Heart of England Health Trust Case Study
Delivering the Safeguarding Children e-Academy Awareness of Child Abuse and Neglect Core Course via e-learning across the Heart of England NHS Trust
BACKGROUND
The Heart of England NHS Foundation Trust is one of the leading foundation trusts in the country, with over 10,000 staff providing general and specialist hospital care for the people of east Birmingham, Solihull, Sutton Coldfield, Tamworth and South Staffordshire. The Trust’s hospitals include Birmingham Heartlands Hospital, Solihull Hospital, Good Hope Hospital in Sutton Coldfield, and Birmingham Chest Clinic. There are also have a number of smaller satellite units, so people can be treated as close to home as possible. Over recent years, the Trust has recognised the need to invest in an ambitious development programme if it is to provide the best patient care.
THE CHALLENGEWorking with the Safeguarding Children e-Academy, Heather Owen has been charged with delivering the online Awareness of Child Abuse and Neglect Core Course to all 10,500 staff across The Heart of England. This is now a legal requirement and a significant task. Heather has been a paediatric nurse since 1991 and recently became Named Nurse for Safeguarding children and Young People..
PROGRESS TO DATEThere has been a promising start. Training first began in August 2007 and by April 2008, a total of 2,968 staff had commenced the learning, either working on computers in the hospitals or at home on their own Personal Computers. Around 759 of these people have now completed the core module and received their certificates, though Heather Owen and her team remain keenly aware that this represents only a fifth of the total uptake and that personal contact must be maintained with all trainees to encourage them to move forward and complete the course.
THE HISTORYWhen Heather Owen came into post in June, 2007, Heart of England NHS Foundation Trust was accountable to three Safeguarding Children Boards in South Staffordshire, Solihull and Birmingham, all charged with undertaking an annual Section 11 Audit. These audits highlighted that further improvements could be made to deliver the Safeguarding Children training across all three Boards.
THE REALISATION
Urgent action was required to deliver this training to all 10,500 staff and an expert team was assembled including Heather Owen; her PA Marilyn Sewell, 
two named midwives, Carol White and Helen Melville; and a named doctor, Dr Leigh Rabb. With the Section 11 Audits almost underway, speedy progress on training implementation was essential.
When Heather Owen first became aware of e-learning, she looked at a number of different training packages available that may be able to meet the Trust’s needs. She visited Staffordshire SCB, which already had in place an e-learning package purpose designed by the Safeguarding Children e-Academy. This was chosen as the most suitable for the Trust’s immediate requirements.
Safeguarding Children e-Academy Manager Abby Dacres was then invited to give a presentation to a team headed by Ian Cunliffe, Medical Director for Surgery and Executive Lead on Safeguarding.
THE EARLY STAGESHeather and the team did a great deal of work in the initial stages in establishing the Safeguarding Unit. The first major challenge encountered, because of the size and geographical spread of staff, was raising awareness that the training initiative was up and running. A logical and methodical way forward was developed which involved prioritising the first groups to undertake training, namely those most involved with children - paediatrics, midwifery and A&E departments in particular.
The next task was to look at other areas, taking into account a child’s journey through the hospitals and who they would come into contact with. These groups of people would obviously need to be next to undertake training – not only nursing staff, but pharmacy, x-ray, radiology, theatres, and ear, nose and throat.
THE DELIVERYThe need for effective communication quickly became a priority. This was achieved by sending e-mails to all target audiences and by speaking directly to departmental managers about how best they and their staff could access the Safeguarding Children e-Academy website and log in to begin their training.
Promotional posters and flyers spreading the e-learning gospel were also provided by the Safeguarding Children e-Academy and distributed around the hospitals. These directed people to the website, encouraging them to log on and find out more about the course.
Heather also regularly hands out copies of the Academy’s newsletter to further raise awareness of its work and the benefits of e-learning. In addition, information is posted on the Trust’s Intranet Safeguarding site.All management are kept fully informed, while steps are taken at every opportunity to spread the e-learning message through a cascading system, to get each and every Trust employee both aware of and fully involved in the learning process, right down to clerical staff who may require only a very basic awareness.
The headline message that such training is now a legal requirement – that it must be undertaken - is driven home at every opportunity.
Effective communication goes a long way in allowing the Safeguarding team to take follow-up actions to ensure that progress is maintained both effectively and efficiently.
CHALLENGES AND SOLUTIONSWhile the Safeguarding team can easily convince staff of the worth of buying into e-learning, the main challenge once they have started their training is to get them to actually complete it. This requires lots of encouragement and asking people who have successfully completed the training to spread the word.
The Safeguarding team helped address the computer accessibility by advising staff that they can complete their training at home – flexibly and in their own time. Indeed, a good number of people have said they much prefer to undertake e-learning in a home environment, rather than dipping in and out of it at work.
