Statewide Education and Training Services. Position Paper. Draft for Consultation 1 July 2013

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1 Statewide Education and Training Services Position Paper Draft for Consultation 1 July 2013 This paper establishes the position for an SA Health Statewide Education and Training Service following the initial proposal distributed for consultation in February 2013

2 Table of Contents Background... 3 Context for the Statewide Education and Training Services Review... 4 Establishing a position... 5 Current activity... 6 Emergent themes... 7 Proposal for change... 8 Scope... 8 Recommendations Statewide Learning and Development Plan (LDP) Leadership and governance Responsibilities Ease of Access Recording, monitoring and reporting Partners Appendix 1: Proposed Functional Structure Appendix 2: Proposed Relationships

3 Background Education and training has a pivotal role in the safety and quality of healthcare delivery, enabling personal growth, and building workforce capability for current and future work roles. The rapid pace of change in knowledge, technology, new skills and roles within the health sector requires commitment and a responsive approach to learning at every career stage. The SA Health Care Plan states that Learning is the key to providing a first class health service and a workforce with high level skills and capacity. We want to ensure that all health service staff have access to ongoing training, support and professional development to ensure that SA remains at the cutting edge of health research and health service technology. The SA Health Strategic Plan also makes reference to the importance of a workforce ready for the future in the following two strategies: Align workforce reform with the service reform agenda to identify new approaches that further develop a competent flexible, sustainable and responsive workforce. Provide workforce development that embraces workforce reform, and links with education and training standards that match changing service needs and demands. Currently, there is significant fragmentation of education and training services across SA Health. This is attributed to the origins of these services as independent entities, segmentation of professional disciplines and an introspective approach to educational governance. Even within professional domains varying degrees of collaboration occurs across the sites and Local Health Networks (LHNs). While there are some local benefits in this service structure there is potential for inconsistency in content, duplication of effort in developing programs, and in some instances the requirement for staff to re-attend programs when working across sites. There is also inequity in the allocation of resources and access to education and training across SA Health. Multiple services (in excess of ten dedicated units) located at various health service sites are providing education and training services to the SA Health workforce. This is carried out by a combination of in-house and on-line delivery methods and includes nationally accredited courses and units as well as non-accredited courses. In some cases training is outsourced to other providers. Education and training is provided to the workforce at every career stage. It is required during induction, to enable participation in corporate and organisational functions, to develop leadership and for clinical development. There are also mandatory requirements relating to safety, quality and accreditation. There are currently two Registered Training Organisations (RTOs): one is based at SA Ambulance Service (SAAS) and the other at Central Adelaide Local Health Network (CALHN) that provide nationally accredited qualifications as part of Australia s Vocational Education and Training (VET) system. 3

4 Establishing priorities for education and training is a process which varies from site to site. Unit management and decisions relating to content and delivery are currently managed locally. While services and resources largely operate independently there are varying degrees of collaboration across departments or specialities. The need for quality learning and development identified in the SA Health Care Plan and the SA Health Strategic Plan combined with the current fragmentation of services reveals an opportunity to develop an integrated and coordinated service to enable sharing of knowledge and resources, reduce duplication and provide greater access and equity to education and training services for the SA Health workforce. These factors provide leverage for change in SA Health. Context for the Statewide Education and Training Services Review The Statewide Education and Training Services Review commenced in early This was undertaken to consider the development of an integrated and coordinated statewide approach to education and training across SA Health which supports interdisciplinary collaboration and acknowledges the requirements of the SA Health Care Plan and the SA Health Strategic Plan The main aim of the review has been to ensure SA Health is able to deliver efficient and effective education and training services for staff where needed and that these services are sustainable into the future. The review included internally and externally provided induction, corporate, clinical and leadership education and training for all SA Health staff. This included nursing and midwifery, medicine and surgery, allied health and other health personnel. The review excluded SA Ambulance Service s clinical education. The review set out by acknowledging that: Learning is the key to providing a first class health service and a workforce with high level skills and capacity. All health service staff require access to training, support and professional development to ensure that SA remains at the cutting edge of health research and health service technology. SA Health should have a workforce which is ready for the future. From the outset it was expected that any proposed development of a statewide education and training service (following consultation) would provide: A robust learning and development governance framework for coordination and delivery of education and training. Streamlined outputs of internal education and greater economies of scale in the engagement of external education and training providers. Management of intellectual property in the education and training domain. Management of accreditation, reporting and review functions relating to the delivery of education and training. 4

