This document is a UK-wide workforce training framework (CSTF) published by Skills for Health that sets minimum standards for statutory and mandatory training subjects for healthcare staff, including equality and diversity, health and safety, fire safety, infection control, moving and handling, safeguarding adults and children, resuscitation, information governance, and violence/aggression. It is directed at healthcare organisations and their learning and development leads, specifying learning outcomes, refresher training frequencies, delivery methods, and trainer qualifications for each subject area. It does not license or regulate any specific healthcare facility type; rather, it governs the training content and competency standards that healthcare organisations must ensure their staff meet.
View official sourceUK Core Skills Training Framework Statutory/Mandatory Subject Guide Version 1.6.2 Page 2 Version control summary Version No Date Comments 1.0 March 2013 Original release of the Framework. 1.1 April 2014 Updates to ensure references to legislation and expert guidance remained current and to provide greater clarification where needed. Some minor amendments to learning outcomes noted in Appendix 1 of version 1.1. 1.2 September 2014 Subject 8: Safeguarding Adults – addition of a new Level 2. Subject 9: Safeguarding Children – significant additions and amendments to align with the Intercollegiate Document (2014) Other minor updates and clarification where needed. 1.3 March 2016 Subject 8a: Preventing Radicalisation added as a new subject Other minor updates and clarification where needed 1.4 October 2017 Subject 8a Preventing Radicalisation – updated to reflect minor amendments in the NHS England Prevent Training and Competencies Framework (2017). Subject 11 Information Governance – updated to reflect the decommissioning of the NHS IG Training Tool (NHS Digital) CSTF User Guide incorporated into this subject guide. Other minor updates and clarification where needed. 1.4.2 May 2018 Subject 11 Information Governance – addition of GDPR. 1.4.3 July 2018 Subjects 12 and 13 Information Governance – addition of GDPR. 1.5 October 2018 Subject 1: Equality, Diversity and Human Rights – updated to include reference to statutory guidance to support the autism strategy. Subject 8: Safeguarding Adults – updated to align with Adult Safeguarding: Roles and Competencies for Health Care Staff (2018) with the addition of a Level 3. Subjects 11, 12 and 13 Information Governance – updated to reflect current guidance for data security. 1.6 June 2019 Subject 9: Safeguarding Children – significant additions and amendments to align with the Intercollegiate Document (2019) Subject 10: Resuscitation – minor changes to Level 2 – Newborn Basic Life Support / Learning Outcomes (b) and (f) 1.6.1 December 2020 Subject 7: Moving and Handling amended with addition of frequencies for refresher training/assessment. 1.6.2 June 2021 Amended to align with changes to CSTF (England) v1.1. A summary of key amendments in this Version 1.6.2 is presented in Appendix 2: Version Control. The Core Skills Training Framework (CSTF) is available for any individual or organisation to access. Current information and access to current CSTF documents is always available from the Core Skills Frameworks web page at: https://skillsforhealth.org.uk/info-hub/category/core-skills-training-framework-cstf/ Page 3 Acknowledgements This framework builds upon the substantial and excellent activity originally undertaken in the devolved countries and health regions in England in seeking to design and develop common guidance for enhancing the quality and delivery of statutory and mandatory training. This framework also benefits from initial developments which commenced in the London region. The Representatives who were involved in this activity have shared their expertise willingly to inform and support the development of the framework offered here, and Skills for Health gratefully acknowledges this substantial contribution (see appendix 3). About Skills for Health Skills for Health, a not-for-profit organisation, is committed to the development of an improved and sustainable healthcare workforce across the UK. Established in 2002 as the Sector Skills Council for the UK health sector, Skills for Health helps to inform policy and standards focusing on health, education and improving the wider wellbeing of public health. If you would like further information about how Skills for Health might support you with the implementation of this framework or other workforce development issues please visit: www.skillsforhealth.org.uk Copyright © 2021 Skills for Health. All Rights Reserved Page 4 UK Core Skills Training Framework Statements of Support The Independent Healthcare Advisory Services (IHAS) welcomes the introduction of the UK wide Core Skills Framework. This will provide all healthcare organisations with the benefit of ensuring consistent approaches to statutory mandatory training providing agreed and consistent periods for refresher training and reducing costs due to unnecessary duplication of learning. Sally Taber, Director of Independent Healthcare Advisory Services The National Association of Healthcare Fire Officers welcomed the request by Skills for Health to be involved in the development of the UK core skills training framework. Any document that strives to improve, develop and set out objectives and training outcomes has to be endorsed. The framework will assist healthcare organisations to achieve statutory compliance with regards to fire safety training. The Infection Prevention Society welcomes the UK core skills training framework developed by Skills for Health. The Infection Prevention Society acknowledges that this framework does not attempt to cover all aspects of infection prevention and control. However following the framework can assist organisations in reviewing and developing their training arrangements. The Health and Safety Executive welcomes the UK core skills training framework developed by Skills for Health. The framework does not attempt to cover all health and safety risks and may go further than the minimum you need to do to comply with the law. However, following the framework will help organisations review and develop their training arrangements and make health and safety improvements in their business. The National Back Exchange has welcomed the opportunity to work with Skills for Health in developing the UK Core Skills Training Framework. We recognise that this framework builds upon other developments which have had benefit in establishing common guidance and which have been well received by healthcare organisations. While the National Back Exchange recognises that this framework does not attempt to cover all aspects of moving and handling the use of the framework can assis t organisations in reviewing, planning and developing their training in moving and handling arrangements. Resuscitation Council (UK): We are pleased to indicate that the information provided in the Resuscitation subject included in this framework has been supported by the Resuscitation Council (UK). Page 5 Contents Introduction ................................ ................................ ................................ ................................ .............. 6 Governance of the CSTF ................................ ................................ ................................ .......................... 7 Core Skills Subjects and Organising Structure ................................ ................................ ......................... 8 Subject 1: Equality, Diversity and Human Rights ................................ ................................ ............. 13 Subject 2: Equality, Diversity and Human Rights (Scotland) ................................ ............................ 16 Subject 3: Health, Safety and Welfare ................................ ................................ ............................. 19 Subject 4: NHS Conflict Resolution (England) ................................ ................................ ................. 23 Subject 5: Fire Safety ................................ ................................ ................................ ...................... 26 Subject 6: Infection Prevention and Control ................................ ................................ ..................... 30 Subject 7: Moving and Handling ................................ ................................ ................................ ...... 34 Subject 8: Safeguarding Adults (Version 2) ................................ ................................ ..................... 39 Subject 8a: Preventing Radicalisation ................................ ................................ .............................. 45 Subject 9: Safeguarding Children (Version 3) ................................ ................................ .................. 49 Subject 10: Resuscitation ................................ ................................ ................................ ................ 57 Subject 11: Information Governance and Data Security................................ ................................ ... 63 Subject 12: Information Governance (Scotland) ................................ ................................ .............. 66 Subject 13: Information Governance (Wales) ................................ ................................ .................. 68 Subject 14: Violence and Aggression (Wales) ................................ ................................ ................. 70 Appendix 1: User Guide ................................ ................................ ................................ ......................... 74 Appendix 2: Version Control ................................ ................................ ................................ ................... 83 Appendix 3: Summary of Subject Matter Expert Bodies consulted ................................ ......................... 86 Appendix 4: Other standards and frameworks ................................ ................................ ........................ 87 Appendix 5: Glossary ................................ ................................ ................................ ............................. 88 Page 6 Introduction Purpose of Document This document sets out a framework for use by healthcare organisations to help guide and standardise the focus and the delivery of key statutory and mandatory training skills. The intention in providing this framework is that healthcare organisations will be able to review their current arrangements for defining and delivering training in relation to the identified subject areas, and through the adoption of the framework align their approaches. Where such alignment is undertaken it should then have benefits for healthcare org anisations in ensuring consistent approaches, promote quality and delivery of training which, through the use of learning outcomes, should be more educationally focused and valued. It is expected that the adoption of this framework will help promote organisational and system wide efficiencies by encouraging the health sector to recognise training which meets recognised standards and in doing so help contribute towards preventing unnecessary duplication. Target Audience This framework should be of particular value to: • Chief Executives and Executive Leads for Human Resources, Organisational Development and Workforce Education: in setting out the minimum training standards that effective healthcare organisations should ensure are in place in relation to the training subjects identified to support them in being able to meet common compliance requirements. • Learning and Development Leads: in helping them to feel confident in planning, targeting and scheduling the delivery of training activity in relation to the training subjects identified, support resource utilisation and guide evaluation approaches to monitor the impact of any training undertaken. • Subject Matter Experts: in helping them to plan and design the delivery of training, ensuring that training is focused upon learning outcomes which are relevant and measurable. This framework should also be helpful to Subject Matter Experts in helping staff understand the purpose of and appreciating the relevance of the training undertaken. • Healthcare Managers: in helping to reinforce the purpose and value of this type of training and the required knowledge and skills performance that their staff should be expected to demonstrate on completion of any training received in relation to the subject areas included. Where an organisation adopts the framework Healthcare managers can also use it as an aid in determining priorities during any Personal Development Discussions. • Education Providers: in helping those supporting the development of the future workforce in being able to integrate the framework as part of their curriculum delivery. This will help ensure that learners undertaking or completing healthcare education programmes are being supported to develop the knowledge and skills required to support their safety when on placement and/or their future employability skills. Page 7 Governance of the CSTF Since 2013, the Core Skills Training Framework (CSTF) has become widely recognised as a national minimum standard for statutory/mandatory training in the health sector. Health Education England and Skills for Health are now working in partnership to further develop the CSTF, to ensure the scope of the CSTF remains relevant to the future workforce and the commitments in the NHS Long Term Plan to enable staff to move more easily from one NHS Employer to another. The aim is to further clarify and consolidate current CSTF guidelines with the expectation that all NHS Trusts in England will ultimately be aligned to the CSTF, and to enable the more effective ‘portability’ of training records and efficiencies in staff movement. Skills for Health remains responsible for maintaining the UK CSTF and developing future CSTF content, tools and processes. Future management and development of the CSTF will be guided by a steering group which will comprise representatives of key stakeholder organisations including Health Education England, Skills for Health, NHS England and NHS Improvement, ESR Central Team, E-Learning for Healthcare, Unions and NHS Providers. The purpose of the steering group is to provide strategic direction for the future development and maintenance of the CSTF. This will include consideration of any changes to CSTF scope and processes and the implications for the national, regional and system-wide approaches to enabling staff movement. Page 8 Core Skills Subjects and Organising Structure This UK Core Skills Training Framework (CSTF) Statutory/Mandatory Subject Guide, sets out for each identified skill area, an organising structure which offers: • a context statement • current policy and legal references with hyperlinks • relevant target audience • key learning outcomes • proposed frequency of refresher training or assessment • suggested standards for training delivery • identification of any available National Occupational Standards Utilising this organising structure will be helpful in encouraging a quality driven and consistent approach. The organizing structure will also aid keeping the framework updated, with the ability to make changes only to the relevant sections as they occur. The guidelines offered here reflect the minimum standards expected. Many healthcare organisations will already meet and exceed these guidelines, and it is not the intention of this guidance to disturb this. It is also important to note that for social care staff there are Codes of Practice and standards for induction which must be met and which have been agreed at country level (Appendix 4). The implication of this is that for those social care staff working in integrated health and social care teams they will be expected to meet these standards. The link with the guidance offered in this framework is that it provides the suggested learning outcomes that should be used to help guide and design training interventions, the completion of which might then contribute towards the achievement of the indicated code and standards where applicable. For the health sector, the Core Skills Training Skills Framework will be helpful in establishing health sector wide minimum standards for the indicated subjects. In addition, the further guidance included will help enable the mechanisms and quality assurance processes to be put in place which will then support consistency, efficiency and also enable potential recognition of training. Table 1 overleaf identifies the subjects included in the framework and gives recommendations in relation to the proposed target audience, frequency of refresher training and training methods. Page 9 Table 1: Summary of Subjects The table below summarises the target audience and proposed frequency of refresher training for each subject. CSTF alignment requires the learning outcomes for each CSTF subject to be met. In general, the CSTF does not prescribe training methods - however, some subjects will require a practical training component. The table therefore indicates the extent to which e-learning is appropriate as an option for training delivery and where practical instruction is a requirement. Subject Audience Proposed frequency of refresher training Comments on training delivery 1. Equality, Diversity and Human Rights All staff, including unpaid and voluntary staff 3 Years Elearning can cover alignment to CSTF learning outcomes. 2. Equality and Diversity (Scotland) All staff, including unpaid and voluntary staff 3 Years Elearning can cover alignment to CSTF learning outcomes. 3. Health, Safety and Welfare All staff, including unpaid and voluntary staff 3 years Elearning can cover alignment to CSTF learning outcomes. Further job specific training may be needed based upon local risk assessment. 4. NHS Conflict Resolution (England) Frontline NHS staff and professionals whose work brings them into direct contact with members of the public 3 Years Elearning can support delivery of knowledge aspects of learning outcomes. Practical instruction also required. 5. Fire Safety All staff, including unpaid and voluntary staff Induction: Site specific training followed by regular updated fire safety training. Staff who may need to help evacuate others, should receive training more frequently than those who may only be required to evacuate themselves. The frequency of refresher training should be determined by training needs and risk analysis with an assessment of competence at least every 2 years Elearning can support delivery of knowledge aspects of learning outcomes. Practical instruction also required e.g. evacuation techniques and use of firefighting equipment. Supplemented by specific job/site training as necessary to ensure safe working practices. 6. Infection Prevention and Control Level 1: All staff including contractors, unpaid and voluntary staff Level 2: All healthcare staff groups involved in direct patient care or services 3 years 1 year Elearning can cover alignment to CSTF learning outcomes. Page 10 Subject Audience Proposed frequency of refresher training Comments on training delivery 7. Moving and Handling Level 1: All staff, including unpaid and voluntary staff Level 2: All staff, including unpaid and voluntary staff whose role involves patient handling activities 3 years (for load handling staff) 2 years Elearning can support delivery of knowledge aspects of learning outcomes. Practical instruction also required for staff involved in load handling and patient handling activities. 8. Safeguarding Adults (Version 2) Level 1: All staff working in health care settings Level 2: All practitioners who have regular contact with patients, their families or carers, or the public. Level 3: Registered health care staff who engage in assessing, planning, intervening and evaluating the needs of adults where there are safeguarding concerns (as appropriate to role). 3 years 3 years 3 years Level 1: Elearning can cover alignment to CSTF learning outcomes. Level 2: Elearning can cover alignment to CSTF learning outcomes. Level 3: Elearning can support delivery of knowledge aspects of learning outcomes. 8a Preventing Radicalisation Basic Prevent Awareness: All clinical and non-clinical staff that have contact with adults, children and young people and/ or parents/carers. Prevent Awareness: All staff who could potentially contribute to assessing, planning, intervening and evaluating the needs of an adult or child where there are safeguarding concerns 3 years 3 years Initial training within 12 months of starting in relevant role with appropriate updating/briefing at least annually. Basic Prevent Awareness: Elearning can cover alignment to CSTF learning outcomes. Can also be incorporated into an organisation’s Safeguarding training. Prevent Awareness should be delivered by attendance at a Workshop to Raise Awareness of Prevent (WRAP) or by completing an approved elearning package Page 11 Subject Audience Proposed frequency of refresher training Comments on training delivery 9. Safeguarding Children (Version 3) Level 1: All staff working in health care settings. Level 2: All non-clinical and clinical staff who have any contact (however small) with children, young people and/or parents/carers or any adult who may pose a risk to children. Level 3: Clinical staff (working with children, young people and/or their parents/ carers and/or any adult who could pose a risk to children), who could potentially contribute to assessing, planning, intervening and/ or evaluating the needs of a child or young person and/or parenting capacity (regardless of whether there have been previously identified child protection/safeguarding concerns or not). 3 years 3 years 3 years E-learning is appropriate to impart knowledge at levels 1 and 2. At Level 2, training, education and learning opportunities should also include multi- disciplinary and scenario-based discussion. At level 3, Elearning can be used as preparation for reflective team- based learning. At level 3, learning should be multi- disciplinary and inter- agency, including opportunities for personal reflection, scenario-based discussion, drawing on case studies etc. 10. Resuscitation Level 1: Any clinical or non- clinical staff, dependent upon local risk assessment or work context Level 2: Staff with direct clinical care responsibilities including all qualified healthcare professionals Level 3: Registered healthcare professionals with a responsibility to participate as part of the resuscitation team 1 year 1 year 1 year A variety of methods can be used for annual updates (including E- Learning). At levels 2 and 3, practical instruction i.e. ‘hands-on’ simulation training and assessment is recommended for clinical staff. 11. Information Governance and Data Security All staff involved in routine access to information 1 year Elearning can cover alignment to CSTF learning outcomes. 12. Information Governance (Scotland) Foundation: Support Staff Roles Intermediate Level 1: Clinical, Administrators and Managers Required refresher periods based upon local assessment Elearning can cover alignment to CSTF learning outcomes. Page 12 Subject Audience Proposed frequency of refresher training Comments on training delivery 13. Information Governance (Wales) All staff including unpaid and voluntary staff 2 years Elearning can cover alignment to CSTF learning outcomes. 14. Violence and Aggression (Wales) Module A – Induction and Awareness Raising: All staff. including those on honorary contracts, unpaid and voluntary staff Module B – Theory of Personal Safety and De- escalation. Required staff based upon local risk assessment and training needs analysis Module C – Breakaway. Required staff based upon local risk assessment and training needs analysis Induction followed by refresher periods based upon local assessment Elearning can support delivery of knowledge aspects of learning outcomes. Practical instruction also required. Return to contents page Page 13 Subject 1: Equality, Diversity and Human Rights 1.1 Context Statement Equality is about creating a fairer society where everyone has the opportunity to fulfil their potential. Diversity is about recognising and valuing difference in its broadest sense. Human rights are the leg al rights and freedoms that individuals can expect to enjoy, can exercise and are based on core principles such as dignity, fairness, equality, respect and autonomy. Equality, Diversity and Human Rights are entirely relevant to day -to-day life and provide the framework which protects the freedom for individuals to control his/her own life, prevent discrimination and set expectations for enabling fair and equal services to and from public authorities. The health sector has a responsibility to ensure delivery of services and workforce management which fully demonstrate and reflect the principles of equality, diversity and human rights. It is through the active and effective understanding of Equality, Diversity and Human Rights that the health sector will be ab le to recruit and retain a workforce that is more reflective of and sensitive to the population it seeks to serve. 1.2 Current Legal or Relevant Expert Guidance Legislation – UK Wide • Equality Act 2010 • Human Rights Act 1998 Legislation – Northern Ireland • Employment Equality (Sex Discrimination) Regulations (Northern Ireland) 2005 • Employment Equality (Sexual Orientation) Regulations (Northern Ireland) 2003 • Northern Ireland Act 1998 • The Employment Equality (Age) Regulations (Northern Ireland) 2006 • The Equality Act (Sexual Orientation) Regulations (Northern Ireland) 2006 Legislation – Wales • Government of Wales Act • Wales Public Sector Duties Key Guidance – England • Department of Health Human Rights in Healthcare • Department of Health (2015), Statutory guidance for Local Authorities and NHS organisations to support implementation of the Adult Autism Strategy • HM Government (2014), Think Autism: Fulfilling and Rewarding Lives, the strategy for adults with autism in England: an update. • NHS Constitution • NHS England (2015), Accessible Information Standard • NHS England (2015), NHS Workforce Race Equality Standard • NHS England (2015), The Equality Delivery System • NHS England (2015), Monitoring Equality and Health Inequalities: A Position Paper Page 14 • NHS England, Workforce Disability Equality Standard • Skills for Health and HEE (2019), Core Capabilities Framework for Supporting Autistic People • Skills for Health, HEE and NHS England (2019), Core Capabilities Framework of Supporting People with a Learning Disability Key Guidance – Wales • Equality information: A guide for listed public authorities in Wales • Assessing Impact and the Equality Duty – A guide for listed public authorities in Wales • Equality Objectives and Strategic Equality Plans (SEPs) Expert Organisations • Equality and Human Rights Commission (England, Wales) • Equality Commission for Northern Ireland • NHS Employers • The NHS Centre for Equality and Human Rights 1.3 Target Audience All staff, including unpaid and voluntary staff. 