'Restrictions on training harm care'

The NHS constitution pledges to provide all its staff with continuing professional development (CPD), access to appropriate training for their jobs, and the line management support they need to succeed. That means the NHS has to provide both the time and the necessary financial support to enable staff to pursue CPD, but the lack of detail in the pledge about this means it starts to become a sticky wicket. The inconsistencies in opportunities for CPD among NHS trusts across the country are, to put it bluntly, unfair.

The constitution has lengthy chapters on the many pledges that it strives to honour, both to its patients and its staff. Though for hard-pressed organisations within the NHS, some pledges inevitably get shunted down the agenda.

Taking a longer-term view, those NHS pledges that have been given less importance will almost certainly turn out to have been the very pillars that hold up the rest and cracks will soon begin to show. I see CPD as the pillars but they are being undermined by their neglect.

The exact content of CPD is difficult to define. Each member of staff and their specialism is different, and a focus and reflection on practice and knowledge are cornerstones to the success of CPD.

“The inconsistencies in opportunities for CPD among NHS trusts across the country are, to put it bluntly, unfair”

The Knowledge and Skills Framework (KSF) has attempted to outline the skills required for each grade and specialism but, in my experience, practitioners don’t consider KSF relevant because it is not always used as a basis for career planning in their workplaces. KSF is great as a benchmark for career development, but sadly it’s lost on the departmental shelf.

Across the UK there have been cost-cutting initiatives and I know that many of us have already experienced a restriction on “non-essential” study. This could be for six months or one year - who knows? But it affects so many staff and I have seen the corrosive impact it is having on perioperative teams.

While time is given to updating mandatory skills, which usually fill a regulatory capacity, these skills can have a minimal impact on the ability to function effectively and safely within a challenging perioperative - or indeed any healthcare - environment.

Individuals are usually actively pursued to complete mandatory courses, but I wonder if this pursuance would stretch to asking if you have completed your “Challenging poor behaviour in your workplace” study course, or if you are up to date on advances in your specialist practice? Have you been given an hour to reflect on the week - on what you have learned and to identify what you need to learn?

I empathise when I read never event reports on unintended swab retention and wrong-site surgery, or Care Quality Commission reports on poor organisational culture and lack of compliance with policy or guidelines. These reports often result in a flurry of training, after which things reportedly improve. However, when clinical staff have to accept study leave reductions and embargos to support budgetary savings, it’s clear that such “savings” can often be the cause of these kinds of disasters.

Courageous professional challenge is vital in upholding safety standards for patients and should be both practised and taught in equal measure. Practitioners deserve the opportunity to do both.

Tracy Coates is a trained nurse, expert in anaesthetics and recovery, and president of the Association for Perioperative Practice, which is campaigning on the importance of continuing professional and personal development to patient safety. Last month AfPP held a parliamentary day to lobby MPs on the issue and will reinforce the message at its Annual Congress & Exhibition in Bournemouth later this month

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