End of CPD: Myth or Reality in the Continuing Education Landscape for Healthcare Professionals?
The question of the "end of CPD" (Continuing Professional Development) is stirring up the healthcare world following the IGAS report. While CPD has been in place since 2009, its effectiveness and suitability to the needs of healthcare professionals are regularly questioned. The introduction of the Complementary Professional Development (CP) program, initially intended for medical professions but extended to seven regulated professions, has raised questions about the sustainability of CPD as it currently exists. This article aims to explore in depth the factors fueling the question of "the end of CPD," drawing on information from official reports and reflections on the future of continuing education in the French healthcare sector.
The current CPD system: a system at a crossroads and its weaknesses
Continuing Professional Development (CPD) was established with the aim of maintaining knowledge and improving the professional skills of the twenty-eight healthcare professions defined by the Public Health Code. Managed since 2016 by the National Agency for Continuing Professional Development (ANDPC), a Public Interest Group (GIP) comprised of the State and the national health insurance system, the Continuing Professional Development (CPD) program aims to finance the training of self-employed professionals and employees of health centers, representing approximately 453,800 people.
However, despite its ambition, the CPD program faces significant criticism and has not fully achieved its objectives. A major finding is the low number of practitioners who have fulfilled their CPD obligation. During the 2020-2022 period, only 5% of professionals subject to this obligation complied. This alarming figure highlights the difficulties encountered by the program.
Several factors explain these disappointing results. The National Agency for Continuing Professional Development (DPC) is criticized for having an overly restrictive interpretation of the regulations, recognizing only actions falling under priority guidelines. These guidelines, although framed by Article L.4021-2 of the Public Health Code, often fail to meet the needs expressed by professionals. Furthermore, the delegation given to the Agency to arbitrate these priority guidelines is deemed not in accordance with Article R.4021-4 of the Public Health Code, which entrusts their drafting to the State for public health guidelines and to the National Professional Councils (CNP) for the specific needs of each profession.
The high number of priority guidelines, considered excessive by the Court of Auditors (238 for the 2020-2022 three-year period and then 205 for 2023-2025), also contributes to the complexity and lack of clarity of the system. Many guidelines have garnered little or no support from professionals. Furthermore, the evaluation of CPD activities by independent scientific committees (ICS), although stipulated by Article R.4021-13 of the Public Health Code, only covers a small proportion of proposed activities due to the workload of some ICS. This situation leads to limited prior quality control of the activities. Paradoxically, the share of activities published by healthcare facilities and universities, potentially closer to skills needs, is decreasing in favor of commercial organizations, perhaps better equipped to meet the Agency's administrative criteria. Finally, the salaried workforce is virtually absent from CPD, particularly in healthcare facilities, which are sometimes even unaware of the legal requirement. Difficulties in reaching agreements between the ANDPC and the National Association for Continuing Education of Hospital Staff (ANFH) as well as the OPCO Santé contribute to this low penetration. Some professions also face a insufficient provision of Continuing Professional Development (CPD), particularly in terms of professional practice assessment (PPA), that meets their specific needs.
The Emergence of Periodic Certification (PC): A New Paradigm?
IGAS Recommendations: Towards the Elimination of Continuing Professional Development (CPD) for Certain Professions?
In a context marked by the difficulties of CPD and the implementation of PPD, the Minister of Health requested a new mission from the General Inspectorate of Social Affairs (IGAS) in November 2023. This mission aimed to examine the future of the ANDPC (National Agency for Continuing Professional Development) and the relationship between CPD and PPD.
The IGAS report, published in December 2024, makes several major recommendations concerning the future of skills maintenance and improvement mechanisms. One of the priority recommendations is the elimination of the CPD requirement for regulated professions. The mission considers that the scope of periodic certification (maintaining skills and improving practices) covers the scope of Continuing Professional Development (CPD) for these professions.
However, the report recommends maintaining the CPD requirement for professions without a professional order. The mission notes that the current scope of CPD activities offered to these professions is too narrow to allow them to fulfill their obligation. It therefore proposes maintaining a CPD requirement by adapting its content, in particular by removing the current system of priority areas, which are considered too numerous and far removed from the needs of professionals. The National Professional Councils (CNPs) would be invited to develop CPD frameworks adapted to their needs. Furthermore, it is deemed necessary to broaden the scope of Continuing Professional Development (CPD) for these professions.
To ensure overall consistency, the report recommends aligning the durations of periodic certification cycles, CPD, and accreditation for high-risk specialties to a six-year period.
Regarding funding, the mission estimates that the amount allocated in 2023 to continuing professional development, continuing professional education (CPD), and skills development for regulated professions (approximately €438 million) could be reallocated to CPD. Analysis of the average costs of CPD activities and draft frameworks suggests that existing funding could cover between 3 and 4 of the 8 mandatory paid activities over six years for regulated professions. Including non-paying activities would allow us to complete the 8 required actions.
