West Midlands Ambulance Service University NHS Foundation Trust

Further education and skills inspection report

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West Midlands Ambulance Service NHS Foundation Trust Employer

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Overall effectiveness Good Effectiveness of leadership and management Good Apprenticeships Good

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Quality of teaching, learning and assessment Good

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Personal development, behaviour and welfare Good

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Overall effectiveness at previous inspection Not previously inspected

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Summary of key findings

 Managers have introduced a sound curriculum pathway for student paramedics on the Associate Ambulance Practitioner apprenticeship to progress and become fully qualified paramedics. They become highly qualified and skilled employees.  Education Training Officers (ETOs) are highly qualified in their field. They provide apprentices with highly effective on- and off-the-job training with access to industry-standard equipment.  Student paramedics develop high levels of competency in both clinical skills and service user care. They become valuable members of the paramedic teams based across the West Midlands.  ETOs and mentors promote equality and inclusion effectively. Theory and practical sessions ensure that apprentices respond well to a diverse population and are sensitive to individual treatment needs.  Student paramedics develop their English and mathematics skills well during their training. The skills they develop are applied in everyday

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Summary of key findings

life and in their future careers.  Leaders and managers do not use data and information well enough to review in detail the progress that apprentices make, including different groups of apprentices and those with subcontractors.  Managers do not yet ensure that there is effective monitoring and support for apprentices to complete their portfolios within the expected timescale.  Apprentices and staff do not have a sufficient understanding of the grades for end-point assessment.  Managers do not sufficiently monitor the progress of business support apprentices with subcontractors.

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Information about the provider

 West Midlands Ambulance Service serves a population of 5.6 million people covering Shropshire, Herefordshire, Worcestershire, Staffordshire, Warwickshire, Coventry, Birmingham and the Black Country areas. The organisation was formed in 2006. In 2013 it was authorised as a Foundation Trust and licensed as a provider of NHS services in the same year. The service employs 4,000 staff and operates from 15 fleet operation hubs across the region and a network of 40 community ambulance stations. They respond to 3,000 ‘999’ calls each day.  West Midlands Ambulance Service has its main training academy in Dudley. It is now in the third year of providing apprenticeship programmes. Most apprentices currently on programme are studying the level 4 Associate Ambulance Practitioner apprenticeship. Apprentices are employed as student paramedics. The provider is currently working with six subcontractors. The subcontractors provide a small number of apprenticeships to

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Information about the provider

those employees in the business support areas, including patient transport, information technology (IT) and business administration.

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What does the provider need to do to improve further?

 Improve the monitoring and analysis of apprentices’ performance data to enable swift action to narrow any identified achievement gaps for different apprenticeship groups, including those aged over 24 and female apprentices.  Review the milestones set within the apprenticeship programme and ensure that apprentices receive sufficient monitoring and support to complete their portfolios on time.  Ensure that quality improvement focuses on improving the impact of the provision on apprentices’ learning and progress. Strengthen the performance management of staff to improve the quality of teaching, learning and assessment and outcomes for apprentices.  Improve the monitoring of apprentices on subcontracted programmes: – ensure that they are making expected levels of progress on their vocational, English and mathematics qualifications – ensure that business support apprentices have a detailed understanding of extremism

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What does the provider need to do to improve further?

and how to keep themselves safe from radicalisation.  Improve staff’s and apprentices’ understanding of end-point assessment. Ensure that staff use the information gathered on apprentices’ previous skills and experience to set appropriate target grades for end-point assessment.

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Effectiveness of leadership and management Good

 Senior leaders and managers recognise that staff work in a demanding work environment and that their job roles and service delivery have an impact on the life chances of people living in the region. Education and training make a positive contribution to the development of the workforce.  Leaders ensure that the service has the right people in the right job roles. Training enables staff to develop their skills to a high standard, reflecting the expectations of senior leaders. Most student paramedics and business support apprentices remain in employment at the end their programme.  Leaders and managers have designed an apprenticeship curriculum that is very responsive to the needs of the service. The programme ensures that every emergency response vehicle has a qualified paramedic on board. Managers have an ambition to provide job opportunities for local people.  Leaders and managers focus on continuous improvement for their education and training

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Effectiveness of leadership and management Good

team. ETOs are well qualified as paramedics and as teachers. Almost all show effective teaching practice in both theory and practical sessions. Leaders and managers ensure ETOs complete specialist training for their roles, including moving vulnerable people, manual handling and driving emergency vehicles.  Annual appraisals and performance discussions with ETOs are regular. They identify and promote development needs. Personal development plans are relevant and relate well to improving teaching practice. They focus on improving knowledge and understanding of the service. Plans for the forthcoming year do not always reflect agreed objectives and targets precisely enough.  Apprentices have a good understanding of their future career prospects. Student paramedics progress to higher education and become qualified paramedics. The majority of apprentices, including those working in support roles, gain employment within the

