NES NES/15/63
Item 8a (Enclosure)
August 2015
NHS Education for Scotland
Board Paper Summary
1.Title of Paper
Update against the Nine Strategic Outcomes
2.Author(s) of Paper
Caroline Lamb (Acting Chief Executive)
Simon Williams (Educational Projects Manager)
Donald Cameron (Acting Associate Director).
- Purpose of Paper
To update on progress against our nine key strategic outcomes for 2014-19.
- Key Issues
The Board and the Finance and Performance Management Committee receive regular reports on progress against our annual Local Delivery Plans (LDP) which are designed to deliver against our five strategic themes.
Our refreshed strategic framework for 2014-19 also identified nine key strategic outcomes, which were designed to develop excellence in specific areas of our business. The Board is aware of some of the developments and challenges in these areas from a range of reports and updates, received over the last year. This report aims to pull together a brief narrative against each one of the nine priority areas, to provide an overview of progress for the Board.
5.Educational Implications
This report includes the educational activity undertaken by NES over the period 1st April 2014 to 30th June 2015 in support of our nine strategic outcomes.
6.Financial Implications
These activities are delivered within the financial plan agreed by the Board.
7.Which NES Strategic Objective(s) does this align to?
These activities specifically support the nine strategic outcomes within the strategic framework approved by the Board on 23rdJanuary 2014.
8.Relevance to ‘Better Health, Better Care’
These activities support the current Scottish health and care policy context allied to feedback from our stakeholders.
9.Key Risks and Proposals to Mitigate the Risks
Some of the strategic challenges facing these activities are as follows:
- financial resourcing
- changing policy and political environment
10.Equality and Diversity Impact Assessment
The NES response to the equality and diversity agenda is set out in ourLDP.
11.Communications Plan
A communications plan has been implementedand a copy sent to the Head of Communications for information and retention:
Yes No
12.Recommendation(s) for Decision
The Board is recommended to consider and comment on the information contained in this report.
Strategic Framework 2014-19: Progress Report
Introduction
This report presentsprogress made over the first 15 months of our refreshed strategic framework for 2014-19. This update is not designed to cover the full scope of our activities, as recorded each year in our Local Delivery Plan(LDP), but insteadfocuses on identifying progress and challenges in delivering the nine strategic outcomes identified as requiring particular attention in our last strategic review.
Strategic Outcome 1
A demonstrable impact of our work on healthcare services.
One of our more complex challenges is how to assess the impact of our work.on those who work in and with NHS Scotland; on the services that they provide; and ultimately the service user. We recognise that in many cases we will only be able to clearly demonstrate our impact on those we train, and that it is extremely difficult to establish causal relationships between training and user outcomes.
Earlier this year we brought our directorates together in a workshopto share what impact data we currently haveand how it is used, in order to identify opportunities for collecting additional impact data or using it in a different way. This approach was generally agreed to be helpful and we expect to be able to build on this to develop core data sets.
We have also placed an increasingemphasis on impact within our updated educational governance framework and our corporate planning processes, supported by impact planning guidance, publications, case studies and workshops. Ultimately we are aiming to ensure that thinking about impact assessment is embeddedin our planning, to enable us to understand impact, (at the level of educational impact on the individual as a minimum), and to provide data to inform our decisions, policy and practice.
The Board has noted that we have now moved to describing the activities in our Local Delivery Plan in terms of their anticipated impact, and we will continue to develop this approach.
Strategic Outcome 2
An excellent learning environment where there is better access to education for all healthcare staff. (** a 2020 Vision priority)
We recognise that most of the learning which we support takes place in environments which are managed by NHS Boards and others. To support the development of an improved learning environment we have introduced and continued to develop a range of quality management systems, which support regulatory standards and excellence in education; and provide us with the potential to join up information across professional groups. Increasingly we are able to collect consistent data through the use of trainee surveys and other mechanisms across medicine and dentistry, nursing and midwifery, pharmacy, psychology and the healthcare sciences. This data is also key to the discussions that we are taking forward through the Sharing Intelligence for Health and Social Care Group which was discussed with the Board in December 2014 and which we co-chair with Healthcare Improvement Scotland (HIS).
It is clear that service pressures and particularly gaps in rotas can very negatively impact on the quality of the learning environment, and there is the potential for tension between the imperatives of delivering service and providing a quality learning environment for staff in training from all disciplines. At the same time, it is clear that the quality of the training environment is one of the factors that assists with the recruitment and retention of staff.
The Board is aware of the challenging nature of some of our discussions with NHS Boards in response to the trainee experience(for example from our report on the Vale of Level Hospital), and it is clear that we need to continue to pursue a robust approach to performance management of the training environment in order to protect trainees and to maintain the attractiveness of Scotland as a place to train. The Board will also be aware of our proposals for a single employer of trainees which have at their heart an opportunity to improve the training experience.
