Clinical support services

Team: CWP Pharmacy, Lead Pharmacist Education and Training, Mersey Care NHS Foundation
Trust (FT), Educational Programme Director, Greater Manchester Mental Health NHS FT,
CMHT Clinical Pharmacist, Pennine Care NHS FT, Rehabilitation Network Pharmacist,
Lancashire and South Cumbria Mental Health NHS FT
Contact: jenny.hulme@nhs.net

What did we want to achieve?

The General Pharmaceutical Council’s (GPhC) new standards for the initial education and training (IET) of pharmacists require increased clinical placement opportunities for undergraduate pharmacy students to practice skills and embed knowledge. Undergraduate pharmacist training has traditionally been a knowledge-led course. New standards require a demonstration of competence across a range of core skills. The assessment uses an established competence and assessment hierarchy known as Miller’s triangle, with many competencies requiring evidence at the ‘does’ level. The group wanted to create a mental health workbook that could be used by any undergraduate pharmacist completing a mental health placement in any organisation.

What we did

This project brought five North West mental health trust pharmacy teams together to co-develop a flexible workbook to support increased access to undergraduate placements - shifting the focus of placements from knowledge to skills to support the new IET. Collaborators explored current opportunities and content of undergraduate mental health placements. They developed a workbook that provided opportunities for students to practice and develop core pharmacy skills to complement taught knowledge, in the context of mental health. The collaborative development of the workbook prompted all North West mental health trusts to re-evaluate their offer for undergraduate placements, supporting development of the future workforce.

Results

A workbook (with versions for students, tutors and model answers) mapped against the Health Education England Core Mental Health Competencies for Pharmacy Professionals, and the newly-published Entrustable Professional Activities, was produced. This provided a range of preparatory activities and a framework for local supervisors to support placement activities. As a coincidental output, a student safety card was developed to allow students to confidentially summarise relevant information for use in a medical emergency whilst on placement. As a result, there has been an increased number of mental health placements available as the workbook can be utilised in any mental health setting.

Next steps

• Evaluate the effectiveness of the undergraduate placements and workbook.
• Review and update the workbook in line with feedback from students and tutors.
• Work with the local schools of pharmacy to increase placement provision for mental health trusts.
• Maximise undergraduate placement provision at CWP, engaging more of the Pharmacy Team.
• Work with the new school of pharmacy at the University of Liverpool to influence the design of future undergraduate placements to ensure parity with acute trusts.
• Continue to collaborate as a North West team to produce material for both undergraduate placements and trainee pharmacists.

Team: Education, Learning and Development Team
Contact: cwp.educationcwp@nhs.net

What did we want to achieve?

The team wanted to improve the experience of people joining CWP by ensuring they had access to the right support, information, resources, and patient-safety-critical training at the very start of their journey with CWP, within a safe and protected learning space.

They also wanted to ensure the clinical teams who the Education, Learning and Development Team are here to support have new starters competent in mandatory skills, have completed systems training and have received ICT support before they reach the workplace for local induction. Key driver: In February 2024, after 12 weeks, only 51% of new starters had completed their mandatory training.

What we did

• Engaged with over 200 stakeholders across CWP to find out the elements of induction most valued by them.
• Designed the ‘Prepare to Care’ programme based on their feedback across 32 pathways defined by service and role to meet the needs of CWP’s dynamic and diverse workplace.
• Worked with colleagues across Clinical Support Services, including Recruitment, Human Resources, the Electronic Patient Record team and ICT to ensure the right support is available within the ‘Prepare to Care’ programme.
• Developed bespoke training programmes, including care planning, safety planning and therapeutic observation training.

Results

In June 2024, 91% of new starters had completed training and were ready to deliver person-centred care. 

Initial feedback and highlights over the first 12 months showed:

• staff value opportunity to meet the Chief Executive on day one
• workforce wellbeing sessions rated highest, with 93% finding it useful
• staff said it gave them the opportunity to build networks and feel part of CWP
• it provided quality person-centred training with dedicated time to complete
• a decrease in new starter calls to ICT from 3.5 contacts in February 2024 to 0 contacts in September 2024
• a decrease in the non-attendance rate on new starter mandatory training courses, from 20% in 2023 to 1% in 2024
• the retention of leavers within six months of start date improved from 27 leavers in April to September 2023 to 22 leavers in same period in 2024

Next steps

• Launching of additional programmes within ‘Prepare to Care’ including the Oliver McGowan training programme.
• Commencement of line manager engagement, with additional workshops on how to support new starters, including reasonable adjustments.
• Continued improvements and updates to learning environments, such as at Sycamore House and Soss Moss.
• Further work on mandatory and role-essential training to ensure content is valuable.
• Further background work to improve digital systems, supporting staff and reducing burden.
• Updating communications, working from the start of process with recruitment and beyond ‘Prepare to Care’ with new starters.

Team: Finance, Contracts and Procurement Team (Business and Value)
Contact: clare.shelley1@nhs.net 

What did we want to achieve?

The Finance, Contracts and Procurement Team wanted to make CWP the best place to work and recognised that they needed to ensure the team felt empowered to shape their workplace, make sure staff felt accepted for who they are, felt valued, and were recognised. 

