Promoting excellence in practice education

Professor Lisa Bayliss-Pratt Director of Nursing

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‘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

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HEE exists for one purpose – to improve the health and wellbeing of the people of England by developing a workforce—both professional and non-professional—with the right skills and values for them to always deliver outstanding healthcare.

Our purpose

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• Workforce Planning• Attracting and recruiting the

right people to the posts we have identified

• Commissioning excellent education and training

• Lifelong investment in our people

Our functions

HEE does not work alone – we have many key partners including other ALBs, HEIs, Regulators, Professional Bodies and the DH

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Human

• We need to Improve patient safety and public satisfaction in an era of ever-higher expectations

• We need to create a sustainable, caring, well motivated and valued workforce

• We need a new, aspirational career structure

• Reduce ‘leaky bucket syndrome,’ which sees attrition waste talent and valuable resources

Our Challenges

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Demographics

, ,,

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Chronic Care Management

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Structural

• Greater integration of health and social care

• Greater parity of esteem of physical and mental health

• Increased co-production of care between staff and patients

• Greater flexibility of nurses and care assistants to work across integrated landscapes.

Our Challenges

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Our best chance of success is to base our long-term workforce strategic framework on the anticipated needs of future patients.

Global drivers of change

Future patients Future workforce

Framework 15: The HEE strategic approach

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We will need a more flexible workforce if we are to provide care for an ageing population with more complex health conditions.

We will need sustainable and better evaluated solutions to problems around nurse retention if we are to meet these future needs

There is concern about the cost of using bank and agency staff

Our consideration of nursing supply and demand is informed by:• The Francis, Berwick, Keogh and Winterbourne View Reviews;• An increasingly ageing population, often with multiple co-

morbidities; • Delivery of the Five Year Forward View, especially the need to

deliver more care in the community• HEE’s Workforce Plan for England

Nursing Supply and Demand

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Short-term• Co-ordinating international recruitment through EURES• Reviewing current nurse retention schemes • Producing a common framework for nurse retention

Medium-term• Come Back To Nursing campaign• Developing flexible nursing pathways for Healthcare Assistants

Long-term• Multi-professional workforce planning – possibly commissioning

more OTs and Physios• Patient pathways

Nursing Supply and Demand

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• The Review was commissioned by Health Education England (HEE).

• The Nursing and Midwifery Council (NMC) is a strategic partner.

Shape of Caring Review

• Independently Chaired by Lord Willis of Knaresborough

• Published in March 2015

“How can we ensure that the education and training of nurses and care assistants is fit for purpose to support

them in delivering high quality care over the next 10-15 years?”

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Shape of Caring Themes

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Mind the (generational) gap

‘Baby Boomers’ ‘Generation X’ ‘Generation Y’ ‘Generation Z’

1946-1964 1965-1980 1981-1994 1995-2010

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. 2015. 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.

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Airedale NHS Foundation Trust24/7 secure video consultation supporting patients at home, and providing service to 200 care homes from Kent to Cumbria, supporting over 6,000 patients, and 800 prison outpatient and emergency consultations per annum.

• Acute admissions down 37%• A&E attendances down 45%

Collaborative Learning in Practice (CLiP)• Real-life learning ward established to support day-to-day learning in

practice.• Approach is student-centred, with typically up to 20 students placed

together in a single learning environment.• Model is underpinned by a philosophy of student-led learning.• Students are learning to become increasingly confident and

autonomous in practice, whilst experienced staff have the opportunity to reflect on care and to develop their resilience.

Outstanding Practice

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Magnet Hospitals• Magnet Hospital designation was developed by the American

Nurses Credentialing Center (ANCC) in the 1980s.

• At a time of acute shortages in nursing, the characteristics of the hospitals with highest rates of nursing recruitment and consistent retention were identified and codified into standards.

• There are 409 Magnet hospitals worldwide – USA, Canada, Australia, New Zealand, Netherlands, Singapore, and Saudi Arabia.

• Top 6-8% hospitals in the USA are Magnet hospitals

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What is Magnet?

• The Magnet credential recognises hospitals that have created:• Outstanding patient care environments;• Excellence in nursing – delivering excellent patient outcomes;• High levels of job satisfaction amongst nurses; and• Innovative practice in nursing care – with emphasis on research.

• Promotes the attraction and retention of nurses – researchers called this the ‘magnet’ effect.

• Encourages organisations to disseminate best practice.

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The Magnet Model

1. Transformational Leadership

2. Structural Empowerment

3. Exemplary Professional Practice

4. New Knowledge, Innovations and Improvements

5. Empirical Outcomes

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• Louis Pasteur’s theory of germs is ridiculous fiction Professor of Physiology Pierre Pachet,1872

• Heavier than air flying machines are impossible Lord Kelvin, 1895

• Computers in the future will weigh no more than 1.5 tons’

Popular Mechanics, 1949

• ‘We don’t like their sound and guitar music is on the way out’

Decca recording company on The Beatles, 1962

Looking to the future

© Ian Cumming

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“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?