Consultation response on education and training approval standards for approved mental health professionals (AMHPs) and approved mental capacity professionals (AMCPs)

We published this consultation response in November 2022, setting out our planned approach to the development of education and training standards for AMHP courses, which we expected to implement in conjunction with the equivalent standards for the planned role of AMCP.

The previous government later postponed the introduction of the AMCP role until after the end of the previous parliament. We therefore paused work on the implementation of the education and training standards for AMHP courses while we prepared new education and training standards for BIA courses during 2023.

These standards and accompanying guidance have had input from subject experts, education providers and the relevant government departments. As part of the refinement and approval process post consultation, and in line with Section 43(2)(b) of the Children and Social Work Act 2017, we have changed a number of standards to remove duplication and align with our education and training standards.

Introduction

On 6 May 2022 we launched 2 individual 12 week public consultations, each on a set of standards that we propose to use to approve certain specialist social work courses. These courses are approved mental health professional (AMHP) and approved mental capacity professional (AMCP). The consultations closed on 1 August 2022.

This response is an overview of the consultations. It describes what we did to reach our proposals, a summary of the consultation responses, and final versions of the education and training approval standards which we now plan to implement.

As a professional regulator, our overarching objective is to protect the public. One of the ways we do this, in addition to the more familiar regulatory function of maintaining the register of social workers, is by regulating education and training. By approving and periodically re-approving courses, we are able to assure the quality of those courses. This ensures that the courses give students the necessary skills and knowledge to practice safely and effectively. We do this for all courses in England which qualify you as a social worker or as an AMHP. We will shortly be taking on the same role for AMCP courses.

Both of these specialisms are multi-professional in that they are open to other professions besides social work. The other professions are nurses, practitioner psychologists and occupational therapists (for AMHP and AMCP) and speech and language therapists (for AMCP only). To ensure consistency of oversight, we are the responsible regulator for overseeing this training on behalf of all regulators in England. We have worked with our fellow regulators - the Nursing and Midwifery Council and the Health and Care Professions Council - to make sure that our proposed standards work for all the eligible professions.

Why we developed these standards

Approved mental health professional (AMHP)

When we were established as the specialist regulator for social workers in England in 2019, we inherited a regulatory framework from our predecessor, the Health and Care Professions Council. While we introduced new professional standards and new education and training approval standards for qualifying social work courses in 2019, we gave a commitment to review and refresh the approval standards for AMHP courses in 2020.

This work was delayed by the pandemic, so we began the work in 2021, leading to the consultation being published this year.

Approved mental capacity professional (AMCP)

The Mental Capacity (Amendment) Act 2019 set out the  government’s plans for reform of the legal framework around mental capacity. One of the measures introduced by this Act was the replacement of the deprivation of liberty safeguards (DoLS) regime with the new Liberty Protection Safeguards. This included the replacement of best interests assessors (BIAs) with a new role, that of AMCPs. Having already been the responsible regulator for BIAs, we were given the role of regulating AMCPs on the same basis. This required us to start with standards for education and training courses leading to AMCP status.

How we consulted

We first discussed our proposals on AMHP and AMCP education and training standards at 3 pre-consultation workshops in 2021. These were attended by practitioners, managers, employers, people with lived experience and course providers.

The feedback from the workshops was broadly supportive of our proposals, and some helpful changes and additions were made to our initial draft standards.

On 6 May 2022 we published the draft AMHP and AMCP education and training standards on our website, alongside information detailing why we had proposed them. We offered a number of ways for people to feedback on our proposals. We:

• asked targeted questions in an online survey
• encouraged feedback by email
• held 3 public online events for each of the specialisms (a total of 6 events)

Consultation methodology 

AMHP consultation

We received 47 responses to the AMHP consultation. 34 of those were from social workers who are AMHPs or who have an interest in mental health, with 8 employers represented and 5 other stakeholder organisations.

