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Trust creates a standardised training framework for all their Clinical Support workers, helping them to acquire new skills and thereby improve patient experience


    • Inequity of pay grades
    • Multiple job descriptions
    • No internal quality assurance of training and lack of standardisation of training programme for Health Care Assistants (HCA)
    • Improve the care given by all support Health Care Assistants


    • Created approximately 35 competency frameworks and developed them into workbooks and e-learning
    • Introduced the Framework to all new starters in April 2012 and used Annex U as a Training Post
    • Provided the local competencies to all existing 1,300 HCAs
    • Introduced a robust framework audit process


    • All new starters employed since 2012 undergo a 2-3 year Framework, have one job description and are all trained to the same standard
    • 100% of the learners thought it very likely that they would apply newly acquired information to their workplace
    • 100% of the learners reported that they have acquired new skills

As soon as we were aware of the pending Francis report in 2012 the Trust has been continually striving to improve the care given by all support Health Care Assistants. We developed and introduced our own competency framework, see below:

•Local competencies core and specific. These are available through ESR Elearning and Workbooks and we have around 35 locally agreed competencies available that are specific to our client needs.

•The use of annex u in Agenda for Change

•One job description

•Working with a variety of providers if need be

•Accessing relevant funding streams.

•Using e-portfolio opportunities

•Aligning local training to Diploma Level 3 in health and social care and literacy and numeracy Level 2.

•Blended methods of learning.

•Recently this has been mapped to the care certificate

•A 2 year training programme for all new starters

•The use of a Return on investment methodology to measure impact of training.

•CRES savings for clinical services achieved.

•In 2015 rolled out to all community Health Care Assistants and currently working on AHP Support Staff.

•Have used Health Education England Talent for Care Strategy to action plan the future developments of our framework.


•Inequity of pay grades

•Multiple job descriptions

•No internal quality assurance of training for this group of staff

•No standardisation of training programme for this group of staff

•Limited opportunities to value bands 1 to 4


•Total involvement of the services, management and staff side

•Aligning the whole framework to meet our specific clients needs as well as national recommendations

•We wanted to have a standardised framework for all which was auditable and achievable

•To be the preferred employer provider within the region of which Health Care Assistants would take pride in working for

•Increase all opportunities to value our bands 1 to 4


•The success rates of completion of the framework

•Investment in over 1400 existing Health Care Assistant staff as well as new starters

•Standardised level of training and development

•Through introduction of the framework it has opened opportunities for other support staff e.g. business administration training

•Vast increase in the number of staff working at level 2 maths and English


For the first three years there was a very detailed financial breakdown of costs and savings which was achieved.

Below is a sample of Return on Investment evaluations

100% of the learners thought it very likely that they would apply newly acquired information to their workplace. 100% of the learners reported that they have acquired new skills. 75% of learners stated that they are very likely to apply newly acquired skills in their workplace with 25% stating that they are likely to. Two learners provided comments to this question which asked what specifically are you going to do differently after attending this development.

The replies are “the way I talk to people/service users, after listening to an ex-service user” and “change the way I study and apply to workplace certain skills”. Doing the course it has helped me to understand ways and techniques to help the two patients I look after, by performing these techniques it will help the patient to remain calm and relaxed.

In detail

1 for all and all 4 One.


TEWV were very clear right back in 2011 that they wanted to be at the forefront nationally in creating an innovative training framework for all their Clinical Support workers. Throughout 2011 the press had been reporting on Care Practice Scandals and TEWV did not want to wait for the recommendations, therefore they researched all the National information about pending changes in order to implement their new Framework from April 2012. Our rationale throughout the development stage focused on ensuring our framework would improve the care all our clients would receive. As well as being focussed on national best practice evidence such as Core Principles of Care i.e., compassion, respect, dignity, TEWV wanted also to ensure the training was personalised to their clients.

This was the major focus on getting the project right. Therefore the Workforce Development Team worked alongside and involved staff from the Specialties to produce local competencies. We produced approximately 35 competencies and developed them into workbooks and e-learning(Please see supplementary evidence for workbook example). Each Speciality picked their own Framework from the local Core and Specific competencies. This Framework was to be undertaken in the workplace using their daily practice to inform competence.

The evaluation of proven competence was jointly agreed through reflective practice with a supervisor. There has been a huge interest in the framework for the Union learning reps in the Trust who sit on the Trust lifelong learning group and the band 1-4 developments is a regular agenda item( Please see supplementary evidence). We also have experts by experiencing delivering their life story of the study days for the HCAs. We also provided an academic component to the Framework;

•NVQ 3 Diploma in Health & Social Care

•Literacy and Numeracy 2

•Care Certificate (introduced 2015) We introduced the Framework to all new starters in April 2012 and used Annex U as a Training Post. However we also provided the local competencies to all existing 1,300 H.C.A.s. Total Figures: Completed Full Framework - 466 Completed Competencies - 636 Literacy 2 - 631 Numeracy 2 - 517

Outcome and Value

•All new starters employed since 2012 undergo a 2-3 year Framework, have one Job Description and are all trained to the same standard.

•We also used a three year financial CRES Scheme – as all new starters were recruited on Annex U. This gave substantial savings to the Trust at the same time as increasing our confidence in producing a safe and exceptionally well trained support workforce.

•Return On Investment – Our staff are sent evaluation forms at the end of their training in order to get a more detailed evaluation about the impact of the Framework on the staff and service users( please see supplementary evidence).

 •Recognition ,Sharing and Replicable NHS Employers were interested in approaching us 2 years into the Framework, and writing a case study Isle of Wight – Invited TEWV to attend, Isle of Wight NHS Trust to give a presentation on the Framework as they had heard about it and wanted to replicate many of the components (Please see supplementary evidence of the presentation). Trust Award – The Framework was awarded the Trust Celebration Award 2015 for “Working behind the scenes”. Talent for care strategy- Following the introduction of the Talent for Care Strategy, TEWV have extended their work, which started with the Framework, into valuing all bands 1-4. The first annual conference took place in October 2015 and aligned to TEWV Talent for Care Action Plan. The conference was a success and is now named 1 for all and all 4 One.

The next conference is planned for the New Year to address more career progression opportunities. Professor Kessler was undertaking a review of Talent for Care with Kings College London and requested to attend the conference to interview our staff as part of his research. We have also used the framework for Medical secretaries training and are currently rolling out a framework for all Allied health Professional support staff. Ongoing The framework keeps growing and developing. We review the competencies regularly against policy and local and national drivers and change. We have introduced a robust framework audit process where an independent member of staff undertakes a sample of completers and visits to interview the member of staff, supervisor and see paperwork.


Focus of improvement

Support service (non-clinical)

Type of organisation


Key individuals

Judith Hurst