PORTSMOUTH HOSPITALS NHS TRUST LEARNING AND DEVELOPMENT STRATEGY

Transcription

1 PORTSMOUTH HOSPITALS NHS TRUST LEARNING AND DEVELOPMENT STRATEGY Providing excellent education, training and development to support the current and future workforce in delivering the best care for our patients

2 Introduction The scale, pace and complexity of change in the NHS provides many challenges for the Trust to ensure that patients receive the best care, making it necessary to constantly, learn, develop and change. The Education, Training and Development Strategy sets out how Portsmouth Hospitals NHS Trust will ensure that the workforce has the right skills and knowledge to meet these challenges whilst delivering high quality care. The vision is to: Provide excellent education, training and development to support the current and future workforce in delivering the best care for our patients This strategy will ensure that the Trust is focused on augmenting a workforce that can meet the challenges of the next five years and beyond, able to adapt to change and transfer skills into new and different roles as required. This will ensure that the Trust meets its four strategic aims to provide: Safe Safe Care Financial Health Organisational Health This strategy is crucial to enable the organisation and its staff to work across sectors as detailed in the Five Year Forward Review and supported by an action plan (appendix A), and compliments the key themes of the Trust s Workforce Strategy: Improving Productivity Investment Cost Reduction Increasing flexibility Maximising skills

3 This underpins the Trusts Strategic Aim of: Develop a reputation for excellence in Innovation, Research & Development and Education in the top 20% of our peers The aims and objectives of the Strategy are influenced by national and local health education drivers, which are constantly evolving and will require flexibility in the delivery of this strategy. These include, but are not limited to: Health Education England (HEE) Mandate/Workforce Strategy Willis Report Shape of Caring Shape of Training Talent for Care Regional Centres of Excellence for Bands 1-4 Modernising Scientific Careers Apprenticeship Frameworks Centre for Workforce Intelligence (predicts workforce shortages) Five Year Forward View Public Health Strategy Care Quality Commission Expectations Current Position The Trust has a Learning and Development Department that is multi-professional, led by senior clinicians working closely with administrative support to ensure optimum utilisation of the resources available to meet both local and national education and training priorities. All professional groups are supported both pre and post registration and the Trust enjoys an excellent reputation for the standard of training it delivers. All professional staff within the department undertake clinical, or other duties, as well as their educational responsibilities, hence are cognisant of the challenges staff face on a daily basis and can be responsive to the changing needs of the organisation and its patients. In addition all CSCs have a commitment to

4 providing education and training, either formally or informally, the Learning and Development Department support these educators to deliver high quality, effective training. Training and education is delivered in a wide variety of modes Simulation Classroom Coaching and Mentoring Training and Education e-learning Work- Based Learning (on the job) Challenges for the Future Workforce All healthcare professions are experiencing difficulties in recruitment both nationally and locally. It is well publicised that there is a national shortage of qualified nurses. This has resulted in the Trust carrying large numbers of nursing vacancies throughout the year and an increasing reliance on recruitment from EU countries such as Portugal and Spain.

5 Several medical specialities, such as Critical Care, are unable to recruit to middle grade training posts resulting in an increased use of locum and agency staff to fill medical rotas. The drive to move more healthcare staff into the community to meet the requirements of the Health and Social Care Act 2012 will see trainee and student posts (and their funding) removed from the Trust. This may further impact on ability to recruit qualified healthcare staff. The Shape of Training Review outlines a change in the training programmes for medical staff. In future doctors training will include more generalist areas with a broader knowledge of multiple complex conditions. Some specialist areas of training will be undertaken after award of certificate of completion of training (CCT) according to the need of the employing organisation. All Health Care Assistants are now required to undertake a Care Certificate before being allowed to work unsupervised. There is a need to implement and support Modernising Scientific Careers training schemes across all healthcare science professions, including requirements for registration and continuing professional development. There will be a need to implement a continuous cycle of workforce and skill mix review, developing and integrating new roles, where they add value, into the current and future workforce. The Workforce Plan for England, published by Health Education England in December 2014 (Health Education England, 2014) sets out a national plan to help build a workforce with the right numbers, skills values and behaviours to meet the needs of patients.

