Scottish Government

CHAPTER EIGHTEEN: TRAINING AND DEVELOPMENT

This section of the Action Framework concentrated on ensuring that the healthcare workforce receives high quality, appropriate, up to date training in caring for children and young people.

18.1 MILESTONES

Four milestones, from the Emergency Care Framework for Children and Young People and Delivering for Health, were set out in the Action Framework and consultees were asked whether they agreed with these milestones. Again, an overwhelming majority; over 90% of those responding at each question, did agree.

Staff providing emergency care to children and young people have achieved core skills and competencies by 2008

The time available to staff for training and the need for replacement staff to cover them, featured in 3 responses.

Consultees mentioned some specific core skills and competencies which, they felt, should be included in the training:

• dealing with children and young people in emergency situations (1 mention);
• dealing with children and young people with differing communication needs (1 mention);
• knowledge of the roles of each member of the MDT (1 mention);
• diversity issues (1 mention);
• equality issues (1 mention);
• the need of young carers (1 mention).

The maintenance of skills and competencies was mentioned by 2 consultees who asked how this will be achieved and measured, and an NHS Service Provider felt that joint training initiatives with the voluntary and local government sectors would be preferable. This consultee also requested that the core competencies be defined.

A Professional Body commented "This will be huge given the diversity of care core skills and competency. Will it be achievable and sustain the workforce? Extra resources and finances may be required for remote and rural areas."

Particular staff groups highlighted for inclusion in the educational framework included:

• SEN auxiliaries (2 mentions);
• classroom assistants (2 mentions);
• those providing out of hours primary care (1 mention).

Table 18.1
47: Staff providing emergency care to children and young people have achieved core skills and competencies by 2008

Base: All those responding in each category

Clear educational programme designed to address care competencies for all staff dealing with children and young people by 2006

The RCGP syllabus was suggested by 1 consultee as a resource for GP core competencies, while an NHS Service Provider noted "standards for asthma services for children and young people have developed some standards against which education will be recorded and audited and this is more measurable."

An NHS Board suggested that a wide range of staff across clinical disciplines should be included; one Local Authority asked "How inclusive is all 'relevant' staff and a Royal College thought that the competencies should be informed by all of the relevant multi-disciplinary team professional bodies.

One consultee questioned whether the timescale was realistic, and another wanted to see separate competencies for each group of staff.

Table 18.2
48: Clear educational programme designed to address core competencies for all staff dealing with children and young people by 2006

Base: All those responding in each category

NHS Boards to have arrangements in place to ensure all relevant staff are trained to appropriate level of competency by 2008

An NHS Board commented "Work based learning / e-learning and secondments should all be utilised to help with this." One consultee felt that delivery of the educational programme would be challenging and required to be well planned, another wondered whether this was a measurable milestone.

" NHS Board arrangements should be inclusive and fully funded across all relevant professional groups within the MDT such that all staff have equal access."
Royal College

Table 18.3
49: NHS Boards to have arrangements in place to ensure all relevant staff are trained to appropriate level of competency by 2008

Base: All those responding in each category

Educational packages to support the implementation of age appropriate care for children and young people by 2008

An Education Body felt that "This requires clarity" while an NHS Board suggested "This should complement Agenda for Change and KSF".

An Individual (Professional) felt that this and the preceding milestone were good ideas but that "No 50 requires to come first from a national perspective with realistic funding, resources and time scale to make it operationally manageable."

Table 18.4
50: Educational packages to support the implementation of age appropriate care for children and young people by 2008

Base: All those responding in each category

General comments regarding key milestones

The need for collaboration between HEIs, Health Boards and service providers was suggested by 2 consultees.

While an NHS Management & Strategy Group felt that the emphasis should be on a wider workforce, a Local Authority said "Clearly, these milestones are intended to refer to the NHS workforce, however with a wider audience this might become unclear and confusing."

The question of how the training will be provided, and who will provide it, was raised by an NHS Clinical Group while an Individual proposed a "Practice skills facilitator post, to ensure pre and post reg ongoing skills training in clinical areas".

