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SASH Education and Development Annual

Report - 2018

Our purpose in this year’s annual education report is to demonstrate early progress against the

operational plan of the education and development strategy and also to outline the current education

work being undertaken at SaSH. We also propose an operational plan for the coming year. In future

years we anticipate that our report will largely focus on yearly developments based upon our strategic

objectives but for this report, since education work was only summarised in the ‘current state’ section

of the strategy, it became apparent that a more detailed overview would be of value to record the

breadth of our current activity

Formal education programmes at SaSH are described here in terms of undergraduate, postgraduate

and apprenticeship programmes across the professions. We summarise current work in these areas

with recent and future developments. We will then outline development towards new roles, our

preceptorship and corporate programmes and describe the use of the bursary funding scheme and

the library an d knowledge services in the last year. As expected our work dovetails with the clinical

strategy and the OD and people strategy.

Key successes and early progress against

operational plan

Safe

MAST – redesigned programmes to provide a more streamlined model of attendance and

refreshed the mandatory training matrix. We have achieved over 80% compliance for the last

two months piloting nudge processes to encourage attendance. The newly formed MAST

group is reviewing content delivery and compliance rates.

Security of CPD funding – this remains uncertain and the faculty has worked hard this year to

seek alternatives funding sources for our courses supported by HEE including bids for

additional funding and hosting internal events to support staff individually. SaSH has joined an

apprenticeship trailblazer to develop a critical care practitioner apprenticeship standard.

SaSH has worked closely with HEE KSS and has successfully bid for additional funding and

places for ACPs and for non-medical prescribing education. We have appointed an ACP

project lead to explore the potential spread of this role across the organisation. ACP

development has moved to an apprenticeship standard.

Head of Education and Training working with STP colleagues to establish clinical education

forum

New framework for nursing and midwifery education launched in June 2018 and aims to

replace current mentor system with education and assessment supervisors for placements.

We await clearer details of this as we maintain our current mentoring capabilities

Effective

Utilisation of Apprenticeship levy

o 60 members of staff progressing through apprenticeships from level 2-7

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o Increase in number of apprenticeships from 2017-18

Grow our own talent pipeline-

o Established first and second cohorts of trainee nursing associates; we are now

planning for cohorts 3 & 4 in 2019.

o Procured Health Care Support Worker apprenticeships levels 1&2

o Established literacy and numeracy programme to reduce barriers to accessing higher

education, allowing more colleague to progress

o Strengthened relationship with schools and colleges eg teach too scheme with East

Surrey College to allow students a clear line of sight into employment at SASH and

open evening events for school children

Improvements in graduate medical education as indicated in the 2018 GMC national training

survey results

Renewal of Quality Mark award in October 2018.

Caring

Communication skills opportunities– suite of in house personal development courses

scheduled including, conflict resolution, resilience, assertiveness, customer care, Sage and

Thyme and Dementia friends workshops. MAST training has been enhanced this year with

the addition of conflict resolution training

Mentoring and supervision development – internal mentorship courses in place in addition to

accredited courses supported via bursary.

Responsive

Quality processes are feeding into planning and investment, via the education governance

and strategy groups with refreshed terms of reference. Recent topics of discussion have

included potential opportunities for healthcare degree apprenticeships and enhancements to

the bursary panel decision making process.

Working with our steering group to develop future workforce in line with workload needs. The

recent appointment of a 0.4 wte secondment role to scope the trust’s future needs around

advanced care practitioners will support this work.

Faculty development programme. Train the trainers programme for large group educators

with good engagement of MAST subject matter experts

Lean for leaders programme reviewed regularly and framework adjusted to support learning

eg timing and content of standard operations modules

Well Led

SaSH leadership framework – consultation with over 50 staff held and being piloted with staff

in leadership roles. Project plan in place to extend work and launch April 2019

SaSH leaders programmes have been mapped, aligned to the leadership framework, into a

one stop shop leaflet to support line managers in outlining opportunities during an

achievement review.

