The Pennine Acute Hospitals NHS Trust

Monitoring visit: The Pennine Acute Hospitals NHS Trust, 11–12 September 2018 The Pennine Acute Hospitals NHS Trust Monitoring visit report

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Name of lead inspector: Anita Pyrkotsch-Jones HMI

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Inspection date(s): 11–12 September 2018

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Address:

Limbert Education Centre North Manchester General Hospital Delaunays Road Crumpsall Manchester M8 5RB Monitoring visit: The Pennine Acute Hospitals NHS Trust, 11–12 September 2018

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Context and focus of visit

This monitoring visit was undertaken as part of a series of monitoring visits to a sample of new apprenticeship training providers that are funded through the apprenticeship levy. Ofsted’s intention to carry out monitoring visits to these new providers was first announced by Her Majesty’s Chief Inspector in November 2017. The focus of these visits is on the three themes set out below.

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Context and focus of visit

The Pennine Acute Hospitals NHS Trust (the Trust) consists of four hospitals. These are North Manchester General Hospital, Rochdale Infirmary, The Royal Oldham Hospital and Fairfield General Hospital in Bury. The Trust employs more than 9,000 staff across the four sites.

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Context and focus of visit

The Trust became a levy-funded employer provider in May 2017. Currently, 52 apprentices are enrolled on standards-based apprenticeships in healthcare support worker at level 2 and 19 on senior healthcare support worker at level 3. A third of apprentices are new to the Trust.

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Reasonable progress

Senior leaders have developed a clear vision, rationale and strategy to develop their workforce using the apprenticeship levy funding. Leaders and managers are committed to ensuring that apprentices are placed on the correct programmes according to their capabilities and career aspirations. The aim of the Trust is to become a centre of excellence for apprenticeships.

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Reasonable progress

Leaders and managers ensure that prospective apprentices receive effective information, advice and guidance about what is required to be a successful apprentice when considering enrolling on an apprenticeship programme. Apprentices complete clinical activities to identify the strengths and weaknesses in their knowledge, skills and behaviours to establish their starting points accurately.

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Reasonable progress

Leaders and managers monitor the standard and frequency of training that apprentices receive. For example, leaders and managers monitor off-the-job training activities to ensure that all apprentices receive their full entitlement to off-the-job training in working hours.

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Reasonable progress

Managers ensure that they collect feedback from apprentices on the quality of their apprenticeship programme. Managers are committed to making swift improvements Monitoring visit: The Pennine Acute Hospitals NHS Trust, 11–12 September 2018 where necessary. Most apprentices appreciate the opportunities they have for the personal and career development that the apprenticeship provides.

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Reasonable progress

Managers track and monitor apprentices’ progress using an electronic monitoring system. However, not all trainer-assessors and apprentices understand the system fully or use it effectively. Managers have scheduled additional training for trainer- assessors and apprentices on the use of the system. Managers have developed and implemented a basic but effective complementary tracking tool. This tracks progress efficiently and identifies clearly those apprentices who are making slow progress. It has a red, amber and green progress-rating system to enable trainer-assessors to provide prompt support or additional challenge where needed.

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Reasonable progress

Managers’ auditing of apprentices’ electronic records is rigorous. They ensure that apprentices complete key activities such as diagnostic assessments and compliance with the Trust’s mandatory training programme.

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Reasonable progress

Leaders ensure that they have sufficient trainer-assessors with the required competencies, knowledge, skills and experience to deliver the apprenticeship programmes. Leaders have implemented an effective lesson observation and appraisal process. Observers focus correctly on apprentices’ learning and the progress that they make. Where weaknesses are identified, managers agree an action plan with the staff member and ensure that they benefit from relevant training and development.

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Reasonable progress

Senior leaders have set up appropriate governance committees that monitor the implementation of the apprenticeship strategy. Currently, this focuses primarily on enrolment of apprentices and the use of levy funding and not on the quality of apprenticeship programmes.

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Reasonable progress

Senior leaders meet regularly with apprenticeship managers to monitor and discuss the performance of trainer-assessors and the progress of apprentices. Senior leaders acknowledge that they need to monitor more closely the wider aspects of apprenticeships such as retention. They have recently implemented specific key performance indicators to facilitate this.

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Reasonable progress

Well-qualified, skilled and experienced managers and trainer-assessors plan apprenticeship programmes thoroughly. Planning is linked closely to apprentices’ job roles and the requirements of their apprenticeship standard. As a result, apprentices’ knowledge, skills and behaviours, including the development of English and mathematics skills, are developed effectively through the tasks they perform on the wards and in the departments in which they work. Apprentices value the new Monitoring visit: The Pennine Acute Hospitals NHS Trust, 11–12 September 2018 knowledge, skills and behaviours they develop, which help them to improve their practice and performance continuously.

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Reasonable progress

Trainer-assessors benefit from good staff development that helped them to prepare for the introduction of apprenticeship standards. All have teaching qualifications and are qualified in information, advice and guidance to at least level 2.

