Shared learning database

Norfolk, Suffolk and Cambridgeshire Critical Care Network
Published date:
February 2011

As a region we created and implemented a web-based e-learning programme that educates, validates, interrogates and accredits the learner's knowledge in the application of educational recommendations laid out in NICE CG50. It is accredited by the Royal College of Nursing and local universities and is designed to increase the skills of staff dealing with acutely ill patients, without taking them away from their work.

Does the example relate to a general implementation of all NICE guidance?
Does the example relate to a specific implementation of a specific piece of NICE guidance?


Aims and objectives

Our aim was to provide a flexible, educational solution to the skills gap that exists in the health care sector in the East of England relating to the Acutely ill Patient in Hospital. We wanted the E-Learning Programme to be interactive and easily accessible with high quality training and expert content. We wanted something that could provide learning, evidence of learning, certification and validation. We aimed to provide the learning without needing to take staff away from their workplace for long periods of time. We also wanted to reach as many staff as possible, and to make it highly cost effective. We wanted to have accreditation from recognised bodies. We wanted employers to be able to manage and monitor their staff training.

Reasons for implementing your project

It began in response to the need identified by Critical Care Outreach nurses who provide support and education to ward based staff. They were being called to help with patients whose condition was deteriorating, and who ward staff were not able to adequately diagnose and manage. These patients would not be receiving optimum care and frequently had poor outcome, extended hospital stay and needed higher levels of care because of lack of clinical skills. This patient cohort exists in all provider trusts and they may be dealt with by nurses, doctors, paramedics and HCAs. Subsequently NICE CG50 was published which contained the same educational recommendations. NICE had extensive evidence and our local evidence was the number and type of calls made to Outreach services in all the Trusts in Norfolk, Suffolk and Cambridgeshire. The baseline audit against compliance with CG50 which was undertaken in all the Trusts in our Critical Care Network highlighted what we already suspected to be true. We held a multi-disciplinary, multi-organisational Network led Stakeholder Event to ensure we fully understood the main issues to improving patient care in relation to the recommendations of CG50. The key problems identified were largely staff training issues. Comments included "we have no time or resources to train our staff" and "it is expected that outreach will provide training yet there are just not enough outreach nurses to go around". We saw the opportunity to improve staff knowledge and skills in this area while at the same time increasing the efficiency of training at no extra cost to the Trusts. Moreover we identified a means of achieving this without increasing the burden on already overstretched staffing levels in wards. The E-Learning Programme was developed as a direct result of CG50 and supported by our findings.

How did you implement the project

Having identified the initiative and established very clear objectives the programme followed 4 distinct stages. In Stage 1 we undertook through consultation, questionnaires and a series of events a gap analysis which provided us with a training needs analysis. In Stage 2 we developed the actual Programme and established a working partnership with Airwave Solutions Ltd who provided the expertise for building the platform for the E-learning Programme. The clinical content and knowledge was provided by experts from all member organisations of the Network and demonstrated collaborative working at its very best. Stage 3 revolved around formal peer review processes and quality assurance and incorporated a pilot study. Stage 4 concentrated on implementation plans and the attaining of both academic and professional accreditation. The final stage involved the assessment procedure and competencies of staff. A nominal contribution was made towards the cost of developing the Programme using Network funds and as a result of the commercial arrangement with Airwave Solutions Ltd, the Programme is free to all trusts in the East of England for 3 years.

Key findings

The pilot study was useful in several ways. It tested the usability of the E-Learning Programme itself both technically and content wise. More significantly, it demonstrated a 22% increase in knowledge and skills of those staff assessed. It showed a level of learning that would be expected to translate into practice and an improvement in recognising and responding to the acutely ill patient in hospital would therefore be anticipated. The next planned audit for compliance against CG50 across the region will, we anticipate, validate our objectives and demonstrate a measurable improvement in service delivery as a result of the E-learning Programme. Based on the work we have already done we anticipate a 20% increase in the skills level of staff at participating organisations. As this initiative has only very recently been implemented across the East of England it is difficult to fully assess the true impact on patient safety and quality of care.

Key learning points

The development and implementation process itself has provided the Norfolk, Suffolk and Cambridgeshire Critical Care Network with valuable experience in a new way of working in the brave new NHS. The support of the NICE CG50 guidelines has facilitated our project. Collaboration from all our trusts was essential to the success of this project and enthusiasm to engage with the content development was very encouraging. We found communicating the value of the Programme and achieving buy-in from those who could influence delivery was vital. We have learned that it is essential to have a planned and phased delivery programme in place. The fact that we negotiated arrangements with the private sector in which they carry the commercial risk provided excellent value for money.

Contact details

Alex Moffat
Clinical Quality Manager
Norfolk, Suffolk and Cambridgeshire Critical Care Network

Secondary care
Is the example industry-sponsored in any way?

We established a commercial partnership with Airwave Solutions Ltd who provided the expertise for building the platform for the E-learning Programme.