6 Five Workforce characteristics required for the future (Health Education England, 2014) It is recognised that the length of time it takes to train professionally qualified staff will impact on the success of the Five Year Forward Review, therefore HEE place emphasis on the need to develop existing staff to take on new or enhanced roles. Finance The introduction of Tariffs for the placement of undergraduate students (medical and non-medical) has increased competition amongst NHS, Private and Voluntary providers. To ensure that the current level of funding continues the Trust needs to maintain and improve on its reputation for providing excellent education and training opportunities.

7 Changes to the funding allocation for doctors in training, moving all salary support to 50% (previously FY1 and Higher Trainees funded at 100%) plus a placement fee to support infrastructure and education costs will impact on overall funding for the Trust. Challenge is to allocate funding in such a way as not to destabilise the CSCs who have a higher proportion of FY1s and ST3+ trainees as the new funding model greatly reduces their allocation. Reduction in external funding to support the development of existing staff. The predicted NHS funding gap will increase pressure to drive down costs whilst improving quality. This will require the development of a workforce that can take on some of the activities currently undertaken by professional staff, releasing their time to concentrate on providing complex care. Reducing the number of higher banded roles and supplementing them with bands 1 4. New roles and different ways of working need exploration, development and embedding into the organisation. The development and introduction of a new role can take up to 4 years depending on the length and type of training required; therefore there will be a requirement for pump priming in some instances. Changing Health Care Environment Five year forward review describes different models for the provision of healthcare in the future; all indicate that care will move closer to the patient and be delivered in the community. As a result the workforce of the future will not only be working in different environments, but with different types of staff. Increasing intensity and complexity of workload due to rising number and acuity of patients will require advanced practice roles across all professions and necessitate a review of cross-profession working.

8 Increase in clinical activity is making it difficult for departments to release staff for training, resulting in a high level of non-attendance. The consequences are wasted resources and staff who have not been enabled to refresh or improve their skills and knowledge. In summary the challenges for the next five years are a shortage of qualified professional staff at a time when funding is reducing and the healthcare arena is changing dramatically. The focus for the Learning and Development Department therefore must be: Providing training and education opportunities that equip staff with the skills and knowledge required to adapt to change quickly and effectively to the needs of the patients of PHT. Ensuring Registered professionals are able to access education, training and development to meet statutory requirements for revalidation and continuous professional development. Developing education pathways to support the creation of new roles and their integration into the workforce. Increasing the use of simulation training to improve the safety and quality of patient care Increase the use of technology to deliver training in the workplace, using e- learning and apps on PCs, tablet devices and smartphones. Further promote and increase the usage of the library and its resources to support the delivery of high quality patient care. Further develop quality metrics to demonstrate that the training and education delivered to staff, trainees and students is effective and impacting on the quality of patient care.

9 Develop robust processes for the effective use of education and training funding received via Health Education England. Further exploitation of income generation opportunities to support education activity across the organisation. Focus For the Future Creating Flexible Learners for the Future Increasingly staff are required to be flexible and adaptable to meet patient needs, in the future this will include working across hospital and community boundaries, delivering care multi-professionally. The provision and content of education must reflect this. Close liaison with local community health trusts and CCGs will facilitate seamless, multi-professional education and training. This will also enable the pooling and sharing of resources to deliver effective and economical training. Training will be provided in more flexible and varied ways (e.g. online such as Massive Open Online Courses) to allow continued development of the workforce as service needs change. Staff will be expected to take responsibility for their own development in partnership with the Trust. We want to develop a culture of reflective practice, encouraging the sharing of learning from the workplace with other professionals and improving practice as a result. Supporting the Development of New Roles Working in collaboration with the Clinical Service Centres (CSCs) we will contribute to the development of new and cross-cutting roles and the underpinning education and training required. This will be achieved through the commissioning and/or development of cost effective new programmes. Acting as an expert resource we

10 will support the development of Career Frameworks that ensure that staff are fit for practice as new ways of working emerge. In order to attract young people from the local community into the health service we will offer a range of training routes e.g. apprenticeships, which feed into a variety of career frameworks at all levels. Where there is no local provision of appropriate programmes we will endeavour to provide them e.g. through our Vocational Education Centre and in collaboration with other providers. We will work in close collaboration with the Regional Centre for Excellence to ensure that our Bands 1-4 staff are able to maximise the opportunities available to develop their skills. Increasing Education and Training Opportunities Through the continued review of education and training provision we will seek to enhance and optimise training opportunities. The annual training plan exercise will be continually reviewed and revised, as necessary, to ensure that the needs of all staff, regardless of role or grade, are captured. As a leading provider of healthcare education in the area we will actively market our provision, where appropriate, to other health and social care providers. We will continue to maximise learning in a safe environment via simulation to ensure our staff have the high acuity skills to meet the increasing complex needs of our patients. Programmes will be developed to incorporate feedback from both patient and student experience to ensure that patient safety and excellent care is central to learning. Providing multi-professional learning opportunities through simulation and vocational education enables the development of flexibility within the workforce putting the patient at the centre of everything we do.

