Storyboard Entry Form 2015
Main author: Trish Mathias-Lloyd
Email: [email protected]
Telephone: 01267 239609
Follow the detailed instructions in this template for writing your
storyboard. Add your information in each section below and save this
completed storyboard document. Please not amend this template.
Follow the instructions in the Information Guide for Authors to submit
your storyboard.
The word limit is 1500 words including references. Your storyboard will
not be accepted if you exceed the word limit.
1. Storyboard title: a clear concise title which describes the work
Skills to Care – investing in our HCSWs - The Hywel Dda University
Health Board Skills to Care Foundation Programme
2. Brief outline of context: where this improvement work was done;
what sort of unit/department; what staff/client groups were involved
In 2009, Skills to Care Foundation Programme (S2C) was
introduced as part of the Skills to Care Framework, a
comprehensive development programme for all newly appointed
HealthCare Support Worker (HCSW) and where necessary, existing
HCSW. The programme began as initial part of the wider S2C
Framework encompassing Basic Skills and Level 2 programme which
then builds a HCSW a career development pathway through to BSc
in Nursing.
The S2C programme continues to this day with HCSW completing it
prior to taking up their duties in the workplace. This ensures that
our HCSW are both competent and confident to give the best care
to our patients, thus ensuring that the Registered Nurse is able to
delegate safely. The programme is aligned to the Diploma in Health,
level 2 to underpin ongoing development.
The programme is reviewed regularly, and updated as necessary– in
regular PDSA, (Plan, Do, Study, Act) cycles. The current cycle is
looking at working in any requirements not already included from
the All-Wales HCSW Framework.
3. Brief outline of problem: statement of problem; how you set out to
tackle it; how it affected patient/client care
The risk of inexperienced HCSW being asked to deliver hands on
care to our patients without training was seen as too high a risk. To
avoid this, we introduced the S2C programme. This ensured that all
HCSW were adequately trained to a basic standard and that the
patients were receiving the care by the appropriately trained HCSW.
It was recognised that the organisation needed to provide timely,
appropriate and accessible education, training and development
opportunities to enable HCSW to develop and strengthen their
clinical skills and knowledge. This was confirmed with the
introduction of the NHS Code of Practice for NHS Employers 2011.
4. Assessment of problem and analysis of its causes: quantified
problem; staff involvement; assessment of the cause of problem;
solutions/changes needed to make improvements
The programme has been expanded to other departmental areas
such as community, mental health & learning disability, therapies
and substance misuse. HCSW working in these areas have
paradoxically, a chronic disproportionate access to accredited
training programmes despite the added responsibility by working
unsupervised for the majority of time, thus taking on extended
roles. This poses a potential risk to the organisation in term of
litigation. This issue is of particular interest when considering the
HDUHB’s strategy to increase the delivery of services out of acute
hospital environments.
5. Strategy for change: how the proposed change was implemented;
clear client or staff group described; explain how you disseminated the
results of the analysis and plans for change to the groups involved
with/affected by the planned change; include a timetable for change
The delivery of the programme is taught by the specialist within
their field of expertise, ensuring the procedure and techniques are
up to date and in-line with local policy. Facilitators are present to
overview these days for assessment and cover eventualities and
assisting the tutor with the completion of the relevant workbooks
and the necessary assessments.
S2C contributes and continuously improve the standards of care in
line with organisational identified training needs. This is based on
the potential flexibility of the programme by adapting required units
to specifically identified training and educational needs.
6. Measurement of improvement: details of how the effects of the
planned changes were measured
Evaluation measures include
Quantitative
Number of HCSW staff commencing employment in the HDUHB
(including Bank)
Number of staff completing the initial S2C Foundation Programme
Qualitative
Feedback from candidates:

“I was dreading this course, I had a fear of being in a
classroom situation but afterwards I felt the opposite. I felt
the questions I asked were relevant and not made to feel
stupid for asking. This, I think has made me a much better
person and think it’s given me a lot more confidence” (HCSW)
Evaluation reports from registered nurses and therapists include the
following quotes:

