Clinical Learning Environment Workshops November 2015

Aim of the Day Aim: To design an approach to improve workforce supply by: Improving the quality and capacity of the clinical learning environment Enhancing approaches to employability of students

Why Review Pre-registration Nurse Education 23 programmes per year at 6 HEIs £100m+ per year National nursing shortage Willis Commission: Shape of Caring KLoE – ‘what should excellent nurse education look like’? Engagement with nurses, students, HEIs, service users

What We Found Practice Education/Mentorship most frequently cited theme Too much variability in practice education Not enough focus on students delivering care Variable assessment of skills Students may not learn to be employees Not enough learning between branches – person centred care Not prepared to work in a range of settings

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 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

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

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

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

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

High quality practice education is key so HEEoE have piloted…. ‘Roving’ practice teacher in HV programme CLiP DEU / PEBL(S) Lead Mentor Model To try to establish a framework and standards for improving the quality and capacity of practice education What HEEoE Has Done

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

Group Work If we implemented these principles, what would success look like? What would be the metrics to measure improvements in quality and capacity?

Jenny McGuinness Head of Education & Commissioning Health Education East of England

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 …..

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

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

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 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

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

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

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

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 students Aim: 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

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 students Aim: 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

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 NQHPs Aim: To ensure that all NQHPs who complete training in HEEoE have a suitable offer of employment within the HEEoE health system

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 NQHPs AIM: 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.

Group Work Are these the right things? Is there anything missing?

Group Work What activities are needed to deliver the elements of the employability workstream? Whose responsibility are they?