11 Supporting Students and Trainees The Students and Trainees who undertake their placements with PHT are the workforce of the future. Ensuring that the learning experiences are positive will provide a good incentive to choose PHT as a place to work upon qualifying. Therefore the Learning and Development Department will work closely with all professions and CSCs to support the provision of high quality learning environments. We will also maintain close working relationships with Health Education Wessex to further develop the number and variety of student placements provided by the Trust. Embracing Learning Technologies Just as technology is changing and enhancing the way in which we work and care for patients, it is also influencing the way in which we learn. As noted earlier the increasing workload and demands on staff time makes release for traditional classroom training challenging, therefore the use of different technologies for the delivery of learning and development will increase in importance. e-learning PHT has a good record for the use of e-learning both for updating statutory and mandatory training and delivering occupational knowledge and skills. e-learning will continue to be an important mode of delivery with the Learning and Development Department working towards solutions for making it more readily available to all staff e.g. available on mobile devices. Apps The popularity of mobile apps has continued to rise, as their usage has become increasingly prevalent across mobile phone users. They are particularly useful to deliver short sharp messages to individuals or to help them retrieve information such as phone numbers or algorithms. There are a few apps developed by PHT staff

12 already in use within the Trust e.g. Micro Guide and Junior Doctors Handy App. The Learning and Development Department will actively encourage the use of preexisting apps, or the creation of PHT specific apps, where appropriate to meet learning needs. Simulated Training The Trust is very fortunate to have two well-equipped simulation training facilities run by the Learning and Development Department: TEAMS (Training Education and Assessment by Medical Simulation) and VIMARS (Victory Institute for Minimal Access and Robotic Surgery). Simulation provides staff, students and trainees the opportunity to practice and learn new skills in a safe environment and will grow in importance with the continued increase in the number of patients requiring complex treatments. PHT is well placed to grow the number of simulation courses offered to staff across the health community, improving outcomes for patients. Library and Knowledge The Portsmouth Hospitals Library Service s strategic aim is to continue to incorporate innovative ideas and technologies to further the involvement of the service in supporting the wider objectives of the Learning and Development Department and the Trust as a whole. As the Library Service evolves from its traditional concept (being a simple repository) to being an outreaching source of knowledge and expertise, it will: Continue to provide high quality, evidence based knowledge services delivered flexibly to meet the needs of an increasingly wide range of customers. Take advantage of opportunities afforded by new technologies for the benefits of our clientele.

13 Champion the importance of knowledge in delivering excellent health care, increasing the utilisation of the Clinical Librarian Service, promoting its value in improving patient care. Work closely with stakeholders and be sensitive to their changing needs. Develop closer partnerships with other organisations and benchmarking services. Offer access to an increasing range of high quality resources, sourced in the most cost effective way. Develop new resources through elearning to allow staff further access to a wide range of learning opportunities. Seek out and evaluate new opportunities to develop services. Work collaboratively with other NHS Library and elearning services to maximise resources and elearning modules available to staff. The recent publication of Knowledge for Healthcare: a development framework from Health Education England, has clarified a number of development possibilities that NHS Libraries are encouraged to work towards to transform and optimise Library services for the future. In line with these development pathways, the Library strategy will need to focus on: Proactive customer focussed services. Quick and easy access to relevant evidence. Effective leadership and planning and the development of the knowledge service workforce. Optimising investment in knowledge services. Delivering the vision: metrics for success. Leadership and Management Development To effectively deliver the Trust s clinical services strategy it is essential that organisational capability is raised in order to ensure that: Patients would choose to receive their care at Portsmouth

14 Commissioners would choose Portsmouth over its competitors in terms of commissioning services The best employees would choose to work at Portsmouth In developing the capability of the organisation it is clear that it is the workforce who will make the critical difference in delivering. Therefore the Trust will further develop and deliver its organisational development strategy focusing on the following areas: Staff engagement making Portsmouth a great place to work and learn Performance and accountability developing a culture of continuous improvement where accountability for decision making and performance is devolved to the most appropriate level Growing the talent pool ensuring that Portsmouth attracts, develops, and retains a high calibre of staff at all levels and across all professions Leadership development developing a leadership brand that ensures those with responsibility for leading services and people are equipped with the necessary skills and behaviours to succeed Values ensuring that the right values and behaviours are evident in everything we do.