5 It was also expected that the functions of any proposed education and training service would: Provide a coordinated and informed approach to induction, mandatory, leadership and ongoing professional education and training for all SA Health staff. Be accountable for education and training resources across SA Health. Ensure education and training is matched to the needs of SA Health and its current and future staff. Ensure access and equity to education and training in the context of SA Health s needs and those of current and future staff. Enable the achievement of contemporary education and training outcomes. Unify the development of specialised SA Health education content and course design. Provide a mechanism to link with others in the learning and development environment including universities, training providers, professional colleges and accrediting bodies, government agencies, the non-government sector, research institutes, scholarship providers and others. Maximise the intent and impact of programs and strategies offered by professional bodies and others in the learning and development environment. Any proposed development of an integrated and coordinated education and training service is expected to build on existing strategy and priorities, programs and projects which demonstrate proven success. The aim is to reduce or remove structures and approaches which are: Fragmented Inconsistent Likely to result in duplication of effort Historically based Lacking in transparency, accountability or quality assurance measures Not tied to priorities or outcomes of SA Health Unlikely to meet the needs of staff. Establishing a position The initial Proposal for a Statewide Education and Training Service dated 8 February 2013 set the expectation that Stage 1 of the review would gather information to support the development of a position paper, including a proposed model for learning and development. The newly proposed model detailed in this document includes leadership and governance arrangements. The Proposal also stated that re-evaluation and relocation of existing activity and workforce would be undertaken based on ideals of reduced duplication and cost efficiency, along with a realignment of existing contracts with external providers to create efficiency. 5

6 The process of consultation with interested parties and seeking advice from a newly established Advisory Panel has been undertaken as described in the Proposal for a Statewide Education and Training Service. Interested parties were invited to respond to Questions for Response by SA Health Chief Executive, David Swan with the knowledge that responses would inform the development of a future model for learning and development. The response process was open from 8 February 2013 until 8 March During this period, 92 responses were received from individuals and groups. Many responses represented a collated response from a work area or area of interest, as detailed in the table below. Group response s Individual response s Total Department for Health and Ageing Central Adelaide Local Health Network / Statewide Services Southern Adelaide Local Health Network Northern Adelaide Local Health Network Women's and Children's Health Network Country Health SA Local Health Network External to SA Health Other (unidentified) South Australian Ambulance Service Analysis of responses demonstrated a number of common themes regarding current and future provisions for learning and development of SA Health staff. This feedback, together with the insights of Advisory Panel members has informed the new approach to learning and development. Current activity There is a large volume of education and training activity which is delivered, contracted, brokered and promoted to meet the needs of staff across SA Health. A portion of this is captured through training calendars which are provided by each hospital and specialist service s education centres. There are at least 26 training calendars spread across 24 sites within four LHNs, DHA, and the Statewide Specialist Clinical Services. These calendars detail more than 1000 courses, seminars and single training sessions offered and delivered by 6

