Quality Education for a Healthier Scotland
NHS Education for ScotlandAnnual Review 2013
Quality Education for a Healthier Scotland
Welcome
Quality Education for a Healthier Scotland
Dr Lindsay Burley
Chair
Quality Education for a Healthier Scotland
Malcolm Wright
Chief Executive
Quality Education for a Healthier Scotland
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
Quality Education for a Healthier Scotland
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
Quality Education for a Healthier Scotland
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
Quality Education for a Healthier Scotland
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
Quality Education for a Healthier Scotland
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
Quality Education for a Healthier Scotland
NES Core Disciplines
Medicine
Nursing, Midwifery and Allied Health Professionals
Dentistry
Pharmacy
Psychology
Healthcare Science
Optometry
Leadership and Management
Healthcare Support Workers
Quality Education for a Healthier Scotland
MedicineStrategy for Attracting and Retaining Trainees
Recognition and approval of Trainees
Recognition and approval of Trainers
Revalidation
Shape of Training Review
Single Scottish Deanery
Quality Education for a Healthier Scotland
Nursing, Midwifery and Allied Health Professionals
Quality Education for a Healthier Scotland
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
Quality Education for a Healthier Scotland
Practice Education Infrastructure
We 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.
Quality Education for a Healthier Scotland
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.
Quality Education for a Healthier 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.
Quality Education for a Healthier Scotland
Bridging Pre-registration and post registration
education for NMAHPs
• Flying Start
• Effective Practitioner
Quality Education for a Healthier Scotland
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
Quality Education for a Healthier Scotland
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
Quality Education for a Healthier Scotland
Support for support workers
Quality Education for a Healthier Scotland
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
Quality Education for a Healthier Scotland
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
Quality Education for a Healthier Scotland
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
Quality Education for a Healthier Scotland
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)
Quality Education for a Healthier Scotland
Cross Discipline Work
Quality Education for a Healthier Scotland
CLEANLINESS CHAMPIONS PROGRAMME
Quality Education for a Healthier Scotland
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.
Quality Education for a Healthier Scotland
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.
Quality Education for a Healthier Scotland
Impact of Cleanliness Champions Programme on MRSA incidence rates
MRSA rates and cleanliness champions by quarter ; Scotland
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Quality Education for a Healthier Scotland
PROMOTING EXCELLENCE IN DEMENTIA CARE
Quality Education for a Healthier Scotland
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
Quality Education for a Healthier Scotland
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
Quality Education for a Healthier Scotland
Quality Education for a Healthier Scotland
Quality Education for a Healthier Scotland
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
Quality Education for a Healthier Scotland
Dementia Champions
Quality Education for a Healthier Scotland
Dementia Managed Knowledge Network
Quality Education for a Healthier Scotland
Quality Improvement Education
Quality Education for a Healthier Scotland
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
Quality Education for a Healthier Scotland
NHS STAFF (ALL)
LEAD
PRACTITIONER
NHS STAFF (ALL)
LEAD
PRACTITIONER
Kaiser Permanente Improvement Skills
ModelNHS Scotland Quality
Improvement Workforce Development Model
Improvement Skills Model
Quality Education for a Healthier Scotland
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
Quality Education for a Healthier Scotland
Quality Education for a Healthier Scotland
NHS Scotland QI HubWeb site usage August 2012- March 2013
Quality Education for a Healthier Scotland
Quality Education for a Healthier Scotland Center for the Developing ChildHarvard University 2008
Quality Education for a Healthier Scotland Center for the Developing ChildHarvard University 2008
Quality Education for a Healthier Scotland
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.
Quality Education for a Healthier Scotland
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.
Quality Education for a Healthier Scotland
NES Contribution to Early Years
Quality Education for a Healthier Scotland
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
Quality Education for a Healthier Scotland
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
Quality Education for a Healthier Scotland
Com
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Organization D
rivers
Organization D
rivers
LeadershipLeadership
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
Quality Education for a Healthier Scotland
NES Supporting Primary Care Workforce
Quality Education for a Healthier Scotland
• 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
Quality Education for a Healthier Scotland
• 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
Quality Education for a Healthier Scotland
Practice Managers Vocational Training Scheme (PM VTS)
VTS Commenced in 2005
In 2012 VTS extended to include Dental Trainee Practice Managers
Programme currently accredited by University of West of Scotland at Degree level – and lasts an academic year
To date 117 GP PM Trainees and 4 Dental PM Trainees have completed the VTS
Currently 16 GP and 7 Dental PM Trainees on the programme.
Quality Education for a Healthier Scotland
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.
Quality Education for a Healthier Scotland
Health and Social Care Integration
Quality Education for a Healthier Scotland
Strong partnership with Scottish Social Services Council
Reshaping Care of Older People
Carers
Dementia
Leadership Action Learning
Quality Education for a Healthier Scotland
Public Service Reform
Quality Education for a Healthier Scotland
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
Quality Education for a Healthier Scotland
Looking Ahead
Quality Education for a Healthier Scotland
Francis Report All doctors, whether fully qualified or in training, work in
environments 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 to
that 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 properly
ignore. Trainees are invaluable eyes and ears in a
hospital setting.”
Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry - Executive summary
.
Quality Education for a Healthier Scotland
Berwick Review
“The most important single change in the NHS in
response to this report would be for it to become, more
than ever before a system devoted to continual learning
and improvement of patient care, top to bottom and end
to end.”
A promise to learn – a commitment to act Improving the Safety of Patients in England.
Quality Education for a Healthier Scotland
Development of the Learning Environment
Using feedback and sharing intelligence and data
Encourage joint working amongst Regulators
Quality Education for a Healthier Scotland
Human Factors
Quality Education for a Healthier Scotland
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)
Quality Education for a Healthier Scotland
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
Quality Education for a Healthier Scotland
Stress, Mental State and Decision Making
• Fatigue• Workload• Time pressures• Interruptions• Distractions
Quality Education for a Healthier Scotland
Non-technical skills
• Communication• Situational awareness• Workload management and prioritisation• Team working • Leadership
Quality Education for a Healthier Scotland
Developing the Organisation to Deliver
Quality Education for a Healthier Scotland
Internal Change to deliver value
Partnership working
Quality Education for a Healthier Scotland
Conclusion
• National and local
• Networked and collaborative
• Core and Cross Disciplines
• Evidence-based and quality assured
• Educational infrastructure
• Wider Public Service reform
Quality Education for a Healthier Scotland
Education and training matters…..
Training is patient safety for the next 30 years.Temple, 2010