“Cant believe that they learn so much and in so much detail”
Registered Nurse

“Feel more confident in asking a HCSW to record observations
for me as I have assessed them as part of the course”
Registered Nurse
Trainer Feedback following discussion with a HCSW
 “confidence of X has improved and the feeling of worth has
returned to X, she now works much better within the team
and feels a lot more valued” (Ward sister who enrolled a
HCSW after 4 years working on this particular ward.)
Economic Returns
While it is difficult to measure the benefits in monetary terms,
improving the standard of patient care and safety is paramount.
There is a proven link between engagement of staff and high
performance. A key contribution to engagement is a workforce who
is appropriately training and developed, with further access to
development throughout their career. This gives the HCSW the
feeling that they are being valued for their work, and thus
improving retention figures within the workforce.
We evaluate each programme undertaking and an end of year
review with all the evidence gained from the evaluation sheets.
From the evaluations forms the evidence shows high motivation,
confidence in ability and encouragement with the feeling of worth.
With this the reduction in complaints has been evident and that the
role of the HCSW has changed in a way that the HCSW now
undertakes 75% of patient care this increasing RN to undertake far
higher level of care to the ill patients.
7. Effects of changes: statement of the effects of the change; how far
these changes resolve the problem that triggered the work; how this
improved patient/client care; the problems encountered with the process
of changes or with the changes
The Skills2Care programme runs over a period of 9 days, 7 of which
are classroom taught, covering Fundamentals of Care, with 2 days
ward based practical induction days.
The programme meets the following criteria



Training & Assessment in line with National Occupational
Standards (Code of Conduct HCSW, EAGLE)
Provides timely, appropriate and accessible education,
training and development opportunities to enable
Healthcare Support Workers to develop and strengthen
their skills and knowledge (Code of Practice for NHS
Employers 2011)
Fulfils the recommendations of the Francis and Cavendish
reports (2013).
Present quality indicators in the form of verbal feedback are very
encouraging and supportive of the notion that the S2C delivers fully
on its initial aim. HCSWs within HDUHB have a clear development
pathway from the beginning of their career, including offering
professional guidance and clarification regarding their job role and
importantly from risk management perspective acts as a platform
for identification with organisational goals of promoting and
safeguarding the best interests of the service user.
The programme has already been adapted to cover dementia which
gives the HCSW a basic insight into the issues encountered by
Dementia patients. The addition of continence promotion and falls is
being looked at to implement into the S2C programme.
8. Lessons learnt: statement of lessons learnt from the work; what
would be done differently next time
There are always lessons learnt during the programme we evaluate
and develop it according to the feedback we receive. This ensures
that it is up to date and fit for purpose. We regularly involve the
specialist guest speakers to develop the programme around current
practice and this had been progressing well over the years.
The Welsh Government has developed an All Wales Operational
Group for HCSW Development and currently are in the process of
implementing a standard induction programme across Wales which
has strong similarity to the S2C we currently run. With this there
are a few changes we have to do to come in line with this. To start
this programme from scratch would need a lot of work and
manpower to ensure that it was fit for purpose and HCSW are
having the right training for the right places at the right time. With
the changes happening within the NHS the programme has to be
continuously updated to meet the new ways of working within the
NHS.
9. Message for others: statement of the main message you would like
to convey to others, based on the experience described
This programme ensures that newly recruited HCSW feel valued,
engaged and invested in. The HB and its staff are assured that
HCSW start their roles, able to deliver competent patient care. The
programme is extremely valued across all professions, and
evaluates consistently well. The Welsh government is currently
developing the All Wales Framework for HCSW education. The
design of the strategic framework is very similar to the S2C
Framework, particularly in setting a standard for credit based
learning. At an operational level, the induction content of the
framework has been developed using the S2C programme as a
contributory model.
10. Please summarise how your entry reflects the principles
of prudent healthcare: you can find out more about prudent
healthcare at http://www.prudenthealthcare.org.uk/
Do no harm – by ensuring that or staff is adequately trained to
deliver the highest possible standard of care, this allowing the staff
to able to progress and develop accordingly.
Carry out the minimum appropriate intervention – by giving
our staff the confidence, knowledge and skill to be able to carry out
their role accordingly, ensuring that we develop team working and
build strong teams.
Organise the workforce around the “only do what only you
can do” – this is about developing our staff to be able to give then
the confidence to deliver the appropriate care required, ensuring
they have the right knowledge and skill and this will not only build
trust within each team member but also the service user.
Promote equity – we not only develop the programme accordingly
based on our ideas and changes in service, we look for feedback
from the staff and patients. We encourage our staff to be reflective
and embrace change, encouraging then to look for changes and
developments in their own service delivery.
Remodel the relationship between user and provider on the
basis of coproduction – to encourage discussions and feedback to
be able to develop the care given and training provided to develop
the knowledge and skills to deliver the care. This includes feedback
from other staff and our patients and their families.
The NHS Wales Awards are organised by
the 1000 Lives Improvement service in
Public Health Wales.
www.1000livesi.wales.nhs.uk