15 Transforming our culture, values and behaviours - Key Strategic Deliverables by 2017 Staff Engagement Performance & Accountability Growing the Talent Pool Leadership Development Listening into Action engagement methodology to be embedded in all change and service improvement activities Year on year improvement in National Staff Survey results Workforce models creating greater flexibility introduced Top 25% performance across key National Staff Survey metrics Structure developed to ensure decision making is devolved through CSC teams Performance framework to focus on outputs and behaviours equally Consistent delivery against balanced scorecard of performance metrics Reward structure revised appropriate to support performance Autonomous selfmanaged teams in place Critical skill gaps identified and associated development plans delivered Succession plans in place for all critical posts Provision of post graduate medical training recognised as best across Wessex region Annual talent review to establish capacity and capability of workforce Education programmes delivered to wider Wessex community Development and delivery of local and national leadership programmes All those with leadership accountabilities appropriately developed for their roles Top 25% for line manager responses in National Staff Survey Re-validation of those with leadership accountabilities Appropriate values and behaviours role modelled across the organisation Maintaining Quality Use of Evaluation and Feedback The Learning and Development Department will continue to use the established Evaluation Framework to evaluate training delivered to staff, trainees and students. There are four tools currently in use, which combine on the day and post course feedback to demonstrate the effectiveness of training in the workplace as well as inform changes to programmes where necessary. The frameworks are: Induction Clinical Skills

16 Programmes Management and Leadership Development Feedback from students in all professional groups will be regularly reviewed to ensure that all placements are providing the same high quality experience and to help form action plans for the future. Results of the feedback will be shared with the placement areas and CSC management teams on a regular basis. Dashboard An Education Quality Dashboard has been created to identify key metrics for each of the CSCs in one place. It is shared on a quarterly basis with the CSC management teams enabling them to track progress and compare achievements. The intention is to develop an Education Accreditation Scheme which will reward CSCs for providing excellent learning and development opportunities for all. The Dashboard will be part of the process for determining the level of the awards allocated. Quality Mark To demonstrate the quality of the internal programmes delivered to PHT Staff the Learning and Development Department will seek external accreditation from Skills for Health. The Quality Mark will demonstrate to staff and potential customers that the training delivered meets minimum national standards. Reporting An Annual Report will be produced for Trust Board celebrating achievements for the year, providing assurance on use of external training funds and outlining challenges for the following year. The report will be shared with the Strategic Education and Workforce Meeting and Health Education Wessex.

17 Funding The use of internal and external funding for education and training will be regularly reviewed to ensure that it is being used to best effect. The Learning and Development Department will ensure that close links are maintained with Health Education Wessex to enable timely access to funding as it becomes available. By keeping up to date with future plans for education delivery and funding contingency plans will be developed to ensure the organisation is prepared for the impact. Funding for training will be allocated to meet the priorities of the Trust in terms of role development, service developments and professional requirements for revalidation. Clinical Service Centres will be required to complete an annual Training Needs Analysis that reflects their key workforce and business plans. Final agreement of CSC TNA s will be the responsibility of the Strategic Workforce and Development Meeting. Utilisation of Education Funding will be governed through both internal and external scrutiny. External governance is undertaken by Health Education Wessex via 6 monthly self-evaluation and annual quality visits. Internally the allocation of flexible funding will be ratified by the Strategic Education and Workforce Meeting and will form part of the Annual Training Planning Process. It is the intention to develop an Education Accreditation Scheme with additional funding being made available to CSCs that can demonstrate a high level of education support within their departments. This will be supported by the creation of an Educational Portfolio linked to the Education Dashboard. In recognition of the anticipated reduction in funding for education nationally, the development of programmes which can be marketed and generate income for the Trust will be pursued. Any profit from courses will be reinvested to support PHT staff learning and development.