7 SA Health staff. Of these, more than half are delivered in a face-to-face, classroom based format, with the remainder delivered via self-directed on-line learning modes. Advertised sessions vary in duration from one hour to 10 days, with some sessions offered in a blended delivery mode combining face-to-face and on-line modes. Of the activity documented in the calendars, about 68% relates to clinical training (the majority of this is aimed at nursing staff, with a smaller portion aimed at allied health or a multi-disciplinary target group). Around 12% is focussed on induction or mandatory skills and knowledge which enable staff to commence in the workforce or undertake duties in a safe or compliant manner. The remaining activity (about 20%) has a leadership, administrative or corporate skills focus. Medical education and training is organised differently in each site, and is unlikely to be included in training calendars. In addition to the offerings documented in training calendars, many sites also provide staff access to on-line learning platforms such as Moodle. This delivery mode has content which may be locally produced to meet an immediate or short term need, or may provide access to externally produced content, including accredited courses. Staff on sites where access to in-house delivery of courses is limited tend to access training from sites where this is offered. This requires staff to travel or select contracted or brokered options as an alternative. While there are similarities in the range of courses offered by sites, and a culture of sharing materials across education and training units, there is little evidence of a coordinated approach to delivering common content. This is problematic for creating a minimum learning standard for staff who perform similar roles at different sites. Additionally, this current state needs to be considered when planning for large scale change such as the introduction of EPAS and the supports required to ensure a consistent, resourced approach across all clinical services. It is apparent that there is a great deal of variability between sites in what is developed and delivered. There is a significant local effort invested in developing content and coordinating delivery to meet staff needs. This effort is frequently replicated between sites. Emergent themes Ten clear themes have emerged from the analysis of responses to the Proposal. These are: 1. Learning and development should be targeted to workforce priorities and supported through our organisation s culture. 2. Each person should have a tailored learning journey which is supported by their managers and leaders. 3. Mandatory requirements for learning and development should be clearly articulated. 7

8 4. Access to learning and development should be easy and equitable. 5. Content of materials should be consistent, up-to-date and set to an agreed standard. 6. Wherever possible, learning should be supported in a relevant context and should enable professions to work and learn together. 7. Skills and qualifications should be portable and where possible provide the opportunity for linking to more advanced options. 8. Purposeful collaborations and partnerships should be driven by SA Health. 9. Systems which enable learning and development should be financially sustainable. 10. Learning and development, particularly where requirements are mandated, should be monitored, reported and evaluated. Proposal for change To account for the business needs of SA Health in a way which honours responses and advice from the Advisory Panel, a proposal for change has been developed for consideration and comment. It is proposed that an Academy for Learning and Development (ALD) 1 is established as a collaborative and supportive body providing service to SA Health (inclusive of the LHNs, SAAS and the Statewide Specialist Clinical Services). Scope The ALD is proposed to provide a coordinated and informed approach to education and training and will include induction, mandatory training, leadership and ongoing professional education and training for all SA Health staff and others working in SA Health facilities. With consideration for the significant activity already occurring, the role of the ALD will change over time. The ALD will commence with induction and mandatory requirements and scale up to include a focus on leadership and then ongoing professional education and training as capability and coordination increases. It is acknowledged that there is a significant component of highly organised work already underway to support learning and development. It is intended that the ALD will complement, enhance and maximise this effort rather than assume control of locally delivered education and training activities. The influence of the ALD is expected to vary according to local needs, with the emphasis being placed on the ALD being a collaborative and supportive body which enables coordinated education and training approaches to meet business needs. 1 Academy for Learning and Development (ALD) is provided as a working title and may be altered in response to feedback. 8

9 Recommendations Six specific recommendations are offered for consideration in support of this proposal for change. 1. Statewide Learning and Development Plan (LDP) It is proposed that a LDP be established which articulates the priorities and workforce context for learning and development within SA Health and the LHNs. The proposed LDP will be refreshed on an annual basis and will include: Reference to current workforce profiles and projections for major workforce groups employed or contracted by SA Health and LHNs. Reference to clinical service plans which impact on current and future education and training needs. Minimum requirements for all staff, including those which are mandated through legislative, professional or organisational requirements. Priorities for learning and development for: It is proposed that: a) all staff b) managers, supervisors and leaders c) contractors and third party providers d) specific workforce groups, including students. Workforce profiles for SA Health and projections will inform decisions about current and future priorities and gaps as well as serving to enhance understanding of constructs of education which are likely to match workforce needs. A statement of minimum requirements will ensure service planning that enables all staff and others including contractors, third party providers and students to access a basic level of education and training to be able to perform daily roles. A statement of priorities will enable service planning with the efficient and effective utilisation of available resources to support accessible and equitable education and training for all SA Health staff. Priorities for learning and development will be prepared in consultation with LHN leaders, SA Health operational and workforce leaders and professional leads. Other entities, such as SA MET and ClinEdSA will also be included in planning. Connections which enable SA Health to prepare for the workforce of the future are important, as is attention to specific strategies. The initial focus of the ALD in delivering the LDP will be induction and mandatory requirements. It is intended to then scale up to include leadership and then ongoing professional education and training as capability and coordination increases. 9

