Education Outcomes Framework (EOF) – LWEG Presentation December 2012

Introduction NHS Mandate Bi-lateral Agreement Education Outcomes Framework - 5 Domains – Excellent Education; Competent and Capable Staff; Flexible Workforce Receptive to Research and Innovation; NHS Values and Behaviours; and Widening Participation - Outcomes and Initial indicators 2013/14 - Development programme and longer term indicators

NHS Mandate Section 4.7 (Page 17) Ensuring that people have a positive experience of care ‘….the NHSCB also has a statutory duty as to promoting education and training, to support an effective system for its planning and delivery. The Board should support HEE in ensuring that the health workforce has the right values, skills and training to enable excellent care.’

Bi-lateral Agreement HEE/NHS CB compact – excellent health and healthcare depend on a highly skilled and educated workforce so the two organisations have a strong shared purpose. Priorities may include: Workforce planning assurance Identification of strategic priority areas for workforce e.g. specific groups Widening participation (using the equality delivery system as a lever)

Education Outcomes Framework – Domains 1. Excellent education – Education and training is commissioned and provided to the highest standards, ensuring learners have an excellent experience and that all elements of education and training are delivered in a safe environment for patients, staff and learners. 2. Competent and capable staff – There are sufficient health staff educated and trained, aligned to service and changing care needs, to ensure that people are cared for by staff who are properly inducted, trained and qualified, who have the required knowledge and skills to do the jobs the service needs, whilst working effectively in a team. 3. Flexible workforce receptive to research and innovation – The workforce is educated to be responsive to changing service models and responsive to innovation and new technologies with knowledge about best practice, research and innovation, that promotes adoption and dissemination of better quality service delivery to reduce variability and poor practice. 4. NHS values and behaviours – Healthcare staff have the necessary compassion, values and behaviours to provide person centred care and enhance the quality of the patient experience through education, training and regular Continuing Personal and Professional Development (CPPD), that instils compassion and respect for patients 5. Widening participation – Talent and leadership flourishes free from discrimination with fair opportunities to progress and everyone can participate to fulfil their potential, recognising individual as well as group differences, treating people as individuals, and placing positive value on diversity in the workforce and there are opportunities to progress across the five leadership framework domains.

Outcomes and Initial Indicators 2013/14 Proposed indicators 2013/14 1. Proportion of NHS providers that deliver integrated workforce plans which meet or exceed minimum expectations, including demonstration of Board/ leadership group commitment. 2. Proportion of NHS providers complying with 11 agreed “placement standards” including support for supervisors and educators (incorporates P2 and P4 ECQ CPIs), and that do not have a “red” return in the six monthly Deanery return to the GMC. 3. RAG rating of evidence that commissioned education providers have responded to student, trainee or Deanery feedback to improve programmes (C2 ECQ CPI), 4. A “safe supervision” indicator derived from the use of both the National Student Survey and the GMC Trainee survey. 5. Average student satisfaction of students on relevant programmes using National Student Survey 6. Proportion of staff responding positively to Staff survey Q2 (training has helped them to do their job) Excellent Education Organisations delivering NHS services plan and implement the education, training and development that all their staff need to deliver excellent and safe services, now and in the future The education and training delivered to the future and current health and social care workforce enables them to deliver consistently excellent and safe care

Outcomes and Initial Indicators 2013/14 Proposed 2013/14 indicators 1. Proportion of staff responding positively to Staff survey Q2 (education and training helped them to do their job) 2. National workforce safe transition indicator on Registered Practitioners: Support Workers (following further discussion with the National Quality Board team to address concerns on case mix). 3. RAG rating of completion of national strategic plan with commissioning tolerances for three major staff groups 4. RAG rating of reaching strategic agreement on three major workforce challenges Competent and capable staff Organisations anticipate the numbers and capabilities of the workforce they will need for the future and demonstrate how they work singly and collectively to meet these needs High quality care will not be compromised by the lack of available staff with the necessary competence, capability and performance

Outcomes and Initial Indicators 2013/14 Proposed indicators 2013/14 1. Proportion of NHS Employer annual plans describing education and training initiatives to support: NICE CG 50 on the care of the acutely ill patient NICE CG (about to be published) on assessment of patients at risk of Fall, or An alternative NICE CG relevant to the work of the organisation 2. Proportion of NHS employers whose Annual plans include case study linking improvement need, to CPPD commissioned through discretionary funds, to outcomes 3. Proportion of staff responding positively to Staff survey Q7 a-d (can show initiative, suggest improvements and drive them through) 4. Identify how many patients are recruited into high quality research studies (defined as studies included within the NIHR CRN Portfolio Flexible workforce receptive to research and innovation Organisations improve services and modify their delivery to meet new demands. Staff respond to the opportunities to develop their understanding, knowledge, skills and their contribution. Organisations display a culture, which values research and innovation, and provide the practical support and the leadership to sustain this

Outcomes and Initial Indicators 2013/14 Proposed indicators 2013/14 1. Proportion of staff who respond positively to Staff survey Q12d 2. Indicator drawn from Patient survey following further consultation with Data Owner as an immediate priority. 3. Establish baseline of extent of values- based selection processes for new entrants into healthcare professional education. NHS Values and Behaviours Patients and carers report a positive experience of services consistent with the values and behaviours identified in the NHS Constitution Staff, including students and those in training, report that their capacity to deliver care consistent with the values and behaviours identified in the NHS Constitution is not compromised, and that their education, training and development positively helps them to do so. Staff report that they are treated in a way consistent with the appropriate values and behaviours by colleagues and by their organisation.

