Pre-Nursing Experience Pilot

Developing people
for health and
healthcare
Pre-Nursing Experience Pilot
The journey so far
Health Education England
Professor Ian Cumming OBE,
Chief Executive, Health
Education England
Foreword
Our pre-nursing experience programme
really demonstrates why Health Education
England (HEE) exists – to, above all, improve
the quality of care delivered to patients.
It is important that everyone who wishes
to start a programme of training and
education that will eventually lead to them
caring for people at their most vulnerable,
when they are ill or infirm, should have
the right values and the right personal
attributes to be a carer.
Through these pilots, prospective nursing
students are on paid placements, providing
care for patients now whilst building their
own experience and preparing them better
for their university courses.
We have been privileged to meet the
participants in several of the pilots, and
have been consistently impressed by
their enthusiasm at working for the NHS,
showing a genuine desire to care, and
Contents
living and breathing the values of the
NHS Constitution.
We are seeing and hearing about
the positive experiences many of the
prospective nursing students are having,
through what is so often their first
experience of caring for someone who is
sick. And for a very small number, they
have realised that nursing isn’t for them,
only highlighting that the pilots are helping
people decide their future careers and
most importantly not waste tax payers’
money on a funded degree.
HEE has been bold in leading these
innovative pilots and our work will allow
the NHS to be confident that the people
produced by our education and training,
not only have the technical skills and
knowledge but also the personal attributes
that we would expect of those we entrust
with our care.
2
4Introduction
5Background
Sir Stephen Moss,
Chair of Pre-Nursing
Experience Pilot
Steering Group
7
Interview Health Education North East
9
Interview Health Education West Midlands
10
Views about the pilot programme
13
Interview Health Education North West
14
Interview Health Education North Central and East London
16Pre-Nursing Experience Pilot Health Education East of England
Regional Launch
17
Pre-Nursing Experience Pilot Evaluation
18 Next steps
3
Background
Introduction
I was delighted and proud to be asked to implement
the challenge of evaluating a pre-nursing experience
pilot. This exciting opportunity for aspiring nurses
with no, or very little, care experience in a real paid,
hands on job as a healthcare assistant (HCA), is
an innovative approach to assure we get the best
possible students.
Robert Francis highlighted the importance of
ensuring the culture of our organisation is caring
and compassionate at the core. I do not believe
anyone enters nursing to not care for patients but,
as Mid Staffs demonstrated, sometimes something
happens along the way that allows poor and
uncaring practice to flourish. Our participants, and
in fact all our students, are the future of healthcare
- the eyes and ears of the system. Their role is vital
in ensuring that patients receive the high quality and
compassionate care they deserve and would expect.
I would like to thank our pilot participants who
are articulating and demonstrating the values and
behaviours of care and compassion we would
expect. As we go around the country listening to
their stories, you can’t help but get swept away with
their enthusiasm and drive to be the best and most
caring future nurses they can be.
4
Dr Lisa Bayliss-Pratt,
Director of Nursing,
Health Education England
Our participants,
and in fact all our
students, are the
future of healthcare
- the eyes and ears
of the system.
In response to the Francis Inquiry, the Government
asked HEE to implement and evaluate a pilot for
prospective nurse students to work for up to a year as
a healthcare assistant, to gain care experience and test
their values and behaviours of care and compassion.
The aim of the pilot was to recruit aspiring nurse
students, with no or little experience, into paid
HCA posts from September 2013, allowing them
to gain caring experience in real jobs, testing to
see if they are right for the job and that the job is
right for them. The pilot is running over one year to
September 2014.
A steering group of key stakeholders has been
guiding and monitoring the pilot, they set out a
series of guiding principles. Six Local Education and
Training Boards (LETBs) took those principles and
developed pilot sites in partnership with universities
and employers – over 30 employers and around
20 universities are involved across the pilot.
The six LETBs are:
• Health Education East of
England
• Health Education East Midlands
• Health Education North Central
and East London
• Health Education North West
• Health Education North East
• Health Education West Midlands
- University Hospital Birmingham
NHS Foundation Trust
We recruited 165 participants to undertake a year in
post as HCAs gaining experience; also getting support
from employers and Higher Education Institutes in their
applications to university.
5
Interview
Health Education North East
Emma Holt, Gateshead Health NHS Foundation Trust,
Newcastle Upon Tyne
How did you hear about the pilot?
I heard about the pilot though the NHS jobs
website, where I first saw it advertised for other
hospitals, so I kept on checking hoping one would
come up a bit closer to where I live.
Why do you want to be a nurse?
