A Review into improving the cost and effectiveness of mandatory training provision in an NHS Foundation Trust

1. The Future of
Mandatory Training Provision
Version 3.3
November 2009
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2. Key contacts in relation to this
Report are:
Paul Jones
Director of Human Resources & Table of contents
Organisational Development
T: 01226 434405 Section Page
E: pauljones1@nhs.net
Recommendations 3
Kevin Palmer Why this is important 4
Assistant Director of Human
Resources (Learning & OD) Defining the problem 7
T: 01226 432703
A New Paradigm 8
E: kevin.palmer@nhs.net
Training Map 9
Change Plan 10
Profile of the Benefits 11
A narrative for the change 12
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3. Summary Recommendations
1. Adoption of national best practice for future mandatory training provision
2. Reducing the number of subject areas which are classed as “mandatory”
3. Training delivered proportionate to the risk which the business runs
4. Rapid accreditation of workplace risk assessors to manage risk and assess need for training
5. Accreditation of prior learning, if people demonstrate competence in the workplace
6. Training to be segmented to the needs of the workforce group to reduce irrelevant or wasted
training
7. Change the modality of training to introduce greater e-learning provision and more training in
the workplace through divisional trainers
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4. Why this is important

5. Balancing Cost with Risk
Scope of our current mandatory training investment:
 3,000 staff per annum require mandatory training under current Trust policy and practices
 £100,000 direct costs of trainers in delivering mandatory training every year
 16,639 hours of staff time invested in training attendance to meet compliance with current Trust policy *
 Equivalent to 8.51 WTE pa displaced from front line delivery to the business
Challenges of managing statutory and regularity risk:
 Unlimited maximum fine for breach of Health & Safety at Work Act
 3,645 deaths occurred across the NHS last year due to poor infection control and avoidable mistakes
 Failure to meet CQC and NHLSA compliance standards has significant financial and reputational implications and can increase insurance
costs by over £ 1.2 million pa
“Can’t my competency be tested rather than having “We really support the Trust’s efforts to deliver
to attend training that I don’t need?” more training through e-learning on the ward and if
possible at home”
”Policies are approved without any consultation “Don’t treat me like an idiot. The Trust does that to
on the relevance or practical ability to deliver” me every year on mandatory training. More
importantly it wastes time and money”
* Based on proposed focus of a core of 9 x mandatory training courses
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6. What we are going to do