New manager development in both management and leadership – established the Level 3

and level 7 apprenticeship pathways with 3 colleagues starting the MBA apprenticeship with

the OU in September 2018.

Piloted a career development tool , elements of which will be embedded into achievement

reviews to support talent management process in the coming year.

Launched a coach to lead programme backed by HEE with two cohorts completed.

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Metrics

Award of Quality Mark renewal this autumn, having first had it awarded three years ago by Skills for

Health. This reviews the quality of education opportunities available at SaSH both in terms of

educational environment and the education faculty.

GMC survey results continue to improve with SASH scores top in 8 of the 17 metrics judged against

the acute trusts in Kent Surrey and Sussex. The core surgical training results were excellent with 8 of

the 17 metrics in the top quartile, the 5th best result in the UK.

Recruitment from undergraduate programmes is outlined in the undergraduate review section of this

document.

Having worked with hard to reach groups on MAST training and implemented nudge strategies our

compliance rates are currently sitting at over 80% for the last 2 months with the cancer and

diagnostics division achieving 86.09%.

The education audit cycle has been completed for us this year by the University of Surrey on behalf of

the three HEIs who offer nursing undergraduate placements at SaSH Surrey Brighton and

Portsmouth. This has been a successful audit for us.

Key reflections and challenges:

The recently formed ‘Ward of the future’ group will help to inform future education

requirements; current challenges include limited long term forecast and the proactive

framework for matching workload needs to future workforce roles.

Funding changes such as the levy still don’t address funding requirement for post graduate

specialist training in areas such as ED, cardiac, critical care. Eg if upskilling funding reduces

further.

The increasing number of apprenticeships places a potential burden on service to support the

mandated 20% off the job training as there is no ‘backfill’ funding.

The increasing number of learners in the workplace and the associated mentor support

required to facilitate skills development in a time of difficulty with recruitment and retention.

The introduction of degree apprenticeship and the associated off the job requirement,

particularly for nursing where the NMC stipulates 60% time in education. This would require

addition funding to be allocated from within Trust, over and above the levy funding for the

education component.

Infrastructure such as education posts to support the fast pace and scale of change within

emerging education models of delivery and support needed to establish and embed

programmes.

Review of operational plan for next year

Safe

Work with steering group to define the future workforce for the divisions at SASH and thus identify education needs to support the workforce strategy. This will include the need for forecasting training needs analyses and other roles within the workforce together with the ACP steering group. It will embed the ACP and physician associate roles within the strategy and identify potential opportunities for new roles.

Continuation of work related to MAST to sustain and lift compliance rates to achieve 90% by the end of the year.

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Effective

Faculty development around learning in the workplace with the support of the PD team and the rest of the education faculty. This is likely to be based on workshops regarding feedback, development of expertise and communities of practice and be of relevance to all workplaces in the trust in order to facilitate the emergence of a culture of educational conversation around the trust.

Scoping work around Nurse of the future framework as it emerges from the Royal College of Nursing

Responsive

Trust wide education around mental health awareness aligned to the draft mental health strategy

The development of an educational programme around sepsis, building on the work of the sepsis education RPIW.

Offer workshops in SASH+ methodology to doctors in training across the Kent Surrey and Sussex region

Caring

We will define the educational and personal development elements of our departmental inductions to ensure that new members of staff feel welcomed and supported as they join our teams

Well Led

Continue with Silvermaple work, launching leadership framework in April 19

Embed talent management work into achievement reviews to enhance the focus on career and developmental planning and to enable SaSH to develop talent mapping across the organisation.

Enhance the SaSH leadership offer and increase its visibility across the organisation.

We will develop a talent dashboard from achievement reviews that will feed into succession planning.

Development of an internal coaching programme

Current State September 2018

Undergraduates

Nursing

53 undergraduate nursing students,

13 of which were paediatric

students,

20 midwifery undergraduate

students.