I have always wanted to be a nurse and my main
reasons are due to personal experiences received
from nurses and whilst I worked as a domiciliary
carer I worked closely with district nurses and I saw
how they cared for each individual and how grateful
the individuals were for the care they received and I
wanted to be able to make the same difference.
It has only strengthened
my desire to become a
nurse and to decide this is
exactly what I want to do.
6
Tell me why you wanted to take part in the pilot?
I thought it would be an interesting opportunity to
gain some hands on experience of working within
the NHS and it would give me the opportunity to
see more of what nurses do every day.
Generic HEE image
7
How is this pilot helping you make a decision
about becoming a nurse?
It has only strengthened my desire to become a nurse
and to decide this is exactly what I want to do.
What has been the best thing about your role
so far?
I wouldn’t say any particular part has been the best
as I have enjoyed every part and it’s enabled me to
broaden my knowledge.
Would you recommend this pre-nursing
care work?
Yes, I would definitely recommend it I think it is
so valuable to have relevant experience before
entering university.
What do you feel are the benefits of doing
this role?
I think the benefits are that you get to gain
valuable experience in both a medical and surgical
ward, it also enables you to speak to other health
professionals about their role and what they think is
the role of a nurse.
Interview
Health Education West Midlands
Chloe Marsh, University Hospital Birmingham NHS Foundation Trust
Queen Elizabeth Hospital Birmingham.
How did you hear about the pilot?
I saw an advert in the Birmingham Mail, I was not
really looking for an opportunity like that, just
flicking through the paper, but then I saw the advert
and was very interested.
Why do you want to be a nurse?
To be honest I had never really thought about it,
I was working in a bar and read the advert and
thought I could do this. It is the best thing I ever did.
Tell me why you wanted to take part in the pilot?
As it was a trial, I did not want to commit for too
long, and realised there were going to be options
open to me afterwards.
How is this pilot helping you make a decision
about becoming a nurse?
It is just giving me such a great
opportunity to learn, you get straight
in there, you have good and bad days.
Chloe Marsh
8
It is just giving me such a great opportunity to learn,
you get straight in there, you have good and bad
days. More good days, I like getting up and coming
in to work.
9
What has been the best thing about your
role so far?
I love learning the medical side, if asked a question
from my family I now feel I am able to answer. Also
working very close to the patients - talking to them
- and getting their trust.
Would you recommend this pre-nursing
care work?
Yes, definitely. The amount of time over the year
is good. I would recommend it to friends and have
a friend who has already applied for the 6 month
trial course.
What do you feel are the benefits of doing
this role?
You get to see the job in real life and get an
understanding of the role beforehand. I know a couple
of people who have left the course, it was not for
them, but that is the point of the pilot to see if this role
is right for you. Very good to get to know the job.
The pilot is great, really intense, but I feel like it has
given me a proper life, I am enjoying it. Without
this opportunity I would not have thought about
becoming a nurse.
Trish Knight, Director of Workforce, Education and
Quality at Health Education East Midlands
“It’s important for aspirant nurses to get a feel of what is required of
nursing and to provide compassionate care for individuals who may be
at their most vulnerable. This is in addition to giving us a chance to test
whether they have the right caring attributes and values to work in the
NHS. We’re enthusiastic about
being part of this pilot to explore
and evaluate ways of ensuring
the NHS recruits the right people
with the right values to work for
our patients. Experiencing the
front line at the very beginning
of their career will allow
those considering a nursing
career, before committing to
a healthcare profession to get
a first-hand understanding of
patient needs”.
Jacqueline Davis,
Head of Nursing Practice Development,
Kettering General
Hospital
“The model used in
Northamptonshire as part of the
national pilot has given people
who had all the criteria to enter
their nursing degree course
apart from caring experience
a real opportunity to gain that
experience and realise their
dream. The pilot has provided
some key learning from which to
build an excellent and pragmatic
option to increase the pool of
people entering nursing”
Kathy Branson, Director – Special Projects, Health Education East of England (HE EoE)
“Health Education East of England is delighted to be part of the pre-nursing experience national pilot. We believe that
experience of high quality essential care, delivered with kindness and compassion is a fundamental pre-requisite for
future nurses. We have recruited 48 new healthcare assistants (HCAs) across seven pilot sites, working in partnership
with service and education providers. All of the HCAs have undergone the HEEoE HCA Apprenticeship Framework,
including training on self-awareness and personal resilience, the implementation of the 6Cs (compassion, care,
commitment, courage, competence and communication) and preparation for entry to university. Some of the HCAs
have already gained places at university and some have decided that nursing is not the career for them. Personally I am
very impressed with how the HCAs have used this time to understand and internalise the delivery of the 6Cs in practice;
their stories about how they deliver essential care to patients with a focus on getting the little things right are both
moving and humbling.”
