Education Commissioning for Quality: An SHA perspective Adam J Turner Education Development Manager NHS West Midlands Lisa Bayliss-Pratt Education Lead NHS West Midlands

Aims

What is ECQ?  Department of Health Policy (Jan 2010)  Commissioning, Contract Management and Quality Monitoring Process for Education Providers (e.g. University) Non-Medical Education and Training (NMET) contracts  Allows us to:  Find innovation and notable practice to share  Find challenges, identify solutions and performance manage these with Education Providers

What makes ECQ Different?  RAG rating of:  Each commissioned education programme  Education provider improvement action plans  Education Provider funding linked to quality  Bringing together different contractual processes:  LDAs with NHS Trusts  Education Contracts with Education Providers

Overview of ECQ Process Placement Provider (i.e. NHS Trust) Self Assessment against ECQ Quality Standards Education Provider (i.e. University) Self Assessment against ECQ Quality Standards Analysis of Information using Review Panels Audit at Education Providers (Annual Review) Development of Findings Report and RAG Ratings Education Provider Improvement Action Plan Monitoring of Action Plan Panel Members:  Lay Chairs  Clinical Externality  Workforce Specialists  Quality and commissioning specialists Payments linked to Quality

Outcome of ECQ Pilot: HEI RAG Rating Summaries for Education Programmes Education Provider Name Specialty Health Programme Birmingham City University (BCU) Coventry University Keele University University of Birmingham (UoB) Staffordshire University University of Wolverhampton University of Worcester Aston University Birmingham Metropolitan College Nursing: Adult Degree73%68%88%68%64%88%68% Nursing: Adult Diploma78%68%88%64%68%88%68% Nursing: Child Degree78%58%73%94%58%64%69% Nursing: Child Diploma83%78%58%63%71% Nursing: Mental Health Degree68%58%94%80%68%78%58% Nursing: Mental Health Diploma78%58%94%68%78%68% Nursing: Learning Disabilities Degree64%82% Nursing: Learning Disabilities Diploma58%68%84%68% Midwifery Degree73% 94%88%68% Midwifery Degree (Short Course)69%90%83%68% Operating Department Practitioner Degree84% Operating Department Practice Diploma78%68% Physiotherapy Degree74%84%100% Physiotherapy Postgraduate90% Diagnostic Radiography Degree68% Therapeutic Radiotherapy Degree68% Psychology Doctorate100%94%88% Paramedic Science100% Speech and Language Therapy Degree78% Audiology Degree82% Podiatry Degree78% Dietetics Degree84% Occupational Therapy Degree78% AVERAGE Score (mean of all Education Provider programmes): 74%76%86%84%74% 71%82%78%

Outcome of ECQ Pilot: HEI RAG Rating Summaries for Action Plan Achievement Birmingham Metropolitan College Aston University Birmingham City University Staffordshire University Coventry University University of Birmingham University of Worcester Keele University University of Wolverhampton Progress Achieved Against Previous Years Action Plan (% of actions confidently signed off by review panels) 45%54%59%64%75%85%86%100%

Outcome of ECQ Pilot: HEI Quality Premium Payment Summary £ Total Achievable£ Achieved% Achieved Total Contract Value for :circa £69.7mcirca £1.7m2% Total 5% achievable for :circa £3.5mcirca £1.7m48% Breakdown of 5%: > Total 3% achievable (Programme Level Review): circa £2.1mcirca £1.1m51% > Total 2% achievable (Action Plan Review): circa £1.4mcirca £600k42%

Outcome of ECQ Pilot: Innovation and Notable Practice – Yearly Report /EducationDevelopmentQualityandResearch.aspx /EducationDevelopmentQualityandResearch.aspx

Evaluation of ECQ Pilot: Areas that Worked Well  Engagement and Partnership Working (Brings Change):  Overarching process and transparency  Engagement, communication, collaboration and support from NHSWM Education Development Team  ECQ stakeholder engagement events  Use of Externality (lay and clinical externality) on review panels  RAG ratings of programmes and action plans

Evaluation of ECQ Pilot: Future Challenges  Increase Confidence of Triangulation of Data:  Increase student feedback (e.g. Questionnaire / whistle blowing / graduate survey)  Increase employer feedback (e.g. Employer questionnaire / overview of partnership working in self assessment)  Establishing saturation of data – when do we know this is the truth?  Establishing data sets to trigger further investigation (e.g. Annual Monitoring Reports by professional bodies)

Evaluation of ECQ Pilot: Future Challenges  Quality is a Perception - Tensions:  Service user perceptions of quality...  “a student reported I was left on my own....”  e.g. Professional body requirements, vs. Education commissioner requirements  e.g. Programme meets professional body standards, however attrition is high

Evaluation of ECQ Pilot: Future Challenges  Partnership Dynamics  50% Education in Practice, 50% Education Theory...  Evaluation demonstrated lack of synergy between stakeholders in some areas

Enhancing Partnership Dynamics: Education and Practice Partnership Agreement What was the gap?  Historic multi-professional gap between Education Providers, Placement Providers and Undergraduate Medical and Dental Schools Contractual Relationships:  Learning and Development Agreements (LDA) between NHSWM and Placement Providers  National Contracts between NHSWM and Higher Education Institutions (Education Providers) What we did:  Large multi-professional stakeholders groups from Placement, HEIs and SHA were involved with the development of EPPA document and pledges

EPPA and the 3 Key Stakeholder Groups Placement Providers i.e. NHS Trust Placement Providers i.e. NHS Trust Education Providers i.e. HEI Education Providers i.e. HEI Commissioner i.e. NHS West Midlands SHA Commissioner i.e. NHS West Midlands SHA

Core EPPA Principles CurriculumRecruitment Placement Learning Placement Capacity Clinical Skills Sharing Information Fitness for Practice Student Support

Turning Principles into Pledges  The pledges...  Reflect a common understanding of how our relationships function  Capture the key roles and responsibilities of all partners in relation to each specific area  Represent a commitment by all  Have been agreed by all partners equally  Aspirational and not legally binding

1. Curriculum Development and Design Pledge

The Future of Education and Training?

The Future... What we know:  DH consultation Liberating the NHS: Developing the Healthcare Workforce (DEC 2010) sets out proposals to change the way the healthcare sector plans, trains and develops its workforce  It proposes the introduction of Provider Skills Networks (PSN)

The Future... Current knowledge to date: Providers need to form PSN as a legal body that will among other functions: 1. Manage and coordinate workforce plans for their health economy 2. Consult with communities to develop a local skills and development strategy 3. old and allocate funds 4. Commission/monitor/performance manage contracts for the provision of education and training (E&T) while quality assuring E&T standards and value for money

The Future... Current knowledge to date: Key national design principles require PSN to be:  Provider and employer driven  Multi professional  Able to evidence strong clinical and professional engagement and partnerships with Higher Education Institutions

The Future... Current knowledge to date : DH propose a new national leadership body – Health Education England (HEE) which will be a statutory body and special health authority to support:  National leadership on workforce planning and development  Allocate and account for resources that promote high quality Education and Training and develop Provider Skills Networks  The proposed timeline for change... March? July?

 Timescales are very tight  Disruption of services  Loss of knowledge  Resources spread too thin  Governance needs balance  Functions fragmented  Providers may disengage  Provider behaviour may not be strategic The Future... Risks

The Future... Opportunities  Provider driven  Local sensitivity  Time for change  New ways of working  Evolutionary

Thank You Adam J Turner Education Development Manager NHS West Midlands Lisa Bayliss-Pratt Education Lead NHS West Midlands