Concern over timescales was expressed by 5 consultees and over funding by 2 consultees.

The issue of safety in the home was also raised by a Voluntary/ Charity Body who stressed "Appropriate home safety training is definitely required as this is the place children and young people are most at risk".

Training to enable staff to care for children with mental health, communication or learning disabilities was suggested by a Voluntary/ Charity Body. This consultee also saw an opportunity to invest in training for parents and carers.

18.2 ACTIONS

Four actions relating to education, training and development are set out in the Action Framework and consultees were asked to comment on these.

Educational Framework

Both an NHS Board and a Local Authority stressed that child protection training should be mandatory and a Public Body suggested a course on children's rights for all medical and support staff. An Education Body wanted to see more emphasis on competencies for those working with children included in health related undergraduate courses. Two consultees said that they would welcome better links with AHP course providers "to ensure all newly graduating staff have some basic knowledge of child development" ( NHS Clinical Group).

A Royal College suggested that AHPs and HEIs as well as professional bodies be involved in developing the educational framework.

"Given the range of staff requiring education ( OoH, CHPs ) and the lack of robust workforce numbers, we propose moving the timescale to 2007 and including a scoping of numbers of staff requiring education in this area."
NHS Management & Strategy

Core skills and competencies

Joint training targets for all staff working with children were suggested by a Local Authority who felt that the education and training actions were focussed on NHS staff only. However, an NHS Management & Strategy Body felt that this action should be reworded "We are unsure where the recommendation 'other providers should develop programmes to ensure' fits with NES action points 84, 86, 87. We suggest rewording to: ' NHS Boards should have plans to ensure'." and another asked who would have responsibility for ensuring that 'other providers' address the action.

Cover for staff attending training was again mentioned; two consultees referred to the problems of providing cover; one felt there needed to be a range of opportunities available while the other stressed the need for additional resources for both training and staff cover.

While a Royal College felt all multi-disciplinary team staff should have equal access to training, a Professional Body expressed reservations and said they would "see this as a retrograde step rather than the pursuance of a well resourced specialist and specific workforce."

Supporting the development of new roles and models of care

A collaborative approach across all relevant professional groups in the development of new roles and models of care was suggested by 3 consultees. Specific roles mentioned were AHP consultants, peer educators, nurse consultants, key workers and lay support.

Educational framework and training programme for adolescent care

An NHS Service Provider commented "For the programmes for adolescent care and new roles, teleconferencing and distance learning should be promoted with the infrastructure to support this available within all centres."

A Royal College again suggested that all relevant professional groups be involved in this development.

General comments on actions relating to education, training and development

Three consultees noted the need for joint working in relation to this action. As noted by one Local Authority "Consideration should be given to ensuring that the actions in this section are as far as is possibly done jointly with social work and others." The content should also reflect the multi-disciplinary nature of care for children and young people; a Professional Body commented "Education and training frameworks and programmes should contain an appropriate mix of uni- and multi-disciplinary content." A Voluntary/ Charity Body felt it was " Important to provide a whole range of training processes, learning styles e.g. job shadowing/ class room courses".

A detailed response was received from an NHS Clinical Group on the availability of respiratory training; some training is only available via distance learning and can be expensive to access.

Education for children in hospital or recuperating at home was described as 'vital' by an Education Organisation, and they also commented on the need to take a holistic view of each individual.

Involving RPGs to ensure sustainability and co-ordination across a region was seen as important, especially for remote and rural areas; an NHS Management & Strategy Group commented on this issue while a Voluntary/ Charity Body commented on the need to ensure continuity and coherence in content across Scotland. Two consultees asked "Could some of this work be done at a national level to avoid duplication?" (Professional Body)

In order to meet the objectives in this section of the Action Framework, one Local Authority wanted to see accelerated training programmes.

A Voluntary/ Charity Group pointed out that there was no mention of training "to enable staff to deal skilfully with needs of children with complex needs or learning disabilities e.g. alternative communication".