7. Defining the Problem
Policy Goal
Ensure the Trust discharges it’s statutory and regulatory
obligations for a competent workforce and effectively
manages risk
Migration to best practice Segmentation of Proportionate risk based Adoption of new
policy workforce assessment Modalities for training
Aim Aim Aim Aim
Not all subjects are Not all subjects are Risk can be managed in a •Training can be delivered in
mandatory for all staff applicable to all staff, multitude of ways, training is a multitude ways
 Not all subjects require training should be based on just one control • For some staff groups
annual update training need  The training response other modalities of training
 Not all training is required  Some staff will have should be proportionate to are both more convenient
to be delivered didactically received training in other the risks we run as a and better meet their training
in the class room organisations business need
Actions Actions Actions Actions
 We will migrate all training  We will develop a map to In future all training will be • We will identify a package
to nationally recognised best signpost staff only to that proportionate to the risk of nationally accredited E-
practice by the Department mandatory training which is  Training will be prioritised learning packages
of Health relevant to them to those job roles or • We will deploy these to
 We will cease to  We will accredit prior business functions where enable ward based access
automatically require annual learning for training done the risk is greatest for the majority of our
updates in all mandatory else where  Training will be part of a workforce
subjects  We will not train staff who blended solution to • People will be sign posted
 We will reclassify subjects already demonstrate they managing risk in the to the appropriate learning
to make clear what is a are competent either business, rather than the package for their role and
statutory requirement and through a workplace only or main solution on-line tests will assess
what is desirable. assessment, e-learning test Prior Learning for new staff competence and provide an
or prior learning elsewhere recognised and updated audit trail
through ESR
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8. Creating a New Paradigm
FROM… “Mandatory TO…“Mandatory training is
training is delivered to delivered to meet the needs
meet legislative needs” of the business”
Reflexive response Mindful approach
• Training is designed and • Training is designed and
delivered to suit trainers Mindset delivered in partnership
with customers in the
business
• E-learning is a major
• E-learning is a minor part component in a blended
of our learning portfolio Technology approach to developing
• Training design is competence
determined by the • Training design is
preference of the policy determined by national
lead or subject trainer best practice standards
• Training is a sheep deep • Training is risk assessed to
which everyone must go recognise peoples
through Segmentation competence
• Use one delivery • Delivery is adjusted to suit
approach for all people, the needs of customers and
and all circumstances recognises prior learning
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9. Mandatory Training Map
Current State Future State
Current Mandatory Future Mandatory
2009 Training Provision: programme: 2010
29 Subjects 9 Subjects
Business Benefits
Fire Health and Safety Annual £276,821 Total Savings
Update
Infection Control Requirement 7,449 hours productive time
Future Mandatory Training Programme
back to the business
Resuscitation *
Equivalent to 3.8 WTE pa
Major Incidents Update
Requirement £135,182 productive time saved
attributable to e-learning
Every 2 Years Update
Manual Handling
Requirement £27,039 productive time savings
Child Protection Every 3 Years attributable to change in frequency
£15,000 pa cash releasing savings
Conflict Resolution attributable to reduced venue hire
Equality & Diversity Better meeting of individual
training need
Adult Protection Proportionate response to
management of risk
The following represents the revised map of statutory and mandatory training provision for Barnsley Hospital NHS Foundation Trust. Account
has also been taken of a recent national PASA study which sought to standardise policy in respect of mandatory training provision across the
NHS. A consultation exercise was also undertake to take account of customer views with representatives drawn from each business unit of
the Trust together with relevant policy and subject leads. In future mandatory training provision will move from 29 subject areas to a core of 9
subjects, with a frequency of update every other or every third year. In addition 8 of the 9 subject areas will have an e-learning option in place
during Q4 2009-10, further reducing the requirement for class room delivery for the majority of staff. A map of training delivery options will be
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produced to guide staff to the training provision which is appropriate to their job role.
* Clinical staff only

10. Change Plan
November December January February March
Adoption of Best Practice Policy
Policy
Mandatory Training moves to 1-3 year update requirement
Course provision adjusted to reflect reduction in annual update requirements
Training of key manual handling trainers in each division for work place training
Capture benefits and assess effectiveness in
Train Risk Assessors in each division Workplace Risk Assessments
Risk
managing risk
of Workforce to E-learning
SHA Funding Application
Migration
Mobilisation of Project Team Deploy E-Learning Packages
Segmentation
Adoption of national best practice Training Delivery prioritised to high risk areas
Signpost training provision to needs of job role
Accreditation of prior learning through ESR record
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11. Capturing the Benefits
Current State Training Future State
Time
100% workforce 16,639 hrs
3,000 WTE
16,639 hours in
class room training
£100,000 in direct 9,170 hrs
trainer costs 8,170 hrs 8,170 hrs
Modal shift to e-learning &
adoption of national best
Further reductions due to
practice on frequency
workplace risk
Hours assessment
2009-10 2010-11 2011-12 2012-13
The following table provides a graphical illustration of the reduction in classroom based training in the proposed mandatory training areas in
each year from 2009-2013. This is based on the adoption of national best practice policy recommendations on frequency of update training, a
migration to e-learning delivery and better targeting of training to individual needs (and prioritise high risk areas) through workplace risk
assessment in areas such as manual handling. Training is therefore more focused on needs and better manages risk for the business. This in
turn leads to a better deal for staff and our patients
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12. Developing the Narrative for this Change
Mandatory
Plans for the Future Training needs
Delivery of Mandatory reform…
Training form the
backbone of the It does not
currently meet
narrative….
business need,
or effectively
manage risk…
…but this will need to be Reform will aid
supported by a compliance and
Compelling Narrative on provide a better
why we need to change to deal for staff
overcome resistance and and patients
build support
The narrative is the plan with a compelling rationale…
…whilst the plan is the narrative with concrete deliverables
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