Agenda Item 12.4 Appendix A Blue Box Item Draft The Best Place to Work (and Train) Our Education, Learning and Development Plan 2015 2020 (Refreshed February 2017) 1
Foreword I am delighted to introduce our refreshed education, learning and development plan 2015-2020 in support of the Trust goal to be a centre of excellence for specialist services, research, education and innovation and our objective to be an outstanding research and education organisation. This plan builds on the education, learning and development already in place at LTHT and describes our aspirations for the future, to position LTHT at the core of high quality healthcare education, training and development as we move towards the establishment of the Leeds Health and Care Academy. The existing relationships with academic health science networks and academic health science centres will be strengthened to further align education with research and innovation. This plan is a chapter of our broader People Strategy that will also include a series of complementary chapters that focus on our volunteers, talent & leadership, engagement and workforce planning to ensure we have the right staff, at the right time with the right skills. We will ensure that there are sufficient staff educated and trained, who are aligned to the Trust values, working in an agile way to adapt to changing service and care needs. Our ambition to be the best for specialist and integrated care will be realised when every one of our patients is cared for by staff who have received an effective induction, on-going development and the highest standards of education provision. On behalf of the Trust Board, I look forward to leading on the delivery of this plan to provide excellent and innovative education and the best possible patient safety, experience and outcomes. Dean Royles, Director of Human Resources & Organisational Development 2
CONTENTS Section 1 Setting the Context - 4 1.1 Introduction Developing the Plan - 4 1.2 - The National Context - 4 1.3 - The Evidence Base for Education - 5 1.4 - The Local Context - 6 Section 2 Our Ambitions - 7 2.1 Key Principles - 7 2.2 - Linkages to other Strategies and Plans - 8 2.3 - Our model of Education, Learning and Development - 8 Section 3 Our Programmes of Work - 9 3.1 - Learning Infrastructure - 9 3.2 - Intra/ Inter Professional Development/ CPD - 10 3.3 - Student Experience - 11 3.4 - Schools Engagement - 11 3.5 - Expanding Apprenticeship Activity - 12 Section 4 Delivering the Plan - 14 4.1 - Presenting and Promoting the Plan -14 4.2 - Roles and Responsibilities - 14 4.3 - How will we measure progress? - 15 4.4 - How will we oversee progress and review the plan? -15 4.5 - Our Education, Learning and Development Goals - What would success look like? - 15 4.6 - Progress to date - 16 Appendix 6A - Key Priorities Action Plan - 17 3
1. Setting the Context 1.1 Introduction Developing the Plan Healthcare providers are responsible for ensuring that they have the right staff, in the right place, at the right time and with the right values and behaviours to provide safe and high quality care. This includes ensuring that their staff have the right training to perform their roles efficiently and effectively. Our Trust five year plan articulates our goal to deliver leading edge innovation, achieve academic and educational excellence and expand the boundaries of healthcare. This education, learning and development plan facilitates the ambition to empower and invest in our staff and allow them the autonomy and freedom to deliver safe, effective and personal healthcare for every patient, every time. It complements the Medical Education Strategy and the LTHT Professional Commitment. Education, learning and development underpin our values and facilitates delivery of our five Trust goals. This plan complements the Research and Innovation Strategy and has been developed using feedback from stakeholders (staff, students and patients), quality assurance outcomes and national drivers. This refreshed plan is a chapter of our broader People Strategy that also includes a series of complementary chapters that focus on our volunteers, talent & leadership, engagement and workforce planning to ensure we have the right staff, at the right time with the right skills. The refreshed plan paves the way for the Leeds Health and Social Care Academy. The plan and its supporting priority work programmes has been developed through feedback from the development of the Leeds Way, engagement with key stakeholders, input from the Research, Education and Training Committee and the Trust Learning and Development group and national drivers of best practice both internally and external to the NHS. Education, learning and development is important for everyone involved in the delivery of our services - staff, students and volunteers in the organisation. This plan focuses primarily on staff and students but will align with the plan for volunteers as a further chapter of our People Strategy. 1.2 The National Context The key principles for the education and training of healthcare workers are set out in the document Liberating the NHS: Developing the Healthcare Workforce From Design to Delivery and are summarised below: greater accountability for all healthcare providers to plan and develop their workforce, whilst being professionally informed and underpinned by strong academic links; aspire to excellence in training and a better experience and outcomes for patients, students and trainees; support NHS values and behaviours to provide person-centred care; 4