From Brighton, Surrey, Portsmouth

3 additional placements for the

Open university

A reduction in Surrey nursing

students with a small rise in

paediatric nursing students

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The future nurse frameworks for education were launched in June 2018 which will impact on

the mentoring of student nurses in the clinical workplace. Students will now have practice

supervisors, practice assessors and academic assessors instead of our current mentoring

system.

We have recruited 12 students into band 5 posts from this year’s student cohort.

We have 50 ‘sign off mentors’ on the register

Our local Universities are now discussing the implementation of a unified student portfolio

across the south east for all undergraduate nurses.

Therapies

Pharmacy

45 undergraduate students working towards an MPharm qualification in the last year

Students from both University of Brighton and University of Sussex are included

These numbers rose last year as we supported University of Sussex Students for the first

time and these numbers are likely to rise again next year with students from years 3&4.

We received extremely positive feedback from the undergraduates this year

Two SASH pharmacists are now working at Sussex University as clinical preceptors teaching

on the MPharm course. This type of partnership working often has profound impact on the

quality of student experience at SASH by deepening our understanding and delivery of

excellent learning opportunities.

Radiography

20 Physiotherapy students from Brighton

5 Occupational therapy students from Brighton

We will be offering placements to students from

Brighton, Canterbury, Brunel and Southbank

universities in the coming year.

Increase of 6 physio students compared to the

previous year

Good feedback from universities, 2 of the 20 physio

students were recruited to band 5 posts at SASH

and one person retrained through the ‘return to work’

scheme.

We held a comprehensive induction and CPD

programme for all staff, with key staff trained in Lean

for leaders

51 undergraduate students

Portsmouth and Southbank Universities

Portsmouth revalidated their course last year

resulting in portfolio changes and assessment

criteria which has impacted on workload for the

education team in radiology

Taking an additional 2 Southbank students in

the 18/19 year with three elective placements

from other universities

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All four Southbank students graduated and have been recruited to SASH. All our Portsmouth

students had passed and one has been recruited. Feedback from students largely extremely

positive with some comments related to the impact of departmental busy-ness upon learning

and the impact of older equipment which is being addressed.

Changes within the team this year with Helen Bucknall taking over as lead educator. Staff

have trained in mentorship and assessment skills with two colleagues in process of Practice

educator accreditation scheme.

Portsmouth students have rotated through Crawley and Horsham departments in the last year

which has been very successful and may be extended to Southbank students next year. A

buddy system has helped to embed changes with the new portfolio.

ODP /Theatres

Three second year Operating Department Practitioner (ODP) students from the University of Surrey are due to qualify in December.

In the last year the number of ODP students being placed at SASH have reduced, (4 in 2015, 3 in 2016 and 2 in 2017) possibly due to a reduction in applicants for the course and self-selection of student placements due to self-funding.

We have plans to offer ODP placements to other universities to increase recruitment. We are liaising with the universities of Portsmouth, Canterbury and Christchurch and South Bank.

We have positive feedback from our students which is fed back to the University of Surrey and a 100% pass rate for our ODP students. Recruitment from our students over the past 5 years is 75%.

We have 38 Mentors in our department. As well as our ODP undergraduates, we have facilitated placements for 11 Student nurses

and 18 Student Paramedics We support student nurses are from the Universities of Surrey, Brighton and Portsmouth.

The Student Paramedics are from the Universities of Surrey, Brighton and SECAMB /St Georges.

Medical scientists

Medical Students

150 students across the academic year from three universities = Brighton and Sussex

Medical School (BSMS), St George’s, University of London (SGUL), Imperial

Increase in BSMS student numbers in the Emergency Department this year

One undergraduate biomedical science student

in blood sciences

University of London

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Anticipating further increase in BSMS students by 3 students for the coming year and SGUL

very keen to increase placements.

Annual faculty update meeting in May and ongoing educational supervision CPD for

consultant supervisors.

Recruitment is national therefore perhaps not as reflective as a metric as other recruitment.

However of our August intake of FY1s, 1 is from BSMS, 2 from Imperial and 6 from SGUL

Feedback very positive, we are limited in increased numbers by accommodation so we’re

looking at transport as a different option.