1.4 Key Learning Outcomes The following learning outcomes reflect a minimum standard which should be incorporated into equality, diversity and human rights education and training for all staff groups. The learner will: a) understand the terms of Equality and Diversity and Human Rights and how they are applied within the context of the health sector b) understand how a proactive inclusive approach to equality and diversity and human rights can be promoted c) understand the purpose and benefits of monitoring equalities and health ineq ualities d) understand the benefits that an effective approach to equality and diversity and human rights can have on society, organisations and individuals e) understand how legislation, organisational policies and processes can empower individuals to act appro priately and understand people’s rights f) know how to treat everyone with dignity, courtesy and respect and value people as individuals g) know what to do if there are concerns about equality and diversity practices, including how to use any local whistle blowing policy procedures and other related policies such as Bullying at Work and Dignity at Work For Wales only: h) understand the Public Sector Equality Duties Page 15 1.5 Proposed Frequency of Refresher Training or Assessment Proposed Refresher Period It is recommended that equality and diversity refresher training for all staff groups should take place at a maximum of every 3 years. Where staff are changing roles and have more direct accountability for Human Resources, staff management and service delivery, they may need to undertake refresher and/or receive specific training ahead of any scheduled update. Wherever possible, such training should also coincide with a much broader review of the organisational approach to equality, diversity and human rights. Organisational Implications: Each healthcare organisation will need to determine the required refresher training periods, ensuring that any agreed training schedule is incorporated into their local policy. Refresher training will be indicated for all staff if there is a change in Equality, Diversity and Human Rights Legislation nationally or an organisation has amended its policy locally. Assessment of Competence • Where a staff member or learner can demonstrate through robust pre-assessment, including where relevant practical assessment, the required level of current knowledge, understanding and practice, then this can be used as evidence that knowledge and skills have been maintained and the staff member may not need to repeat refresher training. • Where a staff member or learner does not meet the required level of current knowledge, understanding and practice through pre-assessment they should complete the refresher training and any associated assessments required. 1.6 Suggested Standards for Training Delivery The employing organisation should be assured that Learning Facilitators who are involved in the delivery of Equality, Diversity and Human Rights education or training have the appropriate experience, background and qualifications to deliver training to a satisfactory standard. For guidance, this may include the following: • A current and thorough knowledge of Equality, Diversity and Human Rights legislation and an understanding of its application and effective practice within a healthcare setting. • Experience of teaching and learning, including the ability to meet the competences expected for LSILADD04 Plan and prepare specific learning and development opportunities. • A relevant qualification in Equality, Diversity and Human Rights such as, for example, the I LM Level 4 in Managing Equality and Diversity. Where any training delivery is supported by a person who is not an expert in the subject, then the organisation should ensure that they have put in place a quality assurance mechanism, whereby the accuracy of the content and the effectiveness of its delivery has been quality assured and is subject to periodic observation. 1.7 Relevant National Occupational Standards Relevant National Occupational Standards • SCDHSC0234: Uphold the rights of individuals • SS01: Foster people’s equality, diversity and rights • SCDHSC0045: Lead practice that promotes the safeguarding of individuals Return to contents page Page 16 Subject 2: Equality, Diversity and Human Rights (Scotland) 2.1 Context Statement Equality is about creating a fairer society where everyone has the opportunity to fulfil their potential. Diversity is about recognising and valuing difference in its broadest sense. Human rights are the legal rights and freedoms that individuals can expect to enjoy, can exercise and are based on core principles such as dignity, fairness, equality, respect and autonomy. Equality, Diversity and Human Rights are entirely relevant to day-to-day life and provide the framework which protects the freedom for individuals to control his/her own life, prevent discrimination and set expectations for enabling fair and equal services to and from public authorities. The health and care sector has a responsibility to ensure delivery of services and workforce management which fully demonstrate and reflect the principles of equality, diversity and human rights. Equality, diversity and human rights are essential underpinnings of quality care and contribute to improved outcomes. It is through the active and effective understanding of Equality, Diversity and Human Rights that the health sector will be able to recruit and retain a workforce that is more reflective of and sensitive to the population it seeks to serve. 2.2 Current Legal or Relevant Expert Guidance Legislation – UK Wide • Equality Act 2010 • Human Rights Act 1998 Legislation – Scotland • Patient Rights (Scotland) Act 2011 • Public Bodies (Joint Working) (Scotland) Bill • Scottish Public Sector Equality Duties Key Guidance – Scotland • Codes of practice for the Equality Act and the Equality Duty • Equally Well – Scotland’s Framework on Health Inequalities • NHS Education Scotland, Inclusive Education and Learning • Public Health Scotland, Improving health • NHS Scotland, Everyone Matters: 2020 Workforce Vision • Route Map to the 2020 Vision for Health and Social Care • Scottish Health Council, Participation Standard • Scottish Human Rights Commission, Care about Rights • Scotland’s National Action Plan for Human Rights (SNAP) Expert Organisation • Equality and Human Rights Commission, Scotland • The Scottish Human Rights Commission • NHS Education Scotland Page 17 2.3 Target Audience All staff, including unpaid and voluntary staff 2.4 Key Learning Outcomes The following learning outcomes reflect a minimum standard which should be incorporated into equa lity and diversity education and training for all staff groups: The learner will: a) understand key concepts and principles in equality, diversity and human rights and how they are applied within the context of the health sector b) understand how a proactive inclusive approach to equality and diversity and human rights can be promoted c) understand the benefits that an effective approach to equality and diversity and human rights can have on society, organisations and individuals d) understand how legislation, organisational policies and processes can empower individuals to act appropriately and understand people’s rights e) know what the equality duties mean for you at work f) know how to treat everyone with dignity, courtesy and respect and value people as individuals g) know what to do if there are concerns about equality and diversity practices, including how to use any local whistle blowing policy procedures and other related policies such as Bullying at Work and Dignity at Work. 2.5 Proposed Frequency of Refresher Training or Assessment Proposed Refresher Period It is recommended that equality and diversity refresher training for all staff groups should take place at a maximum of every 3 years. Where staff are changing roles and have more direct accountability for Human Resources, staff management and service delivery they may need to undertake refresher and/or receive specific training ahead of any scheduled update. Wherever possible, such training should also coincide with a much broader review of the organisational approach to equality, diversity and human rights. Organisational Implications: Each healthcare organisation will need to determine the required refresher training periods, ensuring that any agreed training schedule is incorporated into their local policy. Refresher training will be indicated for all staff if there is a change in Equality, Diversity and Human Rights Legislation nationally or an organisation has amended its policy locally. Assessment of Competence • Where a staff member or learner can demonstrate through robust pre-assessment, including where relevant practical assessment, the required level of current knowledge, understanding and practice, then this can be used as evidence that knowledge and skills have been maintained and the staff member may not need to repeat refresher training. • Where a staff member or learner does not meet the required level of current knowledge, understanding and practice through pre-assessment they should complete the refresher training and any associated assessments required. Page 18 2.6 Suggested Standards for Training Delivery The employing organisation should be assured that Learning Facilitators who are involved in the delivery of Equality, Diversity and Human Rights education or training have the appropriate experience, background and qualifications to deliver training to a satisfactory standard. For guidance, this may include the following: • A current and thorough knowledge of Equality, Diversity and Human Rights legislation and an understanding of its application and effective practice within a healthcare setting. • Experience of teaching and learning, including the ability to meet the competences expected for LSILADD04 Plan and prepare specific learning and development opportunities • A relevant qualification in Equality, Diversity and Human Rights such as, for example, the Institute of Leadership and Management Level 4 Award in Managing Equality and Diversity in an Organisation. Where any training delivery is supported by a person who is not an expert in the subject, then the organisation should ensure that they have put in place a quality assurance mechanism, whereby the accuracy of the content and the effectiveness of its delivery has been quality assured and is subject to periodic revi ew. 2.7 Relevant National Occupational Standards Relevant National Occupational Standards • SCDHSC0234: Uphold the rights of individuals • SS01: Foster people’s equality, diversity and rights • SCDHSC0045: Lead practice that promotes the safeguarding of individuals Return to contents page Page 19 Subject 3: Health, Safety and Welfare 3.1 Context Statement Given the complexity of the purpose, structure and type of activity delivered in healthcare environments, there is a diverse range of potential risks to the health and safety of staff. The law requires employers to provide whatever information, instruction and training is needed to ensure, so far as is reasonably practicable, the health and safety of its employees. Employers are required to provide employees with relevant information on potential risks to their health and safety in the workplace, and how these risks can be minimised. The provision of effective health and safety training will help to avoid the cost and distress that accidents and il l health cause. Of particular importance, is the need to develop a positive health and safety culture where healthy working becomes second nature to everyone. 3.2 Current Legal or Relevant Expert Guidance Legislation – UK Wide • Health and Safety at Work etc Act 1974 • Management of Health and Safety at Work Regulations 1999 • Reporting of Injuries, Diseases and Dangerous Occurrences Regulations (RIDDOR) 2013 • The Control of Substances Hazardous to Health Regulations 2002 • The Health and Safety (Training for Employment) Regulations 1990 • The Health and Safety (Display Screen Equipment) Regulations 1992 • The Provision and Use of Work Equipment Regulations 1998 Legislation – Northern Ireland • Management of Health and Safety at Work Regulations (Northern Ireland) 2000 Key Guidance – England • NHS Employers / Health, Safety and Wellbeing Partnership Group Resources • NHS Employers / Health and Wellbeing • National patient safety syllabus 1.0, Training for all NHS staff (Academy of Medical Royal Colleges in collaboration with Health Education England, NHS England and NHS Improvement) • Health and Safety Executive, Health and social care services • Workplace health and safety standards (The NHS Staff Council) • Managing Conflict (NHS Improvement) Expert Organisations • The Health and Safety Executive (HSE) • The Health and Safety Executive for Northern Ireland • The Care Quality Commission (England) 3.3 Target Audience All staff, including unpaid and voluntary staff. Page 20 3.4 Key Learning Outcomes The following learning outcomes reflect the minimum standard that should be incorporated into general health and safety training. The learner will: a) understand the organisation’s commitment to delivering services safely b) understand the importance of acting in ways that are consistent with legislation, policies and procedures for maintaining own and others’ health and safety c) know the organisation’s arrangements for consulting with employees on health and safety matters d) be able to locate the organisation’s health and safety policy and the arrangements for implementing it e) understand the meaning of hazard, risk and risk assessment f) be able to recognise common work place hazards including: o electricity o slips and trips, falls o chemicals and substances o stress o physical and verbal abuse o traffic routes o display screen equipment (DSE), workstations and the working environment. g) understand how any identified risks might be managed through balanced and appropriate preventive and protective measures h) understand how they could apply and promote safe working practices specific to their job role i) know the actions they should take to ensure patient safety j) understand the importance of reporting health and safety concerns k) know the reporting processes used and how the organisation uses the information gathered to help manage risks l) know how to raise health and safety concerns m) understand individual responsibilities in reporting incidents, ill health and near misses. NB: Additional learning outcomes and practical experience should be added, where appropriate, to take into account the capabilities, knowledge, experience and prior training of workers. Based upon risk assessment, training needs analysis, type of role, location and service need, the learning outcomes stated should be supplemented by specific job and site training as necessary to ensure competence in safe working practices and compliance with legal requirements. Employers should ensure that vulnerable workers such as young people at w ork and learners undertaking work experience receive appropriate training, to protect their health and safety. Managers and supervisors should receive additional health and safety training as appropriate to support them in their role and health and safety responsibilities. Page 21 3.5 Proposed Frequency of Refresher Training or Assessment Proposed Refresher Period Health and Safety law does not mandate defined time schedules for refresher periods but consensus from health care regions who have developed their own frameworks indicate that general health and safety training must take place at induction, with refresher training for all staff groups at least every 3 years. Organisational Implications: Each healthcare organisation will need to determine their position in relation to alignment with the recommended refresher periods, particularly for those staff groups exposed to frequent health and safety risks and ensuring that any agreed training schedule is incorporated into local policy. Organisations should have a programme of health and safety audits in place. The outcomes and implications of audits should be used to ensure that key policies and practices are being monitored and implemented appropriately, and they inform training priorities. Refresher training will be indicated for all staff if there is a change in health and safety legislation nationally or where local risk management assessment identifies new risks, or if there is a change in working practices and procedures and where skills need updating. Assessment of Competence • Where a staff member or learner can demonstrate through robust pre-assessment, including where relevant practical assessment, the required level of current knowledge, understanding and practice, then this can be used as evidence that knowledge and skills have been maintained and the staff member may not need to repeat refresher training. • Where a staff member or learner does not meet the required level of current knowledge, understanding and practice through pre-assessment they should complete the refresher training and any associated assessments required. 3.6 Suggested Standards for Training Delivery The employing organisation should be assured that Learning Facilitators that are involved in the delivery of Health and Safety education or training have the appropriate qualifications, experience, knowledge and skills to deliver training to a satisfactory standard. For guidance, this may include the following: • A current and thorough knowledge of Health and Safety, including risk assessment & management and an understanding of its application and practice within a healthcare setting. • Knowledge and experience of health and safety risks in their own organisation. • Experience of teaching and learning, including the ability to meet the competences expected for LSILADD04 Plan and prepare specific learning and development opportunities • A relevant qualification in Health and Safety. • Membership of a professional organisation, for example, the Chartered Membership of IOSH ( www.iosh.co.uk) (this might be particularly required for any external trainers providing training on behalf of the organisation). Where any training delivery is supported by a person who is not an expert in the subject, then the organisation should ensure that they have put in place a quality assurance mechanism, whereby the accuracy of the content and the effectiveness of its delivery has been quality assured and is subject to periodic observation. Page 22 3.7 Relevant National Occupational Standards Relevant National Occupational Standards • GEN96: Maintain health, safety and security practices within a health setting • SS03: Promote, monitor and maintain health, safety and security in the workplace • SCDHSC0022: Support the health and safety of yourself and individuals • Ento WRV1: Make sure your actions contribute to a positive and safe working culture • COGPACK38: Work safely Return to contents page Page 23 Subject 4: NHS Conflict Resolution (England) 4.1 Context Statement It is important that staff feel safe in their working environments. Violent behaviour not only affects them personally but indirectly it has a negative impact upon the standard of service and the delivery of patient care. In terms of tackling violence against staff, Conflict Resolution Training (CRT) is a key preventative tool. It forms part of a range of measures introduced to make the NHS a safer place to work. Clearly, it is not sufficient to react to incidents after they occur; ways of reducing the risk of incidents occurring and preventing them from happening in the first place must be found. The detail in this subject reflects the Conflict Resolution Training guidance as provided by NHS Protect (2013), now superseded by the NHS Counter Fraud Authority. 4.2 Current Legal or Relevant Expert Guidance England • NHS Protect (2013), Conflict Resolution Training: implementing the learning aims and outcomes • Care Quality Commission: The fundamental standards / safety • NHS violence reduction strategy • The Restraint Reduction Network Training Standards 2019 4.3 Target Audience Frontline NHS staff and professionals whose work brings them into direct contact with members of the public - under legislation it is employer’s responsibility to ensure that these individuals and roles are risk -assessed in relation to violence and aggression. 4.4 Key Learning Outcomes The learning aims and associated outcomes are based on de-escalation techniques. The aims address the way one communicates, patterns of behaviour, recognition of warning signs, impact factors and pre ventative strategies. At the end of the training learners should be able to: a) describe the common causes of conflict and identify the different stages of conflict b) learn from their own experience of conflict situations to develop strategies to reduce the opportunity for conflict in the future c) describe two forms of communication d) indicate the level of emphasis that can be placed on verbal and non-verbal communication during a conflict situation e) understand the impact that cultural differences may have in relation to communication f) identify the causes of communication break down and the importance of creating conditions for communication to succeed g) utilise three communication models that would assist in dealing with different levels of conflict h) recognise the behavioural pattern of individuals during conflict Page 24 i) recognise the warning and danger signals displayed by individuals during a conflict situation including the signs that may indicate the possibility of physical attack j) identify the procedural and environmental factors affecting conflict situations and recognise their importance in decision making k) understand the importance of keeping a safe distance in conflict situations l) summarise the methods and actions appropriate for particular conflict situations bearing in mind that no two situations are same m) explain the use of ‘reasonable force’ as described in law and its limitations and requirements n) identify the range of support, both short and long-term, available to those affected by a violent incident o) understand the need to provide support to those directly affected by a violent incident and the wider organisational benefits of this. NB: It is crucial that employing organisations deliver the appropriate level of CRT to meet the needs of staff at their organisation. For example, the clinical and environmental factors affecting conflict for ambulance services or mental health services will be different to those experienced within the in-patient setting. Even within each type of health organisations there may be different factors coming into play such as location, demographics and geography. Therefore, in addition to delivering the core learning outcomes organisations will need to make a risk assessment of the CRT needs of their staff. In some cases this may result in train ing with additional learning outcomes to meet and mitigate the identified risks. CRT provides staff with important de-escalation, communication and calming skills to help them prevent and manage violent situations. However, there are some incidents which may involve challenging behaviour that is clinically related, one common characteristic being where the individual involved in the incident may have some degree of cognitive impairment and their communication may be temporarily or permanently impaired. NHS organisations and providers of NHS services may therefore choose to include clinically related challenging behaviour awareness as part of a combined course with CRT or incorporate it as part of other training initiatives, such as those addressing staff training needs around dementia. Page 25 4.5 Proposed Frequency of Refresher Training or Assessment The frequency of delivering refresher CRT will be determined by local needs, although it is recommended that, from the viewpoint of retention of knowledge and personal safety, they should not be more than three years from the time of delivery of the previous training. In cases where new employees have already received CRT from other NHS providers or commissioners the prior learning may be recognised if the training has followed NHS Protect guidance. In such cases a risk-based approach should be made of the employee’s present needs before determining whether their prior learning is sufficient for their new role. Assessment of Competence • Where a staff member or learner can demonstrate through robust pre-assessment, including where relevant practical assessment, the required level of current knowledge, understanding and practice, then this can be used as evidence that knowledge and skills have been maintained and the staff member may not need to repeat refresher training. • Where a staff member or learner does not meet the required level of current knowledge, understanding and practice through pre-assessment they should complete the refresher training and any associa ted assessments required. 