support the development of the whole workforce, within a multi-professional and UK-wide context; support innovation, research and quality improvement; providing greater transparency, fairness and efficiency to the investment made in education and training. The mandate from the Government to Health Education England: Delivering high quality, effective, compassionate care: Developing the right people with the right skills and the right values sets out the need to train and retain a healthcare workforce equipped with the skills to deliver much more proactive care. The Greenaway Report sets out a new framework for the future shape of medical training in England, and will have a significant impact on the levels and kind of clinicians employed in the NHS. The Public Inquiry report by Robert Francis QC into the failings at Mid Staffordshire NHS Foundation Trust highlighted a requirement for healthcare providers to support improvements in education and training that puts quality at the centre. This plan responds to ensure that the education, training and development of the entire workforce results in patients, carers and the public reporting a positive experience of healthcare consistent with the values and behaviours identified in the NHS. In response to the findings of the review led by Don Berwick, Improving the Safety of Patients in England this plan will help ensure that there is an increased focus on delivering safe, dignified and compassionate care in the education and training of healthcare professionals. Across the NHS, there are increasing pressures to deliver clinical services in tighter timescales, which impacts training and education. At the same time, we are seeing the removal of some trainee roles, which is forcing NHS organisations to think innovatively about clinical roles. We are seeing the emergence of new roles including: Advanced Nurse Practitioners and Physician Assistants. The landscape for education and training in the NHS is changing at pace with the introduction of the Apprenticeship Levy in April 2017 and changes to the funding model for a range of pre-registration non-medical courses. This refreshed chapter responds to the reform with innovative approaches to reduce waste and deliver education and training in the most efficient way. 1.3 The Evidence Base for Education and Training There is an increasing evidence base linking the quality of education and training directly with the quality of care provided. Further, there is strong evidence that the effective use of simulation in clinical training reduces harm for patients - and results in better inter-professional team working. The role of the educator or trainer, in the context of delivering excellent education and training, is of vital importance and must be seen as an essential part of the healthcare professional s role and responsibilities. We need to ensure that trainers and educators have access to the necessary support and professional development to allow them to provide excellent education and training. 5
1.4 The Local Context Through the development of the Leeds Way, we have articulated our ambition for Leeds Teaching Hospitals to be the best for integrated and specialist care. Further, our five year plan sets out the need for strengthened education. We will only achieve these goals through engaged and appropriately educated and trained people, who embody our values. Through this plan, we will ensure that our staff and partners benefit from high quality education and training that embeds the Leeds Way into our DNA and reinforces them through continuing personal and professional development. This plan aligns with our Talent and Leadership plan and recognises the importance of personal and professional development of our staff whether they are in front-line, supporting, administrative or managerial roles. The Leeds Health and Care Academy aims to bring together health and care workers from all professions for the purposes of education and learning in pursuit of an integrated one workforce approach. This refreshed chapter describes the enabling works to support the delivering of a system-wide workforce. The Health and Wellbeing Strategy for 2016-21 describes the role of world class education and training in attracting and retaining a diverse workforce for Leeds now and in the future and sets out an ambition for a valued, well-trained and supported workforce which aligns with LTHT strategy which is presented below: 6