AMCP consultation 

We received 31 responses to the AMCP consultation. 5 responses are from BIAs, 17 from employers (including 10 local authorities and 2 NHS integrated care boards), 2 course providers, and the remainder from other stakeholder organisations and social workers who did not specify whether they were a BIA.

We counted, read and analysed all responses to both consultations. All of the feedback that we received was considered and recorded, which helped us to review our proposed amendments to the standards.

What you said, and what we did

Relating to AMHP  

Continuing professional development (CPD) and statutory refresher training

Several respondents sought more clarity over the CPD requirements for AMHPs. This is not within the scope of this consultation; guidance about CPD requirements for all qualified social workers is available on our website. AMHPs themselves have, under the relevant regulations, a duty to carry out 18 hours of appropriate training during their approval period. This is currently verified by local authorities at the time of approval. We will consider whether and how we can contribute to the effectiveness of this training, and the quality assurance of it, in due course, but it is not subject to these standards.

Multi-professional profile of AMHPs

We heard a number of views that we needed to recognise more explicitly the different professional backgrounds of AMHPs and potential AMHPs. In response to this feedback we have added an additional standard (standard 1.9) which seeks to ensure that this is integrated into the course design stage by course providers.

Staffing requirements 

There were comments in both directions about the specificity or vagueness of certain standards, in particular 2.5 and the term “appropriately qualified and experienced staff”. Some respondents felt we should be explicit about the requirements here.

We considered this suggestion and understand it, but our view is that it is best addressed in guidance, which will be publishing alongside the standards once they are implemented. As the regulator we have to be careful to ensure our standards are proportionate, enabling flexibility without being too vague. We feel that the standard as drafted, especially once guidance is published, gets this balance right.

A number of respondents felt that standard 5.1.ii requiring course providers to ensure students have access to advice and support about careers including career pathways was unnecessary and more applicable to qualifying training. We agreed that this was not necessary and removed it.

Relating to AMCP

The inclusion of other professions

Some respondents felt that additional professions should be included in the eligible professions to train as AMCPs.

Any decision on adding or removing specific professions from eligibility to train and act as an AMCP will be for the Department of Health and Social Care (DHSC). Our role is restricted to regulating AMCP training and practice, regardless of (and ensuring alignment with and accessibility to) the originating profession of the role holder.

Resourcing implications

A number of respondents were concerned about the resourcing implications, especially in relation to our proposal for observation opportunities.

We recognise that all new requirements have some impact on resourcing. In our early discussions with our expert advisory group, made up of people representing practitioners, managers, employers, people with lived experience and course providers, we agreed that the term “practice observation opportunity” was an appropriate term for the requirement that trainee AMCPs should be able to engage, with the involvement of practitioners, with real world examples of the assessments they will be required to make in practice, but that it would not be appropriate to term this a ”placement”. We chose the wording deliberately in order to allow for sufficient flexibility in how this requirement is met. We will relay the concerns raised to the DHSC as it looks towards finalising the arrangements for implementation of the Liberty Protection Safeguards legal regime and the training framework for professionals at all levels, including AMCPs, which will underpin it.

Observation opportunities

Some respondents felt that the standards around observation opportunities were not tailored to the AMCP’s role as a scrutineer rather than an assessor, one of the key differences from the BIA role that precedes it.

We agree that greater detail is needed to ensure that this standard is properly applied. However, we feel that the most appropriate place for this is in the supporting guidance. We will also need to work with the DHSC to determine an approach for the earlier cohorts of AMCPs for whom opportunities will necessarily be limited or difficult to obtain while the Liberty Protection Safeguards system is in its infancy.

Breadth of lived experience

We refer in the standards to people with lived experience of social work. A number of respondents queried whether, given the multi-professional nature of both AMHP and AMCP, we should broaden this to include people with experience of social care, health and/or education.

We understand the point behind this suggestion. However, the inclusion of people with lived experience is intended to consolidate the opportunity for people who have been in directly relevant situations, as far as possible, to lend their voice to the course design and management processes. Our view is that broadening this requirement would not support or reflect this aim, and we have decided to keep the original proposed wording.

