By Jane Cooper & Jean Thompson, Talking Health Network, www.talkinghealth.org.
It is almost 20 years since Stanford University self-management programmes were first utlilised by voluntary sector organisations in the UK. Over this time staff and volunteers have developed a wealth of knowledge and expertise about the best way to develop, market, and implement Stanford programmes. In 2001 a coalition of organisations (across the NHS and third sector) and people living with long-term conditions initiated a process to develop Ss2Q, a quality assurance framework for the systematic development and implementation of the Chronic Disease Self-Management Course (CDSMC) and other Stanford programmes (www.selfcareconnect.org.uk). More recently, Stanford University has published a series of fidelity manuals that provide guidance to those responsible for developing and implementing Stanford small group programmes. (www.patienteducation.stanford.edu/licensing/implementation).
Both Ss2Q and the Stanford fidelity manuals aim to support the provision of ‘quality’ community courses for people living with long-term conditions. Stanford defines programme quality or ‘fidelity’ as they call it, as the extent to which staff, Leaders (Tutors), Trainers and Coordinators follow the programme as written by the developers. By doing this the desired outcomes of the programme are obtained and unintended effects for participants and Leaders are avoided. The focus of Stanford fidelity is therefore to protect the integrity of the way in which the content of the manual is delivered. However, they recognise that fidelity can cover every aspect of the programme including implementation, recruitment of Leaders and Trainers and gathering feedback. Earlier this year Stanford placed their fidelity documents on the patient education website to be available for downloading (www.patienteducation.stanford.edu/licensing/implementation). There are three documents available; the Implementation Manual which provides guidance on developing the CDSMC and any other Stanford small group programmes. The Fidelity Manual which sets out the ‘must do’s’ and ‘nice to do’s’ when developing and running programmes, and the Fidelity Tool Kit which contains a check list of all the ‘must do’s’ and sample documents to support organisations to adhere to standards within the fidelity manual. Unlike in England, there are no plans to introduce independent audit of providers working within the Stanford fidelity requirements.
Ss2Q is more expansive. In addition to looking at what is needed to recruit, train and support people to deliver courses, Ss2Q concentrates on the requirements for an effective Coordinator, it looks at how the programme is managed, and on the importance of gaining support both internally and externally to develop sustainable programmes. Most importantly, Ss2Q has an explicit focus on ensuring that people living with long-term conditions are involved in all aspects of management, design, delivery and evaluation of programmes. Organisations working within Ss2Q are asked to self assess their practice against a series of quality indicators and collate evidence in a portfolio to demonstrate compliance. According to the answers the programme will be ranked at one of three levels; Minimum, Intermediate and Advanced. Just like the community courses, action planning is used to help organisations identify small steps to achieve their overall goals, and just like the CDSMC tutor and trainer manuals the content of Ss2Q has been developed based on feedback from those involved in front line delivery. Since its publication in 2007, Ss2Q has become the quality assurance framework of choice for organisations delivering Stanford programmes in England. Next year organisations will be able to demonstrate independent verification of their programmes through the Ss2Q Certification Scheme currently being developed by the Quality Institute for Self Management Education and Training (QISMET www.qismet.org.uk).
It is essential that Tutors, Trainers and Coordinators are aware of this best practice wherever they are in their journey so that they can ensure that the courses they deliver to people living with long-term conditions in their local communities are the very best they can be. That is why the National Register has teamed up with the National T-Trainer Network, QISMET and the Talking Health Network to make available an overview of respective quality assurance and fidelity requirements of Ss2Q and Stanford University. The document called From Stanford to Ss2Q details the respective quality documents, signpost to where they can be downloaded and most importantly highlights the additional requirements of Ss2Q in comparison to Stanford. This is especially important for organisations travelling to Stanford to attend Leader/Master training events who also want to work within the Ss2Q quality framework.
Click on the following link to download your free copy of Stanford to Ss2Q - Essential Information for Tutors, Trainer and Coordinators in England: A comparative overview of the respective fidelity and quality assurance requirements of Stanford University and Ss2Q. In addition you can also download the Tutor Competencies.