nhs education for scotland annual review 2013

Quality Education for a Healthier Scotland

NHS Education for ScotlandAnnual Review 2013


Welcome


Dr Lindsay Burley

Chair


Malcolm Wright

Chief Executive


Our vision is Quality Education for a Healthier Scotland

Our mission is to provide education that enables excellence in health and care for the people of Scotland.

Our core business is to ensure that services that are safe, effective and person centred are provided by staff who have been trained to appropriate standards, are in the right place at the right time and who are kept engaged and up to date through access to continuing development and training.

NES Vision and Mission


Consult closely with NHS Boards at an individual and regional level through our strategic engagement process to achieve a common understanding of what we need to do to support them.

Maintain strong links with UK regulatory bodies, professional bodies, Royal Colleges and other important organisations such as Health Education England.

Closer to home the Scottish Funding Council (SFC) and the Scottish Social Services Council are key partners, and we work closely with Scotland’s Colleges and Universities, Skills for Health, COSLA, and Skills Development Scotland.

NES Way of Working


Our vision is that by 2020 everyone is able to live longer healthier lives at home, or in a homely setting.

• We will have a healthcare system where we have integrated health and social care, a focus on prevention, anticipation and supported self management.

• When hospital treatment is required, and cannot be provided in a community setting, day case treatment will be the norm.

• Whatever the setting, care will be provided to the highest standards of quality and safety, with the person at the centre of all decisions.

• There will be a focus on ensuring that people get back into their home or community environment as soon as appropriate, with minimal risk of re-admission.

NHS Scotland 20:20 Vision


2020 Workforce Vision – Priority Areas

To develop and ensure:

• an integrated workforce;

• a sustainable workforce;

• a capable workforce

• effective leadership and management

• a healthy organisational culture


Implications for NES

• Improving digital education

• Providing national leadership and management

development to enable positive change

• Building improvement capacity and capability

• Improving access to education, in particular support

workers

• Providing workforce analysis, intelligence and modelling

• Developing workplace learning environment


NES Core Disciplines

MedicineNursing, Midwifery and Allied Health ProfessionalsDentistryPharmacyPsychologyHealthcare ScienceOptometryLeadership and ManagementHealthcare Support Workers


MedicineStrategy for Attracting and Retaining Trainees

Recognition and approval of Trainees

Recognition and approval of Trainers

Revalidation

Shape of Training Review

Single Scottish Deanery


Nursing, Midwifery and Allied Health Professionals


Practice Education Infrastructure

Pre-registration Nursing and Midwifery

Scottish Collaboration for the enhancement of pre-registration Nursing

Pre and post registration transition

Post registration and CPD

Family Nurse Partnership


Practice Education InfrastructureWe continue to deliver on our strategies with a key aim of getting access to education closer to practice. We have continued to build up a very strong practice education infrastructure of Practice Education Facilitators and Practice Educators supporting mentors, students and Band 5&6 nurses and midwives in direct care giving roles. Not only are we providing support for the learning environment within NHS but the PEF model is now extended to Care Homes – ensuring staff have access to education and can provide robust learning experience for students.

The Practice Educators are working within the Boards to ensure access to education around key priority areas for example, dementia, care of older people in acute care, person centred care.


Pre-registration Nursing and MidwiferyNES continues to lead the Recruitment and Retention Delivery Group, working closely with universities and NHS Boards to support a range of initiatives targeted at increasing the completion rates of students on pre-registration programmes in Scotland.

We now have robust data and a reporting system which clearly demonstrates a significant improvement in the recruitment and the retention of students on pre-registration nursing and midwifery programmes in Scotland. We are seeing a real improvement in completion rates and in the number of newly qualified nurses and midwives ready for employment in Scotland.


The Scottish Collaboration for the Enhancement of Pre-Registration Nursing (SCEPRN)

NES supports an innovative and active national group representing all the Scottish HEIs that offer pre-registration programmes. The Programme Leaders from each university are represented on the group which is supported by NES to take forward collaborative projects which have mutual benefit across the programmes.

