advocacy
The regulatory body routinely provides comments on wide health systems reform and change
Promotes professional issues that are congruent with protecting the public
Responsiveness
The regulatory body has processes that are consistent with those of other disciplines*
The regulatory body keeps guidance, codes, standards, competencies and rules in-step with changing expectations of
the public*
The regulatory body interprets legislation to facilitate and accommodate changing public protection needs
Organisational and Internal Governance
Board
Governance
Board members of the regulatory body are subject to regular performance appraisal
Clear criteria and the necessary competences for the selection and appointment of senior officials and board
members are available
Induction processes are in place for new board members
Business
Processes
The regulatory body collaborates with other regulatory agencies to minimise administrative burden and maximise the
use and impact of data*
The regulatory body has mechanisms to align their accreditation systems with other agencies while continuing to fulfil
their mandate
The regulatory body develops guidance and rules that are supportive of health systems change*
The regulatory body uses new technology to streamline business and regulatory processes*
The regulatory body has mechanisms in place to detect and deal with fraudulent applications and requests for verification*
The regulatory body has in place disaster recovery procedures and processes
The regulatory body has adequate resources to enable all responsibilities to be fully discharged*
Reporting lines are clear and reports are comprehensive and timely
All committees have explicit, regularly reviewed terms of reference, and the activities of the committees are
reported regularly to the full regulatory body
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Health Profession Councils’ National Strategic Plan
Quality
Improvement
The regulatory body identifies and promotes best regulatory practice
The regulatory body has access to relevant expert advice to support its decision-making processes*
Emergent trends from the outcomes of the conduct and competence process are used to inform revisions of
standards and requirements for continuing competence
The regulatory body routinely examines a sample of completed continuing competence evidence from health professionals
The regulatory body monitors its performance and seeks to continually improve the time taken to deal with fitness
to practice allegations
External Governance and Public Accountability
Accountability
The regulatory body is held to account for its performance
The regulatory body has clear set of performance measures that are reported regularly
While there may be multi-stakeholder input to development of standards, codes, scopes of practice policies and procedures,
their application is free of inappropriate influence by government, the profession or other interested parties*
The regulatory body acts in a manner that maintains the confidence of the public, professionals, employers and other
key stakeholders
The regulatory body has a strategic plan with linked operation objectives that are regularly reviewed and updated*
Transparency
The regulatory body has a set of clearly defined and publically available operating procedures
The regulatory body has a balance between lay and professional members
The regulatory body provides clear and succinct information on their responsibilities and process to registrants and
the public*
There are clear appeals processes that can be pursued if the decisions or the actions of the regulatory body are
thought to be unsound
All decision making is transparent, documented and accessible to the profession and the public
Collaboration
The regulatory body engages and consults key stakeholders in the development of policy and standards.*
Responsibilities and Functions
Competence
and Conduct
Continuing competence procedures are in place that use data from multiple sources*
The regulatory body maintains independence in resolving allegations and complaints*
Clear, accessible and well-publicised complaints procedures are readily available
The regulatory body has standards of performance in relation to dealing with the receipt, acknowledgement,
Investigation and resolution of fitness to practice complaints and allegations*
The regulatory body has an impartial approach in dealing with allegation both with regard to complaints and registrants*
An adequate range of meaningful sanctions for non-observance of the standards and non-compliance with codes of
conduct is available*
Registry
Integrity
The register is accurate, comprehensive and readily accessible by the public, the registrants, employers and any other
interesting parties*
The regulatory body ensures that only persons who meet stipulated criteria for licensure can practice as a health
professional
Registration renewal procedures are efficient and effective*
Ethics and
Professional
Behaviour
Promotes registrant behaviour that is reflective and self-regulatory*
Standards and
Education
The regulatory body ensures educational programs are aligned with the competencies required by registrants for
fitness to practice
The regulatory body develops and promotes sound ethical and conduct codes*
Professional standards and competencies are developed and set in collaboration with educational providers,
employers, professional organisation and the public
Mobility
Processes relating to health professionals wishing to migrate into or emigrate from the jurisdiction are efficient and effective*
Health Profession Councils’ National Strategic Plan
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Stakeholders and Partners
These include:
• Ministry of Health
• Ministry of Education, Youth and Sport
• Ministry of Justice
• Education providers (public and private)
• Employers – public and non-government organisations
(not-for-profit and for-profit)
• Professional associations
• Health professionals
• Representative community organisations
• The people of Cambodia
• International health development partners
Inputs
The inputs for each strategic intervention will vary;
however, they will be drawn from the following:
• Financial, human and physical resources: Royal
Government of Cambodia; health development
partners; health professional fees
• Relevant departments of the Ministry of Health, Ministry
of Education, Youth and Sport and Ministry of Justice
• Technical experts - local and international
• USAID ASSIST Project
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Health Profession Councils’ National Strategic Plan
Evaluation and Expected Outcomes
for Strategic Interventions
Both quantitative and qualitative key performance
indicators will be identified for each strategic intervention
to measure the progress and success of each strategic
intervention in achieving the strategic goal.
It is envisaged that many of these key performance
indicators will be developed in partnership with
stakeholders for each of the regulatory and business
functions. It will also provide a mechanism for ongoing
assessment of the performance of the Councils in the
delivery of a cost effective, efficient and quality regulatory
service for all health professions.
