“The impact of education and training on patient safety” International Forum on Quality and Safety in Healthcare Professor Ian Cumming Chief Executive, HEE

‘Health is all about people. Beyond the glittering surface of modern technology, the core space of every health care system is occupied by the unique encounter between one set of people who need services and another who have been entrusted to deliver them’ Health professionals for a new century [first published in the Lancet], 2010 HEE exists for one reason: to improve the quality of care delivered to patients. Through our Local Education and Training Boards (LETBs), we ensure that our workforce has the right skills, values and behaviours, in the right numbers, at the right time and in the right place. Context

Workforce Planning Attracting and recruiting the right people to the posts we have identified Commissioning excellent education and training Lifelong investment in people We have many key partners including other ALBs, HEIs, Regulators, Professional Bodies, DH, Patient & Public organisations Training the future workforce; transforming the present workforce HEE’s core functions

Context…. Winterbourne Worcester Acute Morecambe Bay

The best predictor of the future is the past….

Changing the NHS Culture…. Our business

It takes up to 13 years to train a consultant Every year we invest 4.8b in education and training places, making expensive assumptions about future health care models If we are wrong, under-supply could result in unmet need; over- supply means an unemployed workforce & wasted resources And we risk locking the service into outdated models of care We need an explicit strategy to guide our investments in the future HEE strategy: why a 15 year framework? Success = ‘when a person turns to the NHS for help, their needs are met by people with the right numbers, skills, values and behaviours to provide high quality care.’

Internet access is likely to grow globally by 2-3 billion by 2025, with estimates of new devices ranging from 5 billion to a trillion. in 1948, 48% of people died before the age of 65. At least 1/3 of babies born in the UK today will live to see 100 The average age of NHS employees in the UK is currently 44 years rising to over 47 years by Global Drivers of Change People & Patients of the future The number of people with a long-term condition (LTC) is set to rise by 19% to 18m by 2025 The number of downloads of mobile healthcare and medical apps is predicted to more than triple from 44 million in 2012 to 142 million in % of cancer patients want to be more engaged in their care. Workforce of the Future The hidden workforce: 6m UK carers set to rise to over 9m by 2043 Currently 30% work part time: likely to rise as average age of NHS employees increases and surveys show trainees want to ‘work less and live more’ The Future Patient will require staff who are able to provide ‘whole person’ wherever the patient is: at any time and in any setting.

Key drivers of change -Informatics- Demographics -Economics - Genomics

Mind the (generational) gap ‘Baby Boomers’‘Generation X’‘Generation Y’‘Generation Z’ Motivated and hard working; define self- worth by work and accomplishments. Practical self-starters, but work-life balance important. Ambitious, with high career expectations; need mentorship and reassurance. Highly innovative, but will expect to be informed. Personal freedom is essential. 25% of the NHS workforce 40% of the NHS workforce 35% of the NHS workforce <5% of the NHS workforce Jones K, Warren A, Davies A Mind the Gap: Exploring the needs of early career nurses and midwives in the workplace. Summary report from Birmingham and Solihull Local Education and Training Council.

Patient Safety Programme for England March 2014 Health Secretary call to action to: o Make the NHS the safest system in the world o Halve avoidable harm and save 6000 lives in 3 years Initiatives for safety improvement aligned to contribute towards achieving shared goal Create a conducive context for improvement at a local level

We have a responsibility Our commitments  Include Human Factors in curricula and training frameworks – Human Factors in Healthcare Concordat  Culture of safety and ensure clinical performance is paramount across education and training – Mandate from Government  Staff know how to raise and respond to concerns – Mandate from Government  Ensure principles of safeguarding are integral to curricula – Mandate from Government  Review mandatory training and set minimum standards are set – Mandate from Government

Human Factors and Ergonomics aim to optimise human performance by better understanding the interface between humans, their environment and their equipment It draws upon the characteristics and potential issues that can influence the behaviour and non-technical skills that can affect patient health and safety “About designing for people, wherever they interact with products, systems or processes … to ensure that designs complement the strengths and abilities of people and minimise the effects of their limitations, rather than forcing them to adapt”. Institute of Ergonomics & Human Factors (IEHF) Human Factors & Ergonomics

Our integrated approach Healthcare staff Experts Academics Regulators Patient/lay representatives Learners National partner organisations  Review Education and Training  Identify and evaluate good practice  Raise awareness and share good practice  Build capability across the system Commission’s Report  Review Education and Training  Identify and evaluate good practice  Raise awareness and share good practice  Build capability across the system Commission’s Report Learning to be Safer Programme HEE Advisory Forums Human Factors Commission on Education and Training for Patient Safety Safeguarding Safe Staffing Better Training Better Care

System-wide change and partnership working Local resource to support delivery Local investment is not transparent or consistent – variation and risk of duplication ‘Not invented here’ – lack of buy-in and uptake on recommendations and good practice Challenges

The Commissions Timescale TimelineDeliverable YEAR 1 Current Review Education and Training Identify and evaluate good practice Raise awareness and share good practice Produce educational films on raising and responding to concerns Oct/Nov 2015Publish report and HEE response including commitment to developing strategy YEARS 2-5 March 2016 onwardsPublish and Implement strategy

“We always overestimate the change that will occur in the next two years and underestimate the change that will occur in the next ten. Don’t let yourself be pulled into inaction.” Bill Gates We must be bold and brave…

Questions?