2. Our Ambitions Our goal is for Leeds Teaching Hospitals to be regarded as a centre of excellence for specialist services, research, education and innovation. 2.1 Key Principles Our plan is a partnership and collaboration with the wider health and education community which will move us towards our ambition to establish a state of the art facility with the creation of Leeds Health and Social Care Academy positioning Leeds and LTHT at the centre of healthcare education. By combining education, learning and development with quality improvement science and a passion for patient care and healthcare excellence into the DNA of everyone at LTHT we will attract and retain the most compassionate and caring workforce. We will work closely with the Leeds Academic Health Partnership (LAHP) and AHSN to help facilitate our contribution. We believe that as we work together we should learn and train together. This plan applies to everyone in LTHT, it is: - A philosophy: recognising the importance of education, learning and development to deliver clinical / healthcare excellence. - A commitment: to a joined up multi-professional model of education, learning and development. - An obligation to provide high quality education, learning and development for all. These principles underpin the enabling works for the Health and Social Care Academy and will be implemented by ensuring that all education, learning and development provision is: 7
Presented with clear outcomes for the learner taking into account knowledge they will already have. Contains up-to-date information. Demonstrative of new understanding and context. Designed to assist learners to review and reflect on how they can use and apply their knowledge in the work place. Collaborative in bringing together teams and individuals to learn in a multidisciplinary environment. Puts patient care at the heart of all learning and development programmes. Ultimately leading to: Improved patient outcomes and better patient care/experience. Enhanced capability and career progression for learners. Behaviours which embody the Leeds way values in the work place. 2.2 Linkages to other Strategies and Plans This plan has been developed with clear alignment to the outputs of the Clinical Business Strategies of the CSU s and the development of other complementary strategies in the Trust, in particular, the Medical Education strategy and the Professional Commitment. This plan complements the Research and Innovation Strategy and contributes to realising the potential of research and innovation in healthcare and demonstrates commitment to the UK Life Sciences growth agenda, for example by continued education and training developments for the scientific workforce and more broadly in genomics, bioinformatics and the use of data across all levels of the workforce. 2.3 Our model of Education, Learning and Development All training developed and commissioned is identified through a clear training needs analysis (TNA) based upon the workforce and organisational priorities. The training delivery is systematically reviewed for relevance, appropriateness and priority. 8
3. Our Programmes of Work To achieve our ambition and embed the Leeds Way in everything we do, we will focus on five main areas to educate and train our existing staff and professional in training in our hospitals: Delivering Education Learning Infrastructure: Induction Appraisal Mandatory/Priority Training Technology Enhanced Learning Intra/Inter Professional Development/CPD: Talent & Leadership Clinical Skills Personal Development Simulation Delivering Education and Training Student Experience: Medical & Dental Nursing & Midwifery Allied Health Professionals Clinical Scientists Schools Engagement: Work Experience Employability Expanding Apprenticeship Activity: Employability Traineeships Apprenticeships Widening Participation 3.1 Learning Infrastructure The NHS Constitution commits NHS organisations to providing staff with 'clear roles and responsibilities', and personal development' and 'line management support to succeed'. Induction, appraisal and mandatory/ priority training, IT Training and Clinical Systems are important milestones in the employee journey providing the intervention to ensure staff are supported and developed. Ensuring that staff are clear about what they are doing and why, and have the skills to do their jobs, is crucial in delivering high quality patient care. We are committed to ensuring all staff have a high quality appraisal supported with a personal 9
development plan and will continue to implement a series of actions to improve the quality of the appraisal process. Reinforcing that the safety of our staff, patients and visitors is paramount we will continue to increase accessibility to mandatory and priority training and ensure all of our mandatory and priority training provision is grounded in a robust evidence based TNA. These actions alongside continual evaluation, review and refinement will maintain and improve our mandatory and priority training performance. Ensuring that new starters have a positive experience when they join the Trust is key to staff retention. Trust Induction is a welcome for new employees, giving them a positive experience and preparing them for their new role. It provides an opportunity for new starters to be acquainted with the Leeds Way alongside the Trust values and behaviours. Obtaining and recording accurate patient data is paramount to the safety and care of our patients. Ensuring that training on clinical systems and IT Packages is available in different formats (i.e. elearning) supports staff in their ability to deliver safe patient care and enhance their digital literary. We will continue to embrace Technology Enhanced Learning and provide education in a variety of ways to meet operational constraints and learner preferences. 