4.6 Suggested Standards for Training Delivery It is appropriate that the delivery method for CRT takes into account the needs of learners to ensure that maximum benefit and value is obtained. While not exhaustive, these may include access to resources such as classrooms, literature, audio visual facilities and appropriately qualified trainers. Studies have shown that CRT benefits best from delivery in a classroom setting, although the overriding aim must be that learners achieve al l of the learning outcomes and any additional ones appropriate for their role and setting established by the risk assessment. The duration of CRT courses will vary considerably and their length will depend upon the number of additional learning outcomes identified through a risk assessment of CRT needs. However, all NHS CRT courses will need to be long enough to provide sufficient time to ensure that the core learning outcomes and those identified in the risk assessment are fully met. CRT can be delivered as a standalone course, although there are benefits to it being integrated as part of a more holistic approach to communication, customer care and engagement with service users as these are transferable skills. E-learning may be appropriate to support the delivery of knowledge aspects of CRT but should not be the sole means of training and is not a substitute for practical instruction. 4.7 Relevant National Occupational Standards Relevant National Occupational Standards • Ento WRV6: Promote a safe and positive culture in the workplace • FMH5: Minimise the risks to an individual and staff during clinical interventions and violent and aggressive episodes Return to contents page Page 26 Subject 5: Fire Safety 5.1 Context Statement Since the publication of the fire safety Regulatory Reform (Fire Safety) Order 2005, the provision of fire training has become a legal requirement for all employees within the UK. Fire safety in the healthcare e nvironment is particularly challenging since many people in healthcare environments will require some degree of assistance from healthcare staff to ensure their safety in the event of a fire (Department of Health 2013). Fire within a healthcare setting can have a significant impact and consequences which can include property loss, injury and potential loss of life. High levels of fire safety awareness and knowledge by the healthcare workforce is essential if safe healthcare environments are to be maintained and the distressing consequences that can be caused through fire are to be prevented. Within the UK, healthcare is provided in a wide range of environments, and it is essential that dependent upon the nature of the environment, which might be categorised as either simple or complex, that the relevant guidance related to fire safety management is used to help assess and address potential fire safety risks. 5.2 Current Legal or Relevant Expert Guidance Legislation – England and Wales • The Regulatory Reform (Fire Safety) Order 2005 Legislation – Northern Ireland • The Fire Safety Regulations (Northern Ireland) 2010 Legislation – Scotland • The Fire Safety (Scotland) Regulations 2006 Legislation – Wales • The Smoke-free Premises etc. (Wales) Regulations 2007 Expert Guidance – England • Department of Health policy on fire safety in the NHS in England: Managing He althcare Fire Safety (HTM 05- 01), Second edition April 2013 • DCLG (2006), Fire safety risk assessment: healthcare premises Expert Guidance – Wales • Working Together In Partnership (2007), Concordat Between The Welsh Assembly Government’s Department For Health And Social Services and the Chief Fire Officers’ Association Wales Expert Organisation • National Association of Healthcare Fire Officers (NAHFO) Page 27 5.3 Target Audience Fire Safety training is a legal requirement for all staff. The learning outcomes stated in the Core Skills Training Framework are taken from the Firecode and specify the generic training needed by all staff without exception. Adequate fire safety information and instruction is required for all staff on induction. 5.4 Key Learning Outcomes The following learning outcomes reflect the minimum standard which should be incorporated into fire safety training for all levels, and reflects in England the Department of Health policy on fire safety in the NHS in England: Managing Healthcare Fire Safety (HTM 05-01), Second edition April 2013. The learner will: a) understand the characteristics of fire, smoke and toxic fumes b) know the fire hazards in the working environment c) be aware of the significant findings of relevant fire risk assessments d) understand how to practice and promote fire prevention e) be aware of basic fire safety and local fire safety protocols including staff responsibilities during a fire incident f) know the means of raising the fire alarm and the actions to take on hearing the fire alarm g) know instinctively the right action to take if fire breaks out or smoke is detected h) be familiar with the different types of fire extinguishers, state their use and identify the safety precautions associated with their use i) understand the importance of being familiar with evacuation procedures and associated escape routes. NB: In addition, learners should take part in practical training sessions which include evacuation techniques and where appropriate, use of firefighting equipment. Dependent upon role, location and service need the learning outcomes stated should be supplemented by specific job and site training. This should include, for example, local fire procedures, escape routes, refuges, evacuation aids and fire alarms and any other aspects as deemed necessary based upon localised fire risk assessment, training needs analysis and policy. Similarly, staff involved in particular roles such as telephone operators, estates and working in environments such as operating theatres may need more specific training to fulfil their responsibilities in effective fire preventio n and management. Page 28 5.5 Proposed frequency of Refresher Training or Assessment All staff should on commencement of employment receive local site specific fire induction training, and within a month of starting employment undertake any established corporate fire induction training. All staff should receive regular updated fire safety training and instruction. The duration and frequency of the training should be determined by a training needs analysis. This should take account of the fire risks present in th e premises, the numbers and dependency of people at risk, and the responsibilities of staff in a fire emergency. The outcomes of the fire risk assessment and the resulting determination of training requirements should be formally recorded and periodically reviewed. Organisational Implications: Staff who are involved in the direct care of patients, who may need to help evacuate others, should receive training more frequently than those who may only be required to evacuate themselves, this needs to be based upon current local risk assessment. Refresher training will be indicated if there has been a change in Fire Safety Legislation nationally, an organisation has amended its policy, or the local fire risk assessment identifies a new or changed risk, all staff affected will need to be updated to reflect any changes. Assessment of Competence Assessing the effectiveness of training is important but often difficult to carry out with certainty. The Fire Safety Manager in conjunction with healthcare Fire Safety Advisers should, on a regular basis (but normally no less than every two years), devise methods of testing staff. It is likely that the practical performance of staff at training sessions and during rehearsals of the fire emergency action plan will offer the best indication of the effectiveness of a programme and the degree to which staff have assimilated instruction (Department of Health 2013). 5.6 Suggested Standards for Training Delivery It is the responsibility of the Trust Board (or equivalent), in consultation with the Fire Safety Manager/Advisor to determine how a suitable programme of fire safety is developed and implemented, and provide assurance that it meets the legislative requirements. The employing organisation should be assured that Learning Facilitators who are involved in the delivery of fire training are competent in fire safety in the healthcare environment and have the appropriate qualifications, experience or background to deliver training to a satisfactory standard. The Firecode stipula tes that: “Staff delivering training should have the necessary competence, and if called upon to do so, should be able to demonstrate their competence.” For guidance, this should include the following: • A relevant fire safety qualification e.g. IOSH, the Fire Protection Association Advanced Fire Safety Management, Membership of Institute of Fire Engineers, Loughborough Post Graduate Certificate in Fire Safety Management, CFPA Diploma or extensive fire service experience (Local Authority or MoD) and/or releva nt fire service experience. and • A thorough knowledge of Fire Safety in a healthcare setting, including legislation and the application of the Firecode. • Experience of teaching and learning, including the ability to meet the competences expected for LSILADD04 Plan and prepare specific learning and development opportunities Page 29 Within complex healthcare environments such as hospitals, the requirements are that face-to-face training should be delivered by the designated Authorised Person 1. Where the delivery of any training in complex buildings is supported by designated Fire Wardens/coordinators, then the organisation should ensure that they have put in place a quality assurance mechanism, whereby the accuracy of the content and the effectiveness of its delivery has been quality assured and is subject to periodic review. Where staff work in non-complex buildings, for example, a medical centre, walk in centre or doctors surgery and the treatments provided within the premises are non-invasive, Fire training may be delivered by a person with lesser experience and qualifications than identified above. However, training should follow the guidance in the DCLG guide for healthcare premises (see 5.2). In these cases, the organisation should ensure that they have put in place a quality assurance mechanism to ensure an accurate and effective delivery. The fire safety training programme should include practical sessions and fire drills to supplement classroom instruction. Elearning can be used to support Fire Training but is not acceptable as the sole means of training. 5.7 Relevant National Occupational Standards Relevant National Occupational Standards • GEN96: Maintain health, safety and security practices within a health setting • SS03: Promote, monitor and maintain health, safety and security in the workplace Return to contents page 1 Authorised Person (Fire) who is usually the Fire Adviser for the trust. Page 30 Subject 6: Infection Prevention and Control 6.1 Context Statement The risk of infection within a healthcare setting poses a significant risk to patients, carers and staff. Without effective infection prevention and control approaches, infection can cause distress, harm, and impair the quality of life and healthcare experiences. Infection frequently requires additional costly resources to treat. Th erefore, prevention of infection has to be a key priority for all staff groups working within a healthcare setting. Consequently, ensuring that all staff have high levels of infection prevention and control awareness, supported through an effective educati on and training approach, should form a central feature of any infection prevention and control strategy. 6.2 Current Legal or Relevant Expert Guidance Legislation – UK Wide • Health and Safety at Work etc Act 1974 • The Control of Substances Hazardous to Health Regulations 2002 Legislation – England • Health and Social Care Act 2012 • Public Health (Control of Disease) Act 1984 • The Health Protection (Notification) Regulations 2010 Legislation – Scotland • Public Health etc. (Scotland) Act 2008 • Public Services Reform (Scotland) Act 2010 Key Guidance – England • NHS England & NHS Improvement (2019), Standard infection control precautions: national hand hygiene and personal protective equipment policy • Department of Health (2015), The Health and Social Care Act 2008 Code of Practice on the prevention and control of infections and related guidance • Loveday HP et al (2014), epic3: National Evidence-Based Guidelines for Preventing Healthcare-Associated Infections in NHS Hospitals in England, Journal of Hospital Infection 86S1 (2014) S1 –S70 • NICE (2011), Healthcare-associated infections: prevention and control, Public health guidance [PH36] • NICE (2014), Infection prevention and control: Quality Standard QS61 • NICE (2016), Healthcare-associated infections: Quality Standard QS113 • NICE (2017), Healthcare-associated infections: prevention and control in primary and community care, Clinical guideline [CG139] • NHS Employers (2015), Managing the risks of sharps injuries Key Guidance – Northern Ireland • The Northern Ireland Regional Infection Prevention and Control Manual • Public Health Agency Northern Ireland Key Guidance – Scotland • Health Protection Scotland, Compendium of Healthcare Associated Infection Guidance Page 31 • Health Protection Scotland (2017), National Infection Prevention and Control Manual • NHS Education for Scotland HAI Education for Infection Prevention and Control Key Guidance – Wales • National Infection Control Policies for Wales • NHS Wales. Healthcare Associated Infection Wales Expert Organisations and Resources • Healthcare Infection Society • Health Protection Scotland • Infection Prevention Society • International Resource for Infection Control • Public Health England • Public Health Wales • World Health Organization 6.3 Target Audience Level 1: All staff including contractors, unpaid and voluntary staff. Level 2: All healthcare staff groups involved in direct patient care or services. 6.4 Key Learning Outcomes Learning outcomes are divided into two levels. Each level reflects a level of expected knowledge, skill and understanding. The appropriate level of training is dependent upon role, work context and local risk assessment. Level 1 learning outcomes reflect a basic standard which should be incorporated into infection prevention and control training for all staff, including contractors and volunteers. Level 2 learning outcomes reflect a furt her standard which should be incorporated into infection prevention and control training for all healthcare staff and other staff groups who provide direct patient care. Level 1: All staff, including contractors and unpaid and voluntary staff. The learner will: a) know how individuals can contribute to infection prevention and control b) have knowledge of and demonstrate the standard infection prevention and control precautions relevant to their role which may include: o Hand Hygiene o Personal Protective Equipment (PPE) o Management of Blood and Body Fluid Spillage o Management of Occupational Exposure (including sharps) o Management of the Environment o Management of Care Equipment. c) recognise and act when their personal fitness to work may pose a risk of infectio n to others. Page 32 Level 2: All healthcare staff providing direct patient care and other relevant staff, based upon role and local risk assessment (Level 1 outcomes plus the following). The learner will relevant to their role: a) be able to describe the healthcare organisation’s and their own responsibilities in terms of current infection prevention and control legislation b) know how to obtain information about infection prevention and control within the organisation c) understand what is meant by the term healthcare associated infections d) understand the chain of infection and how this informs infection prevention and control practice e) demonstrate an understanding of the routes of transmission of micro-organisms f) understand individual roles and responsibilities for the three levels of decontamination g) use single use items appropriately h) be able to conduct a risk assessment in respect of ensuring infection prevention and control i) explain different alert organisms and conditions that pose an infection risk j) describe how to safely manage patients with specific alert organisms. Where applicable to the role Apply appropriate health and safety measures, standard precautions for infection prevention and control in obtaining specimens from individuals. NB: It is to be noted that, in some healthcare settings, Level 2 learning outcomes may not be relevant for some clinical roles e.g. Community Healthcare. It is the organisation’s discretion to agree on which learning outcomes are relevant and, therefore, required. 6.5 Proposed Frequency of Refresher Training or Assessment It is recommended that refresher training for infection prevention and control training should be a maximum of: • All staff (Level 1 Outcomes): every 3 years. • All healthcare staff providing direct patient care (Level 2 Outcomes): every year. Organisational Implications: Each healthcare organisation will need to determine their position in relation to alignment with the recommended refresher periods, particularly for those staff groups exposed to greater risks an d ensuring that any agreed training schedule is incorporated into local policy. Additional refresher training will be indicated for all staff if there is a change in infection prevention and control guidelines nationally or where the organisation has amended its policy locally. Organisations should have a programme of quality assurance including audit and feedback. The audit findings should be used to ensure that key policies and practices are being reviewed, implemented and inform training priorities. Assessment of Competence • Where a staff member or learner can demonstrate through robust pre-assessment, including where relevant, practical assessment, the required level of current knowledge, understanding and practice, then this can be used as evidence that knowledge and skills have been maintained and the staff member may not need to repeat refresher training. • Where a staff member or learner does not meet the required level of current knowledge and understanding and practice through pre-assessment, they should complete the refresher training and any associated assessments required. Page 33 6.6 Suggested Standards for Training Delivery The employing organisation should be assured that Learning Facilitators involved in the delivery of Infection prevention and control education or training have the appropriate qualifications, experience or background to deliver training to a satisfactory standard. For guidance, this may include the following: • A relevant professional/healthcare registered qualification e.g. nurse. • Ability to demonstrate significant experience/knowledge of infection prevention and control issues and an understanding of their issues and practice within a healthcare setting. • Recent participation in advanced practice CPD developments in infection prevention an d control. • Experience of teaching and learning, including the ability to meet the competences expected for LSILADD04 Plan and prepare specific learning and development opportunities Where any training delivery is supported by a person who is not an expert in the subject, then the organisation should ensure that they have put in place a quality assurance mechanism, whereby the accuracy of the content and the effectiveness of its delivery has been quality assured and is subject to periodic review. 6.7 Relevant National Occupational Standards Relevant National Occupational Standards • Gen1: Ensure personal fitness for work • Gen2: Prepare and dress for work in healthcare settings • IPC2.2012: Perform hand hygiene to prevent the spread of infection • IPC6.2012: Use personal protective equipment to prevent the spread of infection • IPC1.2012: Minimise the risk of spreading infection by cleaning, disinfecting and maintaining environments • IPC4.2012: Minimise the risk of spreading infection by cleaning, disinfection and storing care equipment • IPC8.2012: Minimise the risk of spreading infection when transporting and storing health and care related waste • IPC3.2012: Clean, disinfect and remove spillages of blood and other body fluids to minimise the risk of infection • IPC7.2012: Safely dispose of healthcare waste, including sharps, to prevent the spread of infection Return to contents page Page 34 Subject 7: Moving and Handling 7.1 Context Statement Healthcare settings can pose significant moving and handling challenges and risks. Work -related musculoskeletal disorders, including manual handling injuries, are amongst the most common type of occupational ill health in the UK (Health and Safety Executive 2019). Given the nature, type and frequency of moving and handling activities undertaken, there are risks of injury to staff and patients and these need to be minimised. As part of health and safety at work requirements, employers are expected to provide training on key health and safety risks and this has been supplemented with additional guidance covering the specific activity of moving a nd handling. In order to assess the learning needs an organisation should employ / access a competent person who can undertake a Training Needs Analysis identifying the ongoing moving and handling education and training requirements for each staffing group and job role. 7.2 Current Legal or Relevant Expert Guidance Legislation • Health and Safety at Work etc Act 1974 • The Manual Handling Operations Regulations (MHOR) 1992 HSE (2016) - Guidance on Regulations L23 4th edition (2016) • Lifting Operations and Lifting Equipment Regulation (LOLER 1998) Approved Code of Practice L113 2014 (amended 2018) • Management of Health and Safety at Work Regulations, 1999 (amendments in 2006) • Provision and Use of Work Equipment regulations (PUWER), 1998 - HSE (2018), Safe use of Work Equipment (PUWER 1998). Approved Code of Practice L22 4th edition (2014 amended 2018) • Reporting of Injuries, Diseases and Dangerous Occurrences Regulations (RIDDOR), 2013 • The Health and Safety (Miscellaneous Amendments) Regulations 2002 Key Guidance – Scotland • Scottish Government (2014), The Scottish Manual Handling Passport Scheme Key Guidance – Wales • All Wales NHS Manual Handling Passport & Information Scheme Key Guidance • National Back Exchange Standards in Manual Handling (2010) Key Organisations • National Back Exchange Page 35 Key References ● Alexander, P.; Johnson, C. (2011) Manual Handling of Children, Towcester: National Back Exchange ● Croshaw, C. & Fray, M. (2019). Moving and Handling People: An Illustrated Guide (3rd ed. 2019) ● Muir, M. A. and Rush, A.J. (2013) Moving and Handling of Plus Size People – an Illustrated Guide, Towcester: National Back Exchange ● Health and Safety Executive. A Competent Person: https://www.hse.gov.uk/involvement/competentperson.htm ● Health and Safety Executive. (2012 November). Manual Handling at Work: A Brief Guide: https://www.hse.gov.uk/pubns/indg143.pdf ● Health and Safety Executive. (2016). Manual Handling Operations Regulations 1992: Guidance on Regulations: https://www.hse.gov.uk/pUbns/priced/l23.pdf ● Ruszala, S.; Alexander, P (2015) Moving and Handling in the Community and Residential Care. Towcester: National Back Exchange ● Ruszala, S.; Hall, J; Alexander, P. (2010) Standards in Manual Handling 3rd Edition. Towcester: National Back Exchange ● Sharpe, N.H.; Briody, K. Love, S. (2014) Safer Moving and Handling in the Perioperative Environment. Towcester: National Back Exchange ● Smith, J (Ed). Handling of People 6th edition (2011) and 5th Edition (2005), Teddington: Backcare ● Sturman, M.; Varnam, B (2019) Dementia Care - A Behavioural Approach to Manual Handling, Towcester: National Back Exchange 7.3 Target Audience Level 1: All staff, including unpaid and voluntary staff. Level 2: Those staff groups, including unpaid and voluntary staff, whose role involves patient handling activities. Page 36 7.4 Key Learning Outcomes Level 1 The following Core Learning Outcomes are transferable between settings: The learner will be able to identify: a) moving and handling risk factors b) employers and employees’ responsibilities under relevant national Health & Safety legislation c) the principles of safer moving & handling d) the principles of using an ergonomic approach for moving and handling activities to sup port musculo-skeletal health e) the factors to consider when undertaking a dynamic risk assessment prior to carrying out a moving and handling activity f) suitable risk control strategies and resources to facilitate good practice following a risk assessment appr opriate to the activity and individual’s role. The following Context Specific Learning Outcomes must be delivered locally and specific to the setting: The learner will be able to: g) identify their own organisation’s risk management processes to inform safe systems of work h) identify the support available to facilitate good practice i) demonstrate application of safer moving and handling principles when using the range of equipment relevant to the individual’s job role and setting. Load Handling Staff All staff involved with the handling of inanimate loads, which involve a risk of injury, will require practical instruction in safer handling techniques. The following Core Learning Outcome is transferable between settings: The learner will be able to: j) demonstrate safer handling strategies relevant to them and their role. Level 2: Patient Handling Staff In addition to the Level 1 learning outcomes listed for all employees, staff identified as being involved in patient handling activities will be required to meet the following: The following Core Learning Outcomes are transferable between settings: The learner will be able to: a) demonstrate safe, dignified approaches for moving and handling activities that promote patient independence and functional mobility b) demonstrate an awareness of normal human movement patterns when moving and handling people c) demonstrate an understanding of person-centred risk assessment to determine safer patient handling techniques, using the multidisciplinary team where appropriate The following Context Specific Learning Outcomes must be delivered locally, specific to the setting: The learner will be able to: Page 37 d) demonstrate a range of practical skills relevant to the needs of the patients in their care and the individual’s job role e) demonstrate the safe use of the range of equipment relevant to the needs of the patients in their care, the individual’s job role and the setting. All practical moving and handling training should be supervised appropriately in the workplace by a compet ent person according to the skill level of the learner. NB: Additional learning outcomes, or specific training, may be necessary to meet the particular needs or function of individual organisations. These should be determined by local risk assessment and policy. 