In February last year, the Mid Staffordshire NHS Foundation Trust Public Inquiry, known as the Francis Report, found a number of failings within the trust which ultimately led to a higher than normal death rate at Stafford Hospital. In addition to this, it was found that staff were failing patients in the most basic of ways, such as (as set out in the report):
- Patients left in soiled bed clothes for extended periods
- Water out of reach
- Failure to assist patients with meals
- Dirty conditions
- Triage undertaken by untrained staff
All of this led to the inquiry and when it was announced the then Secretary of State, Rt Hon Andy Burnham MP said at the House of Commons: “Let me be clear: the care provided was totally unacceptable and a fundamental breach of the values of the NHS.”
Where did it all go wrong?
It’s reasonably common knowledge now that the problems within the NHS in general, and not just in Mid-Staffs, fostered a culture of secrecy and negativity. Leadership and training were inadequate and more importance was placed on the “numbers”, rather than patient care.
Whilst of course the NHS is a business, after a fashion, its primary function is to provide quality and life-saving care to its patients. In this case it failed on a spectacular level. Now, many things could be blamed for this: a lack of funding, under-qualified staff, reluctance to speak out due to the threat to jobs and more.
So how could this be avoided?
With any job comes a requirement to learn. Nobody goes into a new job knowing it all and any organisation that is serious about its staff and in this case standard of care, knows that training is also an ongoing process.
The NHS, like any other organisation, works with a huge amount of staff on many different levels, from porters and healthcare assistants, to consultants and managers. This means that training for all should be targeted towards different positions held within the organisations.
A central LMS module for new employees at any level can introduce all staff to the values of the organisation and what’s expected of every single employee that works within it. This type of induction is perhaps vital for ensuring that no single member of staff is left in any doubt as to the general ethics and aims of the organisation.
Further to this, learning can be targeted to different roles, so that each member of staff/department is made 100% aware of their responsibilities and has the tools and learning materials to support them in attaining the competencies that their particular job role demands.
One of the problems that the NHS has experienced is the level of secrecy surrounding mistakes that ensured junior staff felt that their very career could be on the line if they were to become a ‘whistle blower’.
However, with the use of an LMS to train staff from the beginning about how they can go about raising concerns is vital if the NHS is to foster a culture which allows transparency. Workplace culture is also vital to morale and productivity if it’s a positive one, and this can be fostered with the use of an LMS.
Again, managers and those in leadership were found to be a major failure factor in the Francis Report. Leaders and managers need to know their job inside out and be capable of passing that down the line. They should also be approachable to junior employees and be capable of answering questions and taking responsibility if a concern is raised.
People approach leadership differently, but with an organisation such as the NHS, there should be consistency or there will be mistakes. Managers and leaders need to learn how to handle staff, patients and relatives and in order to do this, they need training. Fostering a healthy culture within any workplace is necessary and doubly so when lives are on the line. Leaders should be taught that staff in roles that are junior to themselves should feel comfortable approaching them with problems and again, for the sake of consistency and care, this is where an LMS comes in to ensure that this is made clear from the very start.
Training those on the ‘shop floor’
Whilst there are many capable and caring healthcare staff in the NHS, without proper training, they cannot carry out their job effectively. Take for example the use of untrained staff for Triage; this is clearly unacceptable and yet is completely avoidable with the use of a well thought out LMS.
Nurses and healthcare assistants are often the first to see patients in Triage and the pressure to make a quick diagnosis is huge. Using staff that have not had enough training to spot danger signs will inevitably lead to oversights that could cost lives. This means that it’s essential to ensure that a training system for Triage and aftercare is properly maintained and the relevant staff are made to take the training before undertaking the work. Of course, once the training is underway, practical supervised training can be used to reinforce the training that has been learned via the LMS.
With large organisations, training is often set up but lost somewhere along the way due to a lack of supervision, or more likely absence of the required reporting systems that facilitate management to enforce compliance or appraise competence within their teams. Having the right reports provided by your LMS is essential when you’re managing learning within a large organisation – failure to set-up reports correctly mean that it’s not always possible to see the bigger picture.
Having an LMS that addresses the key concerns of large organisations such as the NHS should allow for the streamlining of processes, such as getting the right staff onto the right courses. It should also provide a reporting framework that can monitor and address learning gaps while facilitating Performance Appraisal and Development Reviews (PADR). If a job function requires proof of training that needs to be kept up-to date your LMS should provide you with a Compliance Framework to manage and support this.
In healthcare, on the job training is highly risky and if mistakes are made, past culture has been to ensure that staff remain tight-lipped when things go wrong. This is clearly unacceptable and is something that can be addressed with a learning management system by providing an environment where staff can learn when they have the time, rather than ‘on the job’.
The use of an LMS can ensure that a good working culture can be fostered, whilst staff know how to go about raising concerns, how they can further their training and the importance of duty of care.