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Shape of Caring Event 22 nd July 2014. Kathy Branson Director – Special Projects Health Education East of England. Agenda. Shape of Caring review: Education for tomorrow’s nurses Lord Willis of Knaresborough East of England LETB. Context for change.

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Shape of Caring Event

22nd July 2014

Kathy Branson

Director – Special Projects

Health Education East of England


Shape of Caring review:

Education for tomorrow’s nurses

Lord Willis of Knaresborough

East of England LETB

context for change
Context for change

Growing population – 3 million by 2020

Challenge of Aging population

Challenges of long term chronic disease management

Diabetes 25%

Kidney Disease 45%

Dementia 25%

Obesity: 48% Men and 43% Women by 2030

Chronic care management: 70 - 75% of costs of NHS


Context for change continued…

  • Changes in technology – personalized medicine
  • Changes in patient demand
  • Changes in Commissioning
  • Changes in care delivery
context for change1
Context for Change

Funding Uncertainty:

  • Continued growth over past 50 years
  • NHS spend now larger than education and defence
  • 1 in 16 people in England are employed by NHS

Future Funding

Demands will rise but budget will not keep pace

constant factors
Constant factors

Patients, families and communities

‘Caring’ workforce


A vision for the future…

The majority of healthcare will be managed out of the hospital setting, with more care being provided in the community. Patients will be encouraged to self-care as much as possible:

  • Patients will be better supported to manage their own health, with better outcomes for individuals and better value for money
  • Patients will receive high quality care wherever they are and at the time of their choosing, reducing inequalities and outcomes
  • Patients will have higher quality relationships with healthcare professionals, reducing unnecessary visits to different specialists, leading to satisfaction for patients
  • Patients will benefit from the latest research and technology, whilst being treated with care and compassion
  • (Framework 15: HEE’s Strategic Framework 2014-2029)
c are support and nurses in england
Care support and nurses in England

HCSWs in healthcare – 270,000

HCSWs in social care – 1.2 million

Registered nurses – 500,000

These staff deliver most hands-on patient care

Their access to education and training vary

shaping tomorrows workforce
Shaping tomorrows workforce…

Prime Minister’s Commission on the Future of Nursing and Midwifery (2010): 20 recommendations relating to nursing/midwifery

Willis (2012): 29 recommendations relating to nursing

Francis (2013): 29 recommendations for nursing/HCSW

Cavendish (2013): 18 recommendations for HCSWs

Currently we lack a coordinated response

shape of caring review
Shape of Caring review

Patient centered

Evidence based

Build on existing best practice

Output focused

Career focused

Skill focused

Solution and evidence based!

the shape of caring review
The Shape of Caring review

Commissioned by HEE

Sponsoring Board jointly chaired by HEE/ NMC and includes:

Council of Deans; NHS England, Public Health England; LETB’s; NHS Trust Development Authority (TDA); LETB’s; RCN; Unison

In attendance: Chief Nursing Officers: Wales, Scotland and Northern Ireland; Researcher from Kings College, London.

Independent Chair – Lord Willis of Knaresborough

Reports: February 2015

how we are doing it
How we are doing it

Call for evidence/engagement

Review of the literature

Engagement events:

  • HCA’s, nurses, educationalists and the public

Involving a cross section of staff:

  • Independent sector, prison health, community, acute, voluntary sector
  • Commissioning Groups
  • Social media
  • Surveys and questionnaires
the shape of caring emergent themes
The Shape of Caring - Emergent themes:

Increasing patient/carer voice & service user involvement

Valuing the role of the Care Assistant

Widening opportunities for Care Assistant career progression

Assuring flexibility in the model of education and training for the future

Assuring & maintaining high quality learning environments for the future

Assuring Registered Nurses continuous learning and development

Enabling research, innovation and evidence-based practice

Reviewing the use of funding and commissioninglevers to drive up quality


Thank you

Contact details:

heeoe review overview
HEEoE Review-Overview

23 pre-registration nursing programmes commissioned per year by HEEoE

£100m + per annum

The Francis Report identified need for us to ensure programmes meet existing healthcare requirements now and in the future.

The review will align planning for future provision with the emerging implementation of the National Standard Contract Framework

Safer staffing standard/National shortage of nurses

design principles
Design Principles

The study design will be built upon the principlesof Health Education East of England:




With quality at the heart of everything we do:

Quality of patient care

Quality of education provision

key lines of enquiry
Key Lines of Enquiry

The following 4 KLoEs,underpinned by a number of detailed questions, will be considered in the review:

How do we determine what excellent nursing education should look like and how it should be delivered?

How do we ensure the right learning environment?

What is the optimum commissioning pattern for nurse education?

How do we ensure that we have the right applicants on our nursing programmes?

who did we ask
Who did we ask?

8 workshops for nurses (n=191)

3 workshops for service users (n=42)

1 HEI workshop (n=19)

4 workshops for students (n=86)

Collected data (taped and written), analysed by key themes

Carried out a Preliminary Literature Review – setting the context

values care compassion resilience1
Values: Care, Compassion & Resilience

The little things which count………..

next steps
Next steps

Interviews with key stakeholders

Online surveys

Testing & implementation

Website on HEEoE:

Twitter: @HEEoENurse

developing professional practice and expertise requires being in practice and doing practice
Developing professional practice and expertise requires being ‘in practice’ and ‘doing practice’

Situational Leadership

Maximum of 2 areas

Clinical Educator

Grow Coaching Model (Whitmore, 2009)


Maximum of 3 students

Student leads care –

delegates to day coach

Day Coach

Clinical Educator supports challenging conversations and failing to fail issues

Patients allocated:





Year 3

Year 1

Year 2


“Better awareness and understanding of what’s expected of a ward nurse”

“……a license to step back and push the student”

“Ensures we consider the rationale behind decisions”

“Allows students to work as nurses - not be followers


“I felt as though I could really concentrate (my care) on those patients”

“Students more involved, gained more insight, more enquiring”

dual qualifications moving up and sideways
Dual Qualifications Moving Up and Sideways

Service users, nurses and students told us

nurses should recognize / have knowledge of:

preceptorship into community and community pathways
Preceptorship into community and community pathways

Preceptorship Programmes Do you have in place, or are currently developing?


Do you have an induction programme for HCA’s ?

DEVELOPMENT PROGRAMMES – what is out there and what do we need to build on?

Do you have a District Nurse Training Programme ?

why grow your own
Why grow your own?
  • Valuing effective delivery of essential care
  • Person centred & integrated care
  • Skills gap and youth unemployment
  • Representation & inclusivity
  • Cost benefits
what we have already
What we have already
  • Band 5+
  • Registered professions & specialist roles
  • Band 4 inc
  • Assistant
  • Practitioners

Pre-degree care experience pilot; part-time undergraduate courses (OU)

  • Band 2
  • & 3

Foundation degrees;

Higher apprenticeships

  • Band 1 &
  • Pre-employed

Minimum standards; Certification; Apprenticeships and Advanced Apprenticeships

Prince’s Trust; Job Centre Plus;

NHS Careers and Schools;

Traineeships; Project Search

Incorporating the NHS Constitution and Values

what we need to do next
What we need to do next
  • Develop a clear pathway to inform staff and education providers
  • Develop a commissioning model that specifies quality, cost (for practice and education) and practice support standards
  • Build on potential for improved patient care with flexible roles
  • Clarify APEL arrangements
  • Develop a way of workforce planning for Band 1-4 development