7.5 Proposed frequency of Refresher Training or Assessment Proposed Refresher Training Periods Given the potential range of individual local factors and risks that might have an impact upon moving and handling activities it is difficult to set defined refresher periods for all staff groups. Rather the organisation should have monitoring and a programme of audit in place to check that individual employees are moving and handling people safely. The need for updating skills or refresher training will be determined by the monitoring and assessment of the individual’s competence, outcomes of any local audits and whether there are any other changes to tasks, equipment, environment or new developments in moving and handling policy and practice. One of the implications arising from this is that staff who are monitored and demonstrate currency of knowledge and practice as relevant in their workplace will not need to undertake refresher training unless there are changes in the circumstances as indicated above. If organisations determine an agreed refresher training period, then this needs to be incorporated into local policy. Assessment of Competence Staff who are monitored and can demonstrate an agreed / accepted level of competence may not be required to undertake routine refresher training unless changes, such as those listed above, occur. Professional bodies set standards of proficiency and codes which require the registrant to maintain the skills and knowledge necessary for safe and effective practice. If an organisation chooses to assess the Moving and Handling competence of its staff this must be undertaken by appropriately qualified and competent assessors. Training Methods Level 1 training could be delivered by the following methods: • E-Learning • Face to Face • Blended Learning • Written Information Load Handling Practical training ideally should be face to face where practicable and could be: • In a classroom • In a workplace setting. Training can be delivered on a 1:1 basis or in groups. Groups should be no more than 1 trainer: 10 participants, in line with NBE Standards (2010). Level 2 practical training ideally should be face to face where practicable in either a classroom or the workplace setting, on a 1:1 basis or in groups. Groups should be no more than 1 trainer:8 participants, in line with NBE Standards (2010). Page 38 7.6 Suggested Standards for Training Delivery Moving and Handling education or training should be provided by facilitators who ideally have, or are working towards: • A relevant current professional / healthcare qualification e.g. nurse, physiotherapist, ergonomist or extensive knowledge and experience of Moving and Handling within a health or social care setting • A recognised qualification (e.g. Back Care Management) based on the National Back Exchange (NBE) Interprofessional Curriculum or proof of an equivalent qualification • Current Advanced Membership of NBE / Membership of NBE • A recognised teaching / training qualification including the ability to meet the competencies expected for Skills for Health LSILADD04 (Plan and prepare specific learning and development opportunities) • A current and thorough knowledge of Moving and Handling / Manual Handling including Risk Management and Assessment and experience of application to practice. A designated Competent person should oversee the delivery of the Moving and Handling programme however responsibility for maintaining standards in education and training provision remains with the organisation. Return to contents page Page 39 Subject 8: Safeguarding Adults (Version 2) 8.1 Context Statement All citizens have a right to live their lives free from violence, harassment, humiliation and degradation. Ensuring independence, well-being and choice is also a key element of this right (The Association of Directors of S ocial Services, 20052). Adults with capacity also have the right to make decisions, even if they are perceived as unwise. They may make decisions that put their right to privacy, autonomy and family life ahead of their right to live and to be free from inhuman or degrading treatment. There are safeguards for those people who lack capacity and sometimes complex work is needed to weigh up whether action should be taken in the public interest or where the person concerned is being coerced. The health sector can make a positive contribution towards safeguarding those that might be less able to protect themselves from harm, neglect or abuse. Central to effective safeguarding management are trustful and supportive relationships, based upon dignity and respect, between patients, their families and healthcare staff. There are however, distressing examples where this has failed as documented in the Francis Report (2013 3), the Cavendish Review (20134) and findings of Serious Case Reviews where there have been major concerns about adult protection or system failures. Healthcare organisations therefore have a responsibility to be active and responsive in ensuring people’s dignity and rights and meeting statutory duties to safeguard adults. This requires a systematic approach, effective leadership at all levels and an organisational culture where care and compassion are valued. The aims of adult safeguarding are5: • To prevent harm and reduce the risk of abuse or neglect to adults with care and support needs. • To safeguard individuals in a way that supports them in making choices and having control in how they choose to live their lives. • To promote an outcomes approach in safeguarding that works for people resulting in the best experience possible. • To raise public awareness so that professionals, other staff and communities as a whole play their part in preventing, identifying and responding to abuse and neglect. Six key principles underpin all adult safeguarding work: • Empowerment – Personalisation and the presumption of person-led decisions and informed consent • Prevention – It is better to take action before harm occurs • Proportionality – Proportionate and least intrusive response appropriate to the risk represented • Protection – Support and representation for those in greatest need • Partnership – Local solutions through services working with their communities. Communities have a part to play in preventing, detecting and reporting neglect and abuse • Accountability – Accountability and transparency in delivering safeguarding. 2 The Association of Directors of Social Services (2005) Safeguarding Adults. A National Framework of Standards for good practice and outcomes in adult protection work, London. 3 Francis R (2013), Report of the Mid Staffordshire NHS Foundation Trust Public Enquiry, London: The Stationery Office. 4 Cavendish C (2013), The Cavendish Review: An Independent Review into Healthcare Assistants and Support Workers in the NHS and social care settings. 5 Department of Health (2014), Care and Support Statutory Guidance Page 40 8.2 Current Legal or Relevant Expert Guidance Key legislation – UK Wide • Equality Act 2010 • Human Rights Act 1998 • Modern Slavery Act (2015) • Safeguarding Vulnerable Groups Act 2006 • Serious Crime Act (2015) Legislation – England and Wales • Care Act 2014 • Children and Families Act 2014 • Mental Capacity Act 2005 Legislation – Wales • Social Services and Wellbeing (Wales) Act 2014 Legislation – Northern Ireland • Mental Capacity Act (Northern Ireland) 2016 Legislation – Scotland • Adult Support and Protection (Scotland) Act 2007 • Adults with Incapacity (Scotland) 2000 Key Guidance – England • Royal College of Nursing (2018), Adult Safeguarding: Roles and Competencies for Health Care Staff • Bournemouth University (2015) National Competency Framework for Safeguarding Adults, A Comprehensive Guide • Care Quality Commission, Safeguarding People • Department for Constitutional Affairs (2007), Mental Capacity Act 2005: Code of Practice • Department of Health (2015) Guidance: Safeguarding women and girls at risk of FGM • Department of Health (2017), Care and Support Statutory Guidance • Department of Health (2011*), Safeguarding Adults: The role of health service managers and their boards • GOV.UK (2018) Guidance: Domestic violence and abuse • Lampard K and Marsden E (2015), Themes and lessons learnt from NHS investigations into matters relating to Jimmy Savile • NHS England (2015), Safeguarding Vulnerable People in the NHS – Accountability and Assurance Framework • NHS England (2015), Safeguarding Policy • NHS England (2015), Managing Safeguarding Allegations Against Staff Policy and Procedure Page 41 Key Guidance – Northern Ireland • Safeguarding Board of Northern Ireland • Department of Health, Social Services and Public Safety (2015), Adult Safeguarding: Prevention and Protection in Partnership Key Guidance – Scotland • Adult Support and Protection Code of Practice (2014) Key Guidance – Wales • Wales Safeguarding Procedures • Welsh Government Safeguarding Guidance • NHS Wales Governance e-Manual | Safeguarding Vulnerable Adults 8.3 Target Audience Level 1: All staff working in health care settings Level 2: All practitioners who have regular contact with patients, their families or carers, or the public. Level 3: Registered health care staff who engage in assessing, planning, intervening and evaluating the needs of adults where there are safeguarding concerns (as appropriate to role). Those healthcare staff who undertake specialist safeguarding roles and responsibilities including named professionals, designated professionals, experts and board members will need to receive higher levels of training and opportunities to promote acquisition of skills to ensure they can develop the desir ed level of competence for their role and thus contribute to effective safeguarding. The training standards and learning outcomes at Level 4 (Named professionals) and Level 5 (Designated professionals) and requirements for Health Board Executives and non-executive directors/members are set out in the Adult Safeguarding: Roles and Competencies for Health Care Staff (2018). 8.4 Key Learning Outcomes The following section reflects the levels and core learning outcomes in accordance with the Adult Safeguarding : Roles and Competencies for Health Care Staff (2018). However, it needs to be emphasised that dependent upon role/speciality there may be additional learning needs which will need to be addressed. While some of these needs can be addressed through training, some will be achieved through clinical experience and supervision. Level 1 The learner will: a) be able to recognise potential indicators of abuse, harm and neglect b) know what action to take if they have concerns, including to whom you should report your c oncerns and from whom to seek advice c) have a basic knowledge of the relevant legislation. Page 42 Level 2 The learner will: a) understand what constitutes harm, abuse and neglect and be able to identify any signs of harm, abuse or neglect b) be able to ensure effective advocacy is provided where required (for example where there are mental capacity or communication issues, in line with the legislation and professional guidance) c) be able to identify your professional role, responsibilities, and professional bound aries and those of your colleagues in a multidisciplinary team and multi-agency setting d) know how and when to refer to social care in accordance with organisational policies if you have identified an adult safeguarding concern e) be able to document safeguarding concerns in a format that informs the relevant staff and agencies appropriately f) know how to maintain appropriate records including being able differentiate between fact and opinion g) be able to identify the appropriate and relevant information and how to share it with other teams h) understand key statutory and non-statutory guidance and legislation including Human Rights Act and mental capacity legislation in country of practice i) be aware of the risk factors for radicalisation and know who to contact regar ding preventive action and supporting those persons who may be at risk of, or are being drawn into, terrorist related activity. Level 3 The learner will: a) be able to identify possible signs of sexual, physical, or emotional abuse or neglect using a person -centred approach. b) be able to identify adults experiencing abuse, harm or neglect who have caring responsibilities, for other adults or children and make appropriate referrals c) be able to demonstrate a clear understanding, as appropriate to role, of forensic procedures6 in adult safeguarding and knowing how to relate these to practice in order to meet clinical and legal requirements as required d) where undertaking forensic examinations as part of their role, be able to demonstrate an ability to undertake forensic procedures and know how to present the findings and evidence to legal requirements e) be able to undertake, where appropriate, a risk and/or harm assessment f) know how to communicate effectively with adults at risk in particular those with mental capacity is sues, learning disability or communication needs g) know how to contribute to, and make considered judgements about how to act to safeguard an adult at risk h) know how to contribute to / formulate and communicate effective care plans for adults who have been or may be subjected to abuse, harm or neglect 6 The term forensic refers to clinical tests or techniques used in relation to recording or collecting/preserving material that may be used in court as evidence to establish if a crime has taken place. It is important to state that that a forensic test may not necessarily be recognised as such at the time of examination. Practitioners should be aware that routine tests may later become part of forensic evidence/safeguarding procedures and investigations (RCN 2018). Page 43 i) demonstrate an understanding of the issues surrounding suspicion of adult abuse, harm and neglect and to know how to effectively manage uncertainty and risk j) know how to appropriately contribute to inter-agency assessments by gathering and sharing information k) be able to document concerns in a manner that is appropriate for adult safeguarding protection and legal processes l) know how to undertake documented reviews of your own (and/or team) adult safeguarding, as appropriate to role. This can be undertaken in various ways, such as through audit, case discussion, peer review, and supervision and as a component of refresher training m) know how to deliver and receive supervision within effective models of supervision and/or peer review, and be able to recognise the potential personal impact of adult safeguarding on professionals n) know how to apply the lessons learnt from audit and serious case reviews/case management reviews/significant case reviews to improve practice o) know how to advise others on appropriate information sharing p) know how to appropriately contribute to serious case reviews/case management reviews/significant case reviews, and domestic homicide review processes q) know how to obtain support and help in situations where there are safeguarding problems requiring further expertise and experience r) know how to participate in and chair multidisciplinary meetings as required s) demonstrate the skills required to participate in a safeguarding enquiry. 8.5 Proposed Frequency of Refresher Training or Assessment Proposed Refresher Training Periods It is recommended that refresher training should take place at: Level 1 – Induction, to ensure awareness of local procedures and no longer than every 3 years. Level 2 – No longer than every 3 years. Level 3 – No longer than every 3 years. Organisational Implications: Each healthcare organisation will need to determine the required refresher training periods, ensuring that any agreed training schedule is incorporated into local policy. Refresher training will be indicated for all staff if there is a change in safeguarding legislation nationally, or an organisation has amended its policy locally. Assessment of Competence • Where a staff member or learner can demonstrate through robust pre-assessment, including where relevant, practical assessment, the required level of current knowledge, understanding and practice, then this can be used as evidence that knowledge and skills have been maintained and the staff member ma y not need to repeat refresher training. • Where a staff member or learner does not meet the required level of current knowledge, understanding and practice through pre-assessment they should complete the refresher training and any associated assessments required. Page 44 8.6 Suggested Standards for Training Delivery The employing organisation should be assured that Learning Facilitators that are involved in the delivery of safeguarding education or training have the appropriate, experience, background and qualifications to deliver training to a satisfactory standard. For guidance, this may include the following: • Advanced knowledge and understanding of adult safeguarding and its application and practice within a healthcare setting. • Awareness of diversity and cultural issues. • Familiarity with key issues related to the use/misuse of physical restrain, liberty protection safeguards, the Mental Capacity Act and the Care Act. • Familiarity with the interfaces between dignity, safeguarding, serious incidents, whistle blowing, complaints, and patient feedback routes. • Experience of teaching and learning, including the ability to meet the competences expected for LSILADD04 Plan and prepare specific learning and development opportunities Where any training delivery is supported by a person who is not an expert in the subject, then the organisation should ensure that they have put in place a quality assurance mechanism, whereby the accuracy of the content and the effectiveness of its delivery has been quality assured and is subject to periodic review. Training needs to be flexible, encompassing different learning styles and opportunities and recognising that individuals learning styles and the roles they undertake vary considerably. E-learning is appropriate to impart knowledge at levels 1 and 2 and can also be used at level 3 as preparation for reflective team-based learning. At level 2 training, education and learning opportunities should include multi-disciplinary and scenario-based discussion e.g. drawing on case studies and lessons from research and audit as appropriate to the speciality and roles of participants. This should be appropriate to the specialty and roles of participants, en compassing for example, the importance of early help, domestic abuse, adults with cognitive impairment and individuals requiring support with communication. At level 3 training, education and learning opportunities should be multi-disciplinary and inter-agency and delivered internally and externally. It should include personal reflection and scenario-based discussion, drawing on case studies, serious case reviews, lessons from research and audit. Organisations should consider encompassing safeguarding learning within regular, multiagency or family meetings, clinical updating, sharing good practice and clinical audit, reviews of critical incidents and significant unexpected events and peer discussions. Such participative learning time should be documented an d a reflective record kept by the participant. There are several aspects of safeguarding training and education that can apply equally to child and adult safeguarding/protection and that share the same principles. Examples of this may include, but are not limited to; safeguarding ethos, confidentiality, information sharing, documentation and domestic abuse. Those who are providing training on shared aspects must ensure that there is equal weighting given to children and adults within the training and that the relevant learning outcomes of both adult and child safeguarding are met at the appropriate level. Further guidance on underpinning principles for delivery of education and training in Adult Safeguarding is presented in Adult Safeguarding: Roles and Competencies for Health Care Staff ( 2018). 8.7 Relevant National Occupational Standards Relevant National Occupational Standards • SCDHSC0024: Support the safeguarding of individuals • SCDHSC0035: Promote the safeguarding of individuals • SCDHSC0045: Lead practice that promotes the safeguarding of individuals . Page 45 Subject 8a: Preventing Radicalisation 8a.1 Context Statement This subject is derived from the NHS England Prevent Training and Competencies Framework (2017): Prevent is part of the Government counter-terrorism strategy CONTEST and aims to reduce the threat to the UK from terrorism by stopping people becoming terrorists or supporting terrorism. Prevent focuses on all forms of terrorism and operates in a ‘pre-criminal’ space’. The Prevent strategy is focused on providing support and re-direction to individuals at risk of, or in the process of being groomed /radicalised into terrorist activity before any crime is committed. Radicalisation is comparable to other forms of exploitation; it is a safeguarding issue that staff working in the health sector must be aware of. Radicalisation is a process by which an individual or group adopts increasingly extreme p olitical, social, or religious ideals and aspirations that reject or undermine the status quo or undermine contemporary ideas and expressions of freedom of choice. The Prevent Duty 2015 requires all specified authorities including NHS Trusts and Foundation Trusts to ensure that there are mechanisms in place for understanding the risk of radicalisation. Furthermore, they must ensure that health staff understand the risk of radicalisation and how to seek appropriate advice and support. Healthcare staff will meet and treat people who may be vulnerable to being drawn into terrorism. The health sector needs to ensure that healthcare workers are able to identify early signs of an individual being drawn into radicalisation. Staff must be able to recognise key signs of radicalisation and be confident in referring individuals to their organisational safeguarding lead or the police thus enabling them to receive the support and intervention they require. Ref: NHS England (2017), Prevent Training and Competencies Framew ork 8a.2 Current Legal or Relevant Expert Guidance Legislation – UK Wide • Equality Act 2010 • Human Rights Act 1998 • Counter-Terrorism and Security Act (2015) Key Guidance – England and Wales • NHS England (2017), Prevent Training and Competencies Framework • HM Government (July 2015), Revised Prevent Duty Guidance for England and Wales • HM Government (2011), Prevent Strategy • HM Government (2018) CONTEST: The UK Strategy for countering terrorism • NHS England (2017), Guidance for mental health services in exercising duties to safeguard people from the risk of radicalisation Key Guidance – Northern Ireland • Department of Health, Social Services and Public Safety (2015), Adult Safeguarding: Prevention and Protection in Partnership Key Guidance – Scotland • Revised Prevent Duty Guidance for Scotland Page 46 8a.3 Target Audience • Basic Prevent Awareness: All clinical and non-clinical staff that have contact with adults, children and young people and/ or parents/carers. This will include for example receptionists, transport staff and phlebotomists. This is the same target group as for Safeguarding Adults and Safeguarding Children at Levels 1 & 2. • Prevent Awareness: All staff who could potentially contribute to assessing, planning, intervening and evaluating the needs of an adult or child where there are safeguarding concerns. This will include for example; GPs, mental health practitioners, front line ambulance staff and chaplaincy staff. This is the same target group as for Safeguarding Adults and Safeguarding Children at Level 3. This target group for Awareness of Prevent also includes: ➢ Named professionals (named doctors, named nurses named health visitors, named midwives (in organisations delivering maternity services), named health professionals in ambulance organisations and named GPs for Organisations commissioning Primary Care) ➢ Designated Professionals (designated doctors and nurses, lead paediatricians, consultant/lead nurses, Child Protection Nurse Advisers (Scotland). Prevent Leads In addition to Basic Prevent Awareness and Prevent Awareness, there is also a level of competence relevant to organisational Prevent Leads in both commissioner and provider organisations. The competencies for Prevent Leads are outside the scope of the Statutory/Mandatory CSTF, but can be found in the NHS England Prevent Training and Competencies Framework. NB. The Prevent Training and Competencies Framework was developed in conjunction with the 2014 Intercollegiate document7 in order to ensure a consistent approach to training and provide parity between the expectations to safeguard both children and adults with care and support needs. 7 Royal College of Paediatrics and Child Health (2014), Intercollegiate Document, Safeguarding children and young people: roles and competences for health care staff Page 47 8a.4 Key Learning Outcomes8 Basic Prevent Awareness The learner will: a) understand the objectives of the Prevent strategy and the health sector contribution to the Prevent agenda b) know own professional responsibilities in relation to the safeguarding of adults, children and young people at risk c) understand the vulnerability factors that can make individuals susceptible to radicalisation or a risk to others d) know who to contact and where to seek advice if there are concerns about an individual who may be being groomed into terrorist activity9 e) be able to recognise potential indicators of risk relating to individuals being radicalised f) understand what impact direct (bullying, be-friending and influencing) or indirect (internet, media etc.) factors might have on individuals and how it might change their thoughts and behaviours g) be able to raise concerns and take action when they have concerns h) understand the importance of sharing information (including the consequences of failing to do so). Prevent Awareness (Basic Prevent Awareness outcomes plus the following) The learner will: a) know how to support and redirect vulnerable individuals at risk of being groomed into a terrorist related activities b) know how to share concerns, get advice, and make referrals in order to safeguard vulnerable individuals c) understand Channel multi-agency arrangements to provide support and redirection to individuals at risk of radicalisation d) understand Prevent in the context of the Prevent Duty and the concept of non-criminal space e) understand that radicalisation uses normal social processes and the “power of influence” on all f) recognise influence, and understand the concepts of polarisation and the use of narratives and ideology g) understand the current threat level and that Prevent can be applied to all forms of terrorism, present or emerging h) understand the term “vulnerable” in the context of Prevent and what vulnerabilities ar e exploited by terrorist groups i) understand there is no single checklist or profile of a terrorist, and that health staff are a key group and must use their professional judgement in assessing behaviours and risks j) understand how to recognise and share concerns, seek support and advice, and make referrals within own organisation and with other agencies where appropriate k) be aware of Building Partnerships, Staying Safe: The health sector contribution to HM Government’s Prevent Strategy: guidance for healthcare workers and their organisations relevant polic ies, procedures and systems for Prevent. 