Image: Logo Streamlining Programme.Barnet & Chase Farm Hospitals NHS Trust (BCF) has significantly reduced the amount of staff time spent completing statutory and mandatory training, saving £750,000 per year, while increasing staff compliance and the quality of training.

The organisation

BCF offers high quality, specialist hospital treatments and therapies to over half a million patients from Barnet, Enfield, Haringey, East Harrow, South Hertfordshire, South Essex and Waltham Forest each year. One of 40 NHS trusts in London, it employs around 4,100 staff.

What we did and why

In July 2011, BCF attended a seminar for acute trusts as part of the Streamlining Programme. Agreeing to work together to identify best practice and find solutions to long-standing issues with statutory and mandatory training, BCF and seven other trusts adopted a set of tasks and key milestones called the ‘5 Point Plan’. They identified the key barriers and reasons why statutory and mandatory training was taking so much staff time, why training was repeated when staff moved and why compliance rates were so low. At the end of 2011, despite a range of interventions, BCF’s target of 85 per cent compliance for statutory and mandatory training had still not been met. The board was concerned that compliance rates had ‘stuck’ at 60-65 per cent.

The trust recognised a need to review training provision and also identified that only three per cent of the workforce was doing any form of elearning. Increasing elearning had the potential to improve access to learning, test knowledge and record this directly to an employee’s learning record on the Electronic Staff Record (ESR).

How we did it

A small team within the trust’s learning and development (L&D) function formed the project team and focused on achieving the following deliverables:

  • Agree and set frequency of training to the local north London benchmark.
  • Agree and set length of time for training to local north London benchmark.
  • Identify appropriate staff groups actually required to complete training with subject matter experts.
  • Shift focus of accountability to individual staff through a transparent reporting system.
  • Shorten refresher training times and introduce elearning, where appropriate, in line with the north London benchmark.
  • Introduce testing into learning events to test knowledge.

Three levers were key parts of the trust’s journey to change culture and implement the new system:

1) Improving data quality and transparency.

  • The project team implemented a compliance reporting system, provided by Skills for Health, called ‘WIRED,’ which provided a tool to measure both who had completed their training and who had not. It also allowed the trust to set the training needs analysis internally to only train those staff who required specific training and avoid unnecessary time-out for staff.
  • The team ensured that any local elearning produced could be linked to OLM and recorded directly on to individual staff learning records, to decrease the amount of inputting required for face-to-face training, reducing overall costs.

2) Providing smarter and more accessible training.

  • The team adopted elearning which covered 70 per cent of all statutory and mandatory training.
  • A marketing strategy included posters and leaflets to all staff on how to access elearning and ensuring that the L&D team were on hand to provide adequate support to staff to encourage the use of elearning. Open days in the expanded Open Learning Centre were set up to demonstrate the elearning and the team went out to departments and team meetings to show staff how easy it was. The team also provided daily, ongoing support for re-setting passwords and offered both written, face-to-face and telephone guidance on how to access the courses and complete the training. The initial target was to increase use of elearning to 25 per cent of all staff within the first six months. The trust now has 90 per cent of its workforce using elearning to achieve compulsory training compliance.

3) Strong communication and performance management.

  • The chief executive and board directors were committed to supporting this project and issued strong messages to their senior teams to meet the required targets for their areas. League tables were produced monthly and meaningful discussions held at team meetings to ensure where insufficient progress was made. Individual line managers were taken through the initial stages of performance management.

Results and next steps

The trust has achieved a culture of training compliance with the following results:

1. BCF was the first trust to complete all aspects of the 5 Point Plan process. Training compliance rose from 60 per cent to 85 per cent and met all the quality and safety requirements of the Care Quality Commission (CQC) standards of care.

2. Elearning use increased to 90 per cent of the workforce, reducing the amount of time staff needed to complete training. BCF remains top in London on ESR’s league tables for elearning and has also achieved a top five position nationally.

3. The training needs analysis within WIRED has reduced training time from over 25 hours for all subjects to just over eight hours. This has saved the trust £750,000 per year; equivalent to the cost of 22 newly-registered nurses.

4. The trust now has more transparent and real-time reports of compliance, meaning staff and managers can hold themselves accountable for individual and departmental compliance.

5. IT literacy and staff engagement with learning and development have improved and staff now enjoy elearning as an accessible way to keep up to date with their training. The learning and development team now spend their time on other important aspects of Transparent and real-time reports of compliance 3 developing skills and expertise rather than chasing compliance for compulsory training.

6. The trust has also been able to use its experience to support a number of other trusts with implementing the same methodology within their organisations and results have shown they are experiencing similar positive results.

The L&D team has now added five further compulsory subjects of training which are core to the trust’s patient care agenda, such as dementia and dignity and work. The team is now helping the Quality Innovation Productivity and Prevention (QIPP) teams adopt other modules of elearning that will help hospital efficiency and further improve quality of patient care.

Tips for other trusts

  • Create a compelling case for change by emphasising the quality and cost benefits of compliance.
  • Communicate the strategy and progress frequently to management.
  • Make the IT department part of the team.
  • Select a fit-for-purpose and robust system for timely compliance reporting which interfaces with the main employee records system and enables training needs to be clear to ensure training takes place only when needed.
  • Make elearning the norm and ensure learning packages are relevant to the needs of the organization.
  • Align policies to the training compliance such as the appraisal policy.

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