HEE Quality Framework, Professional Regulation and Multi-Professional Reviews David Wilkinson Postgraduate Dean

Multi-professional lens 11/13/2017 HEE Quality Framework Statutory duty to secure continuous improvements in the quality of education and training Promoting skills and behaviours that will uphold the NHS Constitution – work-based learning environment crucial to this endeavour. Quality Framework Core metrics Data driven Risk based Multi-professional lens Measure quality Identify quality Improve quality Clinical environment focus Broad multi-professional education support infrastructure Consistent and comparable view of quality National and local level High quality patient care Supporting learners Quality improvement

HEE Quality Framework – Strategic Context Patient and Learner Outcomes Learning Environment and Culture Educational Governance and Leadership Supporting and Empowering Learners Supporting and Empowering Educators Developing and Implementing Curricula and Assessments Developing a Sustainable Workforce HEE quality framework Custodians of the clinical learning environment Workforce with the right skills, values and behaviours Safe, effective and compassionate patient care Patient Safety Sustainability & Transformation Plans (STPs) Quality Improvement Quality ‘Early Warning System’ September 2016 9

Driving Quality Improvement Proportionate and evidence based support for quality improvement Thresholds for risk assessment, escalation and system response to concerns about quality Interwoven pertinent quality improvement initiatives to gain England-wide traction e.g. feedback, study leave, rotations, raising concerns, induction. Whole workforce quality perspective e.g. MDT development, high quality for all learners Enable identification, sharing and adoption of good practice across England Ensure lessons learned process from any critical issues Robust processes, systems and governance to underpin all of the above

Driving Quality Improvement Approval of programme and work-based learning sites (HEE, Professional Regulators and Local Education Providers) ‘Intensive support’ for quality improvement in learning environment. Suspension of approval and removal of students in partnership with HEIs, providers, regulators. LEARNING ENVIRONMENT High Quality Critical Incident Declining Quality Proportionate and timely support to enable sustainable quality improvement in the clinical training environment

Quality Framework Implementation Examples of exploratory interventions: High risk Learner clinic Desk-top review Programme review Informal visit Triggered visit Escalation to HEE ‘intensive support’ process / regulators Low risk Examples of supportive interventions: Expert advice Access to training Disseminate good practice Facilitate peer review Learner involvement; Senior-led engagement

Risk Rating

Quality Framework Implementation Scenarios – exploratory: a) Programme review Cross-site review of programme Led by quality lead & clinical educator Focus group approach with learners b) Triggered visit Site visit Significant risk / urgent response Team may incl. senior HEE lead, medical & non-medical expert, Quality lead, Lay Partner & poss. regulator input

Quality Framework Implementation Scenarios – supportive: a) Access to training Facilitate access to, or deliver, training for educators / mentors b) Learner involvement Learners often have solution Facilitate networks of learners Support fellowships Support QI projects

The Commission Report: Recommendations Final recommendations have been set out under four broad themes Creating a culture of shared learning 2. Lifelong learning – focussing on safety from start to finish 3. The patient at the centre of education and training 4. Delivering education and training for patient safety

The Commission Report: progress and next steps Mapping exercise undertaken across HEE to establish best practice to deliver the recommendations Stakeholder workshops held on 14th July 2016 to elaborate on mapping and engage key stakeholders HEE Response to the Commission and implementation to deliver the 12 recommendations (to be published December 2016) ALB Roundtable discussion held on the 9th November 2016 involving HEE, Colleges, Academy, NHS I, CQC, NHS LA, Leaners, Patients Strategic Alignment with the HEE Quality Framework which will provide a robust vehicle and local ownership with STP for delivery of the recommendations Patient Safety and Quality Conference scheduled for 2nd February 2017

A multi-professional approach As part of HEEs implementation of the national Quality Framework, the Yorkshire and the Humber office has piloted a new process for the Multi-Professional Review (MPR) of learning environments during 2015/16. The aims of the pilot were to: Establish whether the Quality Framework will assist in the identification of common themes when reviewing the professions together. Establish the extent to which an MPR reduces the burden of HEE visits for local education providers by holding one larger multi-professional visit rather than multiple visits.

A multi-professional approach In total four reviews have taken place: 10th November 2015 to Doncaster and Bassetlaw Hospitals NHS Foundation Trust 11th October 2016 to Bradford Teaching Hospital NHS Foundation Trust 2nd November 2016 to Dental Training, covering all Learning Environments 15th November 2016 to The Rotherham NHS Foundation Trust

A multi-professional approach: Evaluation 71% found the format allowed for a comprehensive exploration of the learning environment 65% felt the MPV made a positive contribution to the understanding of the learning environment 82% found the ‘Standards for Local Education providers’ assisted in identifying common themes 88% of learners felt the discussion alongside other professional colleagues was a positive experience 94% of learners felt they could communicate quality issues with the panel 100% found the multi-professional self-assessment report to be of relevance

A multi-professional approach: Comments .. a welcome new initiative which may add value to the future practices in the NHS (learner) Having a multi-disciplinary approach worked well. It highlighted where communication and training between the different disciplines could be improved. (educator) The approach worked well, it highlighted the lack of opportunity for multidisciplinary learning environments. (learner representative) I wonder whether in 10 years’ time we will look back and wonder why we waited so long to do this (Panel member) ….it was interesting how despite the different professions our views triangulated (Panel Member)

Conclusion Quality Framework introduced in April 15 Development and evaluation takes place during 2016/17 Patient Safety and Quality Conference scheduled for 2nd February 2017 Full Launch April 17

Thank you HEE. CommissioningForQuality@nhs. net hee. nhs Thank you HEE.CommissioningForQuality@nhs.net hee.nhs.uk/our-work/planning-commissioning/commissioning-quality