Lifelong Learning And Continuing Professional Development Strategy February 2005

1. Introduction “Getting the best for patients, staff and the service means developing an organisation wide culture that values training and learning by all staff” (Audit Commission, 2001). Birmingham and Solihull Mental Health NHS Trust is fully committed to equipping all employees and teams with the skills, knowledge and attitudes required to improve and deliver services. The Trust believes that the Diversity of people is the most valuable asset it has. Diversity must play a key part in shaping education, training and development. This strategy aims to make explicit that intent and outline and link developments to ensure that the workforce is capable of delivering both local and national requirements in a way that puts the Service User and /or Carer at the centre of all we do. The Trust firmly believes that learning is key to improving service delivery. This can only be achieved if learning is undertaken by all to improve the ways things are done within the Trust, we believe this is the essence of good Clinical Governance and Service Modernisation. The Trust is therefore working to develop and sustain a culture and environment where learning is recognised and celebrated as being fundamental to its success not in isolation but with service users, carers and partners. The implementation of this strategy will be monitored by the Learning and Development Committee, which will provide feedback to the Clinical Go vernance Committee, and ultimately to the Trust Board (See Appendix one for reporting structure). This will be achieved by providing regular written feedback against the achievement of the key strategic objectives outlined within this Strategy. This document should be used in conjunction with both the Trust Diversity and Risk Management Strategies. 2. Principles and Values Everyone should have access to opportunities to learn and the Trust is committed to providing an environment where this can take place. Learning is, however not something that can be ‘done’ to someone. It is a participative process and the Trust aspire to create an environment where people want to learn with us and from us. It is not just our staff but service users, carers and partners who all have a role to play in learning and in teaching. Learning is not just about sitting in a classroom and being talked to. Learning is about participation and variety, appealing to all learning styles and all abilities. Birmingham and Solihull Mental Health NHS Trust therefore believes in both utilising existing processes and developing learning opportunities that provide a variety of stimuli and activities to meet the needs of all. 2

Learning will be focused on the delivery of care and as such will be designed to improve individuals, teams and the organisation in the way we develop and deliver services in partnership to an increasingly diverse population. In doing this we aim to: q q q

Enhance and maximise individual performance. Promote and develop fle xible working through multi-disciplinary team-based learning across traditional professional and service boundaries. Facilitate the modernisation of working practices.

Finally we aspire to become a Learning Organisation, “one in which people at all levels, individuals and collectively, are continually increasing their capacity to produce results they really care about" (Richard Karesh) 3. Context This Strategy for Lifelong Learning and Continuing Professional Development is influenced by policy initiatives guiding best practice. The NHS New, Modern, Dependable White Paper (1997) heralded a radical change agenda, which introduced the concept of Clinical Governance. For Birmingham and Solihull Mental Health NHS Trust, Clinical Governance is about putting the service user at the focus and developing quality services that ensure that what we do is right, timely and based on best evidence. Learning at all levels and by everybody is key in turning our philosophy of Clinical Governance into reality. In order to achieve this the Trust must also ensure that the following are integral to the education, training and development agenda: •

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Learning in partnership is key to success, in particular partnership with the Strategic Health Authority, Workforce Development Directorate, NIMHE, Primary Care, Secondary Care, Social Services and providers of Education and Training. Establishing the Trust as a Learning Organisation is a prerequisite achievement of success. Senge (1990) identified the core principles of a Learning organisation as personal mastery, mental models, team learning, shared vision, and systems thinking. This is the essence of the type of organisation Birmingham and Solihull Mental Health NHS Trust aspires to be in striving to provide the keys to success for the population of Birmingham and Solihull. Improving Working Lives (DoH, 1999) and a Health Service of all the Talents, (DoH, 2000) highlight the importance of continuing professional development for individual staff, the organisation and patient care. Working Together - Learning Together (DOH, 2001) is a framework for lifelong learning for everyone working in the NHS, which is fully supported by the organisation. Vital Connection (DOH, 2000) highlights the importance of systems and structures to enable diversity to be utilised and championed in a positive way in organisations.

