Education Commissioning for Quality:
An SHA perspective
Adam J Turner
Education Development Manager
Lisa Bayliss-Pratt
Education Lead
NHS West Midlands
NHS West Midlands
Aims
What is ECQ?
 Department of Health Policy (Jan 2010)
 Commissioning, Contract Management and Quality
Monitoring Process for Education Providers (e.g. University)
Non-Medical Education and Training (NMET) contracts
 Allows us to:
Find innovation and notable practice to share
 Find challenges, identify solutions and performance
manage these with Education Providers

What makes ECQ Different?
 RAG rating of:
 Each
commissioned education programme
 Education
provider improvement action plans
 Education Provider funding linked to quality
 Bringing together different contractual processes:

LDAs with NHS Trusts

Education Contracts with Education Providers
Overview of ECQ Process
Placement Provider (i.e. NHS Trust)
Self Assessment against ECQ
Quality Standards
Panel Members:
 Lay Chairs
 Clinical
Externality
 Workforce
Specialists
 Quality and
commissioning
specialists
Education Provider (i.e.
University) Self Assessment
against ECQ Quality Standards
Analysis of Information using
Review Panels
Monitoring
of Action
Plan
Audit at Education Providers
(Annual Review)
Development of Findings
Report and RAG Ratings
Education Provider
Improvement Action Plan
Payments
linked to
Quality
Outcome of ECQ 2010-11 Pilot:
(mean of all Education Provider programmes):
58%
58%
68%
73%
90%
84%
68%
64%
94%
84%
100%
90%
80%
78%
88%
88%
64%
63%
78%
78%
68%
68%
69%
71%
58%
68%
88%
83%
68%
68%
68%
68%
Birmingham
Metropolitan College
64%
68%
58%
58%
68%
68%
Aston University
University of
Birmingham (UoB)
Keele University
88%
88%
73%
78%
94%
94%
82%
84%
94%
University of
Worcester
68%
68%
58%
University of
Wolverhampton
73%
78%
78%
83%
68%
78%
64%
58%
73%
69%
Staffordshire
University
Nursing: Adult Degree
Nursing: Adult Diploma
Nursing: Child Degree
Nursing: Child Diploma
Nursing: Mental Health Degree
Nursing: Mental Health Diploma
Nursing: Learning Disabilities Degree
Nursing: Learning Disabilities Diploma
Midwifery Degree
Midwifery Degree (Short Course)
Operating Department Practitioner Degree
Operating Department Practice Diploma
Physiotherapy Degree
Physiotherapy Postgraduate
Diagnostic Radiography Degree
Therapeutic Radiotherapy Degree
Psychology Doctorate
Paramedic Science
Speech and Language Therapy Degree
Audiology Degree
Podiatry Degree
Dietetics Degree
Occupational Therapy Degree
AVERAGE Score
Coventry University
Education Provider Name
Specialty Health Programme
Birmingham City
University (BCU)
HEI RAG Rating Summaries for Education Programmes
68%
74%
68%
68%
100%
78%
100%
100%
94%
88%
100%
100%
82%
78%
84%
78%
74%
76%
86%
84%
74%
74%
71%
82%
78%
Outcome of ECQ 2010-11 Pilot:
(% of actions
confidently signed off
by review panels)
Aston University
Birmingham City
University
Staffordshire University
Coventry University
University of
Birmingham
University of Worcester
Keele University
University of
Wolverhampton
Progress
Achieved
Against
Previous Years
Action Plan
Birmingham
Metropolitan College
HEI RAG Rating Summaries for Action Plan Achievement
45%
54%
59%
64%
75%
85%
86%
100%
100%
Outcome of ECQ 2010-11 Pilot:
HEI Quality Premium Payment Summary
£ Total Achievable
£ Achieved
% Achieved
Total Contract Value for 2010-11:
circa £69.7m
circa £1.7m
2%
Total 5% achievable for 2010-11:
circa £3.5m
circa £1.7m
48%
> Total 3% achievable
(Programme Level Review):
circa £2.1m
circa £1.1m
51%
> Total 2% achievable
(Action Plan Review):
circa £1.4m
circa £600k
42%
Breakdown of 5%:
Outcome of ECQ 2010-11 Pilot:
Innovation and Notable Practice – Yearly Report
www.westmidlands.nhs.uk/MultiProfessionalWorkforce
/EducationDevelopmentQualityandResearch.aspx
Evaluation of ECQ Pilot:
Areas that Worked Well
 Engagement and Partnership Working (Brings
Change):
Overarching process and transparency
 Engagement, communication, collaboration and support
from NHSWM Education Development Team
 ECQ stakeholder engagement events