8 The levels of target audience and associated learning outcomes for are derived from the Prevent Training and Competencies Framework (NHS England 2015). 9 Prevent aims to address all forms of terrorism and violent extremism Page 48 8a.5 Proposed Frequency of Refresher Training or Assessment Basic Prevent awareness: training should be repeated every 3 years as a minimum to ensure that individuals are up to date with current procedures and contacts. In addition to these programmes, Named Designated Professionals should circulate written update briefings and literature to all staff at least annually which would include, for example, any changes in legislation, changes to local policy and procedure or lessons learnt in respect of Prevent. The training compliance target for Basic Prevent awareness training should be in line with the local agreed safeguarding key performance indicators. Prevent Awareness: Workshops to Raise Awareness of Prevent (WRAP) should be completed within 12 months of starting in a role requiring this level of training. Organisations should ensure that staff are provided with appropriate updating/briefing on Prevent at least yearly; relevant training may also be accessed in a number of ways at local, regional or national level and may be multi - disciplinary or inter-agency, all training and development undertaken should be recorded on completion. Knowledge and skills should be reviewed during the annual appraisal process ensuring that individuals are up to date with current policy and practice, any education and training needs being identified to develop and maintain the required knowledge and skills. The training compliance target for organisations at this level is 85% over 3 years or as agr eed locally by the NHS Standard Contract holder. 8a.6 Suggested Standards for Training Delivery Basic Prevent Awareness training can be incorporated into an organisation’s face to face or e-learning material via: • Induction sessions; • Level 1 Safeguarding Children training and Level 1 Safeguarding Adults training; • Level 2 Safeguarding Children training and level 2 Safeguarding Adults training; • Safeguarding e-learning package. Prevent Awareness should be delivered by attendance at a Workshop to Raise Awareness of Prevent (WRAP) or by completing an approved e-learning package. WRAP can be delivered to staff in a single organisation, on a partnership basis between organisations, or on a multi - agency basis. The employing organisation should be assured that all Facilitators have appropriate experience, background and qualifications to deliver this training. If training is delivered via e-learning it should be via a Home Office, Department of Health or NHS England approved product. 8a.7 Relevant National Occupational Standards Relevant National Occupational Standards • SCDHSC0024: Support the safeguarding of individuals • SCDHSC0035: Promote the safeguarding of individuals • SCDHSC0045: Lead practice that promotes the safeguarding of individuals Return to contents page Page 49 Subject 9: Safeguarding Children (Version 3) 9.1 Context Statement Safeguarding children and young people from harm and providing an environment in which children can flourish is a key societal value. Children and young people have a right to be “protected from all forms of violence, abuse, neglect and bad treatment by their parents or anyone else who looks after them.” (United Nations 1989 10). Organisations are required to co-operate with other agencies to protect individual children and young people from harm. Supportive and trustful relationships between children, their families and healthcare staff will be a key factor in enabling effective safeguarding management. Dependent upon roles, healthcare workers can be in an important position in helping to recognise child maltreatment. Healthcare staff need to be alert to signs and symptoms of maltreatment or neglect. They will have a vital role in ensuring effective recording, communication and sharing of information, to help improve identification and ensure appropriate support is put in place for childre n and young people in need or at risk of harm. Healthcare staff will need to exercise professional judgement focused on the safety and welfare of children and young people (Munro 2011 11) and know how to make a referral when appropriate. Accordingly, healthcare organisations need to ensure that all staff that might be in contact with children or involved with their care have a clear awareness and understanding of safeguarding issues. The guidance and learning outcomes in this subject are derived from the fou rth edition (2019) of the Intercollegiate Document; Safeguarding Children and Young People: Roles and Competencies for Healthcare Staff. It is envisaged that the Intercollegiate Document will be reviewed again in 2022. 9.2 Current Legal or Relevant Expert Guidance UK • United Nations Convention on the Rights of the Child 1989 Legislation – England and Wales • Children Act 2004 • Children and Social Work Act 2017 • Children and Families Act 2014 • Children and Young Persons Act 2008 • Female Genital Mutilation Act 2003 • Sexual Offences Act 2003 • Mental Capacity Act 2005 Legislation – Northern Ireland • The Children (Northern Ireland) Order 1995 • The Safeguarding Vulnerable Groups (Northern Ireland) Order 2007 • Safeguarding Board Act (Northern Ireland) 2011 • Sexual Offences (Northern Ireland) Order 2008 • Mental Capacity Act (Northern Ireland) 2016 10 United Nations (1989), United Nations Convention on the Rights of the Child 11 Department for Education (2011), The Munro Review of Child Protection: Final Report Page 50 Legislation – Scotland • Children and Young People (Scotland) Act 2014 • Children (Scotland) Act 1995 • The Protection of Children (Scotland) Act 2003 • Sexual Offences (Scotland) Act 2009 Legislation – Wales • Children Act 1989 • The Children Act 2004 (Commencement Orders No1-8) (Wales) • The Children and Young Persons Act 2008 (Commencement Orders No.1- 6) (Wales) Order 2011 • Rights of Children and Young Persons (Wales) Measure 2011 • Social Services and Wellbeing (Wales) Act 2014 Key Guidance – UK Wide • Royal College of Nursing (2019), Safeguarding Children and Young People: Roles and Competencies for Healthcare Staff (Intercollegiate Document, Fourth Edition) • General Medical Council (2012), Protecting children and young people: The responsibilities of all doctors • Royal College of General Practitioners (2011), Safeguarding Children & Young People: A toolkit for General Practice • Home Office, Protecting the UK against terrorism: The Prevent strategy Key Guidance – England • HM Government (2018) Working Together to Safeguard Children: A guide to inter -agency working to safeguard and promote the welfare of children • NICE guideline [NG76], Child abuse and neglect • NICE guideline [CG89], Child maltreatment: when to suspect child maltreatment in under 18s • Department of Education (2011) The Munro Review of Child Protection: final report - a child-centred system • Department of Health (2011), Building partnerships, staying safe: The health sector contribution to HM Government’s Prevent strategy: guidance for healthcare organisations • Home Office (2015), Mandatory Reporting of Female Genital Mutilation – procedural information • Lampard K and Marsden E (2015), Themes and lessons learnt from NHS investigations into matters relating to Jimmy Savile • NHS England (2017), Prevent Training and Competencies Framework • NHS England (2015), Safeguarding Vulnerable People in the NHS – Accountability and Assurance Framework • NHS England (2015), Safeguarding Policy • NHS England (2015), Managing Safeguarding Allegations Against Staff Policy and Procedure • Office of the Children’s Commissioner • Report of the Children and Young People’s Health Outcome Forum (2012) Key Guidance Northern Ireland • Department of Health (2017), Cooperating to Safeguard Children • Department of Health, Social Services and Public Safety (2011), UNOCINI Guidance, Understanding the Needs of Children in Northern Ireland Page 51 Key Guidance – Scotland • Scottish Government, Child Protection • Scottish Government (2013), Child Protection Guidance for Health Professionals • Scottish Executive Health Department (2003), Protecting Children. A Shared Responsibility • Scottish Government (2014), National Guidance for Child Protection in Scotland • Scottish Government, Getting it Right for Every Child • National Risk Framework 2012 Key Guidance – Wales • Children in Wales (2008), All Wales Child Protection Procedures • Welsh Government (2003), Safeguarding Children: Working together for positive outcomes • Welsh Government (2006), Safeguarding Children: Working Together under the Children Act 2004 • Welsh Government (2004), Children and Young People: Rights to Action 9.3 Target Audience The target audience and levels given here are those that have been stated in the Intercollegiate Document, Safeguarding Children and Young People: Roles and Competences for Healthcare Staff, Royal College of Nursing (2019). • Level 1: All staff working in health care settings. • Level 2: All non-clinical and clinical staff who have any contact (however small) with children, young people and/or parents/carers or any adult who may pose a risk to children. • Level 3: Clinical staff (working with children, young people and/or their parents/ carers and/or any adult who could pose a risk to children), who could potentially contribute to assessing, planning, intervening and/ or evaluating the needs of a child or young person and/or parenting capacity (regardless of whether there have been previously identified child protection/safeguarding concerns or not). Those healthcare staff who undertake specialist safeguarding roles and responsibilities including named professionals, designated professionals, experts and board members will need to receive higher levels of training and opportunities to promote acquisition of skills to ensure they can develop the desired level of competence for their role and thus contribute to effective safeguarding. The training standards and learning outcomes at Level 4 (Named professionals) and Level 5 (Designated professionals) and requirements for Health Board Executives and non-executive directors/members are beyond the scope of this core skills framework but are set out in the Intercollegiate Document (2019). Page 52 9.4 Key Learning Outcomes The following section reflects the level and core learning outcomes in accordance with the Intercollegiate Document (2019). However, it needs to be emphasised that dependent upon role/speciality there may be additional learning needs which will need to be addressed. While some of these needs can be addressed through training, some will be achieved through clinical experience and supervision. Level 1 The learner will: a) know potential indicators of child maltreatment in its different forms – physical, emotional and sexual abuse, neglect, grooming and exploitation to support and/or commit acts of terrorism (known as radicalisation) b) be aware of child trafficking, female genital mutilation (FGM), forced marriage, modern slavery, gang and electronic media abuse, sexual exploitation, county lines (young people involved in organised crime who are coerced to traffic drugs or other illegal items around the country) c) understand the risks associated with the internet and online social networking d) be aware of the vulnerability of; looked after children, children with disabilities, unaccompanied children, care leavers and young carers, missing children e) understand the impact a parent/carers physical and mental health can have on the wellbeing of a child or young person, including the impact of domestic abuse and violence and substance misuse f) understand the importance of children’s rights in the safeguarding/child protection context g) know what action to take if they have concerns, including to whom concerns should be reported and from whom to seek advice h) be aware of relevant legislation (Children Acts 1989, 2004, and Children and Social Work Act 2017 and the Sexual Offences Act 2003, and the equivalent Acts for Scotland, Northern Ireland and Wales). Level 2 (Level 1 Outcomes plus the following) The learner will: a) understand what constitutes child maltreatment and be able to identify signs of child abuse or neglect b) be able to act as an effective advocate for the child or young person c) understand the potential impact of a parent’s/carer’s physical and mental health on the wellbeing of a child or young person in order to be able to identify a child or young person at risk d) be able to identify one’s own professional role, responsibilities, and professional boundaries, and understand those of colleagues in a multidisciplinary team and in multi-agency setting e) know how and when to refer to social care if a safeguarding/child protection concern is identified f) be able to document safeguarding/child protection concerns in a format that informs the rel evant staff and agencies appropriately g) know how to maintain appropriate records including being able to differentiate between fact and opinion h) be able to identify the appropriate and relevant information and how to share it with other teams i) be aware of the risk of FGM in certain communities, be willing to ask about FGM in the course of taking a routine history where appropriate to role, know who to contact if a child makes a disclosure of impending or completed mutilation, be aware of the signs and symptoms and be able to refer appropriately for further care and support, including the FGM mandatory reporting duties to the police: in accordance with current legislation Page 53 j) be aware of the risk factors for grooming and exploitation to support and/or commit acts of terrorism (known as radicalisation) and know who to contact regarding preventive action and supporting those vulnerable young persons who may be at risk of, or are being drawn into, terrorist related activity k) be able to identify and refer a child suspected of being a victim of trafficking and/or sexual exploitation. Level 3 (Level 1 & 2 Outcomes plus the following) The learner will: a) be able to identify, drawing on professional and clinical expertise, possible signs of sexual, physical, or emotional abuse or neglect including domestic abuse, sexual exploitation, grooming and exploitation to support and/or commit acts of terrorism (known as radicalisation), FGM, modern slavery, gang and electronic media abuse using child and family-focused approach b) understand what constitutes child maltreatment including the effects of carer/parental behaviour on children and young people c) have an awareness or knowledge of, dependent on role, forensic procedures in child maltreatment, with specific requirements and depth of knowledge relating to role (e.g. where role involves/includes forensics teams/working alongside forensics teams) d) know how to undertake, where appropriate, a risk and harm assessment e) know how to communicate effectively with children and young people, and to kn ow how to ensure that they have the opportunity to participate in decisions affecting them as appropriate to their age and ability f) know how to contribute to, and make considered judgements about how to act to safeguard/protect a child or young person, including escalation as part of this process g) know how to contribute to/formulate and communicate effective management plans for children and young people who have been maltreated within a multidisciplinary approach and as related to role h) understand the issues surrounding misdiagnosis in safeguarding/child protection i) know how to ensure the processes and legal requirements for looked after children, including after -care, are appropriately undertaken, where relevant to role j) know how to appropriately contribute to inter-agency assessments by gathering and sharing information, documenting concerns appropriately for safeguarding/child protection and legal purposes, seeking professional guidance in report writing where required k) know how to assess training requirements and contribute to departmental updates where relevant to role. This can be undertaken in various ways, such as through audit, case discussion, peer review, and supervision and as a component of refresher training l) know how to deliver and receive supervision within effective models of supervision and/or peer review as appropriate to role, and be able to recognise the potential personal impact of safeguarding/child protection work on professionals m) be able to identify risk to the unborn child in the antenatal period as appropriate to role n) know how to apply the lessons learnt from audit and serious case reviews/case management reviews/significant case reviews to improve practice o) know, as per role, how to advise others on appropriate information sharing p) know how to (where relevant to role) appropriately contribute to serious case reviews (in Wales child practice reviews)/domestic homicide reviews which include children/case management reviews/significant case reviews, and child death review processes, and seek appropriate advice and guidance for this role Page 54 q) know how to obtain support and help in situations where there are problems requiring further expertise and experience r) know how to participate in and chair peer review and multidisciplinary meetings as required. Level 3: Additional learning outcomes for specialist roles There are additional requirements for the following specialist roles: a) paediatricians b) forensic physicians c) GPs d) GP practice safeguarding leads e) practice nurse f) children’s nurses g) health visitors and family nurses h) midwives i) school nurses j) children and young people’s mental health nurses k) child and adolescent psychiatrists l) child psychotherapists m) child psychologists n) perinatal psychiatrists o) adult mental health psychiatrists and mental health nurses in adult mental health services p) specialist paediatric dentists q) diagnostic radiographers undertaking imaging for suspected physical abuse r) radiologists s) paramedics t) paediatric surgeons u) urgent and unscheduled care staff v) obstetricians w) neonatologists x) paediatric intensivists y) lead anaesthetists for safeguarding/child protection. These specialist learning outcomes are beyond the scope of this core skills framework but are set out in the Intercollegiate Document (2019). Page 55 9.5 Proposed frequency of Refresher Training or Assessment Proposed Refresher Period It is recommended that education, training and competence are reviewed annually as part of staff appraisal in conjunction with individual learning and development plans and that refresher training should take place at: Level 1 – Induction, to ensure awareness of local procedures and no longer than every 3 years. Level 2 – No longer than every 3 years. Level 3 – No longer than every 3 years. Organisational Implications: Each healthcare organisation will need to determine the required refresher training periods, particularly for those staff groups most likely to come into contact with children and young people and/or their parents/carers, ensuring that any agreed training schedule is incorporated into local policy. Refresher training will be indicated for all staff if there is a change in Safeguarding Children and Young People legislation nationally, or an organisation has amended its policy locally. Assessment of Competence • Where a staff member* or learner can demonstrate through robust pre-assessment, including where relevant, practical assessment, the required level of current knowledge, understanding and practice, then this can be used as evidence that knowledge and skills have been maintained and the staff member may not need to repeat refresher training. • Where a staff member or learner does not meet the required level of current knowledge, understanding and practice through pre-assessment they should complete the refresher training and any associated assessments required. * Except those staff members who have been working outside of the area of practice or have had a career break Ultimately employing organisations are responsible for assuring that their emp loyees have the knowledge, skills and competence to undertake their roles, ensuring that sufficient time is afforded to employees to enable acquisition and maintenance relevant to their area of practice. While each individual organisation determines the appropriate time commitment to ensure staff have the required up to date knowledge and skills, as a guide the Intercollegiate document (2019) recommends the following: Level 1; over a three-year period, staff at level 1 should receiver fresher training equivalent to a minimum of two hours. Level 2; over a three-year period, professionals at level 2 should receive refresher training equivalent to a minimum of four hours. Training at level 2 will include the update and training required at level 1 and will negate the need to undertake refresher training at level 1 in addition to level 2 Level 3; Initial training - professionals will complete the equivalent of a minimum of 8 hours education, training and learning related to safeguarding/child protection. Those requiring role specific additional knowledge, skill and competencies should complete a minimum of 16 hours. Level 3; Refresher training - Over a three-year period, professionals should be able to demonstrate refresher education, training and learning equivalent to: • a minimum of eight hours for those requiring Level 3 core knowledge, skills and competencies • a minimum of 12-16 hours for those requiring role specific additional knowledge, skills and competencies. Training at level 3 will include the training required at level 1 and 2 and will negate the need to undertake refresher training at levels 1 and 2 in addition to level 3. Page 56 9.6 Suggested Standards for Training Delivery The employing organisation should be assured that Learning Facilitators who are involved in the delivery of Safeguarding education or training have the appropriate qualifications, experience or background to deliver training to a satisfactory standard. For guidance, this may include the following: • A thorough knowledge of Safeguarding issues and safeguarding procedures and an understanding of their application and practice within a healthcare setting. • Learning Facilitators should also be familiar/have an awareness of diversity and cultural issues. • Experience of teaching and learning, including the ability to meet the competences expected for LSILADD04 Plan and prepare specific learning and development opportunities • Preferable to have a relevant qualification in Safeguarding Vulnerable Children such as a Post Graduate Certificate in Safeguarding Children and Young People. Where any training delivery is supported by a person who is not an expert in the subject, then the organisation should ensure that they have put in place a quality assurance mechanism, whereby the accuracy of the content and the effectiveness of its delivery has been quality assured and is subject to periodic review. Training needs to be flexible, encompassing different learning styles and opportunities. E-learning is appropriate to impart knowledge at levels 1 and 2 and can also be used at level 3 as preparation for reflective team-based learning. At level 2 training, education and learning opportunities should include multi -disciplinary and scenario-based discussion e.g. drawing on case studies and lessons from research and audit as appropriate to the speciality and roles of participants. At level 3 Training, education and learning opportunities should be multi-disciplinary and inter-agency and delivered internally and externally. It should include personal reflection and scenario-based discussion, drawing on case studies, serious case reviews, lessons from research and audit, as well as communicating with children about what is happening as appropriate to the speciality and roles of participants. There are several aspects of safeguarding training and education that can apply equally to child and adult safeguarding/protection and that share the same principles. Examples of this may include, but are not limited to; safeguarding ethos, confidentiality, information sharing, documentation and domestic abuse. Those who are providing training on shared aspects must ensure that there is equal weighting given to children and adults within t he training and that the relevant learning outcomes of both adult and child safeguarding are met at the appropriate level. 