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The three main pillars of Modernisation, Respect, Rebuild and Redesign demand that we use our learning from experience and learn to do things in different ways. HR in the NHS Plan says that we must have more staff working differently (2002). It identifies four pillars: making the NHS a model employer, ensuring the NHS provides a model career through the concept of the skills escalator, improving staff morale and building people management skills are all based on learning and development as a key to improving services. Learning must also support the implementation of National Service Frameworks, which provide structure to improving services.

4. Supporting Learning and Development This section outlines nine key priorities, which are underpinned by strategic objectives, which are key in order to support education, learning and development within Birmingham and Solihull mental Health NHS Trust. These key priorities will underpin the integration of education training and development into the Trusts wider modernisation agenda. 4.1 Patient/User Focus At the centre of all activity within the Trust is the maintenance of a patient focus. Opportunities for learning therefore need to reflect this approach both in terms of the integration of a patient, client or service user, within existing learning opportunities and as part of the development of new learning interventions. We need to seek to engage service users as an integral part of this process. Strategic objectives To support the development of service user centred services in all areas of the Trust. This can be achieved by: q q q

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Ensuring that service users are at the heart of learning activity. Create opportunities to learn with and from services users. Develop opportunities to enable service users to be really involved in and influence learning activity across the organisation to meet identified learning and development needs. When developing training and development interventions consider service user participation and engagement.

4.2 Communication Communication is at the heart of NHS activity. In relation to learning it is a fundamental aspect not only in providing the learning experience but also in accessing opportunities and creating an environment to learn. Improving communication is a continuous process.

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Strategic objectives To listen, learn and really make a difference to service user and staff experiences. q q q q

q q q q q q

q q q q

Facilitate feedback systems to influence the opportunity, style and approach of learning interventions and how these are communicated. Develop a culture where everyone understands their responsibility for sharing their learning. Create opportunities for sharing learning across the health economy. Develop clearly understood systems and processes for accessing learning interventions that are consistent and meet the diverse needs of staff within the organisation. Really listen and act on what service users, carers, staff and our partners are saying. Be clear about the expectation of staff members in relation to training, education and development. Facilitate understanding of the connection between personal development planning, clinical governance and the business of the organisation. Effectively communicate varied learning, education and development opportunities across the Trust. Develop a Study Leave Policy, which incorporates the study leave process and communicate the training and development cycle for all staff. Ensure all staff have a CPD/Personal Development Portfo lio where key information to support individual development and the appraisal/development review process can be maintained. Provide training to support the implementation of Personal Development Portfolios. Undertake publicity to meet Trust targets for Individual Learning Accounts, Basic Skills and Vocational Training. Ensure locality and Trust business planning and development processes are aligned and understood. Develop a framework, which will support the skills escalator and succession planning within the Trust.

4.3 Partnerships Birmingham and Solihull Mental Health NHS Trust sees the development of a wide range of partnerships as an integral ingredient to developing and providing better services for the population of Birmingham and Solihull. This is similarly true for learning and in developing a rich and varied source of opportunities. Strong links need to be developed and established with organisations such as the Strategic Health Authority Workforce Development Directorate, the Learning & Skills Council, local colleges and universities, the Deanery, service user and carer groups, Modernisation Agency, NIMHE, NHS University, Social Services, Schools and other Healthcare providers including voluntary sector organisations.

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Strategic Objectives To maximise opportunities for collaborative working and learning with Primary Care, Secondary Care, Strategic Health Authority Workforce Development Directorate, other agencies and partners. To take advantage of and contribute to all potential partnerships with their associated training, education and development opportunities at local, regional and national level to enhance the learning and growth of our organisation and partner organisations: q

q q

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Develop real partnership links with other agencies, Primary Care, Secondary Care and Social Services which will facilitate opportunities for multidisciplinary and multi-agency learning and sharing and effective use of resources and skills. Work more collaboratively with social services to explore new ways in delive ring integrated training, education and development opportunities. Develop a structured approach to working with the Strategic Health Authority Workforce Development Directorate, so staff are engaged and constantly thinking of innovative and creative training, education and development initiatives that will make a difference to patient care, are aware of Strategic Health Authority Workforce priorities and have access to available funding. Work in partnership with the Strategic Health Authority Workforce Development Directorate and other local partners to deliver the modernisation agenda to facilitate the development of the workforce in new ways of working (e.g. changing workforce programme) including forging links with the Modernisation Agency.