 Use of Externality (lay and clinical externality) on
review panels
 RAG ratings of programmes and action plans
Evaluation of ECQ Pilot:
Future Challenges
 Increase Confidence of Triangulation
of Data:
Increase student feedback (e.g.
Questionnaire / whistle blowing email /
graduate survey)
 Increase employer feedback (e.g. Employer
questionnaire / overview of partnership
working in self assessment)
 Establishing saturation of data – when do
we know this is the truth?
 Establishing data sets to trigger further
investigation (e.g. Annual Monitoring
Reports by professional bodies)

Evaluation of ECQ Pilot:
Future Challenges
 Quality is a Perception -
Tensions:
 Service
user perceptions of
quality...
 “a student reported I was left on
my own....”
 e.g. Professional body
requirements, vs. Education
commissioner requirements

e.g. Programme meets professional
body standards, however attrition is
high
Evaluation of ECQ Pilot:
Future Challenges
 Partnership Dynamics
 50%
Education in Practice, 50% Education Theory...
 Evaluation demonstrated lack of synergy between
stakeholders in some areas
Enhancing Partnership Dynamics:
Education and Practice Partnership Agreement
What was the gap?

Historic multi-professional gap between Education Providers, Placement
Providers and Undergraduate Medical and Dental Schools
Contractual Relationships:

Learning and Development Agreements (LDA) between NHSWM and
Placement Providers

National Contracts between NHSWM and Higher Education Institutions
(Education Providers)
What we did:

Large multi-professional stakeholders groups from Placement, HEIs
and SHA were involved with the development of EPPA document and
pledges
EPPA and the 3 Key Stakeholder Groups
Education
Providers
i.e. HEI
Placement
Providers
i.e. NHS Trust
Commissioner
i.e. NHS West
Midlands SHA
Core EPPA Principles
Curriculum
Recruitment
Placement
Learning
Placement
Capacity
Clinical Skills
Sharing
Information
Fitness for
Practice
Student
Support
Turning Principles into Pledges
 The pledges...
 Reflect a common understanding of how our relationships
function
 Capture the key roles and responsibilities of all partners in
relation to each specific area
 Represent a commitment by all
 Have been agreed by all partners equally
 Aspirational and not legally binding
1. Curriculum Development and Design Pledge
The Future of Education and Training?
The Future...
What we know:
 DH consultation Liberating the
NHS: Developing the
Healthcare Workforce (DEC
2010) sets out proposals to
change the way the healthcare
sector plans, trains and
develops its workforce
 It proposes the introduction of
Provider Skills Networks (PSN)
The Future...
Current knowledge to date:
Providers need to form PSN as a legal body that will among other
functions:
1.
2.
3.
4.
Manage and coordinate workforce plans for their health
economy
Consult with communities to develop a local skills and
development strategy
old and allocate funds
Commission/monitor/performance manage contracts for the
provision of education and training (E&T) while quality
assuring E&T standards and value for money
The Future...
Current knowledge to date:
Key national design principles require PSN to be:
 Provider and employer driven
 Multi professional
 Able to evidence strong clinical and professional
engagement and partnerships with Higher
Education Institutions
The Future...
Current knowledge to date:
DH propose a new national leadership body – Health
Education England (HEE) which will be a statutory body
and special health authority to support:
 National leadership on workforce planning and
development
 Allocate and account for resources that promote high
quality Education and Training and develop Provider
Skills Networks
 The proposed timeline for change... March? July?
The Future... Risks








Timescales are very tight
Disruption of services
Loss of knowledge
Resources spread too thin
Governance needs balance
Functions fragmented
Providers may disengage
Provider behaviour may not be strategic
The Future... Opportunities
 Provider driven
 Local sensitivity
 Time for change
 New ways of working
 Evolutionary
Thank You
Adam J Turner
Education Development Manager
Lisa Bayliss-Pratt
Education Lead
NHS West Midlands
NHS West Midlands