10
Denise Baker, Programme Leader - Foundation Degree
(Assistant Practitioner) / Senior Lecturer Healthcare
Practice, School of Health, University of Derby
“It’s been really helpful to build relationships with the HCAs right from the start of the
programme. Support workers from the University of Derby have been onto the wards
at both of the Derbyshire pilot sites to see first-hand what experiences the HCAs are
having. The good relationships and dialogue between the University of Derby and the
NHS have been key to the success story.”
Liz Libiszewski, Director of Nursing, Quality
& Patient Experience, James Paget Hospital
“The Trust is really pleased to participate in the pilot nursing
scheme. Lauren, Rachel and Sophie, HCAs taking part in the
pilot, have already been able to demonstrate the benefit of the
programme, particularly with regards to their understanding of
the 6Cs of nursing; compassion, care, commitment, courage,
competence and communication. They are an integral part of the
James Paget family.”
Gemma, pilot HCA student,
Chesterfield Royal Hospital
NHS Foundation Trust
Laura, pilot HCA student, Derby
Hospitals NHS Foundation Trust
“I’ve learned so much. My placement has built my
confidence and knowledge - learning new things every
day, learning how to interact with other healthcare
professionals, and of course, the patients.”
“Being part of this national pilot has been
really exciting; it feels like you’re part
of history! We are a new generation of
nurses coming into nurse training.”
11
Interview
Health Education North West
I would value a career
in which I could help
people during their
time of need.
Emily Minchew, HCA pilot student, Wirral University Teaching
Hospital NHS Foundation Trust
How did you hear about the pilot?
I used to regularly check the NHS jobs website for
healthcare jobs or similar roles in order to get some
hospital experience to aid my university application.
Why do you want to be a nurse?
I want to be a nurse because I believe I am kind, caring
and compassionate and I would value a career in which
I could help people during their time of need. I believe
nursing would be a rewarding and fulfilling career and I
would enjoy the daily challenges that would face me in
this role. I think a career in nursing would provide endless
learning opportunities and I am very keen to learn new
skills. Also, my mum has worked in nursing for almost
thirty years and has inspired me to pursue this career.
Tell me why you wanted to take part in the pilot?
I wanted to take part in this pilot as I have applied to
universities to study nursing for the past two years, and
although I have had interviews, I have been unsuccessful. I
hope that by gaining experience in a hospital environment
I will have more chance of getting onto a child nursing
course, as this is where my interests lie and it is the career
I can see myself doing in the future. I also wanted to gain
new skills which would make me more confident and
competent should I be successful in the future.
How is this pilot helping you make a decision
about becoming a nurse?
12
Generic HEE image
During my time at the trust I am being given placements
on three different wards in order to learn about a variety
of different types of nursing and different medical
Emily Minchew
conditions. This pilot is helping me to make a decision
about becoming a nurse because it is giving me an
insight into what is involved in the job, the challenges I
may be faced with and the expectations of the role.
What has been the best thing about your
role so far?
The best things about my role so far have been the
learning experiences as I am always eager to learn,
and also meeting some lovely people, both staff and
patients. It makes my day when I’m helping to look
after a patient who I can have a good chat with and
who genuinely appreciates my help. One patient asked
what my role was and when I explained the pilot to
her she said she thought I would make a fantastic
nurse because I was so caring and even offered to
write me a reference! This made me feel really positive
about myself and the job that I was doing.
Would you recommend this pre-nursing
care work?
I would recommend this pre-degree nursing care
work to anyone who wants to go into nursing as I
believe it offers invaluable experience.
What do you feel are the benefits of doing
this role?
There are a number of benefits to this role, for
example, it helps you to decide if nursing is really
the career for you, and it also prepares you for life
as a student nurse should you be successful, making
you more confident in your role.
Interview
Health Education North Central and East London
Camden and Islington NHS Mental Health Trust – HCA Pilot student
endless learning opportunities
compassion right values
see the job in real life
confidence and knowledge
How did you hear about the pilot?
a genuine desire to care
I saw an advert in the Evening Standard and that
came just at the right time!
I wanted to have a job with a purpose and that was
more rewarding than previous jobs I have had before.
improve the quality of care
Tell me why you wanted to take part in the pilot?
broaden my knowledge
Because I was curious about becoming a nurse but I
didn’t have the qualifications to apply for university
or the money to pay for an access course.
