Health CommitteeWritten evidence from Heart of England NHS Foundation Trust (ETWP 62)

1. Context and Background

The Heart of England NHS Foundation Trust is one of the largest hospital Trusts in the country with over 10,000 staff, a diverse workforce including 6,000 clinical professionals and a workforce spread across three acute hospital sites and community services. The organisation makes a multi-million pound investment in education annually. However, in recent years the organisation became increasingly dissatisfied with the return on this investment in terms of impact on workforce and organisational performance.

In 2009 the organisation, in order to resolve this problem, initiated development of a new Learning and Development Strategy. In order to ensure the strategy was explicitly linked to service enhancement and workforce development needs an extensive action research project was undertaken; engaging staff at all levels within the organisation. The emergent strategy entitled Learn Lead was framed by seven deliverables for learning and development that directly reflected the outcomes of the staff engagement process:

A clearly defined, accessible education service.

Eliminate fragmentation, duplication and variability of learner experience.

A centrally managed education portfolio explicitly linked to business needs, workforce plan and clinical vision.

Effective educational frameworks and curricula that have high impact on service quality and safety.

Effective educational governance and quality management.

Education interventions measured against intended impact and return on investment.

A self sustaining service that generates and uses its income to expand access to a full range of education and development opportunities for all staff.

The strategy was underpinned by a workforce model for developing healthcare careers “the HEFT 6 C’s strategy”. The aim of this model was to provide a framework for recruiting individuals from our local communities and developing them through lifelong careers in healthcare; identifying and growing talent so that any member of the organisation, with the desire and potential, can progress through to an executive level.

As part of the “6 C’s strategy” a foundation year was introduced for the whole workforce. This provides front loaded support for development of core skills and behaviours; staff stepping off this foundation year with a personalised development plan.

The key feature of the new strategy was the development and launch of the Heart of England NHS Foundation Trust Faculty of Education. The “HEFT Faculty” provides a strategic umbrella for the education and development of employees. Drawing on learning from successful US corporate models, the Faculty is central to disseminating the organisations culture, fostering the development of not only job skills but also core workplace skills such as learning-to-learn, leadership, creative thinking and problem solving.1 This marks a shift in focus from employee training to employee education. The HEFT Faculty, in partnership will its accrediting partners, enables the organisation to provide a portfolio of service focussed and patient centric education for employees that can evolve with ever changing organisational needs.

By maximising investment, and securing best value, we have increased access for staff to high quality education that ultimately will enable us to achieve our strategic goals and secure ongoing service improvement.

2. Early Achievements

In house “one stop shop” prospectus-linked with annual training and learning needs analysis offering in house development ranging from key skills to Masters level modules.

Work related learning unit offering placements to young people and others including a successful campaign to increase placement availability entitled “be engaged shape tomorrow”.

Work with local schools to collaboratively deliver the School Health and Development Diploma. Facilitating delivery of integrated learning; work experience and health promotion messages to local communities.

Employment and support of over 400 apprentices.

Launch of a dedicated Healthcare Careers Development Unit. This unit offers readily available information advice and guidance on work related learning to all employees, as well as supporting development and career progression for all non clinical staff and professionals.

Recruitment of the long term unemployed people onto a bespoke healthcare support worker apprenticeship programme; recruited for values and behaviours rather than educational qualifications. Evaluation research has demonstrated enhancements in levels of performance; engagement and positive personal and social outcomes from those moving through the programme.

Development of a range of in house career development frameworks for administration; finance; and HR staff.

First group of in house academically accredited programmes increasing the value of the organisations existing educational spend by the equivalent of 1.2 million pounds. We have halved the cost of academic modules by using this in house delivery approach.

Development of in-house Masters level leadership programme delivering over 100 service improvement projects.

Growth in service situated education offering mentorship; preceptorship and on the job coaching.

Implementation of new development programme for SAS Doctors and skills development for Junior doctors.

Introduction of VITAL for nurses—this is an on-line learning and assessment programme focussed on fundamental nursing care which has contributed to improvements in patient safety and nursing care standards. VITAL has delivered £833,400 savings as compared with traditional methods of training and enabling 65,000 hours to be reinvested back into front line care.

3. Faculty Awards 2010–11

National HPMA excellence in HR management awards—for workforce development strategy.

National HR Excellence awards—for workplace diversity “steps to work apprenticeship programme”.

Nursing times awards—for patient safety (VITAL for nurses).

HSJ awards 2011—for workforce development.

Job centre plus skills development award—large employer.

Personnel today awards—finalist workforce development.

4. Transferable Learning

The NHS, as other public sectors, faces a financially challenged future and as service providers we will need to deliver quality at the same time as realise efficiencies and improve productivity. The NHS needs to be an employer of choice attracting and retaining the talent it needs to deliver the vision of quality healthcare for all. We will need to foster and retain skills and talent through these challenging times, developing the solutions the NHS needs through the people who will deliver them. The NHS has a chance now to take a long term view of the challenges ahead, tackling immediate financial challenges alongside designing a workforce for the future.2 High quality and accessible learning and development will be key in achieving this.

We believe that the HEFT Faculty is an innovative and real example of how this can be achieved enhancing qualitative outcomes as well as realising over one million pounds in benefits in the first year. We believe that this is an example of how transferring responsibility for workforce development to service providers and allowing them more freedom of choice for education commissioning and delivery can deliver both quality enhancement and efficiency in workforce development.

To enable us to continue our work we need to have more influence and control of educational investment so that we can ensure that we can commission and provide education flexibly and at a pace that keeps up with the dynamic nature of contemporary service delivery and workforce planning.

5. Relevant Considerations

It is imperative that workforce planning is better integrated with finance and service planning in order to more effectively manage workforce risks.

The changing service provision priorities eg delivery of care in the community and changes in skill mix within acute and community settings need to be more locally engaged and driven.

Collaborative working will be important with respect to development of LETBs and we are of the view that this should include social care. This will ensure that workforce development is aligned to commissioned services and the respective care pathways. This should enable the provision of improved and sustainable services that are not developed in isolation; thus informing integrated local health economy planning.

Service providers should have a significant level of control of their own education commissioning. They should be given authority to commission with any willing education provider that will deliver high quality and good value education and training.

Service providers must feel they have a “voice” at LETB level and that the size and governance of these does prevent this or stifle choice. There is a real risk that if service providers feel that they do not have this level of authority that will disengage from the process.

December 2011

1 Meister, J (1998). Ten steps to creating a corporate university. Training and Development 52(6)

2 NHS Employers (2010). The workforce of the future. Health Business, http://www.healthbusinessuk.net

Prepared 22nd May 2012