Duration of course, placement and observation opportunity arrangements

A number of respondents questioned why we do not specify a minimum length for AMCP courses. Most people who raised this linked the length of the course to the credibility and authority of the resulting qualification. However, we think a minimum course length set by the regulator would not in itself demonstrate quality. Providers might also wish to respond to the needs of local workforces by innovating with the pace and mode of delivery.

On balance, we feel that mandating a specific duration would not, in itself, produce a reliable indicator of quality. We already require providers to collaborate closely with local employers in designing and delivering courses. We feel that this is a more suitable space for course duration to be determined. Our other standards represent measures of quality that are more appropriate for our regulatory role, and we therefore decided not to add minimum course length to the final standards.

Relating to both AMHP and AMCP roles

Anti-discriminatory, anti-racist and anti-oppressive practice

Most respondents welcomed the inclusion of an explicit requirement to show how the design of the course was aligned with anti-racist, anti-discriminatory and anti-oppressive practice (standard 3.4 for AMHP and standard 4.3 for AMCP). A large number called for us to consider adding a similar requirement to the admissions standard. It was suggested that this would be a logical and effective step to strengthen these commitments among AMCP and AMHP professionals. This would also line up with some of the overall policy aims of the planned reform of mental health legislation.

We agreed and, to give effect to this we introduced a new standard – standard 1.6 for AMHP and standard 1.5 for AMCP.

"Robust and advanced" legal literacy

A number of respondents raised concerns that the term “advanced” was counterproductive. Some felt that trainees from non-social work backgrounds would be disadvantaged, since neither their qualifying training nor their professional experience was as likely to involve the same level of legal literacy as for social workers. Others argued that the purpose of the course was to take a professional with relevant legal literacy and equip them with more advanced skills in this area, and the capacity to develop further.

We agreed with these arguments and have withdrawn the word “advanced” from our admissions standards, standard 1.5 for AMHP and standard 1.4 for AMCP.

Robustness of admission standards

There were mixed views around the robustness of the admissions standards (standard 1 for both AMHP and AMCP). Many respondents endorsed the proposed standards; some felt that 1.4 and 1.5 did not fully recognise the level of knowledge and skills required for the roles (AMHP in particular).

We considered whether any change would find a better balance between stringency and flexibility, which is often at the heart of regulatory standard setting. While we did not feel that there was a better way of setting out these requirements, we will continue to monitor the effectiveness of this standard as we engage with courses. We will also set out in guidance how local course design should draw on the inclusion of stakeholders to support the robustness and richness of admissions criteria and practice, rather than solely relying on admissions standards.

Health and character

Several respondents questioned whether it was for course providers to ‘ensure that there is a thorough and effective process for ensuring the ongoing suitability of students’ conduct, character and health’. The main point raised here was that professional registration is already expected to depend on this and it would not be necessary for course providers to take responsibility for this.

We will amplify this point in guidance. We are not necessarily expecting course providers to carry out parallel processes to determine ongoing suitability; rather this standard is intended to require providers to demonstrate that they take a proactive approach to ongoing suitability - for example, by regularly reviewing students’ professional registration rather than necessarily carrying out all the same detailed checks themselves. Nevertheless, we feel that the standard as drafted is an important marker of this expectation and we have retained it in the final version.

Cross border issues

Social Care Wales asked us to make explicit reference to the need for AMHP courses to equip professionals with the necessary knowledge and skills in relation to cross border issues. We added this to standard 3.2 (AMHP) and standard 3.1 (AMCP) and will provide more detail in the guidance to these standards which we will publish in preparation for implementation.

Whistleblowing

The Professional Standards Authority alerted us to the fact that the whistleblowing standard in the AMCP standards (previously 3.5) had not been replicated in the AMHP standards. We agreed and introduced standard 5.8 to the AMHP standards and moved the equivalent standard 3.5 to 5.9 in the AMCP standards for consistency.

