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Clinical Learning Environment Workshops
November 2015
www.hee.nhs.ukwww.eoe.hee.nhs.uk @HEEoENurse
Aim of the Day
Aim: To design an approach to improve workforce supply by:Improving the quality and capacity of the
clinical learning environmentEnhancing approaches to employability
of students
www.hee.nhs.ukwww.eoe.hee.nhs.uk @HEEoENurse
Why Review Pre-registration Nurse Education
23 programmes per year at 6 HEIs£100m+ per yearNational nursing shortageWillis Commission: Shape of CaringKLoE – ‘what should excellent nurse education
look like’?Engagement with nurses, students, HEIs,
service users
www.hee.nhs.ukwww.eoe.hee.nhs.uk @HEEoENurse
What We Found
Practice Education/Mentorship most frequently cited theme
Too much variability in practice educationNot enough focus on students delivering careVariable assessment of skillsStudents may not learn to be employeesNot enough learning between branches –
person centred careNot prepared to work in a range of settings
www.hee.nhs.ukwww.eoe.hee.nhs.uk @HEEoENurse
The Delivery Plan
Having undertaken the review we identified 3 work streams with key system stakeholders.
These are seen as high impact deliverables that link to Shape of Caring, Talent for Care, HEEoE Board and Workforce Supply priorities
1 Develop new routes into nurse education (to increase nursing outturn)
2 Ensure the education we commission focuses on the right balance of skills, knowledge, confidence and competence
3 To maximise ROI from commissioned programmes by developing a consistent and attractive offer of education and employment
www.hee.nhs.ukwww.eoe.hee.nhs.uk @HEEoENurse
Models of Education
Ensure the education we commission focuses on the right balance of skills, knowledge, confidence and competence
2a Increase capacity and quality of clinical learning environment
2b Increase focus of hands on practice and skills assessment
2c Commission for enhanced learning on delivering person-centred care in a range of settings
www.hee.nhs.ukwww.eoe.hee.nhs.uk @HEEoENurse
Clinical Learning Environment
2a Increase capacity and quality of clinical learning environment
Review learning from funded pilots
Clarify principles and evidence for high quality clinical learning environment
Increase capacity by curriculum design
Develop funding model and governance plan
www.hee.nhs.ukwww.eoe.hee.nhs.uk @HEEoENurse
Focus on Skills
2b Increase focus of hands on practice and skills assessment
Ensure CLE supports coaching models of practice
Ensure CLE supports peer coaching and learning
Equal focus on practice and theory throughout programme
Skills assessment framework
Ensure theory and practice are linked in curriculum
www.hee.nhs.ukwww.eoe.hee.nhs.uk @HEEoENurse
Person-Centred Care
2c Commission for enhanced learning on delivering person-centred care in a range of settings
Explore read across between branches
? Scope the 2+2 programme
Improve development opportunities in community and primary care
Rotational employment in primary and community care (possibly linked to Masters Modules
www.hee.nhs.ukwww.eoe.hee.nhs.uk @HEEoENurse
High quality practice education is key so HEEoE have piloted….
‘Roving’ practice teacher in HV programmeCLiPDEU / PEBL(S)Lead Mentor ModelTo try to establish a framework and standards for improving the quality and capacity of practice education
What HEEoE Has Done
www.hee.nhs.ukwww.eoe.hee.nhs.uk @HEEoENurse
• 1:1 relationship with a mentor is unlikely to provide full range of learning for the student
• There should be a sustainably funded infrastructure to support practice education
• Students should be placed in sufficient numbers so they can support and coach each other
• Students should be placed where they can deliver hands on care under supervision – the coaching approach facilitates this
• Select, train and support learning environments, mentors and coaches with extreme care
• Prepare and support students
Principles of Practice Education
www.hee.nhs.ukwww.eoe.hee.nhs.uk @HEEoENurse
Group Work• If we implemented these
principles, what would success look like?
• What would be the metrics to measure improvements in quality and capacity?
www.hee.nhs.ukwww.eoe.hee.nhs.uk @HEEoENurse
Jenny McGuinnessHead of Education &
CommissioningHealth Education East of
England
www.hee.nhs.ukwww.eoe.hee.nhs.uk @HEEoENurse
• Explain why and how the employability workstream has emerged
• Explain what we are trying to address/achieve
• Describe the work done to date• Discuss the way forward
This Session Will …..
www.hee.nhs.ukwww.eoe.hee.nhs.uk @HEEoENurse
To maximise return on investment from commissioned programmes by developing and delivering a consistent and attractive offer of education and employment to students commissioned and supported to registration as health care professionals. Ensuring that all students are aware of the expectations associated with being an NHS funded student and the support and outcomes they can expect from employers, education providers and HEEoE.
Purpose
www.hee.nhs.ukwww.eoe.hee.nhs.uk @HEEoENurse
The employability work stream is not just about an offer of employment, it includes:
Recruiting the right students Retaining the students Employing the NQHPs Retaining the NQHPs
Purpose
www.hee.nhs.ukwww.eoe.hee.nhs.uk @HEEoENurse
Having undertaken the review we identified 3 work streams with key system stakeholders.