The Strategic Plan and associated work will be reviewed
regularly by the Councils to:
• Assess the progress of the action plan for each
strategic intervention and to reflect changing needs
and priorities;
• Ensure continued alignment with the five health
profession Councils’ shared vision, mission and values;
• Ensure it complements each Council’s existing
legislative mandate to effectively regulate their
respective health profession and thereby protect the
people of Cambodia.
Health Profession Councils’ National Strategic Plan
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Health Profession Councils’ National
Strategic Plan 2015-2020
THEME
STRATEGIC GOAL
STRATEGIES
Legislative Review
and Reform
Goal 1: Review the existing laws for
all Councils and prepare amendments
or develop a new law for all health
profession Councils to meet the current
and future needs of Cambodia
• Review of existing laws and preparation of a legislation plan to guide
development of amendments and/or a new health profession law for
all Councils that ensures all the required regulatory provisions are
addressed at the appropriate level of the law
• Design and prepare legislation for health professions’ regulation at
the appropriate level of the law through a consultative process with
key stakeholders
• Guide the passage of the new law through the legislative process
including the Ministry of Health, Council of Ministers and the
National Assembly
Organisational
Redesign
Goal 2: Fully implement the
amendments or a new health
professions’ law
• Establish and monitor the implementation plan for the
amendments or a new health profession law
Goal 3: Review and redesign the
Councils’ structure to build capacity
to establish and maintain effective
and efficient regulatory systems and
processes
• Review the structure and operations of all Councils and design
appropriate structures and systems that are transparent and
meet the needs of Cambodia
• Disseminate the new health professions’ law through workshops
and other communications to health professionals and relevant
stakeholders
• Review possible models of international regulatory bodies and
work through a consultative process to consider options and
develop an appropriate workable model
• Councils to have in place a sustainable business model that can
mobilise resources for efficient and effective health profession
regulation by 2016
• Creation of a joint secretariat or executive committee that
comprises representatives from all Councils to provide a single
voice for health profession regulation in Cambodia; resolve
problems; and support the Councils’ regulatory work and
business requirements, including a shared office and staff
• Development of guidelines to review and define the roles and
responsibilities of each health profession Council at every level
(national, regional and provincial) and for implementation
• Development of annual action plans with review of progress and
achievements at 6 monthly intervals
• Development of effective tools for monitoring and evaluation
Responsibilities and
Functions
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Goal 4: Achieve full compliance with
registration requirements and full
awareness amongst stakeholders and
health professionals of registration
requirements and obligations
Health Profession Councils’ National Strategic Plan
• Review level of compliance with existing laws; identify and
prioritise gaps and any immediate changes required to the
laws and interim administrative solutions to manage gaps in
registration
• Develop a system and process for dissemination and
implementation of the existing laws at all levels throughout the
country to all health professionals, health care facilities (national,
regional, provincial) and other stakeholders
THEME
STRATEGIC GOAL
STRATEGIES
Responsibilities and
Functions (Cont.)
Goal 5: Review and further strengthen
the level of health professionals’ ethical
behaviour in the delivery of patient
care
• Conduct investigation and research to evaluate (1) client
satisfaction with health professionals and service providers and
(2) whether there is compliance of health professionals with the
legislation and code of ethics
• Conduct dissemination forums to health professionals on the
code of ethics for their health profession
Goal 6: Review and further strengthen
health professionals meeting the
minimum requirements for professional
competence to practice, including
continuing professional development.
• Develop tools to assess the competence of health professionals
registered with Councils and assess when the health professionals
apply for renewal of registration
• Health profession Councils provide de-identified data to the Ministry
of Health to inform the national health workforce development plan
• Councils work with the Ministry of Health, Ministry of Education,
Youth and Sport and education providers to set standards for preservice education to ensure graduates achieve minimum competence
• Establish a framework and guidance for continuing professional
development and ensure that every health professional completes
continuing professional development (CPD) to maintain the
minimum standard of competence
Goal 7: Disciplinary action to be
taken against all registered health
professionals that do not comply with
the laws, regulatory policy, or codes
and standards of professional practice
• Establish disciplinary categories and process for investigations and
non-compliance (e.g., warnings, fines for delays in payments and
infractions, legal action, removal from register for a designated
period of time or cancellation of registration)
• Establish and implement complaint and disciplinary procedures
including disciplinary committee to assess and determine
misconduct behaviours
• Develop reporting and follow-up systems to monitor and
evaluate the improvement progress
• Ensure the clear separation of roles and responsibilities for the
health profession Councils and the professional associations,
particularly in relation to the complaints and disciplinary function
Public Accountability
Goal 8: Monitor health professionals’
practice to ensure quality of health care
• Develop and implement a mechanism for the regular monitoring
of registered health professionals to ensure the quality and
effectiveness of their professional practice
Goal 9: At least 90% of the public know
they need to seek care from registered
health professionals and how to make a
complaint against a health professional
• Disseminate information to the public about:
- The importance of registered health professionals in providing
quality and safe health care
- How to identify a registered health professional
- How to make a complaint against a health professional
Goal 10: 100% of health professionals,
and all relevant organisations delivering
health care services (international,
non-government, Associations and
private and public employers) are
aware that health professionals need
to be registered to practise and their
professional obligations once registered
• Disseminate information to health professionals and all relevant
organisations delivering health care services (international, nongovernment, associations and private and public employers)
about their obligations and:
- The importance of registered health professionals in providing
quality and safe health care
- How to identify a registered health professional
- The professional obligations of health professionals
- How to make a complaint against a health professional
• Integrate information into pre-service education for students of
the health professions
Health Profession Councils’ National Strategic Plan
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