Birmingham Women's and Children's Hospital NHS Foundation Trust

Birmingham Women’s and Children’s Hospital NHS Foundation Trust Interim visit report

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Name of lead inspector: Martin Ward, HMI

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Address: Steelhouse Lane Birmingham B4 6NH Interim visit: Birmingham Women’s and Children’s Hospital Foundation Trust, November 12–13 November

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Context and focus of visit

On 17 March 2020, all routine inspections were suspended due to the COVID-19 (coronavirus) pandemic. As part of our phased return to routine inspections, we are carrying out ‘ interim visits ’ to further education and skills providers. Interim visits are to help learners, parents, employers and government understand how providers are meeting the needs of learners and apprentices in this period, including learners with high needs and those with special educational needs and/or disabilities.

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Context and focus of visit

We intend to return to routine inspection in January 2021 but will keep the exact timing under review.

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Context and focus of visit

The focus of these visits is on the themes set out below and the findings are based on discussions with leaders, managers, staff and learners.

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Context and focus of visit

Following changes to government guidance and the imposition of COVID-19 lockdown restrictions, we made this visit remotely to reduce pressure on the provider.

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Information about the provider

Birmingham Children’s Hospital merged with the Birmingham Women’s Hospital in 2017 to form a larger, acute specialist trust. In March 2017, the trust became a prime contractor. It started delivering apprenticeships in June 2017.

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Information about the provider

At the time of the visit, the trust had 134 apprentices in learning, and 20 on a break in learning. Of these, 118 were on healthcare support worker standards at levels 2 and 3. A further 36 apprentices were on business or customer service apprenticeships at levels 2, 3 and 4. Most apprentices study at level 2. Most apprentices were on standards, but some 18 business administration apprentices at levels 2 and 4 were on frameworks. There were no subcontractors.

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stakeholders and adapts to changed circumstances?

Senior managers reported that they had placed about a third of the healthcare apprentices on a break in learning during the period March to July. This was in response to the redeployment of many healthcare staff and significant work pressures.

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stakeholders and adapts to changed circumstances?

Managers decided that apprentices who were close to the end of their apprenticeship and those in business administration should continue their apprenticeship programme. Interim visit: Birmingham Women’s and Children’s Hospital Foundation Trust, November 12–13 November Senior managers said that these apprentices had now achieved their full apprenticeship. Many of the healthcare apprentices had moved on into trainee nursing associate apprenticeships.

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stakeholders and adapts to changed circumstances?

Managers reported that some apprentices, particularly those who had taken a break in learning, would continue to study beyond their planned end date.

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stakeholders and adapts to changed circumstances?

Managers explained that, from the initial restrictions in March, assessors taught more online. Managers supported this development through extending the availability of computers, and through staff training.

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stakeholders and adapts to changed circumstances?

Managers reported that since August teachers had returned to more face-to-face teaching. This was important in apprentices’ clinical skills development.

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stakeholders and adapts to changed circumstances?

Managers were keen to maintain some of the benefits of online communication. Using online teaching and reviews had brought benefits to the apprentices working in the separate women’s hospital. It saved travel time, and learners were easier to contact.

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stakeholders and adapts to changed circumstances?

Departmental managers described how well they thought that the apprenticeship team communicated with them and worked with them to develop the knowledge, skills and behaviours of the apprentices in their area.

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stakeholders and adapts to changed circumstances?

Governors were supportive of how senior leaders had responded to the restrictions. They received quarterly reports on the performance of the apprenticeship programme. They expressed their commitment to the current apprenticeship programme.

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stakeholders and adapts to changed circumstances?

Senior leaders and managers reported how they had shared good practice through provider and NHS networks. For example, they had shared their ideas of ‘virtual’ open days.

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stakeholders and adapts to changed circumstances?

Managers reported a large and sustained demand for apprenticeships in healthcare, but a reduction in demand for those in business.

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the reasonable needs of learners?

Leaders said that the move to online learning had been a challenge, because of the varied experience and skills of the teachers, apprentices’ limited access to equipment, and the introduction of a new online learning platform.

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the reasonable needs of learners?

Managers and assessors described the range of methods used to ensure that assessors were implementing the curriculum and tracking apprentices’ progress. These included observations of both face-to-face and online teaching sessions. They monitored learners’ Interim visit: Birmingham Women’s and Children’s Hospital Foundation Trust, November 12–13 November progress through individual meetings with assessors, and by using information from the online tracking system. They identified apprentices who were making slow progress and put support in place.

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the reasonable needs of learners?

Leaders and managers outlined strategies that enabled apprentices to stay on track and to develop specialist skills and knowledge. For example, managers described how highly skilled professionals on the wards were used to educate apprentices, conduct observations, and to provide witness statements, when assessors could not be admitted to the wards.

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the reasonable needs of learners?

Assessors explained how they completed reviews and developed action plans for apprentices who fell behind in their work. They adapted the learning to a new role when apprentices moved to a different department. For example, an apprentice who had been redeployed to the accident and emergency department had supported some distressed parents, and assessors helped her to identify the skills she used and how they matched the requirements of the apprenticeship programme.

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the reasonable needs of learners?

Assessors explained how they adapted their assessment practices to support the changing environments where apprentices were working. For example, apprentices working from home completed online presentations and reflective journals.

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the reasonable needs of learners?

Leaders reported that the attendance of those who remained on the programme had stayed at the same level – and in some cases improved – due to more flexible access to learning and support.

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the reasonable needs of learners?

Managers explained how careers advice and guidance started at induction and included career pathways. For example, one recently-recruited apprentice in the neonatal ward was ambitious to move form healthcare assistant to midwife.

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potential risks, including from online sources?

Staff reported that they followed the trust’s policy on COVID-19 infection prevention and control guidance. Staff who inspectors spoke to had undertaken risk assessments and – where required – managers had put support plans in place.

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potential risks, including from online sources?

Assessors reported how they had maintained regular contact with apprentices and increased the frequency for those in wards with highest risk. Apprentices knew where to go for information to support their well-being.

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potential risks, including from online sources?

Leaders provided on-site childcare. This was of benefit to apprentices who were balancing work, study, and childcare. Leaders provided ‘re-charge rooms’ which were places where apprentices could talk through a stressful shift with professionals, including the chaplaincy. Interim visit: Birmingham Women’s and Children’s Hospital Foundation Trust, November 12–13 November Apprentices reported that they knew how to keep themselves safe online and in face-to- face settings. Apprentices and managers described how face-to-face teaching had been organised in smaller groups in larger rooms to ensure social distancing.

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potential risks, including from online sources?

Leaders outlined their partnership work outside the trust, and how they had shared and gained ideas. Interim visit: Birmingham Women’s and Children’s Hospital Foundation Trust, November 12–13 November regulates and inspects to achieve excellence in the care of children and young people, and in education and skills for learners of all ages. It regulates and inspects childcare and children's social care, and inspects the Children and Family Court Advisory and Support Service (Cafcass), schools, colleges, initial teacher training, further education and skills, adult and community learning, and education and training in prisons and other secure establishments. It assesses council children's services, and inspects services for children looked after, safeguarding and child protection.

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potential risks, including from online sources?

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potential risks, including from online sources?

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potential risks, including from online sources?

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potential risks, including from online sources?

T: 0300 123 1231 Textphone: 0161 618 8524 E: enquiries@ofsted.gov.uk W: www.gov.uk/ofsted

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