We also continue to strive to offer improved access to education for all healthcare staff. This is one of the key objectives behind our digital strategy, described under Strategic Objective seven.
Strategic Outcome 3
Flexible access to a broad range of quality improvement education in the workplace. (** a 2020 Vision priority)
Over the last 15 months we have substantiallydeveloped ourquality improvement (QI)education and curriculum. We have also brought together the staff teams responsible for QI, Clinical Skills, Patient Safety and Human Factors within the Professional Development workstream in medicine, thus enabling sharing of resources and expertise.
In April 2014 we assumed responsibility for the delivery of formal QI educational programmes from HIS and we have implemented and evaluated a programme for QI practitioners and leads including; the Scottish Improvement Leader;the Scottish Patient Safety Fellowship and; theScottish Improvement Skills programmes. In addition an ongoing development programme was created and implemented for faculty and facilitators of QI lead and practitioner-level programmes.
We also provide QI education and learning resources through the QI Hub website. There were over 1,000 unique user visits to our education and learning section in July 2014 compared with around 670 unique user visits in July 2013, representing an increase of 57%.
As we move forward with integration a key challenge will be spreading our QI resources across the wider public sector while also putting in place initiatives to embed quality improvement knowledge and skills within professional curricula.
Strategic Outcome 4
Leadership and management development that enables positive change, values and behaviours. (** a 2020 Vision priority)
The Board received an update on Leadership and management activity in NES in December 2014 which described our current provision but which also heralded a shift in emphasis and approach, particularly around enabling leadership for change. Since then, we have worked with Scottish Government and with the Scottish Social Services Council (SSSC) on a detailed leadership and management statement to bring alive the intention for leadership given in Everyone Matters. Discussions have also taken place with colleagues in Scottish Government, SSSC and NHS Boards regarding the development of a Scottish Public Service Leadership Framework.
We have also acknowledged that our provision needs to encompass more digital learning resources to complement the delivery of face to face programmes. We have recently completed a revamp of the GoodPractice.net content on our Leadership and Management Portal in response to feedback from users. This will improve access to digital resources, and is a priority for transitioning into the new NES Digital Platform.
We are now working with Scottish Government toprioritise our leadership and management activities to support the priorities identified for integration. Current initiatives include; public service leadership exchanges and the Enabling Collaborative Leadership Pioneer Programme; a Dialogue Community of Practice; a Scottish Coaching Collaborative; a programme to support leadership for integration e.g. a practical guide, workshops and a leadership framework; and a joint programme with the Royal College of General Practitioners (RCGP) and SSSC to develop collaborative leadership in primary care. It is anticipated that the participants in this programme will include the GP post CCT fellows described in the proposals for Pilot Extended Role Community Hub/Hospitals. This last development is supported by additional funding from Scottish Government, however it remains a challenge to identify resources for new activities and the prioritisation exercise will therefore need to pay careful attention to those things that we can scale back or stop doing in order to make best use of the resources that we have.
Strategic Outcome 5
A key role in analysis, information and modelling for the NHSScotland workforce to strengthen workforce planning. (** a 2020 Vision priority)
Since April 2014 we have continued to develop ourAnalysis, Information and Modelling (AIM) for Workforce programme to support the actions from the Everyone Matters Implementation Plan and the recommendations of the Pan Scotland Workforce Planning report.
We have continued to provide detailed analysis to support workforce reports, reviews and planning across dental, pharmacy, optometry, psychology, nursing and midwifery, and the AHPs; and have worked with the Scottish Ambulance Service on their annual workforce plan and with ISD to develop analysis around the Health Care Support Worker Workforce.
We are also continuing to strive to improve the accuracy of the data on which we can base workforce numbers for recruitment, succession planning and modernisation and to use the data to better understand changes in the workforce. In this context we have already developed extremely strong data that enables us to understand the undergraduate population in nursing and midwifery and have collaborated with SG and NSS to develop a data sharing agreement whichwill allow education and workforce data to be linked and analysed to further support workforce planning in this area. We have also worked on medical workforce data for the Scottish Government (SG) Transition Group, using our own data and GMC data to develop an analysis of the supply pipe for the medical trainee workforce and to further understandissues that impact on recruitment to training grades. Elements of these two pieces of work were shared with the Board at the discussions in our planning day and demonstrate the powerful nature of this analysis.
The data sharing agreement is a significant step forward in this area and opens up the potential for further valuable analysis, the limiting factor being the relatively small resources which we are able to dedicate to this work.
