Guy's and St Thomas' NHS Foundation Trust

Guy’s and St Thomas’ NHS Foundation Trust Monitoring visit report

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Name of lead inspector: Steve Lambert HMI

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Address:

Education Centre 75 York Road London SE1 7NJ Monitoring visit: Guy’s and St Thomas’ NHS Foundation Trust, 12–13 December 2018

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Context and focus of visit

From October 2018, Ofsted undertook to carry out monitoring visits to all newly directly funded providers of apprenticeship training provision which began to be funded from April 2017 or after by the Education and Skills Funding Agency (ESFA) and/or the apprenticeship levy. This monitoring visit was undertaken as part of those arrangements and as outlined in the ‘Further education and skills inspection handbook’, especially the sections entitled ‘Providers newly directly funded to deliver apprenticeship training provision’ and ‘Monitoring visits’. The focus of these visits is on the three themes set out below.

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Context and focus of visit

Guy’s and St Thomas’ NHS Foundation Trust provides a range of acute services for adults and children in south London. Since May 2017, the organisation has been delivering levy-funded apprenticeships to its own employees. At the time of this visit, 19 apprentices are on a level 3 dental nursing standards-based apprenticeship.

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Reasonable progress

Leaders and managers share a vision and ambition to provide high-quality apprenticeship training in dental nursing. They have taken a cautious approach so as not to grow the provision too quickly. They have implemented an apprenticeship programme that supports individuals to gain the knowledge, skills and behaviours that they need in order to work more effectively in hospital dental clinics or community dental settings. Leaders’ and managers’ recruitment of apprentices is effective. They use the apprenticeship programme to recruit new staff to the organisation. They ensure that apprentices understand the programme prior to starting their apprenticeship. Consequently, very few apprentices leave the programme, and those who complete the apprenticeship progress to permanent jobs within the trust. Apprentices have a good understanding of the career benefits that the apprenticeship programme provides. A minority of apprentices have gained

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Reasonable progress

additional responsibilities or promotion to more senior roles after completing their apprenticeship.

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Reasonable progress

Leaders and managers have a secure understanding of the requirements of the apprenticeship programme. They relate the apprenticeship standards successfully to their own organisational requirements. For example, apprentices develop their skills and become effective in supporting the wide range of specialist clinics offered in dentistry. Leaders and managers monitor apprentices’ entitlement to off-the-job training effectively. They ensure the recording of apprentices’ attendance at weekly Monitoring visit: Guy’s and St Thomas’ NHS Foundation Trust, 12–13 December 2018 training days, and apprentices accurately note the time spent undertaking their off- the-job learning. Leaders and managers have recruited tutors with considerable clinical experience, which benefits apprentices.

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Reasonable progress

Leaders and managers have sufficient oversight of the progress that apprentices make towards achieving their apprenticeship. They have implemented an approach to track and monitor apprentices’ progress, to ensure that they complete their programme in the planned timescale. The nursing and midwifery executive group monitors the progress that apprentices make towards achieving their apprenticeship. As a result, leaders and managers hold staff to account for the progress that apprentices make.

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Reasonable progress

Apprentices’ line managers receive comprehensive information about their responsibilities before apprentices begin their training. Leaders and managers work closely with line managers to ensure that the requirements of the apprenticeship are specific to the clinical environment in which apprentices work. This includes the use of organisation-specific approaches to infection control and the procedures for patient sedation.

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Reasonable progress

Leaders and managers, in establishing the apprenticeship training, have subcontracted the teaching of English and mathematics to another provider. So far, those apprentices who have taken functional skills English and mathematics examinations have passed.

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Reasonable progress

Leaders and managers have a formal process for monitoring the quality of teaching, learning and assessment. However, their observations on the quality of teaching, learning and assessment focus too much on what the tutor does and not enough on what apprentices learn. Consequently, they do not support tutors well enough to make further improvements in their teaching.

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Reasonable progress

The majority of apprentices make appropriate progress on their apprenticeships. The work that apprentices produce is of a good standard and covers more than the requirements of the qualification. Apprentices develop good practical skills, such as setting up a dental chair correctly, minimising the risk of infection and knowing the correct use of drugs when sedating a patient. Because of this, apprentices can work in any of the specialist dental services provided by the hospital. When apprentices fall behind, assessors provide effective support to enable them to catch up with their work.