3.2 Intra/Inter Professional Development/CPD It is widely acknowledged that training in multi-professional groups improves team working, communication and patient outcomes. We will continue to ensure that all our staff have access to high quality, evidence based CPD and Learning Beyond Registration (LBR), particularly where it is linked to on-going registration. The Trust will commission programmes to complement externally funded and provided programmes ensuring equity of access and return on investment. Our plans for simulation are included in the Medical Education strategy. In essence, our goal is to ensure the highest quality, and most effective simulation, appropriate for the learner. Simulation ranges from low to high fidelity, and often includes human factors - especially when simulating team working. At the top end, the LIMIT Suite has a range of high to low fidelity (including cutting edge virtual reality) surgical simulators for surgeons in training. LTHT is well regarded nationally and is recognised as having an innovative strategy for achieving the best quality outcomes for patients through the active use of simulation and clinical skills. We will continue to expand and grow our clinical skills offering and seek opportunities for income generation and investment. A concordat from the National Quality Board advocates Human Factors training with a focus on optimising human performance trough better understanding of the behaviour of individuals, their interactions with each other and with their environment. We will include Human Factors principles and practices in core education and training curriculums for health professionals and managers. The Talent and Leadership plan sets out plans for an ambitious programme of management and leadership development offering development opportunities and a 10
complementary programme of personal and skills development across all professions Our programmes of work and priority areas are outlined in Appendix 6A. 3.3 Student Experience We want all learners on placement at LTHT to have a positive experience which equips them with the knowledge and skills to deliver safe compassionate care. The national tariffs in place for non-medical placements, student experience and medical undergraduate and postgraduate placements in secondary care allocate funding which provides an opportunity for both education providers and employers to work in partnership to continually improve the quality of the clinical learning environment, further enhancing the student experience. This funding will be used for developing existing clinical learning environments as well as identifying and opening up new areas which reflect the diversity of experience which future healthcare practitioners will be required to work within. The quality framework governing this funding is set out in the Learning and Development Agreement. The workforce transformational agenda and the changes to services are dynamic and on-going and continue to affect proactive planning of workforce development and education. Our models of clinical placement will be developed to accommodate increasing numbers of students required to meet the growing demand for registered staff, and to recognise the need for staff with the skills to work in a range of settings. Feedback from students and learners will inform our plan of continuous improvement to ensure we provide high quality learning environments that enhance the learning experience with appropriately qualified educators and mentors. A programme of CPD for educators will be available to support staff with an educational role to include both educational and pastoral domains. 3.4 Schools Engagement In recognising the need to have a pool of talent that is readily available to meet current and future workforce requirements our approach and procedures for work experience have been reviewed and refreshed. All work experience participants will attend a welcome event to receive an introduction to the organisation and all essential health and safety information. We are working to achieve a quality mark for our work experience programmes. Internships are available to prepare young people for the world of work. Partnerships with local schools are delivering mutual benefits and our Healthcare Career Ambassadors are available to support a range of activities supporting individuals who aspire to a career in our hospitals. Employability programmes enable people to progress towards or get into employment, to stay in employment, and to move on in the workplace. Many people who are unemployed face greater barriers than others when it comes to getting into and moving forward in the world of work. The reasons for this are often quite 11