4.4 Human Resources & Organisational Development - Becoming a Learning Organisation At the heart of a true learning organisation is the deeply held belief that continuous learning is vital to its long term survival and success and that learning is achieved through everyday experiences as well as more formal approaches. In a learning organisation people actively seek to take responsibility and ownership for their development and work in an environment that encourages people to ‘have a go’ and not to worry if they don’t always ‘get it right first time’. Becoming a learning organisation will mean establishing the processes through which essential training needs are identified and met and ongoing development is pro-actively supported at all levels and across all disciplines. Strategic Objectives To ensure that mechanisms are in place to enhance and capture individual and team learning as part of organisational development processes and clinical governance. To meet the training, education and development needs of staff and teams in order to maintain current business activity and to enable the Trust to look beyond the horizon with aspirations of excellence across all services.

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To develop the organisation against a framework of best practice and evidence in relation to teamwork, human resources management and organisational development (West 2002- Aston University) To proactively contribute to and influence workforce planning and development to enable services to have staff with the skills to meet future service demands and needs. These strategic priorities can be achieved by: • • • •

Identifying specific roles, responsibilities and skills in relation to training and development needs. Ensuring all staff having annual appraisal/development review and a personal development plan which are reviewed, learning implemented and effectively evaluated. Developing a training and development/ study leave policy that ensures that all staff have fair access to available opportunities. Identifying training and development needs from personal development planning and the business plan objectives, and implement appropriate measures to address these needs. Areas of specific priority for the Trust include: Statutory and mandatory training Clinical development Leadership and management development Skills development/New skills development NVQ development Information technology Team support and development

q q

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q q q q

Ensure the training and development needs of all staff and teams in undertaking new roles and working in different ways are met. Develop and implement a framework for leadership and management at all levels of the organisation and facilitate ongoing support, development and learning opportunities. These need to reflect national opportunities and drivers LEO/RCN/ Kings Fund/MESOL etc, be competency and skills based and provide development and support. Continue to develop Leadership programmes and support this through the development and implementation of Management Development programmes. Facilitate a culture whereby all employees are encouraged to reflect upon and record their learning by providing each member of staff with a Personal Development Portfolio. Develop and implement a mentoring network that enables and creates peer support and personal development opportunities. Facilitate career development by providing opportunities that enable a skills escalator to become a reality within the Trust. Promote the concept of Succession Planning and provide guidance to support this. Develop specific workforce plans that reflect changing workforce roles and the associated individual, team and organisational development. For example the development of Nurse Consultant roles and multi-agency appointments.

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q q q

Further develop the ethos of a learning organisation. Continue to develop and evaluate Induction arrangements for all staff. Develop Local Induction Protocol and Staff Handbook.

4.5 Developing the Skills Escalator The development of a Skills Escalator Model within Birmingham and Solihull Mental Health NHS Trust will provide "a dynamic approach to supporting career potential and development" (HR in the NHS Plan, 2002). This model will provide a clear route for staff to step on and off as they develop their careers to fit in with there own personal and professional circumstances. It will provide opportunities for staff to receive training, education and development and for these to fit in to a structure where staff can fulfil their potential without some of the traditional barriers in place. It will also provide opportunities for the local community to find careers within the Trust without having to move away from family and friends and therefore help to meet the need to increase social inclusion of the local population. Strategic Objective Develop and agree a model of the Skills Escalator for the Trust: q q

Work in Partnership with the Strategic Health Authority Workforce Development Directorate and wider Health and Social Care Economy. Make the Skills Escalator a reality for the staff and community of Birmingham and Solihull.