Strategic Outcome 6
A range of development opportunities for support workers and new and extended roles to support integration. (** a 2020 Vision priority)
A clear Everyone Matters priority is education for support workers in clinical support services, administrative services and estates and facilities. In addition we continue to up skill and develop practitioners to help reshape the workforce and support career development.
In late 2014 we published the Estates and Facilities Education Pathway and more recently in July 2015 the Business and Administration Education Pathway. Currently we are working on generic guidance for Recognition of Prior Learningand we are testing a Clinical Learning and Development Pathwayplus a digital resource for clinical Healthcare Support Workers (HCSW) which is in the final stages of development.
Over the last 15 months we have supported the development of HCSW learning networks in NHS Boards and we are running regional and national workshops to strengthen these. The Board will receive a full progress report on our work on HCSW at its September meeting.
We have put in place a funding scheme for access to qualifications for administrative services staff as well as programmes for Optical and Pharmacy assistants and professional development awards (PDAs) for Pharmacy technicians and Medical and Dental practice managers and receptionists.
We have also developed more qualified Pharmacy and Optometry independent prescribers (IP) to help shift the balance of care into the community through accredited IP courses, clinics and practice networks.
To support young people and help develop a more sustainable workforce we now provide careers advice and guidance through Scotland's national careers resource and we support a modern apprenticeship network for NHS Boards. To develop Nursing, Midwifery and AHP roles beyond registration we have put in place early clinical career and AHP fellowships plus practice internship opportunities. In Medicine and Dentistry we have continued to provide remote and rural, health inequality, paediatrics and academic fellowships.
Strategic Outcome 7
Improved and consistent use of technology with measureable benefits for user satisfaction, accessibility and impact.
In September 2014 we commenced development of a new vision for the future of our digital services. This vision is based around putting the user of our digital services at the centre, achieving a personalised experience available anywhere, on any device and with a single log on! To achieve this we are developing a single NES Digital Platform (NDP) hosted on a commercial Cloud platform accompanied by improved development methodologies and resources.
The Board has received a number of updates on progress with our Digital Transformation and is aware of the challenges of achieving this change while maintaining an excellent service to users and providing continuity for existing systems, websites and related platforms. The Board has also been briefed on the new agile development methodology that we have adopted and of the considerable success we have achieved in developing our new applications through this collaborative methodology. The trainee management element of the functionality (TURAS) is now fully delivered and access to partner health boards will be enabled from August. Development of the next aspect of our learning management systems (portfolio functionality) commenced in July, and the technical architecture for the full NDP is well developed.
Strategic Outcome 8
Consistently well developed educational support roles and networks to enable education across the workplace.
Our aspiration to provide an excellent workplace learning environment needs to be enabled by training and support for the network of educational support roles who work for and with us across Scotland. These include our training programme directors (TPDs), trainers, educational supervisors, tutors, practice education coordinators (PECs) and facilitators (PEFs). Over the last 15 months we have worked to ensure that we can meet the requirements of the GMC around recognition of trainers and this has included developing the Scottish Trainer Framework (STF), a digital resource designed to help medical teachers and trainers plan their personal and professional development as educators. These initiatives plus a broad range of Train the Trainer courses and resources such as the Training in Generic Supervision Competences for Psychological Therapies programme for qualified staff who are about to take on an educational supervision role,help us to ensure that there is capacity and capability to deliver and supervise work based education.
There is no doubt that as services are under increasing pressure we will continue to face challenges in accessing and supporting the networks that we need in place in NHS Boards and elsewhere to support education.
Strategic Outcome 9
An effective organisation where staff are enabled to give their best and our values are evident in every day work.
For our staff we are aiming to achieve a continuously improving environment evidenced with high levels of employee engagement and development which helps our staff perform to their potential and aligns individual performance with organisational aims. Over the last 15 months we have progressed a range of initiatives in support of Everyone Matters, such as the iMatter resource, to help us understand and improve our performance against the Staff Governance Standard. In addition we have aligned objective setting and personal development planning to our corporate plans and we have implemented the Managers Passport self assessment resource to support staff development planning. In May 2015 we also introduced an annual staff conference which included an employee recognition scheme. The Board has been kept briefed on these areas through its Staff Governance Committee.
We have also presented a substantive report to the Board on ourOrganisational Performance Improvement Programme (OPIP), through which we continue to support significant programmes oftransformational change in Procurement, Finance, Property and Digital. In addition we have moved from regional to national work streams in our Medical and Dental directorates, we are embedding a programmatic approach to our NMAHP work and we are reviewing how our activitiescould be better delivered across a range of our business processes. We have implemented policies, agreed in partnership, to support organisational change which has a particular focus on communicating, consulting and responding to feedback. As an Executive Team we have also been developing a Leadership Strategy for NES and are currently in the process of consulting with staff on this.