complex, but there are a number of barriers that typically have to be overcome before people re-enter the workplace, including: low confidence and self-esteem gaps on their CV bad experiences of work lack of job references high anxiety lack of recent work experience low stamina out of date core employability skills lack of awareness of employers' expectations stigma around mental health problems We will continue to work collaboratively with schools and other agencies to open up career opportunities to encourage recruitment from across the diverse communities we serve. 3.5 Expanding Apprenticeship Activity Apprenticeships provide routes into a variety of careers and offer the opportunity to earn, learn and achieve nationally recognised qualifications at the same time combine practical training in a job with study to learn. The Trust will increase the number of apprenticeships and grow our established NHS Apprenticeship Scheme to rival the best in the country. A report from the Skills Funding Agency in March 2015 summarises the economic benefits of apprenticeships. Every apprenticeship working in healthcare brings a rise in productivity valued at 5,500. Other benefits of apprenticeships as identified by employers, include a better image in the sector, improved staff retention levels and improvement to staff morale. Apprenticeships will continue to be an integral part of our workforce plans, particularly in light of the new nursing associate role and the removal of bursaries for nursing and allied healthcare professional students. The West Yorkshire and Harrogate Excellence Centre aligned to the STP footprint is part of a larger national network across England. A central hub for employers and training providers ( associates ) who will jointly agree and develop high quality training and development solutions tailored to the needs of the locality and the current and future support staff workforce. There will be equitable access to the Excellence Centre training offer for staff regardless of health or social care employer. The Excellence Centre model provides an opportunity to expand the numbers and range of Apprenticeships across Health and Social care, thus helping employers to capitalise on the apprenticeship levy, and an option to use the National Skills Academy for Health as an umbrella training provider. 12
We will continue to expand our use of apprenticeship standards for both new and existing recruits and: Simplify career progression for those who want it with innovative new roles and pathways to promotion, including more part time higher education as a route into nursing and other registered professions. Agree with employers and education providers a universal acceptance of prior learning, vocational training and qualifications. Support talent development that identifies and nurtures people with the potential to go further, especially for those wanting to move into professional and registered roles. 4. Delivering the Plan Academy Curriculum Supporting the Delivery of Trust Strategy 4.1 Presenting and Promoting the Plan This plan will feature in the marketing and communication plan for education, learning and development which will be rolled out to ensure that all staff are aware of the education, learning and development opportunities available to them and the Trust commitment to this agenda. Existing forums will be used and new forums established to engage with staff, students and education providers. 13
4.2 Roles and Responsibilities The existing groups and committees involved in the planning, delivery and evaluation of education, learning and development strategies include (but not limited to): Research, Education and Training Committee (RET) Medical Education Sub-committee The Learning and Development Group will take responsibility for delivering this plan led by the Director of HR and OD and Chief Medical Officer and delivered by: Head of Organisational Learning Head of Nursing - Workforce and Education General Manager - Medical Education 4.3 How will we measure progress? There are a range of measures in place to measure education and learning. During 2017/18 we will set improvement targets and put the T firmly into Leeds Teaching Hospitals. We will monitor and report on recruitment to all NHS-funded courses against all equality strands and socio-economic groupings in order to demonstrate on-going improvements in levels of applications to NHS funded courses from groups that are currently under represented. We will meet our performance targets for induction, appraisal and mandatory training and deliver improvements in external surveys including the staff survey, medical education feedback reports and PPQA. 4.4 How will we oversee progress and review the plan? The delivery of the plan will be overseen by the Learning and Development Group. Updates will be provided to the Trust Board as part of the People Strategy Report and progress against specific priorities will be reported to RET. 4.5 Our Education, Learning and Development Goals - What would success look like? An effective infrastructure for education, learning and development that supports excellent patient care. Education, learning and development takes place within a high quality environment that enables individuals and teams to reach their full potential. Staff have access to appropriate job related training and personal and professional development. Ensure future professional staff are more digitally enabled and able to promote the adoption and spread of new technologies and innovation, particularly in respect of long-term conditions and their prevention. 14