9.7 Relevant National Occupational Standards Relevant National Occupational Standards • CS16: Improve awareness of the potential abuse of children and young people • CS18: Recognise and respond to possible abuse of children and young people • SCDHSC0325: Contribute to the support of children and young people who have experienced harm or abuse • SCDHSC0034: Promote the safeguarding of children and young people Return to contents page Page 57 Subject 10: Resuscitation 10.1 Context Statement It is a common expectation that healthcare staff will have sufficient knowledge and skills to be able to recognise and respond to signs of clinical deterioration. Where healthcare staff can anticipate, identify and respond to patient signs of clinical deterioration they can prevent further decline that might otherwise culminate in cardiorespiratory arrest. Consequently, there has been a particular focus in promoting greater awareness and understanding in the needs and care of the deteriorating patient. While the priority is on preventing clinical deterioration, some patients’ condition will progress to cardiorespiratory arrest and require cardiopulmonary resuscitation (CPR). Early and effective resuscitation can save lives. Research in emergency care of collapsed people has led to significant advances in resuscitation techniques. Healthcare organisations must have a clearly defined resuscitation policy and ensure that they provide an effective resuscitation response and service. As part of their duty to ensure safe and effective care, healthcare organisations must ensure that their workforce receives the appropriate training, including periodic updates, in order to maintain a level of resuscitation competence relevant to their role. The requirements stated are minimum standards and apply to the majority of the workforce in roles and settings where they might be required to provide initial CPR until the arrival of advanced life support expertise and support. 10.2 Current Policy Guidance Expert Organisation • Resuscitation Council (UK) Relevant Expert Guidance • Resuscitation Council (2013-2017), Quality standards for cardiopulmonary resuscitation practice and training • Resuscitation Council (2021), Resuscitation Guidelines • British Medical Association, Resuscitation Council (UK) and the Royal College of Nursing (2015), Decisions relating to cardiopulmonary resuscitation (June 2016) • General Medical Council (2010), Treatment and care towards the end of life: good practice in decision making Scotland • Scottish Government (2016), Do Not Attempt Cardiopulmonary Resuscitation (DNACPR): Integrated Adult Policy • Scottish Government (2012), Resuscitation Planning Policy for Children and Young People (under 16 years) Page 58 10.3 Target Audience Learning outcomes are divided into three levels based on knowledge, skills and understanding. The appropriate level of training is dependent upon an individual’s role, work context and a local risk assessment. The learning outcomes are derived from the Resuscitation Council (2015) Resuscitation Guidelines. The levels given here are for the majority of staff who might need to be involved in delivering CPR. However, there are additional specialist levels of outcomes which need to be achieved for those who are expected to lead a resuscitation team, are resuscitation team members or teach resuscitation. These specialist outcomes for ‘Advanced Life Support’ are not covered in this framework. For further information about specialist outcomes, please see the Resuscitation Council (2015) Resuscitation Guidelines and the Quality Standards for Clinical Practice and Training. Where staff are exposed to and involved in the care of patients from a range of age groups, they should receive the relevant type of resuscitation training. Level 1 • Non-clinical staff, dependent upon local risk assessment or work context. Level 2 – Basic Life Support Staff with direct clinical care responsibilities including all qualified healthcare professionals: • Staff working with Adult patients should undertake training in adult basic life support. • Staff working with Paediatric patients should undertake training in paediatric basic life support. • Staff working with Newborn patients should undertake training in newborn basic life support. Level 3 – Immediate Life Support Staff with direct clinical care responsibilities including all qualified healthcare professionals: • Registered healthcare professionals with a responsibility to participate as part of the adult resuscitation team should undertake adult immediate life support training. • Registered healthcare professionals with a responsibility to participate as part of the paediatric resuscitation team should undertake paediatric immediate life support training. • Registered healthcare professionals with a responsibility to participate as part of the newborn resuscitation team should undertake newborn life support training. • Registered healthcare professionals involved in administering rapid tranquillisation in the care of patients with disturbed mental functioning should undertake adult immediate life support training. • Registered healthcare professionals involved in administering sedation in the care of dental or podiatric patients should undertake adult immediate life support training and, where appropriate to case load, paediatric immediate life support training. Page 59 10.4 Key Learning Outcomes Level 1 The learner will: a) be able to recognise cardiorespiratory arrest b) know how to summon immediate emergency help in accordance with local protocols c) be able to start CPR using chest compressions d) be able to locate and operate an AED. Level 2 – Adult Basic Life Support (Level 1 outcomes plus the following) The learner will: a) understand national guidelines and local resuscitation policies and procedures b) know how to recognise and respond to patients with clinical deterioration or cardiorespiratory arrest, escalating care in accordance with local policy c) be able to initiate an appropriate emergency response, which may include management of choking, and the use of the recovery position, all in accordance with current Resuscitation Council (UK) guidelines d) be able to initiate and maintain effective chest compressions in accordance with current Resuscitation Council (UK) guidelines e) be able to provide basic airway management i.e. ensure an open airway f) be able to initiate and maintain effective lung ventilations in accordance with current Resuscitation Council (UK) guidelines g) know how an Automated External Defibrillator (AED) can be operated safely and appropriately h) understand their individual role and responsibilities in responding to persons in emergency situations i) understand their individual responsibilities in reporting and recording details of an emergency event accurately j) understand the importance of undertaking any resuscitation interventions within the limits of their personal capabilities and context of any previous training received k) know how they should apply the local Do Not Attempt Cardiopulmonary Resuscitation Policy / anticipatory care decision within clinical context. Level 2 – Newborn Basic Life Support (Level 1 outcomes plus the following) The learner will: a) understand national guidelines and local Resuscitation policies and procedures b) know how to recognise and respond to a newborn infant, escalating care in accordance with local policy c) understand the importance of temperature control in the care of the newborn d) be able to initiate an appropriate emergency response in accordance with cur rent Resuscitation Council (UK) guidelines e) be able to provide basic airway management i.e. ensure an open airway f) be able to initiate and maintain effective respiration in accordance with current Resuscitation Council (UK) guidelines Page 60 g) be able to initiate and maintain effective chest compressions in accordance with current Resuscitation Council (UK) guidelines h) understand their individual role and responsibilities in responding to persons in emergency situations i) understand their individual responsibilities in reporting and recording details of an emergency event accurately j) understand the importance of undertaking any resuscitation interventions within the limits of their per sonal capabilities and context of any previous training received. Level 2 – Paediatric Basic Life Support (Level 1 outcomes plus the following) The learner will: a) understand national guidelines and local Resuscitation policies and procedures b) know how to recognise and respond to patients with clinical deterioration or cardiorespiratory arrest, escalating care in accordance with local policy c) be able to initiate an appropriate emergency response, which may include management of choking and the use of the recovery position, in accordance with current Resuscitation Council (UK) guidelines d) be able to provide basic airway management i.e. ensure an open airway e) be able to initiate and maintain effective lung ventilations in accordance with current Resuscitation Council (UK) guidelines f) be able to initiate and maintain effective chest compressions in accordance with current Resuscitation Council (UK) guidelines g) understand their individual role and responsibilities in responding to persons in emergency situations h) understand their individual responsibilities in reporting and recording details of an emergency event accurately i) understand the importance of undertaking any resuscitation interventions within the limits of their personal capabilities and context of any previous training received j) know how they should apply the local Do Not Attempt Cardiopulmonary Resuscitation Policy / anticipatory care decision within clinical context. Level 3 – Adult Immediate Life Support (Levels 1 & 2 outcomes plus the follo wing) The learner will: a) be able to recognise the seriously ill adult and initiate appropriate interventions to prevent cardiorespiratory arrest b) understand and be able to apply the ABCDE approach c) know how to manage and co-ordinate roles and responsibilities within the team in responding to emergency situations until the arrival of a resuscitation team or more experienced assistance d) be able to participate as a member of the resuscitation team e) be able to provide initial post resuscitation care until the arrival of the resuscitation team or more experienced assistance. Page 61 Level 3 – Newborn Immediate Life Support (Levels 1 & 2 outcomes plus the following) The learner will: a) be able to recognise the seriously ill newborn and initiate appropriate interventions to prevent cardiorespiratory arrest. b) understand the importance of maintaining newborn temperature control c) know how to manage and co-ordinate roles and responsibilities within the team in responding to emergency situations until the arrival of a resuscitation team or more experienced assistance d) be able to participate as a member of the resuscitation team e) be able to provide initial post resuscitation care until the arrival of the resuscitation team or more experienced assistance. Level 3 – Paediatric Immediate Life Support (Levels1 & 2 outcomes plus the following) The learner will: a) be able to recognise the seriously ill child and initiate appropriate interventions to prevent cardiorespiratory arrest b) understand and be able to apply the ABCDE approach c) know how to manage and co-ordinate roles and responsibilities within the team in responding to emergency situations until the arrival of a resuscitation team or more experienced assistance d) be able to participate as a member of the resuscitation team e) be able to provide initial post resuscitation care until the arrival of the resuscitation team or more experienced assistance. 10.5 Proposed Frequency of Refresher Training or Assessment Proposed Refresher Period It is recommended that refresher training should take place at a minimum of: Level 1 – Every year. Level 2 – Every year. Level 3 – Every year. Organisational Implications: Each healthcare organisation should determine the required refresher training periods, ensuring that any agreed training schedule is incorporated into their local policy. Organisations should have a programme of resuscitation audit in place. The outcomes and implications of audits should be used to ensure that key policies and practices are being implemented appropriately and that they inform training priorities in order to improve practice. Refresher training is aimed at ensuring maintenance of knowledge and skills and, dependent upon role, clinical responsibilities and context. Some staff groups may need more frequent refresher training. Additional training will be indicated for all staff if there is a change in Resuscitation guidelines nationally or where the organisation has amended its policy locally. Local action plans developed with the involvement of the lead advisor should determine the best way of achieving any training requirements necessitated by changes in guidelines. A variety of training methods and approaches may be used to plan and deliver flexibly any required refresher training. Refresher training does not mean that staff have to undertake classroom -based training only. Any training Page 62 methods used must be relevant for promoting the maintenance of knowledge and skills and their effectiveness must be monitored. Assessment of Competence • Where a staff member or learner can demonstrate the required level of current knowledge, understanding and practice through robust pre-assessment, including where relevant practical assessment, this can be used as evidence that knowledge and skills have been maintained, and the staff member may not need to undertake refresher training. • Where a staff member or learner does not meet the required level of current knowledge, understanding and practice through pre-assessment they should complete the refresher training and any associated assessments required. • Those individuals who maintain their instructor status on a life support course should be deemed to have the required knowledge, understanding and skills and do not need to undertake refresher training in the speciality concerned. 10.6 Suggested Standards for Training Delivery The Resuscitation Council UK has set out recommendations for the planning, organisation and delivery of resuscitation training and these should be used as a key reference point. This includes guidance on suggested training methods: “For all staff, a variety of methods to acquire, maintain and assess resuscitation skills and knowledge can be used for annual updates (e.g. life support courses, simulation training, in-house training, mock-drills, ‘rolling refreshers’, e- learning, video based training/self-instruction). The appropriate methods must be determined locally… ‘Hands-on’ simulation training and assessment is recommended for clinical staff” (Resuscitation Council 2014-15, Quality standards for cardiopulmonary resuscitation practice and training) In ensuring minimum training standards, the employing organisation should be assured that those learning facilitators that are involved in the delivery of Resuscitation education or training have the appropriate qualifications, experience or background to deliver training to a satisfactory standard. This may include the following: • A relevant professional and/or healthcare qualification and/or experience, for example, a Resuscitation Officer. • Completion of specific training for cardiopulmonary arrests in special circumstances related to the clinical setting in which they deliver training e.g. paediatrics, newborn, pregnancy and trauma • Demonstration of up to date competences in Resuscitation relevant to the level of practice and teaching. • A thorough knowledge of Resuscitation issues and procedures and an understanding of their applica tion and practice within a healthcare setting. • Experience of teaching and learning, including the ability to meet the competences expected for LSILADD04 Plan and prepare specific learning and development opportunities Learning facilitators must have access to equipment for resuscitation training, including as appropriate adult and paediatric manikins, airway management trainers, ECG monitors, rhythm simulators and defibrillator s. Return to contents page Page 63 Subject 11: Information Governance and Data Security 11.1 Context Statement The effective delivery of healthcare services requires the substantial collection, processing and exchange of personal information and data. Ensuring the appropriate collection, use and security of this information is a significant legal responsibility for healthcare organisations and individual healthcare workers. Recent high -profile cases of personal data loss and breaches of confidential information, with a significant number of incidents coming from the health sector, have, however, focused and renewed the requirement for all healthcare staff to have an awareness of their responsibilities in using and safeguarding sensitive information. Data Security has always been important but has become more complex and time -consuming to manage now that technology is so central to the way we deliver health and care. 11.2 Current Legal or Relevant Expert Guidance Expert Organisation • Information Commissioner’s Office (ICO) • NHS Digital • National Data Guardian • NHSX / Information Governance • The National Cyber Security Centre • The UK Caldicott Guardian Council Legislation – England • The common law duty of confidentiality * • The Data Protection Act 2018 • The Freedom of Information Act 2000 Legislation – Northern Ireland • The common law duty of confidentiality * * Although this does not refer to an Act of Parliament it is a form of law based on previous court cases decided by judges; thus it is also referred to as ‘judge-made’ or case law. Key Guidance • Guide to the General Data Protection Regulation (GDPR) • Caldicott 1 - Report on the Review of Patient-Identifiable Information. London: Caldicott Committee, 1997 • Caldicott 2 - Information: To Share Or Not To Share? The Information Governance Review. Lo ndon: Independent Information Governance Oversight Panel, 2013 • Caldicott 3 - Review of Data Security, Consent and Opt-Outs. London: National Data Guardian, 2016 • Care Quality Commission (July 2016), Safe date, safe care • Department of Health (2003), Confidentiality: NHS Code of Practice • Department of Health (2007), Information Security Management: NHS Code of Practice Page 64 • Information Government Alliance, Records Management Code of Practice for Health and Social Care 2016 • National Data Guardian for Health and Care (2016), Review of Data Security, Consent and Opt -Outs • NHS Digital, Codes of practice for handling information in health and care • NHS Digital, Data Security and Protection Toolkit • The Data Protection Act 2018 / UK GDPR 11.3 Target Audience All staff involved in routine access to information. 11.4 Key Learning Outcomes The learner will: a) understand the principles of Information Governance and the importance of data security in health and care b) understand the different types and value of information c) understand the principles of data security, including how to ensure the confidentiality, integrity and availability of data d) be aware of threats to data security and know how to avoid them, including: i. Social engineering12 ii. Using social media safely iii. Using email safely iv. Malicious software v. How to protect information vi. Physical security e) be able to identify data breaches and incidents and know what to report f) understand fundamentals of data protection and the General Data Protection Regulations (GDPR) g) understand the Caldicott Principles and be able to provide a confidential service to patients and service users h) understand the responsibilities of healthcare organisations under the Freedom of Information Act 2000 i) understand individual responsibilities in responding to a Freedom of Information request 12 the use of deception to manipulate individuals into divulging confidential or personal information that may be used for fraudulent purposes Page 65 11.5 Proposed Frequency of Refresher Training Proposed Refresher Period In England, NHS staff (or staff in organisations with access to NHS patient information) should receive refresher training or assessment annually. Assessment of Competence • Where a staff member or learner can demonstrate through robust pre-assessment the required level of current knowledge, understanding and practice, then this can be used as evidence that knowledge and skills have been maintained and the staff member may not need to repeat refresher training. • Where a staff member or learner does not meet the required level of current knowledge, understanding and practice through pre-assessment they should complete the refresher training and any associated assessments required. 11.6 Suggested Standards for Training Delivery The employing organisation should be assured that Learning Facilitators who are involved in the delivery of Information Governance and Data Security education or training have the appropriate qualifications, experience or background to deliver training to a satisfactory standard. For guidance, this may include the following: • A relevant qualification in Information Governance, Quality Assurance. • A thorough knowledge of Information Governance and Data Security issues and procedures and an understanding of their application and practice within a healthcare setting. • Awareness of Clinical Governance, Health Informatics. • Experience of teaching and learning, including the ability to meet the competences expected for LSILADD04 Plan and prepare specific learning and development opportunities Organisations are able to use the Data Security Awareness programme developed by NHS Digital: https://www.e- lfh.org.uk/programmes/data-security-awareness/ The UK Caldicott Guardian Council has stated “that learning objectives are still considered met in those organisations that are adapting the e-learning package locally” and that there is a valid requirement to be able to adapt e-learning locally. Locally produced training will be reported to and signed off by the local organisation’s SIRO or Caldicott Guardian and all staff completing the training will have to achieve the 80% pass mark. 11.7 Relevant National Occupational Standards • HI2.2010: Assure the quality of data and information in a health context • HI1.2010: Identify, and respond to, risks relating to data and information in a health context • HI3.2010: Manage risks relating to data and information in a health context • SS32: Record, store and supply information using a paper-based filing system Return to contents page Page 66 Subject 12: Information Governance (Scotland) 12.1 Context Statement High quality information is crucial to the delivery of safe and effective health care. NHSScotland is putting in place modern and efficient information and communications systems to ensure that the right information is available at the right time and in the right place. It is essential that the benefits which information technology brings to patients and health care professionals, such as improved co-ordination of care, are delivered within a culture which respects, values and keeps data secure. The provision of good quality education and training in Information Governance is an important method of effective information management. It also assists Boards in meeting their statutory responsibilities and policy obligations in Information Governance. 12.2 Current Legal or Relevant Expert Guidance Current guidance on Information Governance, including The Scottish Information Sharing Toolkit is at: https://www.informationgovernance.scot.nhs.uk/istoolkitdrivers/ A standard framework applies to all Scottish public sector organisations, voluntary sector organisations and those private organisations contracted to deliver relevant services to the public sector and who provide services involving the health, education, safety, crime prevention and social well being of people in Scotland. In particular, it concerns those organisations that hold information about individuals and who may consider it appropriate or necessary to share that information with others. 12.3 Target Audience All staff involved in routine access to information including • Foundation: Support Staff Roles. • Intermediate Level 1: Clinical, Administrators & Managers. Further levels of training will be required for staff requiring more advanced competences in their roles (for example, Information Governance Managers). 12.4 Key Learning Outcomes The learner will: a) store, transport and transfer health records and other personal or sensitive data securely and effectively b) understand the safe use of Information and Communication Technology c) understand fundamentals of data protection and the General Data Protection Regulations (GDPR) d) inform individuals about the use of their data e) understand the circumstances when consent should be sought prior to obtaining and using personal data f) verify recorded data using processes for positive identification g) record personal information accurately and consistently h) ensure that recorded information is relevant and not excessive i) use patient related data to support the delivery and management of direct and indirect healthcare Page 67 j) understand the circumstances in which information may be used for secondary purposes k) identify circumstances when personal data can, should and must be shared l) respond appropriately to requests for information demonstrating awareness of local Freedom of Information requirements. 12.5 Proposed Frequency of Refresher Training Organisational Implication: Each healthcare organisation will need to determine the required refresher periods, particularly for those staff groups most likely to be exposed to and involved in Informatio n Governance and ensuring that any agreed training schedule is incorporated into local policy. Refresher training will be indicated if there is a change in new legislation, production of national guidelines, protocols or new health technologies that become available. 12.6 Suggested Standards for Training Delivery The employing organisation should be assured that Learning Facilitators that are involved in the delivery of Information Governance education or training have the appropriate qualifications, experi ence or background to deliver training to a satisfactory standard. For guidance, this may include the following: • A relevant qualification in Information Governance, Quality Assurance. • A thorough knowledge of Information Governance issues and procedures and an understanding of their application and practice within a healthcare setting. • Awareness of Clinical Governance, Health Informatics. • Experience of teaching and learning, including the ability to meet the competences expected for LSILADD04 Plan and prepare specific learning and development opportunities Organisations might also find the Health Informatics Career Framework requirements for a training role helpful to incorporate. 