SEPTEMBER 2014 TEES, ESK & WEAR VALLEY NHS FOUNDATION TRUST BUILDING A LEARNING FRAMEWORK FOR HEALTHCARE ASSISTANTS The organisation, and the team Tees, Esk and Wear Valley (TEWV) NHS Foundation Trust provides mental health and learning disabilities services for sites across a large area of the North East of England. The workforce development team within the HR directorate of the trust develops workforce plans and training needs analyses to identify appropriate pathways for employed staff in NHS pay bands one to four. It uses workplace learning to develop and make the most of its staff s skills, to improve productivity and safety, raise morale and standards of care, reduce risk, and enhance the business. Why a change was needed In 2011 after thorough extensive consultation, a needs analysis carried out by the team, managers and staff side representatives concluded that an appropriate pathway should be developed for all in-patient healthcare assistants (HCAs) which would meet the needs of the staff and fulfil the requirements of the trust. Other reasons for these proposed developments were: The pending Francis and Cavendish reviews, following which, trusts would be expected to review their approach to HCA recruitment, induction and ongoing development. Following a recent merger, HCAs were on a variety of different job descriptions and pay bands which needed to be addressed to assure quality, standardisation, consistency and equality. HCAs in post at the time had received a variety of training and development opportunities, which was neither consistent nor monitored or evaluated. Development of a Healthcare Assistant framework 1
SEPT 2014 CASE STUDY The HCA framework was therefore developed, and introduced in April 2012 for new healthcare assistants and existing band two to three HCAs. It was designed using a blended approach and included a range of competencies which were included to help the learners to adapt theory and knowledge into practice. The HCA framework was developed over a six month period by a task and finish group made up of representatives from all the speciality services, staff side, workforce development team, and HCAs. The group decided on what should be included. It produced core competencies for all staff, and then specific competencies for specialities. It then produced local workbooks and bespoke e- Learning discs, which are now live on the National Learning Management System (NLMS) of ESR. The framework comprised: A four week induction Approximately 30 weeks work based training, Use of reflection methodology E-learning and workbooks locally produced to meet specific trust needs Face to face training Mentor sign off of competency sheets, on subjects such as compassionate care practical assessments of tasks such as escorting Observations NVQ Diploma in health and social care level 3 delivered by the workforce development team Literacy and numeracy level two delivered by an external higher education institute One standard band three job description which is used in the trust s appraisal system to ensure the HCAs maintain the skills and behaviours required of the role, even after the training has finished. The workforce development team organised the training and guidance for managers and employers about how the framework was to be administered was disseminated through close engagement with the right people throughout the trust. Offer to new and existing staff Staff at TEWV have recently been piloting values based recruitment methods to test new HCA recruits for behaviours and attitudes which align with the values of the trust. Since the introduction of the framework, HCAs recruited for their values, are now appointed as trainees on agenda for change annex U. They hold this status for three years to allow them to achieve the full HCA development programme and embed what they have learnt in their practice. Upon full completion of the framework, HCAs start working at band three. 2
Existing staff were given the choice of opting in or out of the framework. Opting in meant an HCA would have to complete the full framework including the competency components by a specific timescale which is dependent on their present grade, length of service and where they are on their current band scale. band twos would be upgraded to band three on completion. Opting out meant that a staff member would not have to do the NVQ and literacy and numeracy but would still have to complete the competencies. One of the key challenges when developing and embedding this framework was that some of existing staff did not want to participate. After considered engagement with them, which helped them to understand the benefits of completing the training (enhanced knowledge, skills and potential career development), and commitment needed, more staff were interested in it. Of the 999 existing staff who were eligible, 770 staff opted in. Evaluation and outcomes The HCA framework has been very successful and, at the time of writing, 92 existing staff had completed the full framework. It has inspired staff to improve patient care by; increasing their understanding and knowledge of best practice progressing in their learning progressing in their existing role or to have the options to progress further into other roles, such as associate practitioner or pre-registration training. The outcome for the trust is a better trained more confident workforce and increased ability to manage poor performance through a structured competency based programme. Return on investment Using a Return on Investment (ROI) model, the trust has gathered feedback received from the learners who had completed the framework. This is what it has found: The majority of learners thought that: the content of the development was very relevant to their current position it was very likely that they will apply the newly acquired skills back in their workplace it was very important for them to complete the framework the majority of the skills learnt were new skills they would recommend the development to others All learners stated that: 3
SEPT 2014 CASE STUDY the majority of the information/learning received was new information the competencies met their training needs they were able to complete the competencies within the workplace the competencies helped them to increase their record keeping skills they now have a better understanding of associated conditions related to learning disabilities/mental health the development had met their expectations. someone within the workplace had supported them in completing the competencies The learners stated that they would specifically do the following things differently after completing the framework: Reflect more on experience and events Question and challenge more Be aware of job/role when carrying out designated jobs on the ward Keep up to date with policies and procedures Enhance communication skills Ensure notes are of a good standard Take patients observations correctly Be aware of health care law Have more up to date knowledge with mental health problems Be more security conscious Have a better understanding of patients diagnosis and be able to help them with their needs Perform with greater confidence Put all of the new skills into practice To celebrate their achievement the learners, upon completion of the framework, receive a framework completion certificate as well as certificates for all of the parts of the completed framework. The TEWV HCA framework was mapped to the draft documents for the Care Certificate to be introduced as a requirement for health and social care support workers, in 2015. It was found to align very closely, therefore the developing and embedding of the HCA framework into the trust is to be continued with only a few additional competencies which need to be added by March 2015. TEWV has also introduced a successful framework for medical secretaries and plans to introduce a framework for community staff based on the HCA framework. Top tips The team s tips to others considering such a framework would be to; Consider the wider healthcare drivers and policy context (such as Cavendish and the Care Certificate), when you are developing your own 4
pathways and frameworks, to ensure their recommendations are reflected in them. Recruiting the right people into your organisation, who want to learn and provide excellent patient care is so important. Find out more about recruiting for values in the NHS on the NHS Employers website. Using different modes of education, and blended learning, will help your staff to get the most out of it. Ensure you offer enough support for learners. Allow staff the time and space to learn. Group/ peer support is invaluable for learners. Having learners with a diverse range of roles and experience is also beneficial to learning. Celebrate the achievement of your learners. Contact us NHS Employers 2 Brewery Wharf Kendell Street Leeds LS10 1JR Published NHS Employers 2014. Ref: www.nhsemployers.org enquiries@nhsemployers.org @nhsemployers NHS Employers www.youtube.com/nhsemployers 5