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Reasonable progress

Trainer-assessors do not update the electronic tracking and monitoring system regularly enough. Consequently, it appears that many apprentices are working below target when most of them are making or exceeding the progress expected of them. Very few apprentices are making slow progress. Trainer-assessors monitor closely apprentices who are making slow progress and provide them with additional support to help them to catch up. A few apprentices are beginning to prepare for their end- point assessments. They have a good understanding of what is required of them and appreciate the support that trainer-assessors provide in helping them to prepare for end-point assessments.

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Reasonable progress

Healthcare support workers on the apprenticeship standard at level 2 benefit from a 15-day induction programme that includes the ongoing assessment of their academic starting points, including English and mathematics, and practical aptitudes. Clinical competencies are assessed thoroughly on the wards and departments where apprentices work and action plans are developed to address apprentices’ skills gaps. Senior healthcare support workers on the apprenticeship standard at level 3 receive relevant off-the-job training fortnightly at the training centre to develop knowledge, skills and behaviours related to their job role.

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Reasonable progress

All apprentices receive a wide range of on- and off-the-job training which includes job shadowing, ward training, completion of training packages and time to complete reflective logs. Consequently, apprentices are developing a good range of new knowledge, skills and behaviours, including reflective skills. Apprentices’ managers report that apprentices bring new and innovative approaches to patient care. Consequently, apprentices are encouraged to identify and share best practice with their colleagues.

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Reasonable progress

Apprentices reflect positively on their training sessions. They articulate clearly examples of how they apply the knowledge, skills and behaviours learned in training sessions to the workplace. For example, they apply their newly developed knowledge, skills and behaviours sensitively and effectively when caring for patients with dementia.

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Reasonable progress

Apprentices receive good career guidance throughout their apprenticeship. They can gain, in consultation with their trainer-assessors and ward managers, additional qualifications that will support them in applying for promotion or progressing to the next level of training. For example, most apprentices have completed successfully the physiological measurements course and the venepuncture qualification. A few apprentices have already been promoted to jobs that require specialist training and skills such as electrocardiogram (ECG). Monitoring visit: The Pennine Acute Hospitals NHS Trust, 11–12 September 2018 Communication between trainer-assessors and ward managers varies across wards, departments and hospital sites. For example, a minority of ward managers interviewed by inspectors have very good communication with trainer-assessors, are involved in apprentices’ progress reviews and receive comprehensive updates on

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Reasonable progress

apprentices’ progress. However, this is not consistent across the Trust and it is an aspect that requires improvement.

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Reasonable progress

Safeguarding across the Trust, which includes patients, staff and apprentices, is rigorous. A high priority is placed on safeguarding. Senior leaders and managers use safe recruitment practices when employing staff at all levels in the Trust. All staff have disclosure and barring service checks.

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Reasonable progress

Managers update safeguarding policies and procedures regularly. They have recently developed a draft safeguarding policy specifically for apprentices so that apprentices understand how to keep themselves safe. This has yet to be approved by the board.

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Reasonable progress

All staff across the Trust complete mandatory training in safeguarding and the ‘Prevent’ duty. Apprentices complete safeguarding training to at least level 2. They know to whom they should report any safeguarding concerns they may have.

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Reasonable progress

Apprentices have a good understanding of the dangers associated with radicalisation and extremism. Many staff at the Trust were directly involved in treating casualties following the terrorist attack on the Manchester Arena in May 2017 and are now vigilant in identifying and reporting potential threats and extremist behaviours.

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Reasonable progress

Staff across the Trust, including apprentices, have a good understanding of their roles and responsibilities in protecting themselves, their colleagues and their patients. All hospital wards have named safeguarding officers. The designated safeguarding officer and deputy safeguarding officer for apprentices have completed appropriate training to enable them to undertake their roles. So far, no apprentice has raised a safeguarding concern.

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Reasonable progress

The Trust takes the continued well-being of all staff, including apprentices, very seriously. Apprentices have good access to a range of health and well-being services, such as occupational health, to ensure that they maintain good mental and physical health.

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Reasonable progress

Apprentices follow safe working practices. These include, for example, the correct use of personal protective equipment and the safe disposal of hazardous substances. Monitoring visit: The Pennine Acute Hospitals NHS Trust, 11–12 September 2018 the guidance ‘Raising concerns and making a complaint about Ofsted’, which is available from Ofsted’s website: www.gov.uk/government/publications/complaints-about-ofsted . If you would like Ofsted to send you a copy of the guidance, please telephone 0300 123 4234, or email enquiries@ofsted.gov.uk . Learner View Learner View is a website where learners can tell Ofsted what they think about their college or provider. They can also see what other learners think about them too. To find out more go to www.learnerview.ofsted.gov.uk .

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Employer View Employer View is a website where employers can tell Ofsted what they think about their employees’ college or provider. They can also see what other employers think about them too. To find out more go to www.employerview.ofsted.gov.uk .

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