Achieve a significant increase in the use of technology in the education, training and development of staff including through e-learning. The principles of equality and diversity are integral to education, learning and development and, it is used as a vehicle to will promote equality and diversity. Student support arrangements are effectively targeted to support widening participation objectives. Ensure that staff and trainee feedback is acted upon where issues relating to safety are raised. 4.6 Progress to date Ensure that all new starters have an effective Corporate and Local Induction. Evaluate Corporate Induction from a patient perspective and update accordingly. Ensure that all staff have a quality Appraisal with a personal development plan. Deliver 80% performance for Mandatory Training. Develop a series of action to progressively improve Priority Training performance. Create a plan to develop and embed Technology Enhanced Learning within the Learning and Development Infrastructure. Continue to deliver clinical systems training to meet the organisations requirements. Implemented Trust-wide evaluation of student experience. Established a multi-professional Student Forum. Delivered a programme of CPD for educators. Commissioned Human Factors training. LTHT now has 199 staff registered as Healthcare Career Ambassadors (HCCA). The HCCA 100% requests for attendance at all Leeds events. Launch of the HCCA quarterly newsletter which shows off the work our HCCA and helps to raise the profile. The work experience process has been written and available on the internet pages. Work Experience Welcome launched in Sept 2016-16 sessions - 63 individuals attended. Work experience placements have been undertaken in 49 areas. LTHT has undertaken a pilot bespoke employability programme with students from our partnership schools. All new clinical staff in Band 1-4 patient facing roles undertake the Care Certificate within 15 weeks of commencing employment. LTHT has increased the number of ACSW s.in 2015/16- LTHT employed 176 apprentices- this year this is 268. Introduction of Level 3 Apprenticeships for existing staff - 45 across clinical roles. Engagement with CSU s to plan workforce requirement and expansion of nursing roles to include Band 1-5 apprenticeship pathways. In 2016/17 we have had 390 apprentices start with us. 15
Appendix 6A Our Education, Learning and Development Plan 2017-2020 No Priority Lead Learning Infrastructure Work Stream Lead - Karen Vella KV 1 Ensure that all new starters have an effective Corporate and Local Induction. KV 2 Evaluate Corporate Induction from a patient perspective and update accordingly. KV 3 Ensure that all staff have a quality Appraisal with a personal development plan. KV 4 Deliver 80% performance for Mandatory Training. KV 5 Develop a series of action to progressively improve Priority Training performance. KV 6 Create a plan to develop and embed Technology Enhanced Learning within the Learning and Development Infrastructure. KV 7 Continue to deliver clinical systems training to meet the organisations requirements. KV Intra/Inter Professional Learning and CPD Work Stream Lead - Heather McClelland, Stuart Haines and Karen Vella 1 Embed the Leeds Way values in our internally commissioned CPD provision KV/SH/HM 2 Increase the use of simulation in teaching SH 3 Explore opportunities for income generation SH 4 Monitor access and take up of HEYH LBR provision and ensure organisational needs are met HM Student Experience Work Stream Lead - Heather McClelland, Stuart Haines and Karen Vella 1 Implement actions from PPQA and GMC assessments and other sources of learner feedback. SH/HM/KV 2 Maintain the database of educators and provide CPD and ongoing support KV/SH 3 Deliver a programme of CPD for educators SH/HM/KV Schools Engagement / Work Experience / Employability Work Stream Lead - Karen Vella 1 Implement Healthcare Career Ambassador scheme to engage with schools, colleges and potential employees KV 2 Work with partnership schools to support young people interested in a healthcare career. KV 3 Offer a range of employability programmes KV/SD/HM 4 Support work experience placements and internships working with other agencies. KV Apprenticeships Work Stream Lead - Karen Vella 1 Increase the number and range of apprenticeship opportunities to 600 in 2017/18 KV 2 Develop and promote career pathways into professional training KV/HM 16
3 Utilise apprenticeship levy for existing staff KV Evaluation and Reporting Work Stream Lead - Karen Vella 1 Ensure all education provision is subject to evaluation and review KV 2 KPI s agreed KV 3 Report KPI s and progress to RET and Trust Board KV Initials SH HM KV Lead Stuart Haines - General Manager (Medical Education) Heather McClelland - Lead Nurse (Nursing & Midwifery Workforce Education) Karen Vella - Head of Education, Learning & Organisational Development Role of the Work Stream Leads The Work Stream Leads are responsible for overseeing, reviewing and reporting on progress against the key priorities in each of the 5 work stream areas to the Research Education & Training Committee (RET). Role of the Priority Leads The Priority Leads are responsible for the delivery of the individual priority areas against agreed plans. 17