4.6 Risk Management With increasing need to reduce risk and maintain the health, safety and welfare of the public and staff it is vital to provide the appropriate training, education and development opportunities but also to learn from critical and adverse incidents and near misses within the team, the Directorate, across the organisation and with other organisations. This is part of developing and promoting a ‘just and fair’ culture and the learning organisation that Birmingham and Solihull Mental Health NHS Trust aspires to achieve. Strategic Objective To ensure training and development is provided and information is available to meet statutory requirements in order to promote a safe working environment for staff and patients. •

Provide training to meet the needs of specific areas of concern from the Staff Attitude Survey. For example the management of actual and potential aggression (ref: CFSMS National Training Syllabus), equality and diversity, harassment and bullying.

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Clarify expectation of attendance and practice in relation to mandatory training so that it minimises and manages risks for both patients and staff and ensures the organisation is safe and compliant. Facilitate the development of systems and processes that that enable learning and sharing from untowa rd incidents, claims, complaints and compliments. Explore new, innovative ways of learning e.g. E learning. Continue to develop understanding and competency around Standards for Better Health, CNST standards and legislation. Provide opportunities for staff to de-brief and learn from clinical incidents and serious untoward incidents in line with the Trust policy on the Management of Serious Untoward Incidents.

4.7 Effective Services and Modernisation The prime function of learning, education and development in the Trust must be to maintain and improve the effectiveness of service delivery. To achieve this learning needs to take account of both local and national strategies. These will include the local Health Improvement Programme and National Service Frameworks for Mental Health and Older People. Modernising services means rethinking the way that services are organised, it is not about asking already busy people to work even harder. Rethinking the way we do things should mean improvements to the service user experience of using our service and increased job satisfaction for our staff. We need to ensure we encourage staff to be forward thinking, innovative and involved in ensuring best practice standards are utilised. Strategic Objective To ensure that practice is evidence-based and in line with National Service Frameworks, NICE, professional and local recommendations and guidelines. • • • •

Develop training programmes that meet national and local priorities. Facilitate the ongoing development of evidence-based practice by creating innovative, accessible learning opportunities that appeal to all learning styles. Facilitate a culture whereby quality improvement, clinical audit and its associated learning are central to practice by all clinicians and teams. Develop opportunities for staff to actively engage in research.

4.8 Knowledge Management The ability for staff, service users, carers and the public to access information and knowledge to support understanding and learning is another key aspect to improve the health of people using services. This information and knowledge has to be in the right format and available in an appropriate timescale. The Trust therefore subscribes to the principles of national initiatives such as the National Electronic Library for Health and the NHS Information Authority priorities for desktop access. For learning to be a continual process there needs to be access to information.

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Strategic Objective To use and develop information to inform practice and associated training, education and development activity. • • • • • • •

Provide guidance to ensure that business and development planning cycles work in tandem. Develop information systems and access to those systems that identify training needs, training undertaken, and learning outcomes. Identify uptake of courses against current training programmes/contracts to inform future commissioning and provision. Champion investment in library services to meet the growing information needs of the organisation and its partners. Ensure that staff are given the appropriate training opportunities to improve their IT skills, including encouraging the take up of ECDL. Create training opportunities for staff to be able to access and interpret clinical data in order to inform practice. Work in partnership with the Health Informatics Service to ensure that systems for learning, information and knowledge management are integrated.

4.9 Evaluation and Performance Central to developing the Trust as a Learning Organisation, to optimise services for the public and develop staff to deliver and improve services is an evidence base. For Birmingham and Solihull Mental Health NHS Trust this not only comes from national research and practice but also the development of local research and the attainment of local evidence to demonstrate where interventions are effective and where they require further development. Strategic objective For the organisation to have evidence of the impact of learning interventions on service delivery and personal and professional development. • •

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Develop a process for evaluating the impact of learning, education and development that has demonstrable benefits for staff using the process. Develop and implement a training and education information system that maintains records of training, education and development including the monitoring of non attendance in line with CNST standards, and which has the potential to be developed further to include training needs analysis, a booking system for internal courses, study leave approval and evaluation. Demonstrate the benefits of using this system to individuals, teams, directorates and the Trust to promote ownership and responsibility. Provide accredited programmes where possible to demonstrate quality. Develop a system of two-way feedback with provider universities and other education providers to ensure that programmes meet requirements and benefits can be monitored. Invest in research and audit of the learning interventions.