To ensure financial sustainability, the report emphasizes the need to review the rules applied to the financing of CPD activities, in particular by harmonizing the accounting rules and limiting the unit cost of paid activities. The implementation of an individual six-year financial entitlement for each healthcare professional to fund fee-based activities is also recommended. Finally, the mission emphasizes the need to implement a post-evaluation for Continuing Professional Development (CPD) and for Professional Certification (PC), with the definition of sufficiently precise ethical and scientific standards. Implications and Consequences of a Potential End to CPD: The elimination of the CPD requirement for regulated professions, if implemented, would have significant implications for the professionals concerned and for the landscape of continuing education. For regulated professions, periodic certification would become the central mechanism for maintaining and improving skills. They would have to engage in the four modules of PC and complete a minimum of eight activities over six years. The recognition of non-remunerated activities, such as participation in multidisciplinary meetings, the preparation of structured reports, or the monitoring of quality and safety indicators, would be given greater importance. The individual "Ma Certif Pro Santé" account would play a key role in tracking completed activities, whether paid or unpaid. Professional bodies would see their role strengthened in monitoring and enforcing the mandatory Continuing Professional Development (CPD) requirement. For professions without a professional body, CPD would be maintained but adapted. The elimination of priority guidelines and the increased involvement of National Professional Councils (CNPs) in defining standards should allow for a better response to their specific needs. A broadening of the scope of CPD is planned, as well as the development of continuing professional development (CPD) offerings. The establishment of a common label for the various CPD funders is also desired.
At the funding level, the reallocation of funds dedicated to CPD from professional bodies to the CP would require rigorous management and a harmonization of funding rules. The concept of an individual financial entitlement could modify access to funding for fee-based activities.
The transformation of the ANDPC is also a potential consequence. The IGAS report considers three scenarios: its transformation into a public institution, the transfer of its resources and responsibilities to a department attached to the Minister of Health, or the transfer of responsibilities to the HAS. The scenario favored by the mission is the transfer of responsibilities to the HAS (French National Authority for Health). Finally, it is crucial to emphasize that removing the mandatory CPD (Continuing Professional Development) requirement for regulated professions would necessitate a legislative measure. The recommendations of the IGAS (General Inspectorate of Social Affairs) report must therefore be taken into account by public authorities for any potential regulatory changes. The future of continuing education: integration or coexistence of CPD and CP (Continuing Professional Development)? The future of continuing education for healthcare professionals seems to be heading towards a profound reconfiguration of existing systems. The coexistence of Continuing Professional Development (CPD) and Professional Certification (PC), with distinct objectives and methods depending on the profession, could be a transitional phase before further integration. The IGAS report highlights the need for a new, unified organizational structure for PCD and CPD. Transferring the responsibilities of the ANDPC (National Agency for Continuing Professional Development) to the HAS (French National Authority for Health) is presented as the preferred scenario. The HAS would then play a leading role in defining guidelines, evaluating standards and actions, in conjunction with the CNPs (National Professional Councils). A specialized HAS commission, incorporating the current CNCP (National Council for Professional Certification), could be created to oversee PCD and CPD. Streamlining the systems is a priority, with the elimination of mandatory CPD for regulated professions and its maintenance, in an adapted form, for others. The harmonization of training cycle durations and funding rules is also essential. The individual "Ma Certif Pro Santé" account is destined to become a central tool for managing continuing professional development (CPD) activities and potentially continuing professional development (CPD). Its development must take into account strategic changes and the recommendations of the IGAS (General Inspectorate of Social Affairs) mission. The DGOS (General Directorate of Healthcare Provision) is identified as the strategic leader of this transformation, in conjunction with the ANS (Digital Health Agency) as the operational leader. A new set of specifications for individual accounts will need to be established.
Broad and consistent communication with healthcare professionals is essential to support these changes and ensure a good understanding of the new systems.
Finally, implementing an impact assessment of the systems on practices and patient health is crucial, given the significant public spending dedicated to continuing education.
Conclusion: Navigating the Future of Continuing Education for Healthcare Professionals
The end of CPD does not necessarily mean the complete disappearance of the concept of continuing professional development, but rather a significant evolution of the continuing education landscape for healthcare professionals. Healthcare professionals in France. The emergence of periodic certification for regulated professions, combined with the observed limitations of the current Continuing Professional Development (CPD) system, paves the way for a reconfiguration of the existing systems. The recommendations of the IGAS (General Inspectorate of Social Affairs) in favor of eliminating the CPD requirement for regulated professions and adapting it for other professions represent a potential break with the current system. The increased role of National Professional Councils (CNPs) and professional bodies, the recognition of non-remunerated activities, and the implementation of an individual account are key elements of this transformation. While the end of Continuing Professional Development (CPD) as we know it seems to be looming for some professions, it reflects a desire to create a more coherent system, better adapted to the needs of professionals, and potentially more effective in terms of improving practices and the quality of care. The future of continuing education will likely involve a gradual integration of CPD and Continuing Professional Development (CPD), potentially under unified governance around the French National Authority for Health (HAS). The coming years will be crucial for implementing these changes and defining the future of continuing education for healthcare professionals.
