Health Education South London Standards for Assuring Quality in Practice Placements

1. Health Education South London Standards for Assuring Quality in Practice Placements Susan Aitkenhead, Project Lead Susan.aitkenhead@gstt.nhs.uk

2. Project Scope – Assuring Quality in Practice Placements • The over-arching scope of this project is to work with the relevant stakeholders across South London to develop a set of standards for assuring the quality of practice placements and an aligned multi-professional methodology to ensure their achievement. • Quality is the main driver of this work while also examining the linking of the payment of the placement tariff to the successful achievement of the standards, to ensure the strengthening and support of multi-professional practice education.

3. Environment • Focus on the areas that learners can be placed to gain practical healthcare experience during their training across all of the sectors and the specialties.

4. Background and Rationale • Ensuring the health workforce has the right skills, behaviours and training, available in the right numbers, to support the delivery of excellent healthcare and health improvement: The Education Outcomes Framework (2013) • The final Mid Staffordshire NHS Foundation Trust Public Inquiry by Sir Robert Francis (2013) has several recommendations pertinent to education and training central to the report, urging that providers of clinical placements should be unable to take on students or learners in areas which do not comply with fundamental patient safety and quality standards. • The government response to the final Francis Report, Hard Truths: the Journey to Putting Patients First has education and training as concurrent themes throughout the response and it is particularly highlighted that ‘education and training are critical to securing the culture change necessary for the best patient care now and in the future’.

5. Methodology of development: • It was recognised there are a varied collection of documents already relating to guidance and standards for practice-based learning, and a review has been undertaken to consider other work and the reporting and measurement. • Meetings have been held with a wide range of multi-professional and academic stakeholders across a variety of sectors and organisations. • Information relating to existing quality standards for practice education or placements was also accessed and discussed directly with bodies such as the professional colleges, via email and face to face. • Meetings have additionally been held with some experienced practice educators and some pre-reg nursing students kindly volunteered their time to help consider what made a practice learning environment a high quality experience for them.

6. It was recognised that the national regulatory bodies are charged in legislation with setting UK standards and meetings have been held with the Nursing and Midwifery Council (NMC), the Health and Care Professions Council (HCPC) and the General Medical Council (GMC). These meetings were to inform the regulators of the project, and check that there was no duplication or confusion in relation to the aims of the project. • The draft Standards were discussed with the HESL medical quality and commissioning team to ensure alignment with standards already in use. • Additionally a very helpful teleconference with NHS Education for Scotland discussed their extensive work in this area.

7. Stakeholder meetings: • An abundance of helpful information was gathered from these meetings and was explored to see where any similarities or themes existed to help shape the draft Standards.

8. Works well.... • A lot of strong and committed mentorship; • Local award schemes – mentors and clinical areas; • Students are felt to be more confident in raising concerns about patient care; • Some local approaches to student feedback similar to FFT methodology; • Key accounts meetings strengthening HEI/Provider relationships; • NSS data helpful; • Learning contracts – staff agree what they will bring back to the practice area post course to support development and learning culture; • Student support skills for Nursing Assistants; • Chartered Society of Physiotherapists undertaking work on online interactive resource with information, support and guidance related to practice education.

9. Challenges and Gaps: • Education not always being recognised as a core component of everyone’s role; • The need for more inter-professional working and assessment; • Still some reliance on ‘relationships’ rather than systems and processes; • Lack of equity in standard of mentorship/supervision; • Lack of seniority and ‘authority’ of some provider educational roles; • Methodology for working out ratios of educational supervision to learners/bed numbers; • Lack of detailed costing breakdown by profession; • ‘Power balance’ still not equitable – particularly early student placements; • Language – ‘work’ not ‘learn’; • Need clearer process/structure around info-sharing including private and 3rd sector; • Exemplars to be shared and help align best practice across the patch.

10. Draft Standards with associated principles

11. Indicators sit under each Standards • Request for ‘evidence’ under each... Now in Phase 2 – developmental pilot stage testing in a variety of environments: • Test the relevance and measurability of the standards; • Include representation from multiple professional groups; • Examine the applicability of the Standards in a range of settings where education and training take place; • Examine the need to balance rigour with the need to minimise additional burden on staff when taking into consideration other reporting that is currently undertaken; • Highlight recommendations for wider roll-out and any further development.

12. ‘Test’ Quality Review Process • The purpose of the Quality Review is to: • Identify and highlight excellent standards of practice; • Further explore areas where concern might appear and then help with any required improvement. • July 2014:Separate site visits led by Health Education South London – • Senior HEI rep – such as Head of School or Pro-Vice Chancellor; • DoN external to patch; • Expert clinicians; • Learner representatives; • Lay representatives; • Pan London Quality and Regulation Unit

13. This pilot is focusing on non-medical practice placements; however from the start of this project an aim has been to develop a set of standards for assuring the quality of practice placements with an aligned multi-professional methodology to monitor and assure their achievement and the results of this pilot will help inform the consideration of how that objective can be met. • [END]