There were also difficulties because some people said they did not pick up Safeguarding emails, did not have personal e-mail addresses or could not actually log on to the site. This is being resolved by issuing lists to ward managers containing the names of people undertaking training, along with the personal codes and passwords of both existing and new users, and simple instructions on how to access the site.
The Trust’s IT department helped resolve equipment and technology issues. For example, on investigation it was discovered that many Safeguarding emails were going into junk mail boxes and therefore being missed. A paper back-up system is now also in place to help track emails more effectively.
FEEDBACKThere has been positive feedback from both Safeguarding Boards on how training is being delivered and from Trust staff who feel it is easy to access, use and understand.
INTERNAL SUPPORTBoth Ian Cunliffe and Lynne Bowyer, Acting Directorate Manager for Paediatrics, have been extremely supportive and, while fully recognising the challenges, have encouraged and urged the Safeguarding team to keep up the pressure and forge ahead in attempt to achieve the goal of seeing all 10,000-plus Trust members successfully achieve the qualification.
EXTERNAL SUPPORTThe Safeguarding Children e-Academy team has been extremely supportive in providing help and guidance throughout the process to date, particularly assisting in problem-solving and how issues might be tackled in a better way.
THE SUCCESSESHeart of England NHS Foundation Trust is a fast-paced, growing organisation, with Good Hope Hospital having only been part of the Trust for a year. As such, all departments have been facing a period of change and it was challenging for the Safeguarding Team to access all areas and encourage staff to take an interest when they are in a busy time of adapting.
Staff who have completed their training have expressed a sense of satisfaction in what they have achieved, whereas in the past they would make informed judgment calls, they now feel more familiar with safeguarding procedures and increasingly confident in their decisions.
The Safeguarding team is extremely optimistic that the situation can only improve as the Safeguarding ethos and philosophy becomes more embedded in the organisation.
LEARNING POINTSMore scoping should have taken place at the outset to understand the size of the task and the need for extensive administrative support from the start.
ADVICE TO OTHER ORGANISATIONS?Heather Owen would recommend e-learning as the way forward to other NHS Trusts as a quick, efficient and cost-effective solution, though they would need to be fully aware of the vital need to :
- Identify the correct target audiencies right at the outset.
- Have a clearly defined action plan of how the project will run.
- The active participation of all staff – and the correct means to get them involved in and committed to the whole training process.
- In-depth IT and administration support.
- To be very methodical in your approach by keeping a clear audit trail throughout the project.
- That staff are changing all the time, so new people are constantly coming on board. Ensure they do not miss out by distributing promotional leaflets and Safeguarding Children e-Academy inductiion forms.
The mission continues to roll out the Awareness of Child Abuse and Neglect course to all who work for the Trust at the earliest possible opportunity, at the same time promoting best practice at every turn. A Safeguarding audit system is now in place detailing what has been achieved to date and what needs to be done in the future.Heather Owen and her team have just three years to deliver Safeguarding training to all, but in reality much of the groundwork needs to be in place by the end of 2008. With this in mind, a new awareness-raising drive has been implemented.e-learning will be promoted more effectively to key groups and must be supplemented by face-to-face training as and when required, particularly for staff in emergency and paediatric services. Based on the success of what has been experienced to date, the Trust is also looking to buy into the Safeguarding Children e-Academy’s Awareness of Domestic Abuse. Initial research has shown that this would be a natural follow-on to the Child Abuse and Neglect module and would fill a further need Trust-wide.Externally, Heather is also making inroads into Adult Services in terms of both raising awareness and encouraging them to buy into the training process. A Safeguarding Adults Steering Group has now been established and Heather has been invited to become involved, which she regards as a positive move in the right direction.Based on the success of what has been experienced to date, the Trust is also looking to buy into the Safeguarding Children e-Academy’s Awareness of Domestic Abuse. Initial research has shown that this would be a natural follow-on to the Child Abuse and Neglect module and would actually fill a further need Trust-wide.
THE SUMMARYHeather Owen: “Our people are now increasingly buying into e-learning and recognising the benefits as awareness spreads. We are definitely succeeding, but there is still much work to do. We are getting there, but we must not rest on our laurels. We must continue to work together to achieve our legal and moral objectives.”
HEART OF ENGLAND SAFEGUARDING TREE
Ian Cunliffe, Medical Director for Surgery and Executive Lead on Safeguarding
Lynne Bowyer, Acting Directorate Manager for Paediatrics
Heather Owen Named Nurse for Safeguarding
PA Marilyn Sewell
Named Doctor Leigh Rabb
Named Midwives Carol White and Helen Melville
2 Local Forums – 1 for Good Hope, 1 for Heartlands and Solihul
The Forums are made up of representatives of all hospital departments, along with multi-agency representation. Each ward and unit is represesented by a link nurse who, in effect, acts as Heather Owen’s eyes and ears on the shop floor, driving forward training at every opportunity.
For more information on Heart of England's experience, please contact Abby Dacres on 01943 605976 or email info@safeguardingchildrenea.co.uk