This year NES and the SCEPRN Group hosted a unique conference led and delivered mainly by undergraduate nurses. Sessions included:

• Ways of teaching and learning • Professionalism and fitness for practice • Practice learning • Meaningful engagement with service users and careers

The keynote address, focussed on the link between career-long professionalism and the quality of care, was delivered by Professor Brian Webster, Assistant Dean at the Faculty of Health, Life & Social Sciences, Edinburgh Napier University.


Bridging Pre-registration and post registration

education for NMAHPs

• Flying Start

• Effective Practitioner


Supporting Post Registration education and CPD

Last year NES provided £500,000 to NHS Boards for community nurses and health visitors. The funding supported a range of educational opportunities linked to the early years and to health and social care integration.

The AHP Career Fellowship Scheme

Person Centred Care – Values Based Reflective Practice


Family Nurse Partnership

The Family Nurse Partnership National Unit now part of NES with the team rolling out the programme in line with the policy across.

Recent visit from Professor David Olds, founder of FNP from University of Colorado, commended the developments of the programme within NES


Support for support workers


Who are ‘support workers’?• Staff working in support roles make up more than 40% of

the NHSS workforce.

• Most working in one of 3 main areas:• Administrative services (approx 20,000)• Clinical healthcare support roles (approx 20,000)• Estates & facilities services (approx 20,000)

• Delivering very different services but overarching education issues and challenges very similar


Issues and challenges• Lack of clear definition of the knowledge and skills needed

at different levels within each area – and the type and levels of education needed to support these

• Most learning takes place in or near the workplace, but is not formally recognised, making it difficult to build on and ensure progression in learning

• Many staff may not have participated in formal learning since school, and may need additional support to participate successfully in education

• There is a need to ensure the skills of the future workforce as we move forward


NES’s approach to the issues and challenges

• Co-production: A focus on growing solutions in partnership with the service and the education sector

• Maximising the benefits of existing systems and resources: Building on and adding value to what’s already there

• Reducing duplication of effort through sharing: Developing a national resource built on local developments

• Promoting informed ‘choosing’: Ensuring that staff, managers and planners have the understanding and access to information needed to make informed choices about learning


Examples of current / recent work

RECOGNISING THE SKILLS WE NEED• Developing education pathways for estates & facilities• Using core skills maps to support PDP/R• The VQ Finder – information about qualifications for support staff

Ensuring future skills

• The Modern Apprenticeship ‘How To..’ Guide (with SDS)

• Using the Certificate of Work Readiness (in development)

Making the most of workplace learning

• RPL test projects – to underpin development of national guidance

• Development of resources to support PDP/R

• Online resources for staff groups

Supporting success in learning

• Supporting Literacies portal (in partnership with Education Scotland)

• Improve Your Study Skills programmes (with WEA)


Cross Discipline Work


CLEANLINESS CHAMPIONS PROGRAMME


Cleanliness Champions Programme

Largest unique education programme of its kind available internationally.

Programme comprises 9 learning units including topics such as the chain of infection, hand hygiene, personal protective equipment and waste disposal.

The programme content has been customised for dental services, the Scottish Ambulance Service and medical and dental undergraduates.


Where are we now?Anyone working in healthcare

can be a Cleanliness Champion

To date: • 31,500 NHS Scotland staff

registered on the programme

• 16,600 + Cleanliness Champions to date within health boards

• Approx. 2,000 undergraduate students/year.