10 2. Leadership and governance It is proposed that leadership arrangements for the ALD will support and enable the delivery of the priorities outlined in the LDP across SA Health including the LHNs and Statewide Specialist Clinical Services thereby creating a statewide approach. The ALD will be governed by a collaborative body, referred to as the Learning and Development Collaborative with representation from each LHN, Statewide Specialist Clinical Services, SAAS, relevant divisions of the Department for Health and Ageing, SA MET and ClinEdSA. The proposed leadership arrangements for the ALD include a Group Director for Learning and Development who will relate to the collaborative governing body and will ensure the strategic and operational responsibilities of the ALD are met. Refer to Appendix 1. It is proposed that each LHN, Statewide Specialist Clinical Service and relevant divisions of the Department for Health and Ageing will identify or appoint a senior leader with responsibility for Learning and Development. The proposed function of these roles is one of consultancy, advice and navigation, to draw on the resources and expertise available from the ALD. This will deliver the requirements of the Statewide LDP in the context of the local site. Refer to Appendix 2. It is proposed that LHN CEOs have responsibility for ensuring financially sustainable structures are in place to support the specific learning and development needs of LHN staff. Feedback from interested parties regarding delivery indicates that: Statewide coordinated programs which are delivered locally are desirable, as is content which is developed by the ALD and shared locally. Content which is responsive to current, evidenced practice expectations should be informed by those with current expertise and practice knowledge. Content should be mapped to accredited frameworks, or recognised standards where these exist. Portable qualifications and skills recognition are highly valued by staff. As such it is proposed that the Group Director Learning and Development will be supported by two key functions, one centred on content development and the other on delivery systems. The content development function will include: Academic advice to ensure content is developed in a way which links to delivery options and the needs of the workforce. Links to standardised frameworks, where available, and clinical networks for advice on content requirements. A rotational staffing arrangement to bring in content specialists at regular intervals to advise on the content being developed to support education and training activities. 10

11 Materials will be available to deliver content locally. These are proposed to be accessed through an advisory service. The delivery systems function will focus on enabling local delivery of content through supportive systems and advice including: Statewide advertising of locally managed programs. Consistent and standardised management of participant records. Informatics to support reporting, evaluation and monitoring, especially related to the achievement of the LDP. Learning journey advisory and coordination functions to guide and plan for optimal management of staff s personal learning plans to meet performance plans outcomes. Simulation facility management and coordination. E-learning system development and management. Management of enabling programs and projects such as mentoring, scholarships and educational counselling and advice. Statewide management of contracts for the provision of education and training services to SA Health and the LHNs. Delivery will still be carried out locally, by locally employed staff, using materials produced by the ALD. Additionally, it is proposed that the Registered Training Organisation currently attached to Central Adelaide Local Health Network, its resources and staff are migrated to the ALD. This is seen as an important step in providing staff training where highly specialised accredited training is required, and this function is unlikely to be readily available from other providers. 3. Responsibilities It is proposed that the ALD is responsible for: Establishing and managing the Statewide LDP. Establishing a standard for content with relevant clinical and other expert input. Developing and managing materials to support education and training which are aligned to the agreed standard. Providing an enabling environment for the local delivery of activities which meet the needs of the Statewide LDP. Ensuring that the Statewide LDP is managed in a way that promotes financial sustainability. It is proposed that the LHNs, Statewide Specialist Clinical Services, SAAS and SA Health (in the management of Department for Health and Ageing staff) are responsible for: Identifying and supporting a senior leader with authority for delivering on the priorities of the Statewide LDP. 11

