Health Education and Improvement Wales
Other
Noted
Health Education and Improvement Wales (HEIW) describes the healthcare education commissioning cycle which aims to ensure high-quality education, training, and support for preregistration nursing students. They state that Multifactorial Risk Assessment education and training during their pre-registration education is not appropriate. (AI summary)
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Dear Ms Saunders Re: Health Education and Improvement Wales response to Regulation 28 Report to Prevent Deaths, received following the Inquest touching on the death of Glenys Lillian Phipps. Thank you for your report dated 22 December 2022, which was received on 28th December 2022 following annual leave and Christmas Bank Holidays.
Further to you report, the information presented below is intended to describe the action taken/being taken by Health Education and Improvement Wales (HEIW) to mitigate the risk of future deaths.
Health Education and Improvement Wales (HEIW) is the strategic workforce and education body for NHS Wales and sits alongside Health Boards and Trusts. We are committed to delivering the vision of transforming the workforce for a healthier Wales and have a leading role in education, training, development and shaping the healthcare workforce in Wales to ensure high-quality care for the people of Wales
Excellent education and training underpin the development of a sustainable workforce, which in turn provides the capacity and capability to lead and promote high quality, safe patient, person, and community centred care.
In 2021, following extensive stakeholder engagement and researched international best practice, the HEIW Board approved and awarded healthcare education contracts, for delivery over next 10 years,. Alongside the NMC Standards framework for nursing and midwifery education. and Standards for student supervision and assessment, key themes were built into the contract specification to meet the future healthcare needs in Wales.
Clinical placements and student supervision HEIW is committed through a programme approach to support the development of clinical placement availability and quality to underpin delivery of education and training across healthcare programmes. Placement learning constitutes a significant proportion of healthcare education and training in Wales, with over 11,000 students undertaking pre-registration education programmes at any one time. Increases in student and trainee numbers has placed a substantial premium on placement availability. Building on existing placement availability , new models for placement learning, inter-professional education and supervision; continue to be developed to meet the required quality benchmarks for placement excellence
[Type here]
Prior to attending their first clinical placement It is a contractual requirement with Universities for all student nurses to undertake a range of mandatory eLearning modules, which includes Moving and Handling and Falls Prevention.
While on placement, the student is supported by a Practice Education Facilitator (PEF) funded by HEIW. PEF roles are multi-layered and span the whole student journey including involvement in selection and recruitment; facilitation of placement capacity, delivery of supervisor and assessor training, quality assurance of practice learning environments; and supporting registered staff with students who may not be meeting required levels of proficiency, through to the point of registration and support of new employees during their initial period of preceptorship. Positive feedback continues to be received from students, supervisors and assessors about the support provided by PEFs.
Matter of concern – is it beneficial for Multifactorial Risk Assessment (MFRA) processes to be taught to student nurses prior to qualification?
We fully accept that improving patient safety and protecting patients from Falls is the responsibility of the entire multidisciplinary team, both registered and non registered staff. This is fully supported by the evidence and national guidance
With reference to the MFRA, this is a nationally agreed programme delivered by all Health Boards and Trusts across Wales. The MFRA is an assessment with multiple components that aims to identify a person’s risk factors for falling. It should be performed by a healthcare professional with appropriate skills and experience and should be part of an individualised multifactorial intervention which may need to be coordinated across different professionals and settings; to ensure the patient receives the appropriate safe care.
While student nurses may be introduced and learn about the MFRA at various stages of practice placement under supervision, they cannot be held responsible to coordinate care. it is therefore not appropriate for MFRA education and training during their pre-registration education.
I am pleased to report that Aneurin Bevan deliver MFRA education to all new registered nurses as part of their induction into the organisation and provide support to develop and enhance their skills . I would suggest the the lessons to be learned from this incident and the safety improvements introduced at Aneurin Bevan, be shared with other organisations.
I trust the above addresses the concerns raised in your report. However, please do not hesitate to contact me should you require further information
Your sincerely,
Director of Nurse and Health Professional Education Health Education and Improvement Wales (HEIW)
Further to you report, the information presented below is intended to describe the action taken/being taken by Health Education and Improvement Wales (HEIW) to mitigate the risk of future deaths.
Health Education and Improvement Wales (HEIW) is the strategic workforce and education body for NHS Wales and sits alongside Health Boards and Trusts. We are committed to delivering the vision of transforming the workforce for a healthier Wales and have a leading role in education, training, development and shaping the healthcare workforce in Wales to ensure high-quality care for the people of Wales
Excellent education and training underpin the development of a sustainable workforce, which in turn provides the capacity and capability to lead and promote high quality, safe patient, person, and community centred care.
In 2021, following extensive stakeholder engagement and researched international best practice, the HEIW Board approved and awarded healthcare education contracts, for delivery over next 10 years,. Alongside the NMC Standards framework for nursing and midwifery education. and Standards for student supervision and assessment, key themes were built into the contract specification to meet the future healthcare needs in Wales.
Clinical placements and student supervision HEIW is committed through a programme approach to support the development of clinical placement availability and quality to underpin delivery of education and training across healthcare programmes. Placement learning constitutes a significant proportion of healthcare education and training in Wales, with over 11,000 students undertaking pre-registration education programmes at any one time. Increases in student and trainee numbers has placed a substantial premium on placement availability. Building on existing placement availability , new models for placement learning, inter-professional education and supervision; continue to be developed to meet the required quality benchmarks for placement excellence
[Type here]
Prior to attending their first clinical placement It is a contractual requirement with Universities for all student nurses to undertake a range of mandatory eLearning modules, which includes Moving and Handling and Falls Prevention.
While on placement, the student is supported by a Practice Education Facilitator (PEF) funded by HEIW. PEF roles are multi-layered and span the whole student journey including involvement in selection and recruitment; facilitation of placement capacity, delivery of supervisor and assessor training, quality assurance of practice learning environments; and supporting registered staff with students who may not be meeting required levels of proficiency, through to the point of registration and support of new employees during their initial period of preceptorship. Positive feedback continues to be received from students, supervisors and assessors about the support provided by PEFs.
Matter of concern – is it beneficial for Multifactorial Risk Assessment (MFRA) processes to be taught to student nurses prior to qualification?
We fully accept that improving patient safety and protecting patients from Falls is the responsibility of the entire multidisciplinary team, both registered and non registered staff. This is fully supported by the evidence and national guidance
With reference to the MFRA, this is a nationally agreed programme delivered by all Health Boards and Trusts across Wales. The MFRA is an assessment with multiple components that aims to identify a person’s risk factors for falling. It should be performed by a healthcare professional with appropriate skills and experience and should be part of an individualised multifactorial intervention which may need to be coordinated across different professionals and settings; to ensure the patient receives the appropriate safe care.
While student nurses may be introduced and learn about the MFRA at various stages of practice placement under supervision, they cannot be held responsible to coordinate care. it is therefore not appropriate for MFRA education and training during their pre-registration education.
I am pleased to report that Aneurin Bevan deliver MFRA education to all new registered nurses as part of their induction into the organisation and provide support to develop and enhance their skills . I would suggest the the lessons to be learned from this incident and the safety improvements introduced at Aneurin Bevan, be shared with other organisations.
I trust the above addresses the concerns raised in your report. However, please do not hesitate to contact me should you require further information
Your sincerely,
Director of Nurse and Health Professional Education Health Education and Improvement Wales (HEIW)