Final year students offered simulation sessions and point of care ultrasound education.

Postgraduates

Medicine

Around 200 doctors are placed at SASH for postgraduate training. Of these, 60 doctors are in

the foundation programme, around 50 doctors in GP training and the rest in core and higher

specialty training.

Feedback from individual programmes is presented to local faculty groups three times per

year and training progression is also discussed during these meetings.

Peer comparison metrics are gathered every year by the GMC national training survey and

are published in July representing a ‘snapshot view’ of March placements. This year’s results

placed us top of the acute trusts in the region for 8 of 18 metrics, including for overall

satisfaction

Pharmacy

8 Postgraduate pharmacists

All studying towards a postgraduate diploma as part of

a foundation programme

Funding for foundation programme by HEE ended this

year so pharmacists are applying to the bursary

scheme for funding

All passed their exams

Physician Associates

Feedback from students is very positive; we are regarded as a leading example of an

employer of PAs.

All students are postgraduates: we supported 31

students across the 17/18 academic year, from

University of Surrey and St George’s University of

London

We expect a slight increase in numbers for the coming

year.

Student supervisors meet twice a year in the PA

governance group

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The KSS School of PAs is based at SASH, which supports students and universities across

the region and is also working with the PA faculty at the RCP to establish as CPD model for

post qualification education.

First year PG students are offered a taster session at the trust to support their transition into

hospital placements. All final year students are offered simulation sessions at SASH in ward

round training and preparation. All PAs and students are offered a mentor for support and

have a yearly appraisal and we have added an additional surgical PA role this year and an PA

in O&G.

Radiography

We have 5 radiographers on PGCert courses and 5 more studying for M level diploma

courses with Canterbury Christchurch, City, Kingston, West England, Bournemouth and

Sheffield Hallam Universities. Many study areas are new for SASH to support work within the

department and across the trust

6 radiographers are pursuing other CPD courses

2 external candidates being supported through ultra sound training

All courses that finished before April were successfully passed. Those colleagues studying on

reporting courses due to finish shortly will be moving into band 7 roles. The mammography

PGDiploma course has resulted in a senior radiographer working independently sharing the

workload of the consultant breast radiologists to support the breast cancer service.

Theatres

We have both ODPs and nurses undertaking postgraduate courses.

Four courses being undertaken by theatre staff. One ODP and one Nurse are undertaking

the Surgical First Assistance Course level 6 at the University of Surrey. One nurse

undertaking the Health Assessment Course level 6 at the University of Surrey. One ODP is

undertaking PGCert in education for professional practice level 7 at the University of Surrey.

We anticipate that more staff members will undertake the Surgical First Assistants course in

the future.

All the above are anticipated to pass their courses. Our theatre nurse will undertake their non-

medical prescribing course upon completion of the health assessment course.

Medical Science

One colleague completed an MSc in infectious diseases from the London school of hygiene

and tropical medicine and received a distinction mark

Apprenticeships

Our apprenticeship programme has undergone rapid expansion in the last 15 months since the

introduction of the apprenticeship levy at SASH. At that time there were a limited number of

healthcare specific apprenticeships available. We have moved from a position of our apprenticeships

supporting recruitment at novice level to the creation of development opportunities for staff working in

AfC bands 2-4 and then on to the exploration of apprenticeships meeting the wider needs of the

workforce at SASH. The introduction of the nursing associate role and associated apprenticeship

provides a great opportunity for existing staff to train into this extended role within the nursing

workforce. We currently have over 60 members of staff progressing through apprenticeships:

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Business administration Level 2

Cleaning Level 2

Hospitality Level 2

Customer Service Level 2

Team Leader Level 2

Health Pharmacy Services Level 2

Health and Social Care Level 2

Nursing Associate Level 5

Painting and Decorating Level 2

Management Level 3

Management Level 7

All but 2 of our apprentices were existing members of our workforce developing their skills in order to

progress to the next stage of their careers.

