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

Birmingham Women’s and Children’s Hospital NHS Foundation Trust Report following a monitoring visit to a ‘requires improvement’ provider

p.1

Name of lead inspector: Steve Lambert, Her Majesty’s Inspector

p.1

Address:

Steelhouse Lane Birmingham B4 6NH Monitoring visit: Birmingham Women’s and Children’s Hospital NHS Foundation Trust, 15 September 2021

p.1

Context and focus of visit

Birmingham Women’s and Children’s Hospital NHS Foundation Trust was inspected in January 2020. At that time, inspectors judged the overall effectiveness of the provision to require improvement.

p.2

Context and focus of visit

The focus of this monitoring visit was to evaluate the progress that leaders and managers have made in tackling the main areas for improvement identified at the previous inspection.

p.2

Context and focus of visit

Birmingham Children’s Hospital merged with Birmingham Women’s Hospital in 2017 to form a larger, acute specialist trust. It started training apprentices in June 2017.

p.2

Context and focus of visit

At the time of the visit, the trust had 76 apprentices. Most apprentices were on healthcare support worker standards at levels 2 and 3. A small number were on business or customer service apprenticeships at levels 2 and 3. There were no subcontractors.

p.2

Reasonable progress

Apprentices demonstrate a good understanding of their progress and the skills they need to develop. These are discussed with apprentices at their monthly review meetings with their assessors, with specific actions identified.

p.2

Reasonable progress

Assessors challenge apprentices to develop their learning beyond the requirements of the apprenticeship. For example, apprentices with no experience of end-of-life care were supported to create memory boxes for patients’ families with guidance from specialist nurses.

p.2

Reasonable progress

Assessors routinely encourage and support apprentices to achieve high grades. They put in place additional support to help apprentices achieve their best. For example, healthcare support worker apprentices identified their areas for development, which included further practice in professional discussions in preparation for the end-point assessment. This led to additional support being provided by assessors. As a result, apprentices’ confidence increased, and they now feel able to achieve a distinction. Monitoring visit: Birmingham Women’s and Children’s Hospital NHS Foundation Trust, 15 September 2021 Apprentices participate in a detailed induction that includes the identification of prior knowledge and skills. However, staff do not use this information well enough to plan apprentices’ learning. A small minority of apprentices repeat prior learning and are not consistently challenged throughout their apprenticeship.

p.2

Reasonable progress

Assessors do not use information gained at the start of the course on apprentices’ English and mathematics skills well enough. They do not identify gaps in apprentices’ knowledge and support them to improve in these subjects.

p.3

Reasonable progress

Since the previous inspection, leaders and managers have improved the working relationship and practice between the education team and clinical teams. Clinical staff actively engage in supporting apprentices to develop wider skills. For example, apprentices are encouraged and supported to experience other areas of interest in the hospital, such as working in intensive care. They have spent some time working in the accident and emergency department.

p.3

Reasonable progress

Most apprentices are developing significant new knowledge, skills and behaviours. For example, apprentices with no prior clinical experience can complete effectively procedures such as inserting nasogastric feeding tubes and monitoring the clinical care of children with complex clinical issues.

p.3

Reasonable progress

In customer services, assessors share their training plan with the workplace mentor, who uses this to plan activities to coincide with the theory taught. For example, after completing the telephone techniques theory, apprentices put this into practice by working on the hospital’s helpline. As a result, apprentices are able to apply the theories for managing conversations with customers.

p.3

Reasonable progress

Most healthcare support worker apprentices can link theory to workplace practice well. These apprentices make a valuable contribution to the workplace. For example, apprentices received extra support from the training team to master the skill of carrying out nasogastric feeds and went on to develop a guide for the procedure that is now being used across the hospital.

p.3

Reasonable progress

Assessors work with workplace mentors well to support apprentices to develop their clinical skills, putting in place extra support and training where necessary. For example, assessors arranged for additional training from specialists to ensure that Monitoring visit: Birmingham Women’s and Children’s Hospital NHS Foundation Trust, 15 September 2021 apprentices are confident in caring for patients who require a catheter. As a result, the apprentices are now competent in this skill.