Outcomes and Initial Indicators 2013/14 Proposed indicators 2013/14 1. Establish baseline of RAG assessments for outcomes most relevant to education and training within the current NHS EDS, namely outcomes 3.1(recruitment and selection), 3.3 (training and development), 3.4 (freedom from abuse), 3.5 (Flexible working) 4.1 (inclusive leadership), and 4.3 (leadership competency framework) 2. Education providers demonstrate their approach to equality and diversity using metrics agreed with HFCE and OFFA. 3. RAG rating of education commissioner’s response to equality and diversity metrics from those organisations from which they commission. Widening Participation Organisations delivering NHS care help all staff to meet their potential and meet or exceed their obligations to equality and diversity Those commissioned to deliver education and training for the health and social care workforce meet or exceed their equality and diversity obligations

Excellent Education Development work 1. Longitudinal monitoring of major milestones for those completing training. 2. Studies of the impact of continuous personal and professional development activity (CPPD) on quality of care. 3. Work to strengthen the breadth and depth of data derived from survey instruments. One example being to seek to improve the data linking CQC standards 13 and 14 with health outcomes. Longer term indicators 1. Longitudinal studies of comparative performance in the workplace over a career of those having received different educational inputs. 2. Side by side analysis of Education, Training and Workforce Development plans with quality of care metrics for service provider organisations. 3. Analysis of impact of patient and carer experience on Education, Training and Workforce Development plans for healthcare providers.

Competent and capable staff Development work 1. Design, pilot and, if acceptable, implement surveillance of staffing related service failures. (This topic was not supported by all stakeholders, some being concerned about validity, and about attribution to the Education, Training and Workforce development system.) 2. Design and implement more robust monitoring of vacancies, including data from NHS Jobs Longer term indicators 1. Extent of alignment of service commissioner plans to transform services with provider and LETB workforce plans. 2. The surveillance of staffing related SUIs if this is implemented. 3. Reduced dependence on imported workforce, reflected in fewer professions on the Migratory Advisory Committee list.

Flexible workforce receptive to research and innovation Development work 1. Work with DH and with NICE to track the adoption of key innovations 2. How is the LETB linked to Academic Health Science Networks (AHSNs)? Develop measures drawn from the monitoring of Academic Health Science Networks 3. Establish a baseline to identify how many staff, including NIHR trainees are employed in the NHS and by qualified providers within the LETB. 4. Establish trends in emergence and adoption of new workforce roles in response to identified needs 5. Enhance evidence base linking education and training to implementation of innovative care and to reducing the translation gap. Longer term indicators 1. The wider adoption of valid measures such as the NHS Innovation Culture tool 2. Further development of the relevant parts of the staff survey 3. Data on academic careers.

NHS Values and Behaviours Development work 1. Further develop, with the appropriate data owners of the staff and patient survey instruments, to acquire more real-time data on patient and staff experience. 2. Work with professional regulators, including all of the PSRBs and with HEFCE and the Councils of Deans to move towards common approaches to obtaining feedback from students and trainees concerning their experience when on clinical placement. 3. Strengthen evidence of the impact of educational approaches designed to improve delivery of care e.g. Human Factors training, Use of Simulation, Initiatives to support distributed leadership Patient and carer direct input into education and training, 4. And from this develop new impact measures for the EOF. Longer term indicators 1. Measures derived from the activity described in the preceding paragraph 2. Used of shared decision making as a valuable proxy measure 3. Improved survey instruments with real-time feedback.

Widening Participation Development work 1. Work in partnership with those responsible for the NHS Equality Delivery System to strengthen links with the EOF outcomes, where necessary. 2. Evaluate effectiveness of NHS sponsored initiatives to widen participation in the NHS workforce 3. Work in partnership with HEFCE and OFFA to identify most effective ways of broadening the base of those entering education for the healthcare market. 4. Explore establishment of valid markers of equitable support for development for staff across the NHS workforce. Longer term indicators 1. Analysis of relevant elements of staff, student/trainee and patient surveys by protected characteristic 2. Enhancements to the NHS EDS 3. Indicators derived from new strategic widening participation agreements developed by HE and FE providers, including the ability to monitor impact of new Student Financing regime on the healthcare workforce.

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