12 Contributing to the establishment and management of the Statewide LDP through collating and communicating staff requirements for learning and development based on workforce and clinical service priorities. Determining immediate and future workforce priorities based on organisational need and the content of personal learning plans. Utilising materials, advice and delivery systems available from the ALD to deliver a financially sustainable Statewide LDP. Maintaining specialist staff skilled in delivery of education and training in the workplace to support locally determined requirements. It is proposed that managers are responsible for: Ensuring that each person within the manager s line management responsibility has planned performance review and development which aligns to their personal learning journey. Ensuring staff are supported to participate in agreed learning and development activities. Collating information about local workforce priorities. It is proposed that all staff are responsible for: Planning and maintaining an up-to-date performance review and development which aligns to their personal learning journey. Communicating requirements and priorities for learning and development to their line managers and leaders. Participating in agreed learning and development activities. 4. Ease of Access Ease of access to education and training is expected to be a core value of the ALD and local activity. This is proposed to be achieved through the purposeful selection of approaches which value the principles of adult learning. Statewide coordination and advertising of opportunities for education and training is also expected to support ease of access. Respondents to the Statewide Education and Training Services Review consultation process have been unanimous in the view that appropriate education and training should be accessible to staff regardless of the geographic location of the workplace. This includes having flexibility to participate in education and training activities offered by sites other than the person s site of regular employment if this is the most appropriate way to meet a learning need. Calls for increased access to e-learning and other flexible modes of delivery also featured prominently in feedback and this must be considered by the ALD in developing materials and enabling delivery. Respondents have supported practice based approaches to learning with specific reference to case-based, bed-side and problem-based approaches to learning. It is proposed that this feedback is considered as a way of valuing workplace experience, adding context to activities and maximising time available for learning and development by planning activities in, or close to, the actual place of work and for 12

13 providing a mechanism to achieve synergy between learning, clinical practice and current research. 5. Recording, monitoring and reporting It is proposed that record keeping of participation and attainment for all staff is undertaken as a function the ALD. Participants will have access to their own records. Accurate and accessible records are essential to track education and training of individuals, as well as in providing a current picture of achievement at a service or organisational level. Through accurate and accessible records, meaningful reporting and monitoring of progress against the Statewide LDP can be provided. This is informative as a planning tool and for demonstrating regulatory compliance with mandated requirements. Further exploration of a suitable mechanism for providing this function is required. 6. Partners SA Health does not operate in isolation when providing education and training to staff. Universities, other training providers, professional colleges and accrediting bodies, other government agencies, the non-government sector, professional discipline organisations, research institutes, scholarship providers and others are all active in the rich environment which shapes the workforce education and training environment for SA Health staff. It is proposed that SA Health, via the ALD, establishes a communication plan and mechanisms for regular engagement with others in the learning and development environment. This is for the purpose of both informing the Statewide LDP and building SA Health s capacity to deliver on its priorities. It is essential that the ALD can represent the priorities expressed in the Statewide LDP in a way which builds a collaborative network and strengthens and enables collective approaches to achieving the goals set out in the Statewide LDP. This can only be achieved through purposeful collaborations and partnerships driven by SA Health. 13

14 Appendix 1: Proposed Functional Structure Learning and Development Proposed Functional Structure Group Director Learning and Development Resources and Facilities e.g. Libraries Content Development Specialist approaches to: Induction Mandatory Leadership Ongoing professional Delivery Systems System Evaluation and Monitoring elearning System Registered Training Organisation Delivery of: Accredited courses Projects and Programs 14

15 Appendix 2: Proposed Relationships LHNs DHA Clin Ed Learning and Development Collaborative Statewide Support Services SA Ambulance Group Director, Learning and Development NALHN CALHN SALHN DHA Academy WCHN Statewide Support Services SAAS CHSA LHN 15

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