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Reasonable progress

Tutors, in their feedback on apprentices’ assignment work, identify how apprentices can improve their work to ensure that they achieve a pass. Tutors also provide Monitoring visit: Guy’s and St Thomas’ NHS Foundation Trust, 12–13 December 2018 effective support to apprentices on improving their written work. They correct the misspelling of technical words and provide guidance to apprentices on how to structure their sentences. As a result, apprentices understand the progress that they make and what they need to do to improve.

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Reasonable progress

When assessing apprentices in the workplace, assessors use a range of different approaches well. These help to meet the needs of apprentices and of their work environments. Assessors enable apprentices and their line managers to benefit from the apprenticeship programme, by using relevant activities related to apprentices’ jobs.

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Reasonable progress

Tutors provide effective support to apprentices to develop their skills in mathematics. For example, tutors ensure that apprentices can calculate the correct ratio for preparing orthodontic mixtures, and the correct time required to clean dental equipment. As a result, apprentices develop the mathematical skills they need for their job.

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Reasonable progress

Tutors provide effective support to apprentices to enable them to move on to their chosen speciality at the end of their apprenticeships. With the guidance of tutors, apprentices spend a longer period of time at the end of their training in the specialist areas in which they wish to work, once qualified. Because of this, almost all apprentices stay at the trust upon completion of their apprenticeship.

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Reasonable progress

Tutors provide apprentices with effective information prior to the start of the apprenticeship. As a result, apprentices have a good understanding of the expectations placed on them. These include being professional and responsible, as well as the importance of wearing their uniform correctly. Apprentices have a good understanding of the end-point assessments and know what they need to do to achieve high grades.

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Reasonable progress

Most apprentices are highly motivated, and they value the opportunity to develop new knowledge, skills and behaviours that are relevant to their job roles. Tutors help apprentices develop their knowledge, specifically related to their own job. For example, apprentices are right to speak positively about gaining confidence in speaking to dentists and other clinicians during operations.

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Reasonable progress

Tutors assess apprentices carefully when they begin their apprenticeship. In conjunction with apprentices’ line managers and tutors, they review apprentices’ existing knowledge, skills and experience. However, tutors do not routinely use this information to plan learning that meets the needs of all the apprentices. A few apprentices repeat the learning they have previously done on other courses and as a result, do not progress as quickly as they could.

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Reasonable progress

Apprentices benefit from frequent teaching and learning reviews with their tutor to monitor their progress. Tutors set apprentices targets they should complete between reviews. In a minority of cases, however, these targets do not have a deadline for completion. Monitoring visit: Guy’s and St Thomas’ NHS Foundation Trust, 12–13 December 2018

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Reasonable progress

Leaders and managers ensure that safeguarding arrangements are effective. They have suitable policies in place, which they review frequently.

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Reasonable progress

Apprentices receive appropriate safeguarding and ‘Prevent’ duty training at induction. This includes information on how to keep themselves safe when dealing with patients. Apprentices undertake additional safeguarding training during their apprenticeship, ready for when they move into paediatric dentistry. They learn, for example, how to manage anxious or nervous patients, whom they may meet as part of their job. Apprentices feel confident about reporting issues to managers, or to managers with responsibility for safeguarding or to an externally provided helpline. Apprentices know that they will deal with these issues effectively.

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Reasonable progress

Apprentices receive effective support to keep them safe. They receive guidance at the start of their programme on how to access support from the occupational health team on a range of mental health and well-being needs. Apprentices routinely receive advice on the safe use of computers. Consequently, they have a good understanding of how to keep themselves safe online.

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Reasonable progress

Leaders and managers ensure that staff carry out appropriate pre-employment checks prior to an individual joining the organisation.

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Reasonable progress

Tutors, in their reviews with apprentices, check their understanding of the dangers associated with radicalisation and extremism. Apprentices understand the importance of these issues, not just in protecting patients, but how these dangers affect them. As a result, apprentices have an appropriate understanding of how these topics apply to them in their workplace and in their lives. Monitoring visit: Guy’s and St Thomas’ NHS Foundation Trust, 12–13 December 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

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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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