The application processes for apprentices in the last year have identified the need to support some

staff with skills development in literacy and numeracy. We have 91 members of staff working towards

functional skills level 1 and 2 qualifications. We anticipate that some of these colleagues will go on to

access the nurse associate apprenticeship programme and other higher level qualifications in the

future.

11 trainee nurse associates started their two-year apprenticeship in March 2018 working at foundation

degree level with the University of Brighton. Adele Kendrick has coordinated work at a regional level

to create a collaborative approach to procuring this programme with placements across the local

healthcare system from home based nursing services to acute care. This has been a fantastic

achievement across the region on behalf of SASH and our partner organisations. A further cohort of

12 started their course at the end of September with a 3rd

cohort of 10-15 currently in recruitment for a

January start.

Procurement is now complete for the Healthcare Support Worker Apprenticeship levels 2 & 3, which

will in time ensure a pipeline for talent into nursing and other career careers.

Apprenticeship support leadership and management development – we are currently recruiting a

cohort of 16 for the level three first line manager apprenticeships commencing in September. In

addition 4 staff in leadership roles have just successfully gained places on level 7 MBA programmes

with the Open University.

Our projections suggest that we will have approximately 80 members of staff on apprenticeship

programmes in the 2018-19 financial year.

New Roles

The education faculty work closely with the workforce team in order to develop education and

development programmes for the workforce of the future. Thus far departments have developed

individual members of staff when an expression of interest is made or when internal workforce

pressures require a novel approach to managing a clinical workload. The ‘Ward of the future’ group at

SASH are in the early stages of developing the Trust’s approach to identifying the appropriate role to

fit the workload requirement.

The trainee nursing associates are being implemented supported by the associated apprenticeship

education pathway. Once qualified these new roles will complement existing roles and enable new

ways of working.

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The Emergency department team have adopted the advanced care practitioner role to support their

clinical workload in the ED, accessing educational development via Masters level programmes. We

anticipate that an ACP apprenticeship will be available locally from September 2019 but currently the

development of the role is funded by a combination of departmental and bursary funds. We anticipate

that the ACP role will spread further across the trust and have just appointed a programme project

lead to oversee this spread, ensuring that roles are deployed appropriately.

Preceptorship

Practice development programmes

In house development programmes

SaSH offers a wide range of leadership and management development opportunities, combined with

clinical skills training and personal effectiveness programmes. These short courses provide staff with

an opportunity to address personal and professional development needs identified as part of the

annual achievement review process.

The main leadership development programmes include:

Springboard –This course, previously named ‘Band 6 ready’ works with band 5 members of staff –

nurses, ODPs, and therapists to prepare for their potential leadership roles, providing coaching and

application of leadership, innovation, human factors and support within the workplace. This

culminates in a practice improvement project, attendance and observation at wider Trust activities and

formal presentation to Divisional leaders. In the last year members of staff have accessed this course

created peer support networks across professions and have moved into their next roles.

Developmental mentoring –The Kent, Surrey and Sussex leadership collaborative set up this

coaching and mentoring programme and have accredited our education and training team to deliver a

Nurses moving into Band 5 roles at SASH are offered preceptorship

programmes, extending their clinical knowledge as they develop their

clinical skills in the workplace. These supportive regular meetings

involve tuition from experts across the trust. Cohorts on the

programme currently start every month with a curriculum which is

responsive to both their needs and the needs of the organisation.

The practice development team work at both a corporate level

for trust-wide programmes and at a clinical level within

departments supporting the development of expertise within

our specialty nursing teams. The corporate team support our

overseas nursing programme from induction to completion of

NMC registration. They deliver manual handling and back

care training and support our clinical skills development work.

