Older readers may recall an episode of Yes Prime Minister in which the redoubtable Sir Humphrey Appleby was excluded from a meeting the Prime Minister was holding. Barred from entering the room, he was told that the meeting was on a 'need to know' basis only. 'But I must go in. I need to know everything!' Sir Humphrey fumed.
These days the list of what staff need to know about seems never-ending. I am not suggesting your staff, like Sir Humphrey, need to know everything that goes on in the practice but it is worth taking a moment to think about what exactly your staff do need in terms of knowledge, skills and behaviours so they can be motivated and productive members of your team.
There are, of course, key areas your staff need to know about; as we are all aware, in addition to their professional and technical skills, they need to understand how thinking changes and update themselves in areas such as cross-infection control and CPR. The General Dental Council in its core CPD requirements and the CQC make this clear as both a professional and a practice responsibility.
However, as the world changes (and our patient base too) there are other areas that need to be considered. Your staff need to know their responsibilities in relation to the protection of children and vulnerable adults, for example, and some practices may consider it prudent to make sure that their staff have some sort of disability awareness training. Grappling with the CQC outcomes has brought the Mental Capacity Act to the forefront of many people's minds and it is explicit in the outcomes it sets out that staff need to know the basics of what this is and how it might affect them. We might consider it a sad reflection on society that some knowledge and skills - such as how to deal with suspected abuse - are now a professional requirement but as the world changes so we must reconsider what the professional team member needs to know to deal with such eventualities. We are all too familiar with child abuse but how many of us are on the same lookout for elder abuse?
However, as the list of knowledge and skills required by your staff grows, it's important not to set aside some things your staff really need to know if they are going to contribute fully to your practice and its ongoing success. It is a generally accepted truth that staff are likely to be more motivated if they understand the context of what they are doing. This is why setting practice objectives and even more importantly sharing news of progress with your team is so important. The days of 'just do it and don't ask why 'are long gone. Good practice suggests that your staff need to know your practice's values and goals if you want them to behave in the right way and do the right things to help you achieve them – and they need to know them right from the outset. This is why your induction procedure is so important.
Your staff also need to know how you do things in your practice. Every practice has its own way of doing things and its own signature way of dealing with patients as well as protocols developed over a period of time. Different practices will also expect different types of behaviour depending on what culture you are trying to promote in your practice. Your staff need to know what type of behaviours are appropriate and just as important, what are not. This goes far beyond issues of patient confidentiality and the like (crucial though these things are). For example, how do you want your team to greet and treat patients? How do you want them to contribute to team working? Do you expect more senior members of your staff to coach the less experienced, and how?
It's also important to remember that what your staff need to know will vary. Alongside general training you provide to everyone, or where it's important to develop a practice-wide approach to something such as customer care, they will each have individual needs to know more or do things better. Carrying out an analysis of current job requirements in terms of skills, knowledge, and behaviour and them assessing what the individual staff member is currently capable of doing will give a unique insight into their capabilities and allow you to identify training needs.
Training staff does not automatically mean that they know what they need to know or can do what we want them to be able to do. We need to know if the training we have invested in has been worthwhile, if the objectives for the training have been achieved, and if the people being trained are now contributing more to the practice.
Throughout this article I have used the term 'staff 'but perhaps I should declare my hand here. Just as the CQC considers all who work for a practice, whether employed or self employed, to be staff, so I would argue that what I have written so far applies to all practice members, associates, therapists, hygienists, and other staff. Anyone contributing to the success of your practice needs the key knowledge and skills that you require them to have. If for some of those people you are not directly providing training, such as associates, then you need to be confident that they are undertaking this on their own account. Similarly it is a wise owner or manager that has a system in place to ensure that the temporary nurse or member of agency staff has a short and intensive induction into the ways of the practice and the use of equipment before they embark on their day's work, rather than rely on common sense or previous knowledge.
What they need to know is what you need them to know – and isn't it worth investing some time and effort in clarifying that for everyone? CODE provides a number of documents essential for planning and recording training and CPD. CODE's Clinical governance made simple encourages you to hold regular staff training meetings and use provided templates as your training records.