It’s helped to decide that
I actually don’t want to
be a nurse, such as the
fact that I am dyslexic, so
I struggle to read certain
things off the computer.
The workload of an HCA
is more manageable and enjoyable for me at the
moment and I would like to stick to that.
14
courage
an insight into what is involved in the job
Why do you want to be a nurse?
How is this pilot
helping you make
a decision about
becoming a nurse?
the best thing I ever did
recruit aspiring nurse students
competence
care
an interesting opportunity to gain some hands on experience
What has been the best thing about your
role so far?
The patients and the spirit of staff.
Would you recommend this pre-nursing
care work?
Definitely!
What do you feel are the benefits of doing
this role?
You learn something new every day whilst getting
paid for experience which is really helpful.
innovative approach
positive experiences
communication
working very close to the patients
a focus on getting the little things right
commitment
15
Health Education East of England (HE EoE)
Pre-Nursing Experience Pilot Regional Launch
Monday 27 January 2014 | Trinity Park, Ipswich
This event was one of the regional events held to
informally launch the pre-nursing experience pilot –
this particular one in the East of England shared and
celebrated best practice. Over 150 people attended
including the pre-nursing
experience HCAs, their
mentors, ward and team
leaders, and many more.
Delegates heard that
Health Education East
of England has the
biggest pilot cohort of 48
HCAs and thanked the
seven pilot sites for their
incredible hard work in implementing the project.
They also heard from the HCAs themselves - telling
their incredibly moving and humbling stories, and
how they demonstrate the 6Cs during the course of
their duties.
Emma McKay, Director of Nursing, Norfolk & Norwich
University Hospitals NHS Foundation Trust said:
‘These HCAs are of incredibly high calibre. I have been
impressed with everything they have achieved and
look forward to employing them when they graduate.’
Pre-Nursing Experience Pilot Evaluation
A case study service evaluation of the six pilot LETB
sites is underway. This method is being used as the
situation under investigation is novel and it allows
for the local variations in approach. For example, the
different approaches to recruiting the HCAs to
the Pre-Nursing Experience Pilot; the length of
time they are employed in clinical service;
the nature of that clinical experience;
the experience of the HCAs and their
mentors; the professional aspirations
of the HCAs; and the impact of this
development on the clinical service.
The data is collected through a ‘mixed
methods’ methodology which includes
surveys, focus groups with HCAs and
mentors/supervisors, and individual interviews.
There are three main data collection points: at
the beginning of their pre-nursing experience;
midway through the pilot; and immediately
prior to starting their pre-registration
undergraduate nursing course.
Delegates were also involved in a marketplace
showcasing best practice, in addition to hosting a
series of workshops to share and build upon the things
learnt, such as the best mentorship support for HCAs.
16
17
The Department of Health Policy Research
programme has decided to fund a substantive
longitudinal study following the experience of these
HCAs through their pre-registration education and
training. This research study on the evaluation of the
impact of care experience prior to undertaking NHS
funded education and training will commence in
September 2014 and aim to report in 2018.
Next steps
Five of the current six pilot sites are planning a
further cohort of participants in February/March:
• East Midlands – proposed a further cohort of
around 20 for 6 months.
• North Central and East London – a further
cohort of around 30 for 6 months.
• North East – proposed a further cohort of up to
20 for 6 months.
• North West – Plan to recruit a further 17 in
February/March for a year, to make up to original
33 projected recruitment number.
• West Midlands (Birmingham) – a further
cohort of around 20 for 9 months.
• We are also working with further LETBs to
introduce cohorts in September.
Dr Lisa Bayliss-Pratt reflects:
“We know that the UK faces major health and
social care challenges over the coming years. The
nursing and healthcare support workforce will have
an instrumental role in meeting those challenges.
This pilot is a fantastic step towards addressing
some of those issues.
18
Never before has there been so much interest in the
nursing profession, with all eyes on it and these pilot
HCAs are pioneers in a new learning opportunity
that could well be adopted and spread amongst
other professions.
We must seize every opportunity to lead and
innovate with the care that we give.
We are the touchstones for the patient and when
we get it right, we know we can make such a
difference to the people that we treat and care for.”
We must seize
every opportunity
to lead and
innovate with the
care that we give
Developing people
for health and
healthcare
Contact us
If you would like to know more about our work,
or have a comment, query, or suggestion then
please visit our website at www.hee.nhs.uk
or email the team: [email protected]
Alternatively, keep up to date with HEE
news by following us online:
www.twitter.com/nhs_healthedeng
www.facebook.com/nhshee
Or you can subscribe to our free HEE email update by
sending an email to [email protected]