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Effectiveness of leadership and management Good

service.  Leaders and managers promote equality, diversity and British values to apprentices well. Apprentices have a strong commitment to the expectations of the service. Respect, tolerance and equality are implicit throughout their training and in their job roles.  Managers know their provision well. However, their evaluation of teaching, learning and assessment, and self-assessment do not yet focus well enough on improving the quality of provision in terms of its impact on apprentices’ learning and skills development. Leaders and managers focus on the compliance of teaching, learning and assessment with the expectations of awarding bodies. They carry out meaningful and worthwhile observations of teaching, learning and assessment. This ensures that ETOs remain competent and up to date in their clinical skills or driving knowledge.  Leaders and managers do not use data and information well enough to review in detail

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Effectiveness of leadership and management Good

the progress apprentices make, including the progress of different groups of learners and those apprentices with subcontractors. A small minority of learners are not progressing sufficiently.

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The governance of the provider

 Senior leaders and non-executive directors receive detailed information on the performance of the education and training department. They have a good understanding of the education and training within the service. They hold managers to account. They provide effective support and challenge and ensure that training meets the needs of the service. However, senior leaders place too little emphasis on the improvements to the quality of teaching, learning and assessment. They do not place enough focus on the progress that all apprentices make.

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Safeguarding

 The arrangements for safeguarding are effective.  Leaders and managers from across the service have ensured that comprehensive safeguarding arrangements are in place. Safeguarding and a comprehensive understanding of the ‘Prevent’ duty are an expectation of all staff who work within the ambulance service.  Staff make good use of data and information to report and monitor safeguarding practices. Managers, staff and apprentices have all undertaken the relevant checks to work in the service. They have completed appropriate training in safeguarding and the ‘Prevent’ duty. Safeguarding managers have established effective relationships with external partners across other emergency services, and with local and regional stakeholders.  Apprentices feel safe and well supported during their training in work placements and when out on ambulances and visiting the homes of service users. They know to whom to

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Safeguarding

report safeguarding and safety concerns. A few apprentices in business support teams are not confident or do not have enough awareness about the threats from radicalisation or extremism.

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Quality of teaching, learning and assessment Good

 ETOs and mentors in the workplace provide effective support to student paramedics, who become skilled practitioners. Apprentices are keen to learn and deepen their knowledge and skills for the workplace. Student paramedics demonstrate new skills such as respiratory intervention, neurological assessment and cardiac resuscitation. Driving instructors provide timely verbal feedback during practical sessions. They set challenging targets for blue-light emergency-response driving. Student paramedics improve their driving techniques and gain confidence.  ETOs use their high-level skills to relate theory to practice using personal experience from the workplace. Theory and practical sessions are integrated well. Apprentices learn about the structure of the heart and blood pressure theory, and then immediately put learning into practice by taking blood pressures and using mobile clinical diagnostic equipment. A

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Quality of teaching, learning and assessment Good

few ETOs do not check learning frequently enough, and a few apprentices struggle to keep up with the rapid pace.  Student paramedics have access to industry-standard resources. They have the use of medical equipment such as ECG strips and defibrillators, alongside relevant and useful training presentations and good online materials. Student paramedics complete driving training. They learn in a high-quality fleet of training vehicles and benefit from simulations of road traffic accidents.  ETOs and mentors promote equality and inclusion effectively. The planning and delivery of theory and practical sessions ensure that the apprentices respond well to a diverse local population. Student paramedics are sensitive to the individual treatment needs of service users and demonstrate good customer service.  Managers regularly review those student paramedics who are at risk of failure on their programme. A panel of senior managers meets to review and consider how to best

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Quality of teaching, learning and assessment Good

support the apprentice and meet the needs of the business. Interventions enable apprentices who are at risk to be supported to stay on their programme.  Mentors in the workplace do not monitor with consistent frequency the progress that apprentices make across the different fleet preparation hubs. Apprentices make good progress where they receive regular assessment and feedback on their portfolios. A minority of mentors and managers are unaware of those apprentices who have missed a progress review, or who are unsure about the requirements of producing evidence for the portfolio and therefore miss the submission deadline. Written feedback is not sufficiently detailed and evaluative to help the minority of apprentices achieve in the required time.  Mentors and managers do not monitor the support that the small number of apprentices on health and social care and those working to complete their English and mathematics

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Quality of teaching, learning and assessment Good

receive from subcontractors. Apprentices are unclear about the assignment criteria, have insufficient support from assessors, and are making slow progress.  ETOs and apprentices do not have a sufficient understanding of end-point assessment. They do not know when it is planned and are unaware of the grading. The minority of ETOs do not use the information from recruitment to set appropriate targets for end-point assessment.