Impact of Cleanliness Champions Programme on MRSA incidence rates

MRSA rates and cleanliness champions by quarter ; Scotland

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Cleanliness Champions

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R= -0.952


PROMOTING EXCELLENCE IN DEMENTIA CARE


Promoting Excellence in Person Centred Dementia Care and Support

Partnership between:

• NHS Education for Scotland

• Alzheimer Scotland

• Scottish Social Services Council

To develop a knowledge and skills framework for all health and social care staff


Bespoke Dementia Learning Resources

• Dementia Skilled – Improving Practice

• Informed about Dementia DVD – Improving Practice

• Promoting Excellence: Guidance for Trainers and

Educators

• Acute Care Dementia

• Dementia Care in the Emergency Department


Training Programmes

1,430 health and social care staff completed a variety of training programmes

• Acute Hospital Dementia Champions• Psychological Therapies and Interventions• Palliative Care• Support following a diagnosis of dementia


Dementia Champions


Dementia Managed Knowledge Network


Quality Improvement Education


Aims:• To provide ongoing support for development of

learning in quality improvement• To describe knowledge and skills needed to

continually improve services• To enable access to appropriate learning and

development resources

Quality Improvement Curriculum Framework


NHS STAFF (ALL)

LEAD

PRACTITIONER

NHS STAFF (ALL)

LEAD

PRACTITIONER

Kaiser Permanente Improvement Skills

Model NHS Scotland Quality Improvement Workforce

Development Model

Improvement Skills Model


Quality Improvement Educational Resources E-learning modules

Internal Training courses

External Training Courseso Improvement Advisor (IHI)o Improvement Science in Action (IHI)o Lean (GE and Atos)

Collaborativeso Scottish Patient Safety Programme (SPSP)

- SPSP Fellowso Person Centred Health & Careo Early Years


NHS Scotland QI HubWeb site usage August 2012- March 2013

Quality Education for a Healthier Scotland Center for the Developing ChildHarvard University 2008


The Early Years Collaborative - Ambition

To make Scotland the best place in the world to grow up in by improving outcomes, and reducing inequalities, for all babies, children, mothers, fathers and families across Scotland to ensure that all children have the best start in life and are ready to succeed.


The Early Years Collaborative - Aims

1. A reduction of 15% in the rates of stillbirths and infant mortality by 2015.

2. 85% of all children have reached all of the expected developmental milestones at the time of the child’s 27-30 month child health review, by end of 2016.

3. 90% of all children have reached all of the expected developmental milestones at the time the child starts primary school, by end of 2017.


NES Contribution to Early Years


PoPP aims• To improve outcomes for children with significant levels of early-onset disruptive behaviour problems

• To increase workforce capacity around evidence-based parenting interventions for such children and their families

• To assist services shift towards preventive early years spending

• To promote effective early years partnership working


PoPP Dissemination Plan• Scotland-wide focus on top 10% of 3-4 years olds who show significantly elevated levels

of disruptive behaviour

• Build workforce capacity so that 1/3rd of the parents of these children can have access to Incredible Years and 2/3rds can have access to level 4 Group Triple P groups

• Health-led initiative promoting interagency delivery aligned with Local needsGIRFEC EYTF prioritiesNational Parenting StrategyMental Health Strategy

• The PoPP Implementation system augments programme-specific fidelity mechanisms within an enhanced learning scheme to ensure high quality delivery of these programmes

• The PoPP Implementation Plan adopts best practice principles from Implementation Science by integrating the development of staff competence with strength-based leadership and organisational support mechanisms


Com

pete

ncy

Driv

ers Organization Drivers

Leadership

Improved Outcomes

Sustainable

evidence-based

parenting programmes

High

fidelity

• Standardised core training

• Checklist and video-based fidelity monitoring

• Authorised supervision and consultation Accreditation data-driven

decision-making

• Intelligent targeting

• Proactive parent recruitment

• Data management

• Efficient use of resources

• Service redesign

• Dedicated staff time

• Sustainability planning

PoPP Implementation Framework

• Peer practice and learning

• Parent engagement communication skills training


NES Supporting Primary Care Workforce


• Alignment of NES CPD activities for four Primary Care Contractor Professions

• Multidisciplinary Learning and Sharing best practice e.g:Practice-Based Small Group learning (PBSGL) with GPs and Community Pharmacists and Practice Nurses

• Integration and Multi-Disciplinary working in Primary Care practice around Quality Agenda, e.g:

Patient Safety Programme Primary Care with Trigger Review and Safety Climate Survey Assessment