These are seen as high impact deliverables that link to Shape of Caring, Talent for Care, HEEoE Board and Workforce Supply priorities
The Delivery Plan
1 Develop new routes into nurse education (to increase nursing outturn)
2 Ensure the education we commission focuses on the right balance of skills, knowledge, confidence and competence
3 To maximise ROI from commissioned programmes by developing a consistent and attractive offer of education and employment
www.hee.nhs.ukwww.eoe.hee.nhs.uk @HEEoENurse
• For every 100 students that start a nursing programme 72 will actually qualify as a registered nurse. This represents wastage of 28%.
• This equates to approximately £676K
• For every 100 students that completes a nursing programme we can evidence that 66 take up posts within the NHS in EoE. A further 15 will take up post in the NHS outside of EoE. The remaining 19 are potentially lost which equates to £445k
It is a Board priority
Why it is important
www.hee.nhs.ukwww.eoe.hee.nhs.uk @HEEoENurse
• Students do not necessarily learn to be employees• Students do not feel part of the NHS• Students do not feel valued as the future
workforce• Students would welcome more clarity about
expectation and commitment Student survey Student focus groups Board event
What we know from the students
www.hee.nhs.ukwww.eoe.hee.nhs.uk @HEEoENurse
To maximise ROI from commissioned programmes by developing and delivering a consistent and attractive offer of education and employment to commissioned and supported students
Employability
Recruiting the right students
Retaining the students
Employing the NQHPs
Retaining the NQHPs
www.hee.nhs.ukwww.eoe.hee.nhs.uk @HEEoENurse
Key Deliverables:• Review current commissioning patterns to ensure they optimise
retention of students and employment of NQHPs.• Develop core principles of recruitment which align students to an
employer or system and reflect NHS values.• Ensure students are aware of their unique position as being NHS
funded and supported.• Ensure that employers are jointly responsible for the recruitment of
students as their future workforce.• Agree operating model for managing region wide recruitment to ensure
supply is maximised by filling all commissions places.
Recruiting the right studentsAim: To Recruit the right number of high quality students in line with the
NHS Values who understand their unique position as funded NHS students and the expectations that they will return this investment by working in the NHS system
www.hee.nhs.ukwww.eoe.hee.nhs.uk @HEEoENurse
Key Deliverables:• Clear and agreed methodology for HEEoE and employers to maintain effective,
personal communication with commissioned students throughout their training.• Revise programmes and develop tools to support students at critical points
during their programmes.• Scope opportunities to reduce intensity of programme including review of
different delivery patterns e.g. block placements.• Develop resources to support students and mentors i.e. tablet based practice
assessment (SEA project), Common Assessment Documentation (CAD).• Implement the outcomes from RePAIR. • Consider additional accommodation and travel support for students in difficult
to recruit areas.
Retaining the studentsAim: To retain the right number of high quality students through support both in the academic and practice settings. Ensuring they are aware of their importance to the NHS as the future workforce and ensuring they feel valued to, and connected with, the NHS
www.hee.nhs.ukwww.eoe.hee.nhs.uk @HEEoENurse
Key Deliverables:• Scope existing employment offers in place across HEEoE.• Explore funding options and appetite for supporting students such as ‘golden
handshakes’, assistance with repaying debt (MSc).• Develop a portfolio of employment offer options for discussion with DoNs and HRDs with
a view to adopting an agreed minimum standard offer across HEEoE.• Develop a portfolio of potential employers, available roles and USPs.• Scope existing careers events and develop a portfolio of good practice. • Ensure clarity of process including timelines for NQHP recruitment and development of
system wide approaches.• Ensure students are confident and competent to move into graduate roles by ensuring
consistent assessment criteria and standards across system, addressing ‘failure to fail’ and inconsistency of sign-off across geography (SEA project, Consistency of skills training and assessment which DoNs have confidence in (CAD), e-portfolio).
• Develop a system for tracking students who qualify with a view to understanding the rates of employment.
Employing the NQHPsAim: To ensure that all NQHPs who complete training in HEEoE have a suitable offer of employment within the HEEoE health system
www.hee.nhs.ukwww.eoe.hee.nhs.uk @HEEoENurse
Key Deliverables:• Embed the national preceptorship standards into QIPF and LDA to
measure compliance of organisations in the delivery of comprehensive high quality preceptorship programmes for all NQHPs.
• Rotational programmes for NQHPs to be developed in partnership with employing organisations across a range of organisations and across a variety of different care settings.
• Work with provider organisations to ensure that all NQHPs are supported within their preceptorship period to develop skills and competencies, utilising CPD and other funding to achieve this.
• Improving CLE to give improved clinical careers progression.
Retaining the NQHPsAIM: To retain the NQHPs within the health system in HEEoE by ensuring they see the East of England as the best place to work and further their careers by offering excellent support and development opportunities.
www.hee.nhs.ukwww.eoe.hee.nhs.uk @HEEoENurse
Group Work• Are these the right things?• Is there anything missing?
www.hee.nhs.ukwww.eoe.hee.nhs.uk @HEEoENurse
Group Work• What activities are needed to deliver the
elements of the employability workstream?
• Whose responsibility are they?