p.3

Reasonable progress

Since the previous inspection, leaders and managers have implemented a more rigorous approach to quality assurance. This has included establishing a set of performance indicators that they use to monitor the provision. As a result, they now have a better understanding of the quality of the apprenticeship programme.

p.4

Reasonable progress

Leaders and managers meet frequently with apprenticeship assessors and tutors to review the progress that apprentices are making. This enables staff to identify apprentices who are not making the progress expected of them and to put actions in place to support them. As a result, leaders and managers have a better understanding of the progress that apprentices are making.

p.4

Reasonable progress

Leaders and managers have started to meet frequently with groups of apprentices to gain feedback on the apprenticeship programme. This has resulted in changes to the way the apprenticeship programme is taught. For example, apprentices at the children’s hospital are taught separately from apprentices at the women’s hospital. This enables tutors to teach lessons that are more relevant to the work that apprentices do on their respective wards.

p.4

Reasonable progress

Leaders and managers have improved the way they communicate with ward managers to ensure that the latter have a good understanding of what is expected of apprentices. Ward managers commented on how they feel that they have a better understanding of the apprenticeship programme and what is expected of them. For example, ward managers work together to provide opportunities for apprentices to visit other departments or go into operating theatres to observe operations. This has helped apprentices to gain a wider range of experience through the support of their managers.

p.4

Reasonable progress

Twice a year, leaders and managers observe all tutors and assessors. Where strengths have been identified, these are too often normal expectations, such as ‘setting the date for the next review’; areas for improvement are not specific enough and do not feature in the summary of the observation report. As a result, it is not sufficiently clear what staff are expected to improve and how they are to go about doing this. Monitoring visit: Birmingham Women’s and Children’s Hospital NHS Foundation Trust, 15 September 2021

p.4

Reasonable progress

Leaders and managers have recently established an apprenticeship governance board. Board members represent a wide range of hospital services, both clinical and non-clinical, and report ultimately to the trust’s board.

p.5

Reasonable progress

Governors have a good understanding of the strengths and weaknesses of the apprenticeship provision. They provide appropriate challenges to leaders and managers. For example, they have been instrumental in increasing the number of male healthcare support workers from under-represented groups, to better represent the patient population.

p.5

Reasonable progress

Governors value the role that apprentices have within the trust. For example, they are keen to see apprentices move on from healthcare support into nursing.

p.5

Reasonable progress

Leaders and managers need to ensure that the governance arrangement that they have recently introduced in apprenticeships becomes established as part of the trust’s governance arrangements.

p.5

Reasonable progress

Governors are reliant on the information that leaders and managers provide to them. While they feel confident that they can ask for information at any point, they do not have access to information independently of the apprenticeship team, which hinders their ability to provide independent scrutiny of the apprenticeship provision and support leaders and managers to improve. Monitoring visit: Birmingham Women’s and Children’s Hospital NHS Foundation Trust, 15 September 2021 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

p.5

Reasonable progress

children’s services, and inspects services for children looked after, safeguarding and child protection.

p.6

Reasonable progress

If you would like a copy of this document in a different format, such as large print or Braille, please telephone 0300 123 1231, or email enquiries@ofsted.gov.uk .

p.6

Reasonable progress

You may reuse this information (not including logos) free of charge in any format or medium, under the terms of the Open Government Licence. To view this licence, visit www.nationalarchives.gov.uk/doc/open-government-licence/ , write to the Information Policy Team, The National Archives, Kew, London TW9 4DU, or email: psi@nationalarchives.gsi.gov.uk .

p.6

Reasonable progress

Interested in our work? You can subscribe to our monthly newsletter for more information and updates: http://eepurl.com/iTrDn .

p.6

Reasonable progress

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

p.6