• Patient Safety Methodology incorporated into GP Appraisal, Revalidation and Specialty Training


• Community Hospital Improvement Network (established September 2012)

• Clinical Leadership with NES, Scottish Government Health and Social Care Directorate and Royal College of General Practitioners

• NES Primary Care Educational Network

• Integrating Human Factors Principles and Learning from enhanced SEAs in Primary Care


Practice Managers Vocational Training Scheme (PM VTS)

VTS Commenced in 2005 In 2012 VTS extended to include Dental Trainee Practice ManagersProgramme currently accredited by University of West of Scotland at Degree level – and lasts an academic yearTo date 117 GP PM Trainees and 4 Dental PM Trainees have completed the VTSCurrently 16 GP and 7 Dental PM Trainees on the programme.


Practice Managers VTS

Change Management Projects Completed in 2013 include:• Patient Education Programme for Warfarin Administration• Medicines Reconciliation following Hospital Discharge• Workforce Redesign and Staff Appraisal• Implementation of a Patient Participation Group• Texting Reminder Service to Reduce DNAs• Travel Clinic• In-house INR Warfarin Testing• Person Centre Programme for Chronic Disease Management • Developing IT in Transition to a ‘Paperless’ Dental Office.


Health and Social Care Integration


Strong partnership with Scottish Social Services Council

Reshaping Care of Older People

Carers

Dementia

Leadership Action Learning


Public Service Reform


Public Service Collaborative Learning

12 Core National Organisations

Scottish Coaching Collaborative

Leadership Exchanges

Community Planning Partnership

Talent Management and Succession Planning

and

Public Service Leadership Programme


Looking Ahead


Francis Report All doctors, whether fully qualified or in training, work inenvironments where they are under a duty to protect patients. Good practical training should only be given where there is good clinical care. Absence of care tothat standard will mean that training is deficient.Therefore, there is an inextricable link between the two that no organisation responsible for the provision,supervision or regulation of education can properlyignore. Trainees are invaluable eyes and ears in a hospital setting.”

Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry - Executive summary

.


Berwick Review

“The most important single change in the NHS inresponse to this report would be for it to become, morethan ever before a system devoted to continual learningand improvement of patient care, top to bottom and endto end.”

A promise to learn – a commitment to act Improving the Safety of Patients in England.


Development of the Learning Environment

Using feedback and sharing intelligence and data

Encourage joint working amongst Regulators


Human Factors


Human FactorsA common language

“Enhancing clinical performance through an understanding of the effects of teamwork, tasks, equipment, workspace, culture and organisation on human behaviour and abilities and application of that knowledge in clinical settings” (Catchpole 2010)

“Making it easy to do the right thing” (Bromiley 2011)

Organisational/ Management-Safety Culture

-Managers’ Leadership-Organisation communication

Work/Environment-Work environment

and hazards(ergonomics)

Workgroup/Team-Teamwork

structures & processes-Team Leadership

Individual Worker-Cognitive skills

• Situation awareness• Decision making- Personal resources

• Management of stress• Management of fatigue

(Flin, Patey 2012)


Understanding Human Thinking and Decision Making

• Cognitive Function– Clinic Reasoning/decision making– Stress and Mental State

• Non-Technical Skills– generic behavioural skills that underpin the

performance of technical tasks


Stress, Mental State and Decision Making

• Fatigue• Workload• Time pressures• Interruptions• Distractions


Non-technical skills

• Communication• Situational awareness• Workload management and prioritisation• Team working • Leadership


Developing the Organisation to Deliver


Internal Change to deliver value

Partnership working


Conclusion

• National and local

• Networked and collaborative

• Core and Cross Disciplines

• Evidence-based and quality assured

• Educational infrastructure

• Wider Public Service reform


Education and training matters…..

Training is patient safety for the next 30 years.Temple, 2010

nhs education for scotland annual review 2013

Documents

vision quality education

welcomequality education

missionquality education

healthier lives

nhs scotland

people of scotland

health education england

skills development scotland