12.7 Relevant National Occupational Standards • HI2.2010: Assure the quality of data and information in a health context • HI1.2010: Identify, and respond to, risks relating to data and information in a health context • HI3.2010: Manage risks relating to data and information in a health context • SS32: Record, store and supply information using a paper-based filing system Return to contents page Page 68 Subject 13: Information Governance (Wales) 13.1 Context Statement The effective delivery of healthcare services requires the substantial collection, processing and exchange of personal information and data. Ensuring the appropriate collection, use and security of this information is a major legal responsibility for healthcare organisations and individual healthcare workers withi n NHS Wales. NHS Wales is putting in place modern and efficient information and communications systems to ensure that the right information is available at the right time and in the right place; however the continued high profile cases of personal data losses and breaches of confidential information have focused and renewed the requirement for all healthcare staff to have an awareness of their responsibilities in using and safeguarding sensitive information. The provision of good quality education and training in information governance is therefore vital as this can be seen as an effective information management awareness mechanism. 13.2 Current Legal or Relevant Expert Guidance Expert Organisation • Information Commissioner’s Office (ICO) Regulation • General Data Protection Regulation (GDPR) Legislation – Wales • The common law duty of confidentiality * • The Data Protection Act 2018 • The Freedom of Information Act 2000 * Although this does not refer to an Act of Parliament it is a form of law based on previous court cases decided by judges; thus it is also referred to as ‘judge-made’ or case law. Key Guidance NHS Wales provides guidance support to NHS organisations across Wales around current legislation and best practice regarding the current Information Governance agenda at: http://www.wales.nhs.uk/sites3/home.cfm?orgid=950 13.3 Target Audience All staff, including unpaid and voluntary staff. Page 69 13.4 Key Learning Outcomes The learner will: a) understand how Information Governance is standardised within Wales b) recognise principles of Information Governance and how they apply in every day working environments. c) understand fundamentals of data protection and the General Data Protection Regulations (GDPR) d) understand the fundamentals of confidentiality and the Caldicott Principles. e) identify NHS Wales’s healthcare organisations responsibilities under the Freedom of Information Act 2000 f) demonstrate principles of good record keeping g) recognise, within the context of their role, how they can apply and maintain information security guidelines h) understand the circumstances in which information may be used and how access must be appropriately authorised i) identify where they can gain local access to policies, procedures and further information on Information Governance. 13.5 Proposed Frequency of Refresher Training Proposed Refresher Period Refresher training should take place at a minimum of every 2 years; however each healthcare organisation within NHS Wales will need to determine the required regular refresher periods, particularly for those staff groups most likely to be exposed to and involved in Information Governance. One-off refresher training/notification will be indicated if there is a change in new legislation, production of national guidelines, protocols or new health technologies that become available. 13.6 Suggested Standards for Training Delivery The employing organisation should be assured that Learning Facilitators that are involved in the delivery of Information Governance education or training have the appropriate qualifications, experience or background to deliver the training to a satisfactory standard. For guidance, this may include the following: • Preferable to have a relevant qualification in Information Governance, Quality Assurance. • A thorough knowledge of Information Governance issues and procedures and an understanding of their application and practice within a healthcare setting. • Awareness of Clinical Governance, Health Informatics. • Experience of teaching and learning, including ability to meet the competences expected for LSILADD04 Plan and prepare specific learning and development opportunities Organisations might also find the Health Informatics Career Framework requirements for a training role helpful to incorporate. 13.7 Relevant National Occupational Standards • HI2.2010: Assure the quality of data and information in a health context • HI1.2010: Identify, and respond to, risks relating to data and information in a health context • HI3.2010: Manage risks relating to data and information in a health context • SS32: Record, store and supply information using a paper-based filing system Page 70 Subject 14: Violence and Aggression (Wales) 14.1 Context Statement Providing health care services can be challenging and often despite best efforts difficult conflict situations, including risk of violence, can arise. Unless managed effectively, they can have a potentially adverse impact for patients or carers, staff and organisations. The NHS In Wales is committed to Zero Tolerance confirming that violence against staff working in the NHS is unacceptable. Employers are required to have policies, procedures and documentation which can help to identify and effectively manage the risk of violence and aggression. 14.2 Current Legal or Relevant Expert Guidance Legislation • Health and Safety at Work etc Act 1974 • Human Rights Act 1998 • Management of Health and Safety at Work Regulations 1999 Key Guidance • HSE (2006), Violence at work A guide for employers • NAO (2003), A Safer Place to Work: Protecting NHS Hospital and Ambulance Staff from Viol ence and Aggression • NHS Wales, All Wales NHS Violence and Aggression Training Passport and Information Scheme Expert Organisations • The Health and Safety Executive (HSE) 14.3 Target Audience Wales has the All Wales Violence and Aggression Training Passport in place, which is overseen by The All Wales Violence and Aggression Advisory Group. This sets out the required training that NHS staff should receive in relation to Violence and Aggression. The training recommended has identified the need for three modules of learni ng and sets out the expected learning outcomes as follows: Module A – Induction and Awareness Raising: All staff including those on honorary contracts, unpaid and voluntary staff. Module B – Theory of Personal Safety and De-escalation. Required staff based upon local risk assessment and training needs analysis. Module C – Breakaway. Required staff based upon local risk assessment and training needs analysis. Page 71 14.4 Key Learning Outcomes Module A: Induction & Awareness Raising The learner will: a) define the terms ‘violence and aggression’ b) demonstrate an awareness of the different types of violence and aggression c) state the responsibilities of the employer d) demonstrate knowledge of their responsibilities as employees e) demonstrate an understanding of the importance of reporting incidents and be able to describe the process for reporting such incidents f) define the concept of risk assessment g) describe where the local policy and procedure for management of violence and aggression is located h) demonstrate an awareness of the staff support mechanisms available within the organisation and how to access this service. Module B: Theory of Personal Safety and De-escalation The learner will: a) define the terms ‘violence and aggression’ b) describe the factors which could influence and affect your personal safety and environment c) identify trigger factors which can lead to a violent and/or aggressive incident d) identify communication skills which can de-escalate a potentially aggressive and/or violent situation e) discuss legal and ethical issues associated with the management of violence and aggression f) discuss cultural and gender issues associated with the management of violence and aggression g) state employer and employee responsibilities with regard to relevant health and safety l egislation h) demonstrate an understanding of the organisation’s policies and procedures on the management of violence and aggression i) demonstrate an understanding of the importance of reporting incidents and be able to describe the process for reporting such incidents j) demonstrate an understanding of staff support systems available. Module C: Breakaway * The learner will: a) understand and explain communication skills which can assist in de-escalating a violent/aggressive situation b) awareness of the environment and the risks it may present c) awareness of personal safety and describe factors which could influence and affect your personal safety and environment d) describe the factors which could influence and affect your personal safety and environment e) explain communication skills which can assist in de-escalating a violent/aggressive situation Page 72 f) demonstrate an understanding of local reporting policies and procedures g) state employer and employee responsibilities with regard to relevant health and safety legisla tion h) discuss legal and ethical issues associated with the management of violence and aggression i) discuss cultural and gender issues associated with the management of violence and aggression j) demonstrate and practice the practical use of breakaway techniques specific to the needs of the staff group subject to risk assessment k) describe situations which may require additional assistance l) describe circumstances when personal/alarm systems should be used m) explain how clinical risk assessment can help to reduce risk of assault * Must only be undertaken after any learner has completed Module B NOTE: A further module is in development proposing learning related to physical interventions and will be included in the framework once published. 14.5 Proposed Frequency of Refresher Training or Assessment Proposed Refresher Period Update/refresher training for employees should be prioritised based upon risk assessment. Organisational Implication: Each healthcare organisation will need to determine the required refresher t raining periods, ensuring that any agreed training schedule is incorporated into their local policy. Refresher training will be indicated for all staff if there is a change in national legislation, healthcare policy or an organisation has amended its policy locally. Assessment of Competence • Where a staff member or learner can demonstrate through robust pre-assessment, including where relevant practical assessment, the required level of current knowledge, understanding and practice, then this can be used as evidence that knowledge and skills have been maintained and the staff member may not need to repeat refresher training • Where a staff member or learner does not meet the required level of current knowledge, understanding and practice through pre-assessment they should complete the refresher training and any associated assessments required. Page 73 14.6 Suggested Standards for Training Delivery The All Wales Violence and Aggression Training Passport sets out the suggested standards which the employing organisation should assure and they include: Specification for training Induction & Awareness Learning Facilitators must be able to: • demonstrate ability to deliver a presentation • demonstrate an understanding of local health and safety policies and procedures relevant to the management of violence and aggression • translate theoretical knowledge of the subject matter into an appropriate healthcare context • demonstrate an up to date knowledge of relevant health and safety legislation • demonstrate a working knowledge and understanding of the cultural/societal issues associated with violence and aggression. Specification for training Talkdown and Breakaway Learning Facilitators must have a recognised training qualification or be able to demonstrate experience up to City and Guilds 730/NVQ equivalent/Certificate in Education and must be able to: • demonstrate up to date knowledge of relevant literature and professional guidelines associated with the management of violence and aggression • demonstrate up to date knowledge of relevant legal issues • translate theoretical knowledge of the subject matter into appropriate healthcare context with knowledge of practical application • be physically capable of demonstrating good practice • demonstrate/identify the mechanism for keeping abreast of developments in the field • demonstrate a working knowledge and understanding of the professional codes of practice of the employees receiving training • demonstrate an understanding of risk assessment processes within a healthcare setting. 14.7 Relevant National Occupational Standards • Ento WRV6: Promote a safe and positive culture in the workplace • FMH5: Minimise the risks to an individual and staff during clinical interventions and violent and aggressive episodes • WRV4: Develop effective policies and procedures for minimising the risk of violence to workers and review their effectiveness Return to contents page Page 74 Appendix 1: User Guide 1. Background to development of the CSTF Healthcare organisations have legal responsibilities to ensure that their staff receives training to develop the knowledge and skills to ensure a safe and healthy workplace (Garcaz & Wilcock 2005)13. Furthermore, in the effort to improve healthcare services, organisations are required to meet quality standards required by government and other agencies, many of which need to be evidenced through compliance training of the workforce. Given the imperative for organisations to ensure their compliance, ensure focus on key training priorities and making effective use of resources, many healthcare organisations have defined their approaches for the provision of statutory and mandatory training. Frequently, these approaches will be formally reflected in local policies and procedures. The provision of statutory and mandatory training represents a significant organisational investment. While many employers recognise and are certain of their commitment in ensuring their workforce receives this training, the focus and delivery of such training can be challenging These challenges include: • ensuring that the purpose of the training is understood and appreciated by employees • ensuring that any training delivered is educationally sound • that the impact of training results in required performance and risk management behaviours • is delivered in a cost-effective way. Development of the CSTF was originally based on evidence that healthcare organisations were interested in a more consistent approach in which this type of training can be prioritised, flexibly delivered, resourced and evaluated. For example, several healthcare regions had previously been working with local employers and Subject Matter Experts to define and help standardise approaches (London, North West, South Central and West Midlands Strategic Health Authorities). In part, the activity in these areas was triggered by a report conducted by PASA (2009) 14 which found substantial opportunity to standardise and consolidate guidance around statutory and mandatory training and particularly prevent duplication of learning. PASA concluded that should consolidation and unnecessary duplication of statutory and mandatory training be achieved, there are opportunities for exploiting cost efficiencies. An early adopter of this approach was the London region, which established a programme of activity to streamline statutory and mandatory training in healthcare organisations and in doing so benefited from significant cost efficiencies. While the fiscal benefit does not necessarily mean cash-releasing efficiency savings, if the recognition and prevention of unnecessary duplication can be achieved at scale across the health sector, it should result in better compliance rates and more direct service contact time given that the workforce will require less time away from the work environment to undertake this type of training. Furthermore, it allows organisations sufficient head room to focus on other training priorities that have benefit for patient and service activity. The interest in a Core Skills Framework was also strongly supported with the responses to a consultation conducted by Skills for Health exploring the support for a UK Core Skills Framework. Skills for Health was subsequently commissioned as part of a programme of work funded by The UK Commission for Employment and Skills to develop a UK wide Core Skills Framework. Skills for Health has since been working with key national stakeholders to develop and maintain the CSTF for statutory and mandatory training. 13 Garcaz W & Wilcock E (2005) Statutory and Mandatory Training in Health and Social Care. Radcliffe Publishing, Oxon.UK. 14 The ‘Statutory and Mandatory Skills Training in the NHS Report’ (NHS PASA, 2009) Page 75 2. Defining Statutory and Mandatory Training One of the challenges related to the issue of statutory and mandatory training is the interchangeable use of terms of Statutory and Mandatory training. For the purpose of this framework the following definitions have been used: Statutory Training: this is training that employers are either legally required to provide as defined by law and for which there is a stated legal reference and/or where a government or regulatory body have instructed employers to provide training on the basis of legislation. These examples would include: • Health and Safety training (required by legal statute). • Equality Act 2010 specifies that all employees receive training in order to ensure that employees appreciate their legal obligations in promoting equality. • Fire safety training is required by statute as determined by the Regulatory Reform (Fire Safety) Order 2005. Mandatory Training: is a training requirement that has been determined by organisations themselves. This can include: Policy Required Mandatory Training: these are requirements for mandatory training which have been determined by a government department, or regulatory body, as part of the implementation of an agreed national policy. For example, in England all staff are required to undertake Information Governance train ing on an annual basis. Organisationally Required Mandatory Training: these are those training requirements that organisations set themselves. These requirements are usually introduced to ensure that the organisation is compliant with key risk areas that might have an impact upon safety, or alternatively, are being delivered to achieve a corporate priority/service improvement which the organisation has set itself. Typically, this type of training is undertaken to provide assurance that local policies governing key corporate and risk activities are understood and are being followed by employees. 3. Importance of Learning Outcomes Often the delivery of statutory/ mandatory training is just focused on providing staff with information about a particular subject. This approach can be limited in its impact in terms of what staff are expected to understand and demonstrate in their work roles. Given both the volume of core skills training needed and the investment level required, an approach which seeks to promote clearer expectations about the purpose of core skills training is required. Moreover, an approach which enables a better understanding of the processes by which effective learning in relation to these common areas of learning activity can be supported and then demonstrated by the learners is essential. One of the key processes to encourage this is the effective use of learning outcomes to drive and underpin any learning activity. Therefore, one of the key aspects covered in each CSTF subject is the identification of the key learning outcomes to be achieved. Although there is some debate about the limitations of using learning outcomes, there is common agreement that the effective use of learning outcomes can provide a clearer focus for determining wh at a learner should know, understand or be able to do following completion of any learning activity (Kennedy et al. 2006) 15. Using learning outcomes can: • Set out clear expectations for learners in terms of what they should be able to demonstrate. • Help those who design education and training opportunities to focus on key knowledge and skills areas that the learner needs to achieve, which in turn will guide the content to be included. • Be used to promote learner progress. 15 Kennedy, D. Hyland, A. Ryan, N. 2006: “Writing and Using Learning Outcomes: a Practical Guide”. In: Froment, Eric (Ed.): EUA Bologna handbook. Making Bologna work. Berlin: Raabe Page 76 • Be observed and assessed. • The use of learning outcomes can guide learning facilitators in the use of appropriate teaching strategies and assessment methods. • Can be used by those who design healthcare education and training curricula to consider how the required Core Skills learning outcomes can be integrated appropriately and/or demonstrate how they map to overall achievement of curriculum aims. In this way, it will help ensure that those learners undertaking healthcare programmes are being given opportunity to acquire core knowledge and skills that employing organisations will need to be assured are being addressed. 4. Key Benefits of the CSTF to Organisations The key benefits of the CSTF are: • That it provides a consolidation and integration of available guidance which org anisations can use to inform and, where appropriate, rationalise the delivery of statutory and mandatory training activity. • It provides a guide for those who have accountability for corporate governance, those with responsibility for delivery of training activity and those internal advisors who guide the content of any training delivery to have a common statement which they can use to audit, and collectively agree, plan and determine how the organisation can best meet or exceed the guidance offered here. • It helps organisations to more explicitly guide training delivery quality and consistency for the identified Subjects. • It helps to set more explicit expected levels of staff performance following delivery of any core skills training. • It can be used to guide some of the measures that might be used to assess the effectiveness and impact of training activity supported. • It can provide a source of guidance in the development of a specification for those organisations who might need/or wish to commission external training provision to deliver any core skills training. 5. Who Needs to Receive Training? The framework broadly identifies for each subject the key target audience who will need to receive the indicated training. Some of the Subjects are aimed at all the workforce within an organisation, while other Subjects and expected levels of knowledge and skill will be more role dependent and only apply for those in more direct patient/service roles. It should be noted that workforce relates to all members of the workforce that the organisation has responsibility for in the conduct of its business and delivery of activities. This will include those learners on work placements, unpaid staff and volunteers. Local factors such as role and responsibility, work context and setting and levels of expected supervision will also be important aspects which will have an impact on the relevance and appli cation of the guidance given in each topic. Some discretion in application of the framework guidance might be warranted in some situations, for example the healthcare student who is on a fully supervised short study placement, or the volunteer who makes a contribution to an organisation on a short but infrequent basis. Accordingly, each organisation will need to use the framework to help it inform and map to their local learning/training needs matrix, risk management analysis controls and to refine more spe cifically the staff groups/roles that will need to receive the suggested level of training indicated. It is envisaged that education providers will contribute to the preparation of learners by embedding, as appropriate, the use of the CSTF as part of curriculum delivery. Where such delivery is clearly evidenced, it should then be recognised by healthcare organisations which then prevents any unnecessary duplication of training. Page 77 6. Promoting Workforce Values The core skills statutory and mandatory training Subjects identified in the CSTF are deemed a priority for an organisation to deliver, given that they focus on areas that contribute towards patient and workforce safety. However, the value of the training on these Subjects has been eroded given concerns about educational impact, frequency and format of learning and that they frequently focus on policy and procedural aspects. While such concerns will be relevant from an organisational perspective, they might seem remote to those receiving the training. In addition, given that those being trained might have other significant learning priorities, the participation in statutory and mandatory training activity can seem a distraction and thus is undervalued. If thi s is evident, this will have potentially adverse implications for organisations given that the impact of their investment in providing the training is lost, whilst also creating pressures on service delivery contact time. There is an opportunity to view and represent this framework as a Curriculum for Patient and Organisational Safety. In doing so, this highlights more specifically how attention to the knowledge and skills gained through participation in this type of training gives an opportunity for the learner to demonstrate on a daily basis, how they express the values being promoted by the organisation. Presenting the Subjects as a themed and joined up curriculum can be used to promote the following key values: • Commitment to quality of care: recognising the need to get the essentials of care right, willingness to learn and build upon success. • Professionalism: to ensure high personal standards of behaviour and response and the commitment to adhere to established policies and procedures. • Personal accountability: the willingness to take responsibility for own actions, recognise limitations and avoid taking inappropriate actions which might have an adverse impact for self and others. • Team work and cooperation: the willingness for working with others for common benefit, to overcome shared challenges and the commitment for improving the performance of all. • Dignity and Respect: recognising and being committed to the imperative of responding with concern, sensitivity and compassion, having positive regard for others, appreciating and acknowledging diversity. 