18 References: Department of Health, Policy paper: Modernising scientific careers: the UK way forward. [Online] Available at: [Accessed 2 October 2015]. Department of Health, Gov.UK: Publications. [Online] Available at: [Accessed 2 October 2015]. Greenaway, D., Home: The Review So Far: Shape of Training. [Online] Available at: [Accessed 2 October 2015]. Health Education England, Home: News. [Online] Available at: [Accessed 2 October 2015]. Health Education England, Home: Our Work: Shape of Caring Review. [Online] Available at: [Accessed 2 October 2015]. Health Education England, Home: Our Work: Talent for Care. [Online] Available at: [Accessed 2 October 2015]. Health Education England, Knowledge for Healthcare: a develoopment framework for NHS library and knowledge services in England [Online] Available at: [Accessed 18 September 2015]. NHS England, Home: Our Work: The NHS Five Year Forward View. [Online] Available at: [Accessed 2 October 2015].

19 APPENDIX A Action Success Criteria Completion Date Responsibility Creating Flexible Learners for the Future Investigation of available Massive Open Online Courses to identify ones that may be of interest to PHT staff Communication strategy developed to ensure that PHT staff are aware of MOOC opportunities and how to access them Develop a blog to encourage sharing of learning from the workplace Work with community trusts and CCGs and education providers to investigate developing training that works across the acute and community setting and implement where there is agreement with partners Identify key providers and course and publicise widely across Trust Initial launch June 2016 on-going thereafter Library Identified on L&D Webpage, section in the Link and publicised in the library Jun-16 Library At least one blog per month Sep-16 Deputy Head of Nursing and Midwifery Education To create further opportunities for apprenticeship training across organisations Oct-16 Head of Education HSAHP To develop new programmes in partnership if appropriate Oct-16 Head of Education HSAHP Supporting the Development of New Roles Provide dedicated time at Strategic Education and Workforce Development Group for CSCs to submit and discuss plans and seek support CSCs attendance at SEWDM improves to enable partnership working Sep-16 Director of Education

20 Action Success Criteria Completion Date Responsibility Ensure relevant links with HEW are maintained to enable access to funding to support new initiatives Implement process for identifying gaps in vocational qualification provision and creation of relevant programmes Develop relationship with Regional Centre of Excellence Input into Sustainability and Transformation Plan for Hampshire and Isle of Wight All opportunities to develop new roles are realised on-going Learning and Development Team Education programmes will be matched to new roles Sep-16 Barry Hodgson Participate in appropriate meetings and ensure maximisation of opportunities afforded by the Centre of Excellence on-going Head of Education HSAHP To create models for sustainable clinical teams for the future in line with STP Learning and Development Team Increasing Education and Training Opportunities Further develop and enhance the annual Training Plan Process to ensure all training needs are captured Incorporate patient voice and learner voice into programmes Promote all courses in the ALERT suite to increase market share and income generation, e.g. care home, ambulance, community, maternity, AWARE, BEACH Continued updating of process and partnership working Sep-16 Head of Nursing and Midwifery Education Programmes are continually updated to reflect increased patient involvement in design and delivery. Feedback from all learners is used to inform provision Sep-16 Learning and Development Team Continue to grow market share and income for the Trust. on-going Resuscitation /LDD Business

21 Action Success Criteria Completion Date Responsibility Introduce courses in education for staff in PHT who have an education component within their job role to improve capability of educators New programmes will be delivered for staff to access Jun-16 Learning and Development Team Create placement expectation documents Develop relationships with students to encourage recruitment into PHT Work towards 100% GMC approved educational and clinical supervisors Enhance the use of value based recruitment of mentors Developing mentor capability to support the changing needs of the learner in line with the five year forward view vision of the NHS and changing roles. Supporting Students and Trainees Students and mentors are clear about learning opportunities from P1 - P6 Apr-17 Head of Nursing and Midwifery Education Students from P3 onwards are given recruitment information in induction Jan-17 Head of Nursing and Midwifery Education 100% approved education supervisors Jul-16 Director of Education Utilising the value based recruitment tool and mentors complete requisite education on-going Head of Nursing and Midwifery Education Mentors and supervisors understand the expectations for change within the NHS and provide a good and appropriate learning experience Dec-17 Learning and Development Team

