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Where training is valued

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In recent weeks, NT’s training campaign, Time out for Training, has focused on the lack of time, funds and support given to nurses’ post-registration education. This week, Jennifer Taylor contrasts staff experiences in the NHS with those in the independent and voluntary sectors

‘It’s not exciting for nursing staff to only do mandatory training, it doesn’t inspire them,’ says Ann Smallman, head of care at Acorns Children’s Hospice, a charity in the Black Country. ‘If all you’re ever doing is ticking the boxes, it becomes a bit mundane.’

But Ms Smallman recognises, having been a manager in the NHS herself, that sometimes nurses struggle to even access mandatory training.
Ms Smallman trained as a general and paediatric nurse. She has been with Acorns for four years and before that was an assistant general manager for paediatrics at a district general hospital. She says it’s much easier for staff outside the NHS to obtain training.

‘There is a much bigger commitment [from management] to training and that is really seen as integral to both recruiting and retaining staff.’

Ms Smallman says that while the NHS has limited provision for education and training, and budgets get swallowed up on the essentials, at the hospice they can access extras like complementary therapy courses, which enhance patient care.

She says: ‘[These courses] are never going to provide mandatory skills for a nurse but to have people around who have got those skills helps some of the children and young people relax.’

She explains that nurses at the hospice are encouraged to develop an interest in an aspect of care, such as enteral feeding. They receive first pick on study days on that topic, then teach their colleagues.

Training is negotiated in line with personal development plans and organisational need. While there is an allocated budget, it is not restricted to so many pounds or so many hours per person.

‘I’ve found the contributions far more generous [than the NHS] and quite often we are able to fund entire courses, particularly if they are for core skills.’

She explains the nurse lead for infection control is taking an advanced infection control course next year, which will be fully funded. And one of the staff nurses has just completed a degree in health and social care with the Open University and was able to split the funding and the time with the hospice.

‘We have a clear process but it also gives us the flexibility that if I identify something that particularly interests me, I can say to my line manager: “This fits with what we’re doing at
the moment”.’

She goes on to explain that last year, the hospice was doing some work on performance indicators and she attended a conference day in London – even though it hadn’t been part of her development plan, as it fitted in well with the hospice’s agenda.

Backfill is seldom a problem, since staff ratios are better than the NHS, plus the hospice has its own nurse bank.

Ms Smallman adds that each hospice has one staff nurse who coordinates education and training, which shows the high priority placed on training.

Valerie Smith, independent sector adviser at the RCN, agrees that training is better supported in the independent sector and says there are several reasons for this.

‘You don’t have the same sorts of problems or restrictions. For example, if you look at the national minimum standards for regulation of this sector, it has a requirement for quite a lot of core training. And nurses have to comply with that in order to be registered with the regulator. So mandatory training is more than that required in the NHS.’

Ms Smith adds that backfill is less of an issue in the independent sector.

‘The workforce, particularly in care homes, is much more flexible because they have a lot of part-time staff. This enables them to arrange training in a flexible way to suit the working patterns of staff.’

She explains that another reason why training is better supported is because a lot of large independent providers put on their own courses or run training packages across the country, with dedicated staff to deliver them.

One such independent provider dedicated to nurses’ post-registration training is Care UK, says Nigel Jopson, home manager for the nursing home Jubilee House, in Godalming, Surrey.

The company paid for him to do a certificate in education. ‘That was something I identified as useful to me and my line manager backed me all the way.’

Mr Jopson’s previous experiences of training in the NHS left a bitter taste. ‘It was totally unfocused,’ he says. ‘They spent an enormous amount of money training me to be a nurse practitioner, and as soon as I qualified, they discovered they didn’t have a job for me.’ The PCT ended his contract but when it opened a new minor injuries unit, it hired him through an agency.

The nursing home, by contrast, is more focused. Training needs are identified through staff supervision every two months, and extras are available. ‘If somebody thinks that a particular training would be useful, then we can usually facilitate that,’ says Mr Jopson.

Staff are not allocated a specific number of days for courses but training is either when they’re on duty, or they are paid extra for the time. As for backfill, there are plenty of staff and they cover each other.

Mr Jopson believes that internal training is very useful, and to that end staff are trained up to be trainers themselves. Mr Jopson leads training on moving and handling, plus dementia, health and safety and POVA (protection of vulnerable adults). Trainers receive a yearly sum, in addition to their salary, from Care UK. External trainers visit to teach subjects the nursing home doesn’t cover itself.

Overall, Mr Jopson says he has ‘a very settled bunch of nurses’ and turnover is low. He feels the company’s attitude to training contributes to the positive atmosphere because staff feel more valued when their training requests are
taken seriously.

‘If you care for someone who is disabled in the appropriate and correct way, you can prolong their life and give it some quality,’ says Sheila Flynn, assistant director of learning and development at Grooms Shaftesbury. The charity provides residential and nursing care for people with learning and physical disabilities and Ms Flynn is passionate about training staff to prevent avoidable suffering and death.

Every nurse who comes to the charity, regardless of their background, goes through a three-month induction to physical and learning disabilities. ‘That’s really instilling in the nurses that a body that is disabled or immobile functions very differently,’ she says.

Each year the charity does a skills analysis of staff, to decide which CPD courses they should attend. Each nurse has a minimum of five paid study days per year for training outside the organisation. But Ms Flynn says: ‘If we’re sending them on a course and we feel there’s an area of expertise that we need, then obviously it would be more than that.’ Permanent and agency staff provide backfill.

Ms Flynn has been at the charity for 17 years, and it has paid for her BSc in health studies and a master’s in advanced nursing practice.

She feels her career has been enhanced by the organisation’s commitment to training. ‘I’ve benefited around disability and disability issues, from a generic nurse training to actually understanding that it’s a different specialism in its own right,’ she says.

‘I just wish the NHS would pay it more attention, and I think as a charity that’s what we’re pioneering.’

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