7. Delivery and Formats of Core Skills Training This CSTF does not generally prescribe how the educational and training activity required to implement the framework should be delivered. Similarly, it is not the intention to indicate that only specific training suppliers are endorsed to deliver training in relation to the indicated Subjects. The approach used for delivery of any training is a shared local decision, which needs to involve the relevant staff with responsibilities for either leading, managing or delivering training and should be based upon: • meeting any legal requirements which state which delivery formats must be supported • requirements of local education governance and quality assurance arrangements • availability of learning infrastructure • and the flexibility that best ensures the workforce is able to access and benefit from the training in a timely manner. The health sector needs to recognise and appreciate that provided there is purposeful and careful consideration of key learning and training principles that a variety of training methods can be effectively used to achieve the desired learning outcomes indicated in the CSTF. The challenge is for organisations to best consider and evaluate potential options. As with other activities that require substantial investment and effort, organisations will need to increasingly evidence that any training interventions put in place are designed and monitored for their effectiveness. In recent years there has been particular interest by organisations in using E-Learning as a method to help support delivery of core skills training. Given that research has demonstrated that in the right conditions, E -Learning is at least as effective as face to face training then the validity of using E-Learning to help support delivery, particularly for knowledge elements of any topic should be considered seriously. Page 78 The health sector to date, has at national, regional and local level made significant investments in developing E - Learning programmes to support the delivery of statutory and mandatory training. The key priority is for organisations to review the available programmes and assure themselves that they address any legal requirements for the format of delivery, meet the learning outcomes of the CSTF, or if there is a need to develop further content that it is informed by the CSTF. 8. The Value of Assessment Currently much of the reporting of statutory and mandatory training is recorded on a completion-based process. While recording completion is a key metric for organisations in being able to demonstrate their compliance with key standards the health sector needs to consider much more the value of assessment as a component for the delivery of core skills training. Educational research has demonstrated that the use of assessment which enables the learner to self -monitor and regulate their progress leads to a deeper level of learning. Where this occurs, there is a greater likelihood that learners will have the confidence to apply what they have learnt in practice. Assessment is a key feature of effective learning as: • it helps to indicate whether learning has taken place • it can influence the engagement and behaviours of the learner and can direct and support progress • the use of feedback related with assessment outcomes enriches learner understanding. The results of learner assessment can provide valuable information for organisations in evaluating the effectiveness of teaching and learning approaches and inform further learning needs analysis. There has to be a greater expectation by organisations that given the purpose and investment of providing statutory mandatory core skills training that staff will act upon the training provided. The use of assessment will be a tangible way in which a greater value and expectation on the implications of statutory and mandatory training can be recognised and so should be utilised much more. The effective use of assessment will increase learner motivation and participation and will provide the organisation with a more credible indicator of the workforce’s knowledge and skills in these key risk areas and identify potential gaps which should then be addressed. This approach would be more consistent with responsive risk management assurance. In addition to this, if the effective use of assessment is established, the validity of using pre-assessment must be a significant way in which the management of refresher training could be more efficiently managed. That is where a learner undertakes and demonstrates through a well-planned assessment an acceptable level of knowledge and/or skill application against the specific learning outcomes for a subject, then this can be used as a valid indicator for currency of their competence in relation to the topic assessed. This should mean that learners do not duplica te or repeat what they already know. This approach would be consistent with principles of effective adult learning which places value on autonomous, self-directed and goal orientated learning. It is recognised that the health sector has to gain greater confidence and practical use in the use of assessment. Encouragingly, there is now some concerted efforts to develop resources and approaches to achieve this. Organisations are strongly encouraged to consider the use of assessment, including pre -assessment approaches, and work to integrate their use and recognise their value as part of delivery of training activity. 9. Refresher Periods It is anticipated that given the purpose and focus of the Subjects included in this framework, potential changes in legislation and healthcare policy that the workforce will need periodic training updates. The suggested time period is indicated within each of the Subjects. While refresher training provides an opportunity to practise and update knowledge and skills it should not be just about repeating information that the learners may have already received and know. Rather, it provides an opportunity to also extend knowledge by ensuring that any training update reflects: Page 79 • any new policy/organisational changes • draws upon learning needs analysis and the findings of audits and evaluation. These should be used to prioritise knowledge and understanding on problematic areas or gaps which the organisation has identified which need to be addressed, if currency of knowledge and skills in relation to the identified areas are to be effective. Where there have not been any substantial programme content changes, then organisations should consider how they use pre-assessment as a mechanism for checking the currency of knowledge and understanding . Likewise, the methods for delivery of any refresher training should be considered for ways in which it can be delivered flexibly. There may not always be a requirement for formal classroom based attendance. The use of a variety of learning formats could provide useful ways in which updating of knowledge can and should be supported e.g. • readers • case study briefings • structured professional team based discussions • peer learning and assessment • practical assessments and simulations. There are also opportunities for more use of flexible, randomly assigned, electronic scenario based assessments, which if well designed and their use monitored can be a valid means of ascertaining the knowledge and understanding of the workforce. To maximise flexibility and impact there are opportunities for organisations to develop approaches, quality assurance processes and monitoring which enables refresher update review by and within team structures. Utilising such an approach will promote further accountability at individual and team level for ensuring these updates occurs. They should also enhance better application of knowledge and understanding when individuals/teams are triggered to consider risk issues reflected in core skill learning and examples of application within the context of their own roles and working environment. Before the end of the refresher period, or potentially when there is a major change in legislation or policy, staff need to be assessed to ensure that they have retained the knowledge and/or can demonstrate the skill or capability required. Refresher training should be focused on updating knowledge or facilitate where applicable the acquisition of new and improved skills, techniques and best practice. Each organisation needs to consider how best to deliver any required refresher training but the focus should be not on repeating training and content previously delivered but instead to assess whether the staff member has retained knowledge and understanding and if appropriate, that their knowledge and skills are extended beyond the minimum levels. Page 80 10. CSTF documents and mapping tools The Core Skills Training Framework (CSTF) is available for any individual or organisation to access. Current information about the CSTF is always available from the CSTF home page at: https://skillsforhealth.org.uk/info- hub/category/core-skills-training-framework-cstf/ From the CSTF home page, there are links to access the framework documents including: • Statutory/Mandatory Subject Guide (this document) • Statutory/Mandatory Mapping Tool (a spreadsheet to support the systematic mapping of local provision t o the CSTF learning outcomes) • Declaration of Alignment Commencing in 2020, a new programme of work will ensure the sustainability of a robust Core Skills Training Framework (CSTF) for NHS Trusts in England. The aim is to ensure CSTF alignment, which is assured and related data which transfers efficiently, safely and accurately between employer organisations : Further information and guidance for NHS Trusts in England is available at: https://www.skillsforhealth.org.uk/cstf- england 11. Declaring alignment to the Framework Healthcare providers which have mapped their in-house training to the framework are eligible to submit a Declaration of Alignment, confirming which of their training programmes are aligned to the framework subjects. The process for submitting a Declaration of Alignment to the framework is summarised in Figure 1 overleaf. Aligned healthcare provider organisations are listed on an online Directory; https://cstfdirectory.skillsforhealth.org.uk/ By sharing this information on the CSTF Directory, employer organisations can recognise where training delivered in other organisations is in compliance with the CSTF and thereby help to prevent unnecessary duplication of training as staff move between roles and organisations. 12. Data Portability (Naming Conventions) One of the main aims of the CSTF is to prevent unnecessary duplication of training. This will only be achieved if organisations accurately record training undertaken using a recognised naming convention or subject code for each of the CSTF Subjects. These mechanisms will help enable data portability, which will be essential if organisations are to be able to recognise training undertaken in other organisations. As part of aligning their delivery of training with the framework, organisations will need to capture training activity using the agreed naming conventions or subject codes and/or map the names currently used for recording training for each of the indicated Subjects. For the NHS in England, given the common use of the Electronic Staff Record (ESR) Oracle Learning Management (OLM) system, there has been agreement with the National Central ESR team and the regional leads from the OLM Specialist Interest Group to use the Competency Naming functionality available to aid the consistent recording of training aligned with the CSTF. Further information on the use of ESR competencies is available from the CSTF web page at: https://www.skillsforhealth.org.uk/cstf-england Page 81 Figure 1: The process for healthcare provider organisations to align with the framework Download the Core Skills Training Framework documents Review your training provision against the Framework Map your training provision against the Framework using the Content Mapping Tool. Identify any gaps and undertake developments required to meet the learning outcomes and training standards Complete a Declaration of Alignment showing the subjects where your training provision is aligned to the Framework Submit the completed Declaration of Alignment to Skills for Health Organisations on the Directory of Aligned Organisations and using ESR/OLM are entitled to use the CSTF competencies on ESR Skills for Health reviews your Declaration of Alignment and if necessary requests any further details or clarification Skills for Health confirms when the required details have been provided and eligible organisations are added to the Directory of Aligned Organisations Page 82 13. Arrangements for Quality Assuring the Framework and Sustainability The updating and quality assurance of the CSTF is critical if organisations are to have confidence in its continuing relevance and authority. For some of the local frameworks that have been developed, maintaining the relevance of the framework provides a substantial challenge. Skills for Health, given its national role, activity and reach is in a strong position to add value and assure the currency of the framework. Since the launch for the CSTF in 2013, Skills for Health has maintained and updated the CSTF, through mechanisms including the following : • Providing access to the framework from the Skills for Health web site. • Providing Framework Management support, with responsibility to keep the CSTF subjects under review to ensure accuracy, currency and manage quality assurance processes together with the required communications to alert users of any changes. • Conducting a formal review once a year, including participation by the key national endorsing and subject matter expert bodies. It is through this process that any new subjects for inclusion in the framework have been identified and where appropriate incorporated. • Ensuring the framework documents are fully Version Controlled. 14. The CSTF and Enabling Staff Movement The Department of Health and Social Care mandate to Health Education England: April 2019 to March 2020 states the requirement to ‘further develop the core skills training framework to reflect the future service needs of the NHS’. Additionally, NHS England and NHS Improvement has committed in its Long-Term Plan to enable “staff to more easily move from one NHS Employer to another”. This aim was reinforced in the NHS People Plan (2020/21). A key commitment is to reduce the unnecessary repetition of statutory and mandatory training and ensure data is accepted and trusted by all NHS providers. Alignment to the CSTF is a key component of the Enabling Staff Movement programme, which is jointly led between NHS England and NHS Improvement and Health Education England. For further information see: https://www.skillsforhealth.org.uk/cstf-england 14. Summary This document sets out a framework to help guide organisations in the development, planning and delivery of their core statutory and mandatory training. The effective use of the CSTF should be helpful in promoting consistency and quality of training, help prevent needless duplication of training, better direct resources for quality and risk management and help achieve efficiency benefits which are relevant for organisations and indeed learners. The effective use of the CSTF as presented here could offer further benefits in informing the design and approaches of other frameworks which might be relevant to the sector and development of the workforce. Getting the CSTF right and used will not always be an easy task but given the wide range of challenges and priorities faced by the health sector; this framework is indeed timely, relevant and needed. Return to contents page Page 83 Appendix 2: Version Control The following table highlights those significant changes in this Version 1.6.2 which may have an impact on the mapping to local training provision. Subject Additions or amendments (deleted or amended text in red) Subject 1. Equality, Diversity and Human Rights Key Guidance • NHS England, Workforce Disability Equality Standard • Skills for Health and HEE (2019), Core Capabilities Framework for Supporting Autistic People • Skills for Health, HEE and NHS England (2019), Core Capabilities Framework of Supporting People with a Learning Disability Subject 3. Health, Safety and Welfare Key Guidance • NHS Employers / Health, Safety and Wellbeing Partnership Group Resources • NHS Employers / Health and Wellbeing • National patient safety syllabus 1.0, Training for all NHS staff (Academy of Medic al Royal Colleges in collaboration with Health Education England, NHS England and NHS Improvement) Subject 6. Infection Prevention and Control Key Guidance • NICE (2016), Healthcare-associated infections: Quality Standard QS113 • NHS Employers (2015), Managing the risks of sharps injuries Subject 7. Moving and Handling Key References • Smith, J (Ed). Handling of People 6th edition (2011) and 5th Edition (2005), Teddington: Backcare Training Methods Level 1 training could be delivered by the following methods: • E-Learning • Face to Face • Blended Learning • Written Information Load Handling Practical training must be face to face ideally should be face to face where reasonably practicable and could be: • In a classroom • In a workplace setting. Training can be delivered on a 1:1 basis or in groups. Groups should be no more than 1 trainer: 10 participants, in line with NBE Standards (2010). Page 84 Subject Additions or amendments (deleted or amended text in red) Level 2 practical training must be delivered face to face ideally should be face to face where reasonably practicable in either a classroom or the workplace setting, on a 1:1 basis or in groups. Groups should be no more than 1 trainer:8 participants, in line with NBE Standards (2010). Subject 8a. Preventing Radicalisation • HM Government (2011), Counter-terrorism strategy (CONTEST) • Department of Health (2011), Building Partnerships, Staying Safe: guidance for healthcare organisations • HM Government (2018) CONTEST: The UK Strategy for countering terrorism • NHS England (2017), Guidance for mental health services in exercising duties to safeguard people from the risk of radicalisation Prevent Awareness (Basic Prevent Awareness outcomes plus the following) The learner will: b) know how to share concerns, get advice, and make referrals into the Channel process and Prevent Case Management in order to safeguard vulnerable individuals. c) understand Channel multi-agency arrangements to provide support and redirection to individuals at risk of radicalisation (moved up from (j). d) understand Prevent in the context of the Prevent Duty CONTEST strategy and the concept of non-pre-criminal space. Standards for Training Delivery …Only a WRAP Facilitator, registered with NHS England/NHS Improvement and th e Home Office can deliver WRAP. WRAP can be delivered to staff in a single organisation, on a partnership basis between organisations, or on a multi-agency basis. The employing organisation should be assured that all Facilitators have appropriate experienc e, background and qualifications to deliver this training. If training is delivered via E- Learning it should be via a Home Office, Department of Health or NHS England /NHS Improvement approved product. Subject 10. Resuscitation Level 1 The learner will: d) be able to locate and operate an AED. Level 2 – Adult Basic Life Support (Level 1 outcomes plus the following) The learner will: k) know how they should apply the local Do Not Attempt Cardiopulmonary Resuscitation Policy / anticipatory care decision within clinical context. Level 2 – Paediatric Basic Life Support (Level 1 outcomes plus the following) The learner will: Page 85 Subject Additions or amendments (deleted or amended text in red) j) know how they should apply the local Do Not Attempt Cardiopulmonary Resuscitation Policy / anticipatory care decision within clinical context. Current Policy Guidance Relevant Expert Guidance • Resuscitation Council (2015) (2021), Resuscitation Guidelines Subject 11. Information Governance and Data Security Expert Organisation • Information Governance Alliance • National Data Guardian • NHSX / Information Governance Legislation • The Data Protection Act 2018 / UK GDPR Key Guidance • Guide to the UK General Data Protection Regulation (UK GDPR) • NHS Digital, National data opt-out Return to contents page Page 86 Appendix 3: Summary of Subject Matter Expert Bodies consulted Relevant experts have been consulted, as indicated below, and where appropriate their advice has been incorporated into the guidance Subjects National Subject Matter Expert Bodies 1. Equality, Diversity and Human Rights NHS Employers (Diversity and Inclusion Team) Department of Health Equality and Diversity Policy Team and NHS Employers 2. Equality and Diversity (Scotland) NHS Education Scotland 3. Health, Safety and Welfare NHS Employers Health and Safety Executive 4. NHS Conflict Resolution (England) NHS England and NHS Improvement 5. Fire Safety National Association of Healthcare Fire Officers – NAHFO 6. Infection Prevention and Control Infection Prevention Society NHS England and NHS Improvement 7. Moving and Handling National Back Exchange Health and Safety Executive 8. Safeguarding Adults Department of Health Social Care Policy Team National Centre for Post-Qualifying Social Work NHS England, Safeguarding Nursing Directorate 8a Preventing Radicalisation NHS England and NHS Improvement 9. Safeguarding Children Royal College of Paediatrics and Child Health Royal College of Nursing 10. Resuscitation Resuscitation Council UK 11. Information Governance (England) NHS Digital NHSX UK Caldicott Guardian Council 12. Information Governance (Scotland) NHS Education Scotland 13. Information Governance (Wales) Wales Information Governance Group Network 14. Violence and Aggression (Wales) The All Wales Violence and Aggression Advisory Group Page 87 Appendix 4: Other standards and frameworks Country specific healthcare standards Each devolved country has defined its own healthcare standards and has set out how it anticipates that healthcare organisations within its jurisdiction will utilise the standards. Although these standards are country specific, they have a common focus and propose compliance in relation to a broad set of governance and service issues, most specifically around ensuring equity, promoting effective risk management and ensuring quality. The standards provide an underpinning rationale and reference point for each and all of the skills Subjects included here. Thus, attention to the skill areas identified will be one of the ways in which healthcare organisations can demonstrate their compliance with the standards. The key national healthcare standards are: England • Care Quality Commission - Fundamental Standards / Health and Social Care Act 2008 (Regulated Activities) Regulations North Ireland • Department of Health, Social Services and Public Safety, The Quality Standards for Health and Social Care Scotland • Healthcare Improvement Scotland, The Quality Framework First Edition – Evaluating and improving healthcare Wales • Welsh Government (2015), Health and Care Standards Regulatory bodies standards for competence In addition, the subjects in this framework underpin the standards for competence and revalidation specified by a number of professional regulatory bodies e.g. • General Dental Council • General Medical Council • Health & Care Professions Council • Nursing and Midwifery Council Other workforce education and training developments The guidance in this framework can be used to inform the delivery of educational and training interventions which might contribute towards the aims of the following developments: • Care Certificate • Code of Conduct for Healthcare Support Workers and Adult Social Care Workers in England • Code of Practice for Social Care Workers and Employers (Scottish Social Care Council) * • Healthcare Support Workers in Scotland Standards and Codes • Code of Conduct for Healthcare Support Workers in Wales • Code of Professional Practice for Social Care (Social Care Wales) * Page 88 • Standards of Conduct and Practice for Social Workers and Social Care Workers (Northern Ireland Social Care Council) * * Where this applies to Social Care Workers working as part of integrated health and social care teams Appendix 5: Glossary Learning Facilitators: The term used to describe the staff member involved in supporting the learning of others. Learning Outcomes: Learning Outcomes are statements of what a learner is expected to know, understand and/or do as a result of a learning activity (normally, a module or programme of study) and should be clearly linked to assessment methods as an indication of the evidence required to demonstrate that the required learning has taken place. Levels: Learning outcomes for some core skill Subjects are divided into different levels. Each level reflects a level of expected knowledge, skill and understanding. The appropriate level of training is dependent upon role, work context and local risk assessment. Naming Convention: The structure and rules for recording details of training activity which has been aligned to the Core Skills Training Framework. National Occupational Standards: Developed with employers, National Occupational Standards (NOS) are the building blocks of vocational and other qualifications. They specify the standards of performance and the knowledge and skills required to perform specific functions to a nationally recognised level of competence. They can also be used outside of qualifications, for example, to support NHS KSF post outlines. Return to contents page Page 89