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one-day developmental mentoring training workshop to train new mentors. We are keen that line

managers join our education supervisors and student mentors in developing their mentoring skills to

support their colleagues in their career

Essentials of management – We have previously offered a series of stand-alone modules as half

day workshops including: confident conversations, finance for non-financial managers, introduction to

coaching skills, managing for better performance and recruiting talent. We are now offering this as a

Team Leader Apprenticeship (incorporating CMI Level 3 Diploma in First Line Management)

Coach to lead – a 2.5 day workshop completed by one cohort of staff with a second in recruitment,

which will add to our coaching capacity in order to support an internal coaching programme in 2019

and beyond.

SASH+

The education element of our SASH+ work continues to develop with cohorts 7&8 celebrating their

successes on the Lean for Leaders course in December 2018 as cohort 9&10 start their assignment

work for modules 2a and 2b. The second cohort of advanced lean training candidates completed their

course in September. We have been funded to provide training in SASH+ methodology to doctors in

training across the region of Kent Surrey and Sussex and these single day workshops share lean

tools and experiences of daily management techniques. Our single day taster and workshop sessions

continue for internal staff at SASH with impact seen across the organisation.

Bursary Update

The Trust is able to support the development of staff through the provision of funded external learning

opportunities via the Upskilling funding allocation awarded by HEE KSS. The bursary panel (made up

of multi-professional representatives from Divisions and education leads) makes funding decisions

and ensures the resources for training and development of staff are utilised effectively. In 2017-18 the

bursary panel approved approximately 200 applications from a wide range of members of staff from

different departments and disciplines - supporting their ongoing professional and personal

development. The panel refreshed their terms of reference this year in line with our education

strategy approach to ensure that all agenda for change staff have access to the funding. Expenditure

and allocation of funding is reported to the Education Governance Group and therefore upwards to

the finance and workforce committee. This external funding is not assured year on year and has

decreased in the previous two years. External courses are only funded where there is not a suitable

alternative apprenticeship pathway which can be funded via the levy.

As the demand upon our bursary funding increases in the landscape of a decreasing allocation, it is

important to ensure that the money is dispersed in a coordinated and strategic manner. Further focus

on forward planning in relation to future workforce requirements is needed to ensure that education

and development is prioritised in line with the strategic direction.

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0 50 100 150 200 250

1

Applications, 208

Totally funded, 181

50% funded, 4

75% funded, 11

Declined or withdrawn, 12

2017 -2018

TOTAL BURSARY APPLICATIONS

9%

13% 4%

0%

2% 72%

Staff groups who accessed the bursary fund

Add Prof Scientific Technic

Aditional Clinical Services

Administrative and Clerical

Estates and Facilities

Healthccare Scientists

Nursing and Midwifery

3%

0% 2%

33%

31%

27%

4%

Bands of staff who accessed the bursary fund

Band 2

Band 3

Band 4

Band 5

Band 6

Band 7

Band 8

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Library and Knowledge Services

Students on Placement

Total number of students on placement who were registered library members

As is to be expected the majority of students registered with the library service were either medical or

nursing students.

Although the students have access to library services at their university, when on placement they tend

to use the hospital library service. SASH Library and Knowledge Service provides services and

receives funding from the other local NHS organisations, which means when students are on a

community placements they continue to access the SASH service.

The students use both of the libraries as a place to study (during the day and out of hours) and to

borrow books (see tables below). The library team carries out group inductions and individual

inductions for students, the SASH team does not carry out more detailed group training sessions as

the students are expected to receive these from their university library service, however the SASH

team frequently provides one to one advice and support.

The library service liaises with the university libraries to ensure that the right resources are being

purchased and that the services being provided are as required. There are annual meetings with

Brighton and Sussex Medical School library team, Brighton University in relation to student nurses,

and University of Surrey Library Service.

Feedback from the universities and students is analysed and acted on. One such example is the

improved study area.

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By university

By course of student

The library service provides a wide range of resources for the students and junior doctors such as

Clinical Key, Clinical Skills, Royal Marsden Manual Online and UpToDate Anywhere; however it is not

possible identify from the usage data for each resources who within the organisation is using the

resource. The library service purchases access to one of the main revision tool for junior doctors, 84

individual access codes to individual exams were given out by the library team in in 2017-18.