Shared learning database

South Staffordshire & Shropshire Healthcare NHS Foundation Trust
Published date:
October 2009

NICE and Knowledge identifies Technology Appraisals and Clinical Guidelines relevant to the Children's Directorate caseload (and more recently Mental Health and Learning Disabilities) and has developed e-learning modules linking the NICE quick reference guide, clinical standards and a test assessing knowledge of these standards, to provide evidence of knowledge to be presented at appraisal. Disciplines within the directorate have checklists identifying all appropriate NICE guidance and indicating whether they need to undertake the test or simply provide evidence that they have accessed the information. In both instances a certificate is generated to evidence compliance, which is required for annual appraisal and cross linked with the KSF requirements to simultaneously support staff and organisational needs.

Guidance the shared learning relates to:
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

The submission relates to general implementation of NICE Guidance with the following sets of guidance currently available or being actively developed on e-learning modules: TA10,13,24,35,38,40,42,57,63,79,81,97,82 CG26,28,38,47,57,60 The initiative was developed to enable a robust cascade of NICE guidance backed by documentary evidence of clinician's knowledge at appraisal. 1. Identify NICE guidance relevant to the Children's Directorate and develop processes to ensure appropriate staff awareness and knowledge, linking e-learning, KSF (knowledge and skills framework) and the appraisal process in such a way that cascade of knowledge and assessment of staff knowledge are a fundamental part of the annual mandatory appraisal. 2. Identify gaps in knowledge and awareness of NICE guidance that can be used to inform future audit and training programmes. 3. Develop a Trust wide programme for all Directorates (Mental Health, Developmental Neurosciences & Learning Disabilities, Forensic Services and Specialist Services) building on the lessons learnt from the initial work within the Children?s Directorate.

Reasons for implementing your project

1. Following an audit of activity and clinician's involvement relating to relevant NICE guidance within our Children's Directorate, it became apparent that most guidance did not require full implementation and audit. However, clinicians require robust knowledge of appropriate NICE guidance in order to advise and support other clinical decisions and provide meaningful information for children, parents and staff. Consequently, a recommendation was made to look at the cascade of knowledge of NICE guidance to all clinical staff and develop a process that would both educate staff and enable the directorate to identify gaps in knowledge to inform future training. 2. To ensure that this was robust it was agreed with the Clinical Director that this would be a requirement for all appraisals. 3. An e-learning package was used to facilitate this, allowing ease of access and feedback. This was the key to providing detailed information regarding access to modules and provided an opportunity to assess individual and group knowledge of NICE standards, within a standard report format. 4. To further support staff requirements each module was linked to KSF requirements. 5. Clinical staff are advised which Technology Appraisals and Clinical Guidelines relate to their work by line managers via agreed checklists and advised of the need to complete the modules for their annual appraisal. 6. Following implementation within the Children?s Directorate the model was promoted widely across the Trust with support offered to implement it in other Directorates.

How did you implement the project

1. Relevant NICE guidance has been identified by the directorate clinical governance lead and e-learning modules developed. Checklists have been distributed to each discipline identifying guidance appropriate to them. Each module includes a hyperlink to the summary of the Technology Appraisal or Clinical Guidelines and a list of standards identified from this. Finally a short test relating to the standards is included. 2. The modules are written on an e-learning package which is also used to distribute the trust's human resources mandatory training programmes. Each module identifies which KSF criteria it represents. Upon successful completion of the questions a certificate can be printed off. These certificates must be taken to appraisals and used as evidence of application for the KSF process. 3. The modules provide detailed information on individual and group knowledge and help to identify future audit and training programmes. 4. Reports have been created within the software which have been reviewed by the Clinical Governance lead, Clinical Audit Team and Human Resources Department. Learning from early use of the modules is being fed back to a number of staff groups. 5. The initiative was cascaded via a trust wide conference, Clinical Effectiveness and Risk Committee and Directorate governance steering groups, promoting the process which is now being adopted across the Trust. The Mental Health and the Learning Disability directorates are now actively involved in using the model.

Key findings

Reports from the e-learning modules detail the required information allowing - identification of staff undertaking this workstream, - length of time spent on each module and - knowledge of standards. Individuals and groups of staff with training needs can be identified and similarly guidance where knowledge is universally poor can be targeted for training. A review of current usage also included an evaluation of the process to assess; ease of use, quality of information/modules, benefits and areas for improvement. Feedback from the audit of usage was cascaded to the Community Paediatricians, the clinical governance steering group and the directorate management team, consequently the link between completing Training Tracker and requirement of certificate for appraisal was strengthened and the modules are being added to the Trust's mandatory training programme

Key learning points

To instigate the processes used required the involvement of stakeholders with the power to create change. Within our Directorate the Clinical Director was interested in the outcomes from the NICE baseline audit. Consequently, this helped develop the recommendations and fully supported the implementation of linking knowledge of NICE guidelines with KSF and the appraisal process. Whilst involving the Clinical Governance lead and Audit Team leader to drive the process forward the modules are currently being assessed by the clinicians prior to implementation facilitating validation, acceptance, ownership and empowerment. Systems familiar to clinicians were adapted for the process strengthening the links with Mandatory training, appraisal and KSF. The cascading of information through Trust wide groups has led to the involvement of other directorates in the process. Monitoring of the process enabled: - Further promotion of the model - Identification of uptake within professional groups - Identification of small difficulties encountered in trying to re-use the models annually. - Clinicians feedback regarding content of modules to be modified. - Agreement to place appropriate modules on the Children's Directorate mandatory training matrix. Feedback has been positive and the process is being actively supported.

Contact details

Dr Andrea Voice
Community Paediatrician
South Staffordshire & Shropshire Healthcare NHS Foundation Trust

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