At a development day, the Finance, Contracts and Procurement Team launched the Engage Programme which acts as a framework to everything they do to make CWP the best place to work. Key aspects include:

• creating an inclusive culture owned by the team
• continuous focus rather than short term goal
• seek out views - the People Promise states ‘everyone should have a voice that counts’
• adapt and innovate

What we did

This covers four key areas:

• Employee journey and experience – supporting personal and professional development. Talent management conversations alongside personal development reviews. Staff are supported by two Equality, Diversity and Inclusion (EDI) Ambassadors, including EDI celebration days.
• Recognition / celebration – Business and Value Hero Award nominated by colleagues and announced at monthly team meetings, highlighting why they have made a difference. The team also celebrates exam success and award nominations.
• Communication – staff have access to one-to-ones and a monthly Business and Value Team meeting. The ‘Big Conversation’ is used to focus on a collectively-owned action plan from the annual Staff Survey.
• Wellbeing – two Health and Wellbeing Leads providing resources from Action for Happiness, mindfulness and communications to support staff.

Results

The team has since been successful in obtaining one NHS Finance Level 2 Towards Excellence Accreditation (high level of performance) and working towards Level 3, which is Leading Edge Finance Function. Assessors quoted the Engage Programme as a key highlight for them. 
The team has been successful in the national innovation forum for innovations implemented within the team. This is shared with other organisations for best practice.

There have also been:

• many award nominations and shortlists locally and regionally for the team and individuals.
• Staff Survey results 
• positive feedback from a band 3 who shadowed the Clinical Engagement and Leadership Forum (CELF).

Next steps

The team continues to drive innovation and improvement from what has been learned. The team has supported CWP Succeed and Inspire programmes and is now looking to implement a library of training videos to support finance awareness. The remit of the project will shift to share what the team does externally. They have volunteered to present for NHS England on how they have implemented faster reporting which will support others. Feedback will be collated from the 2024 Staff Survey with another ‘Big Conversation’ to ensure they work towards a collective goal. There is an ambition to be a leading-edge function.

Team: Pharmacy Team
Contact: laire.kelty1@nhs.net 

What we wanted to achieve

The NHS Long Term Plan highlighted a need to grow pharmacy technician numbers to meet the increasing demand for patient-facing clinical pharmacy roles. As part of this, NHS England developed the Pharmacy Technician Workforce Programme to support the development of pre-registration pharmacy technicians across different healthcare settings. CWP’s Pharmacy Team identified this as an opportunity to collaborate with local acute trusts to develop the role of the pre-registration trainee pharmacy technician (PTPT). The aim was to give PTPTs a better understanding of mental health to contribute to growing a more adaptable workforce.

What we did

CWP has partnered with Wirral University Teaching Hospitals NHS Foundation Trust to train cross-sector PTPTs over the past four years and has successfully trained four PTPTs in this time.

The programme supports the development of PTPTs - gaining mental health experience in inpatient hospitals as well as with community mental health teams, home treatment teams, and neighbourhood services. Training is supervised by the experienced Clinical Pharmacy Technician Team which has helped to educate and support them with medicine reconciliation, named patient stock ordering, education around mental health therapeutic medication and patient counselling.

Students are supported to carry out a medicine safety audit. This includes omitted dose audit, high-dose antipsychotic treatment audit and medicine reconciliation audit. At the end of each rotation, students complete an evaluation form to allow the team to make improvements to the structure of the training programme.

Results

• Improved communication across trusts - leading to a cohesive, patient-centred approach.
• Shared learning across healthcare settings.
• Technicians spent time on wards across different trusts to see which processes could be adapted to improve their own trust processes.
• Training has developed skills around inhaler counselling, direct oral anticoagulant counselling and clozapine.
• The team has facilitated 182 student days.
• CWP pharmacy technicians have been able to lead education and supervision sessions.

Feedback includes: “I had a fantastic experience on my CWP rotation. I found the speciality and medicines very insightful”.

Next steps

The team would like to expand the number of PTPTs trained, and develop collaborative working with other partner organisations. They would like to grow their own pharmacy technician workforce in the future, expanding pharmacy technical services within CWP. They would also like to expand the workforce, introducing experienced pharmacy technicians to deliver clinics in the community.

Team: Electronic Patient Record Team
Contact: peter.hardy@nhs.net   

What we wanted to achieve

Promoting the national Electronic Patient Record (ePR) Survey so the results of the could help influence national policy and initiatives, put pressure on the system providers to improve as well as helping us plan how we continue to develop, support and train our systems locally.

What we did

All members of the ePR Team and some other members of the digital team emailed all colleagues they have worked with over the last 12 months to invite them personally to complete the survey. 

In addition to this, the survey was promoted on the front of SystmOne, EMIS, and staff Facebook using humorous Christmas-related posts to capture the interest of staff. 

Twelve different posts were used on the front page of clinical systems and the Staff Facebook page. These were mostly puns on Christmas songs and films were used in conjunction with the personalised emails.

Results

CWP submitted the third most responses of any Trust in England with a total of 824 responses submitted, and the engagement rate for CWP was number one when calculated as a percentage of the workforce.

Next steps

Once NHS England releases the results from the survey, this will be used to share areas identified as best practice with other trusts and more importantly, areas where the Trust has scored lowest will be prioritised for improvements.

This will include training, how support is provided, how new functionality is rolled out, as well as changes to the systems to make them more intuitive, easier to use and reduce the admin burden on staff.