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Personal development, behaviour and welfare Good

 Apprentices gain good levels of self-confidence, are self-assured and are proud of their developing skills and roles within the ambulance service. Almost all develop good personal, social and employability skills. They work collaboratively and develop good teamworking skills. Most student paramedics plan to progress to higher education and become qualified paramedics.  Apprentices become highly skilled in their job roles. Student paramedics develop clinical and personal skills at the high standard and level required to be an effective paramedic. They understand medical conditions and can identify when service users need emergency treatment. Business support apprentices demonstrate that they are highly skilled in problem-solving IT, diagnosing and repairing faults on ambulances, and moving non- mobile service users with care.  Student paramedics develop their English and mathematics skills well during their

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Personal development, behaviour and welfare Good

training. They apply the skills they develop in everyday life and in their careers. Apprentices improve and adapt their communication skills when working with vulnerable service users, reporting their condition and calculating medication. A small minority of apprentices studying with subcontractors do not receive the support they need to improve their English and mathematics skills.  Apprentices receive useful careers guidance to secure future careers within the ambulance service. The recruitment and selection process provides apprentices with a detailed understanding of the demands of the job. Apprentices understand the standards required for theory and practical work through their handbook.  Apprentices with additional learning needs are supported well. Apprentices who receive support progress better than their peers. Staff have developed access programmes for those apprentices in business support roles to enable them to apply for student

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Personal development, behaviour and welfare Good

paramedic roles. Staff have been successful in increasing the number of Black and minority ethnic applicants, though the numbers are still low compared to the local population.  Student paramedics are clear on the risks posed to themselves, their colleagues and their service users by extremism and radicalisation. Through their training, student paramedics understand the need to be alert for the safeguarding issues they may see during their work. They can confidently describe how they would deal with concerns with service users in their homes, such as the welfare of young children, and vulnerable adults being provided with alcohol.  Apprentices feel safe and are well informed about the range of hazards they may encounter at work and in their personal lives. They are aware of the risks of infection, risks regarding social media and abuse and can confidently report any concerns. Apprentices are supported by a wide range of services in dealing with the personal and

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Personal development, behaviour and welfare Good

emotional challenges resulting from their work. These include debriefs by experienced mentors, and counselling and support services.  Apprentices who are studying with subcontractors, and not able to remain in their role or progress to further study, are not aware of their next steps. Employment for a small number of business administration and health and social care apprentices ceases at the end of their apprenticeship. Staff do not provide timely careers guidance to support them to apply for suitable roles within the service.

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Outcomes for learners Good

 Apprentices are developing high-quality skills relevant to their job role. Student paramedics develop high levels of skills and knowledge in clinical and service user care. Almost all are retained and complete on their programme. They become valuable members of the paramedic teams based across the West Midlands.  Student paramedics receive high-quality on- and-off-the-job training. Apprentices become highly skilled in identifying service users’ clinical needs and in emergency transport driving through their off-the-job training prior to starting their placements. This ensures that they can provide high standards of care when working with service users in their local communities.  Staff are improving achievement rates and first-time pass rates for student paramedics. The large majority of student paramedics are making at least the expected progress on their qualification. The support and monitoring of apprentices’ progress is not yet frequent

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Outcomes for learners Good

enough across the different fleet preparation hubs. A minority of apprentices do not complete in the required timescale.  Leaders and managers plan the programme well to ensure that student paramedics progress to higher levels of learning. This will enable them to become qualified paramedics. Student paramedics who have completed their programme have all progressed onto higher education. The majority of business support apprentices remain in employment in the service.  Apprentices employed within business support teams do not progress at the same rate as their peers. The few health and social care apprentices and those studying English and mathematics are making slow progress.  Leaders and managers do not track or identify achievement gaps for different groups of apprentices, which does not enable them to make effective interventions for those apprentices. Student paramedics aged 24 and over and female apprentices achieve less

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Provider details

Approximate number of all learners over the previous full contract year Principal/CEO Dr Anthony Marsh

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Provider information at the time of the inspection

Main course or learning programme level Level 1 or below Level 2 Level 3 Level 4 or above Total number of learners (excluding apprenticeships) 16–18 19+ 16–18 19+ 16–18 19+ 16–18 19+

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Provider information at the time of the inspection

– – – – – – – – Number of apprentices by apprenticeship level and age Intermediate Advanced Higher

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Provider information at the time of the inspection

16–18 19+ 16–18 19+ 16–18 19+ 14 42 1 13 10 467 Number of traineeships 16–19 19+ Total – – – Number of learners aged 14 to –

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Provider information at the time of the inspection

Number of learners for which the provider receives high- needs funding –

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Provider information at the time of the inspection

At the time of inspection, the provider contracts with the following main subcontractors: City of Wolverhampton College Coventry College Heart of Worcestershire College Performance Through People Training Limited The In-Training Group Limited Walsall College

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Information about this inspection

The inspection team was assisted by the apprenticeship data and compliance officer, as nominee. Inspectors took account of the provider’s most recent self-assessment report and development plans, and the previous inspection report. Inspectors used group and individual interviews, telephone calls and online questionnaires to gather the views of learners and employers; these views are reflected within the report. They observed learning sessions, assessments and progress reviews. The inspection took into account all relevant provision at the provider.

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Inspection team

Andrea Dill-Russell, lead inspector Her Majesty’s Inspector

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Inspection team

Barbara Hughes Ofsted Inspector 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 .

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Inspection team

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Inspection team

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Inspection team

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