22 Success Criteria Completion Date Responsibility Ensure appropriate and effective utilisation of practice placements for all learners in health care to maximise capacity whilst maintaining quality Increased number of placements offered across all areas and learners report good learning experience Dec-17 Learning and Development Team Implementing new ESR User Interface as part of National Pilot Promote use of smart phones and tablets for accessing ESR, including e-learning Promote the skills of the e- Learning Technologist for the development of local programmes or provision of expert knowledge if external companies are involved. Develop a process for the development of e-learning to ensure that the programmes meet Trust priorities and an agreed standard is achieved. Develop and introduce short virtual learning objects that can be accessed in the work place e.g. via tablets or mobile phones Embracing Learning Technologies Improved e-learning experience for staff Dec-16 LDD Business Staff report wider access to e-learning functionality Apr-17 Library Raised profile of the e-learning team Dec-17 Library Cost effective creation of e-learning programmes Apr-18 Library Easily accessible Virtual Learning Objects enable staff to undertake increased education in the workplace Apr-17 Library

23 Action Success Criteria Completion Date Responsibility Increase use of YouTube and other free education resources for teaching Develop a process for the development of apps to ensure that there is a Trust standard/template. enhanced use of Learning and Development website to enable staff to access material Dec-16 Library Increased and widely utilised apps covering a wide range of subjects for all professions are readily available Dec-16 Library Proactive customer focussed services Library and Knowledge Review and update the Library marketing strategy to communicate with customers Develop targeted services. Embedding key staff into clinical and corporate practice settings and meetings. Promoting key Library and elearning messages throughout the Trust. Developing or sourcing essential elearning material that is required to support the clinical competency of staff. Engaging with other departments. Mar-16 Library Jun-16 Library Apr-16 Library Dec-16 Library Apr-16 Library On-going Library

24 Action Success Criteria Completion Date Responsibility Quick and easy access to relevant evidence Effective leadership and planning, and the development of the knowledge service workforce Support, maintain and develop competencies for all staff. Ensuring that services are available when required. Supporting patient care through the involvement of the Clinical Librarian. Providing access to the resources in an easy to find (and use) portal. Collaborative purchasing of resources to provide further access to information and elearning resources, whilst ensuring value for money. Looking into new technologies and forthcoming IT developments to improve access to elearning and eresources. Staff attending a range of training and development sessions to further their knowledge. Working with other departments to plan for future changes within the organisation and to influence this where possible. Encouraging the exploitation of the Library environment to support a wide range of learning activities for all staff. On-going Library On-going Library Dec-15 Clinical Librarians Library On-going Library On-going Library On-going All Library staff Dec-16 Library On-going All Library staff Improving understanding about the barriers to the use of knowledge resources created by literacy issues and dyslexia. Dec-16 Library

25 Action Success Criteria Completion Date Responsibility Optimising investment in knowledge services Delivering the vision: Metrics for success Costing Library services and processes and exploring how costs can be reduced. Measuring the impact of high cost services. Reviewing Library and elearning staff roles to improve flexibility whilst also considering cost effectiveness. Looking for ways to increase income. Ensuring service level agreements are up to date and reflect the services provided. Involving metrics such as the revised Library Impact Toolkit. Maintaining and improving the level of standards achieved through the Library Quality Accreditation Framework (LQAF). Utilising the local ESR compliance completion rates. Gathering and acting upon customer feedback. Using the evidence base to demonstrate the value of Library and elearning services. Dec-16 Library Dec-16 Library Jul-16 Library Dec-16 All Library staff On-going Library Dec-16 Library Jun-16 Library On-going Library On-going All Library staff Sept Library

26 Action Success Criteria Completion Date Responsibility Development of Education Portfolio Maintaining Quality Each CSC has an education portfolio which demonstrates their commitment to education and training. Portfolio is used to inform allocation of any education awards Mar-21 Director of Education Develop process for feeding back results of post course survey results to CSC's Implement a robust process for peer review of teaching for all staff with education as part of their role Further developing the Education Dashboard to enable targeted information to be provided where appropriate to improve education quality Ensure annual review of external education funding Maximising Income Generation Opportunities Education Accreditation Scheme CSC management teams are sited on impact of training in the workplace Apr-17 LDD Business Peer review documentation updated and rolled out across the organisation. Monitoring of completion and quality assurance process in place Granular data is provided to operational departments to identify where variances in performance are identified Education Funding Available funding is allocated as per the LDA and to meet the needs of the Trust as identified in the annual TNA process Apr-18 Dec-17 on-going LDT LDD Business LDD Senior Management Team VIMARS and TEAMS Centre working to capacity Director of Simulation CSCs recoup costs of faculty released to teach on income generating courses on-going LDD Business Funding is identified each year to enable CSCs to bid for an education award to enhance training and development for their staff Mar-21 LDD Business