Minor amendments to language and terminology

We agreed to make a number of small, specific changes that were suggested by respondents. These include:

a) We have amended the accidental omission of “carers” from standard 1.5 (AMCP).

b) We moved section 4.8 of the AMCP standards to become section 2.6. We agreed that it related more to standard 2, course governance, management and quality, than standard 4, curriculum.

c) We replaced the term ‘vulnerable to’ with ‘at greater risk of’ in standard 3.4 (AMHP).

d) We removed the word ‘fully’ in standard 4.3 (AMHP) as we agreed it was redundant.

Equality impact assessment

We’re committed to monitoring the impact, and enhancing the accessibility and content, of all our services to meet our equality duties and objectives. We’ve reflected on the feedback from our consultation to assess the potential positive and negative impacts of our proposals.

We have conducted an equality impact assessment for this policy and have determined that there is minimal direct impact arising from the introduction of these standards. The standards do not apply to individuals but to course providers, and because there are a range of other standards and requirements which already apply to them (and us) under the public sector equality duty, we expect any impact from these standards to be marginal at most (though still positive).

• Standard 1.7 reads “ensure that there are equality, diversity and inclusion policies in relation to applicants and that they are implemented and monitored.”
• Standard 4.3 reads “4.3. Ensure that the course is designed in accordance with equality, diversity and inclusion principles, and fully aligned with and informed by human rights and mental capacity legislation and the principles of anti-discriminatory, anti-oppressive or anti-racist practice.”
• Standard 5.4 (as drafted) reads “Make reasonable adjustments for students with health conditions or impairments to enable them to progress through their course and meet the specialist standards, in accordance with relevant legislation.”

These are all closely aligned with the existing standards for AMHP courses, on which both these sets of standards are based and set out that courses must comply actively with the existing framework of equality legislation.

Besides these, we have included an additional line in Standard 2.3, which now reads:

• “Ensure that the number of students admitted is aligned to a clear strategy, which includes consideration of […] the availability of part-time and other flexible course arrangements to widen access wherever possible”.

This represents an additional expectation that providers will demonstrate thinking about this during the course design process. This is a minor, but proportionate, step we will take to bolster thinking about equality of access to courses.

This equality impact assessment has been undertaken and signed off in accordance with Social Work England’s responsibilities under the Public Sector Equality Duty, as set out in the Equality Act 2010.

Name: Sarah Blackmore
Title: Executive Director of Professional Practice and External Engagement
Date approved: 9 November 2022

What happens next?

AMHP

The revised and final education and training approval standards for AMHP courses can be found on our website. These are not yet in effect, which means we are not yet quality assuring AMHP education and training courses against them.

The implementation date for these standards will be summer 2025. They will then apply to all new approvals or re-approvals of AMHP courses regulated by us in England. We will publish supporting guidance to give more detail about how course providers can demonstrate that they meet the standards.

AMCP

The picture for implementation of these standards is more complex, as we await a timeline for the implementation of the Liberty Protection Safeguards. We currently expect the DHSC to publish its response to its own consultation on the new Mental Capacity Regulations and Code of Practice by the end of the year, at which point the DHSC will unveil the final version of these documents. These will then be put to Parliament for approval.

We will then need to hold a short consultation on any changes to our own rules. This will enable us formally to put into effect the new powers we will be given under the Mental Capacity Regulations to regulate AMCP courses. We will republish these standards at that point as part of the lead-up to implementation.

We will do all this in line with our approach so far, which has been to prepare and publish those parts of the Liberty Protection Safeguards landscape for which we are responsible in close collaboration with the Department of Health and Social Care’s work on the underpinning legislation. This enables us to minimise the time that we take to develop standards, instead allowing as much time as possible for course providers to prepare, receive approval for, and open their courses.

Standards and guidance

For both AMHP and AMCP, once implemented, we will publish the standards and associated guidance in the standards section of our website.

This consultation response was originally published in November 2022, before a change in Government policy delayed the introduction of the AMCP role. You can view the standards we implemented for the AMHP role and the BIA role on our standards page.