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5. The Infrastructure for Delivering Learning The current infrastructure for providing and/or facilitating learning, education and development across the Trust is ad hoc and requires extensive development. The Trust Workforce and Organisational Development Directorate has an Assistant Director of Education and Development, Trainers responsible for Cadet Schemes. In addition the Trust has some other specialists across the organisation with key responsibilities for delivering training including, for example, Professional Leads, Fire Safety, Health and Safety, Clinical Risk Assessment, Root Cause Analysis and Manual Handling. Some Directorates have posts that are designated for education, training and development. Financial Resources A key consideration for the development of effective learning within Birmingham and Solihull Mental Health NHS Trust is the appropriate funding arrangements for learning activities to take place. Not all activities require funding to be made available. In fact there are many excellent opportunities that can be accessed without direct financial costs. For example coaching, mentoring, supervision, shadowing can all be achieved without direct cost. However, inevitably there will be developments that need to be financed appropriately. Training and Education Budgets Training and Education budgets will be devolved to directorates to allow them to determine their priorities and the spend against these. Training and Education budgets must be determined each year against priorities identified in Locality Training, Education and Development Plans. A central fund will be needed to ensure that the delivery of in-house training for core training activities and/or new developments required on a Trust wide basis are resourced appropriately. Funding for some Education and Training projects are funded by the Workforce Development Directorate for example NVQ’s, Individual Learning Accounts and monies for Continuing Professional Development. Other potential sources of income for Education and Training are the Learning Skills Council and NHSU. Strategic Objective To ensure that financial resources are identified and matched appropriately to agreed training, education and development needs through an effective planning and budget setting process, and that the use of informal and flexible learning opportunities and partnerships are further developed and capitalised on. • • •

Undertake a review and mapping of current resources available. Identify significant gaps in financial and other resources. Identify key partner organisations where resources can be shared or reciprocal service arrangements can be established. 11

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Actively seek to arrange training provision through external organisations that have access to funding streams not available directly to the NHS Pro-actively seek financial contributions from external agencies such as the Strategic Health Authority Workforce Directorate and Learning Skills Councils. Optimise the use of other Workforce Development monies to support the achievement of national education targets such as NVQ’s, ILA’s and Basic Skills training. Fully establish a system through which training plans are developed in line with business plan requirements and appraisal/development reviews and are matched appropriately to available resources.

6. Conclusion Birmingham and Solihull Mental Health NHS Trust aspires to be a Learning Organisation. This is seen as a fundamental step in developing and delivering services to the people of Birmingham and Solihull. This will be achieved through a commitment to learning for all staff with all of our partners, not only in the arenas of education and the NHS but also importantly with our service users and carers. This Lifelong Learning and Continuing Professional Development Strategy sets out our vision for change and ambitious plans to modernise our services through the key principles of developing and becoming a learning organisation and in establishing a culture for continuous development and improvement through partnership and team working. In working towards these high aspirations our strategy recognises the work to be done in ensuring solid foundations are laid in terms of the core systems, processes and procedures that will make our vision a reality. The strategy has therefore outlined the key strategic objectives to achieve and translated these into operational priorities. In order to underpin this strategy and strategic objectives the Trust will also develop the following guidance, frameworks and policies: • • • • • • •

Guidelines on induction and a staff handbook. Appraisal/Development Review Policy incorporating the Knowledge and Skills Framework. Study leave Policy. Skills Escalator/Succession Planning Model. Clinical Supervision Policy. Framework for Management and Leadership Development. Guidance on Evaluation of Learning, Education and Development.

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Appendix One

Clinical Governance Reporting Structure Trust Board

Clinical Governance Committee

Learning and Development Committee

Education and Development Sub group

Staffing and Staff Management Sub Group

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