Improving education, training, and service re-design in healthcare services – Clinovia implements Skills for Health competences

Clinovia, who have subsequently been acquired by Bupa, identified the need to review existing services, education, and training programmes. In the past, training for phlebotomists has tended to reflect local and regional needs.

Practitioners are not currently required to be healthcare professionals and therefore are not subject to national regulations. Clinovia recognised the importance of developing a standardised set of practices using nationally recognised competencies to help address this.

The aims of the service and programme review were to:

• Benchmark existing training programmes against Skills for Health competences for blood taking and venepuncture
• Further, develop education and training programmes based on competencies.
• Use competencies to develop best practice guidelines and protocols to standardise practice.
• Provide an educational and training programme to roll out to other Clinovia staff to develop the phlebotomy business

Clinovia turned to our team to help it develop a new framework for the phlebotomists’ role based on the Skills for Health competences. Working with the Skills for Health website and their London regional team, Clinovia began to learn how to make the best use of the frameworks and tools.

Clinovia is a leading independent healthcare company with more than 30 years’ experience in providing acute, complex, and chronic medical treatments to patients at home. Clinovia phlebotomy service provides phlebotomy clinics and domiciliary services across central and west London.

“Skills for Health’s assistance in developing a competence-based approach to workforce and service development has been invaluable. Our new clinical skills programme for venepuncture has helped us support our practitioners and raise the standards of our service to an even higher level.”

Kay Ferris, Director of Education and Training, Clinovia

We developed a bank of national workforce competences (NWCs) and National Occupational Standards (NOS) which describe the skills and knowledge required to carry out a task or function effectively. Competences are designed to underpin and be integral to accredited and non-accredited education and training programmes.

One of Clinovia’s main aims was to develop competency-based job descriptions and person specifications linked to recognised competences and the NHS Knowledge and Skills Framework.

The team began with an audit of services provided in all the clinics with which they are allied, currently about 30 practices. They reviewed the existing education and training programme and held a training workshop, supported by Skills for Health. The event helped Clinovia’s education and training department and senior nurses leading the phlebotomy service learn more about how best to utilise implementation tools and competencies.

Using the Skills for Health database of competences, the team defined job roles and updated job descriptions, ensuring that each was competence-based. Competences are now used to inform Clinovia’s education and training package for all practitioners who take blood including registered nurses and new phlebotomists. The competencies also offer learning outcomes and provide a framework of assessment across the patient pathway.

Example competences identified and used:

• Responsibility, accountability, and liability
• Describe anatomical structures and physiology
• Obtain venous blood samples
• Insert intravenous needles for the collection of blood at donation sessions.
• Obtain venous blood samples using invasive techniques.
• Take samples of blood fit for laboratory analysis

The competencies are part of a range of electronic tools available on the Skills for Health website which can help managers design roles, services, education, and training and forecast future needs. They are a powerful tool for those who want to structure their teams’ and individuals’ learning and development around patient needs and they can all be linked to the Knowledge and Skills Framework.

Clinovia’s clinical training package, education, and training programmes have now all successfully been standardised. Training registered nurses or new phlebotomists is based on the new education and training package, ensuring new and existing employees are working to the same standards. It also now applies to nurses who take blood, bringing a consistent competence-based approach to other clinical roles.

Implementation and evaluation of the programme will be ongoing but early signs are positive. Standardisation of protocols is being completed and updated in line with the competencies work. Clinovia has audited current working practices in the clinics thereby providing a benchmark for further reviews in the future. This in effect becomes a circular process with improvement, review, and audit built-in.

Clinovia’s competency-based training and education package will sit alongside similarly informed job descriptions and person specifications. The team applied this model to other new services. For example, Clinovia worked with Baxter Renal Services to develop an education and training package and associated training programmes for automated assisted peritoneal dialysis. Healthcare support workers will be trained to assist patients with this therapy in their own homes.

Benefits

• Raised levels of service delivery to patients
• Improved continuity of service for patients
• Increased motivation and confidence in the staff who are clearer about what is required of them, supported by additional training
• Better retention and recruitment of staff
• Standards protocols will be evidence-based i.e. minimum amount of time to take blood

Since competencies describe what individuals need to know and do, regardless of who is performing the task, they have many and varied uses. The application of Skills for Health competencies has provided Clinovia with the means to manage more robustly the redesign of services and the necessary supporting education and training programmes.

“We believe that Clinovia is one of the first organisations to use a competency-based approach to develop phlebotomy services and we are delighted with the early signs of success we have seen. Incorporating the competencies has moved beyond the education of one part of the workforce and is also influencing our standards, policies, and procedures in other parts of the organisation.”

Kay Ferris, Director of Education and Training, Clinovia

Skills for Health continues to support the development of competence-based approaches to the design and redesign of roles and services. As part of this, we are helping health care organisations strengthen their professional development programmes.

As the Sector Skills Council for the UK health sector for the NHS, independent healthcare providers, and voluntary organisations. Our purpose is to help develop solutions that can deliver a skilled and flexible workforce to improve health and healthcare.