Lyndsay Corbett - Training Manager at Eastwood Park - considers the staff retention and development challenges facing engineering, estates and support service departments in the NHS and how to tackle the growing skills gap.
Faulty medical devices or sterilisation equipment, power failures, theatre air quality, lift breakdowns, poor water quality and fire safety are typical of the issues faced by hospital engineering and estates teams daily. With the potential for significant impact on patient safety within such critical hospital services, managing maintenance and technical resources in these areas is paramount. In turn the ability to do this reflects on the knowledge, skills and competencies of both staff and management.
Hospital engineering and support services delivered by in-house and external specialised service providers have workforces that are predominantly ageing and male. They also face challenges recruiting suitable new staff and once on board, retention is proving a big challenge for many. Keeping staff motivated, feeling valued and appropriately rewarded is not straightforward while also demanding increased flexibility and increasing workload pressures.
Poor recruitment levels have been partly down to a lack of awareness of the many and varied engineering and estates roles accessible for new entrants to the healthcare sector, but it is also compounded by both limited specialised training being available as well as a lack of progressive career development opportunities. There is also a general lack of take-up of maths and science subjects in secondary and tertiary education which compounds this problem.
The skills gaps
The knock on effect of poor recruitment levels is making succession planning and workforce development another demanding issue for both employers and employees alike.To help develop strategies to deal with this, firstly managers need to identify and recognise where the real skills gaps lie, by listing the roles within their areas of responsibility and the skills needed for each role. Survey or audit tools are available to assist with a workforce audit. Then after compiling the results, analysing the data, the gaps will become obvious. A comprehensive organisation/departmental/team training plan will then help fill those gaps identified, prior to launching a development/recruitment programme.
An assessment/appraisal needs to be a part of any recruitment/development programme, the output of which will drive the training plan, which is likely to comprise a mix of internal mentoring and development often supported by more specialist external training. This approach enables an organisation to develop knowledge, skills and abilities in order to prepare staff for advancement or promotion.
Apprenticeships part of the succession planning
Good succession planning ensures that employees are constantly developed to fill each role in an organisation. As departments/organisations grow or lose key staff, succession planning should ensure that there are key, keen employees on hand ready and waiting to fill new roles. A good example would be developing apprentices beyond their initial apprenticeship programmes.
Apprentice schemes do attract new talent to the hospital sector, as apprentices are normally employed and as such earn and learn as they work. Good apprenticeship programmes, which contain knowledge and competence-based qualifications, prepare new entrants well for a specific trade. They complement the more traditional academic routes to professional engineering roles. Undoubtedly the growing source of new talent amongst graduates is equally valued as they bring in-depth technical knowledge and important research skills, although they may be lacking the practical skills.
In Eastwood Park’s UK training centre much of the training provided is ‘hands on’ with learners challenged by practical exercises/tasks in replica hospital environments. Learning can take place in as close to a real hospital environment as possible, yet enabling students to learn from their mistakes, safely and without risk to others. For example our new high voltage (HV) training facility - where there is a simulated 11kv open ring system with 6 distribution substations and an intake substation based on a typical hospital system with dual feeds and bus coupler - has simulated faults which gives learners the opportunity to fault find and operate switchgear safely, under close supervision.
Graduate with Eastwood Park
After apprenticeships for those skilled tradesmen and estates officers who may have not seized the opportunity to gain a degree at the start of their career, but recognise they need one to progress in their jobs, we are now offering two foundation degrees and an option of a third year to gain a BSc.
Geared specifically towards the needs of engineers in healthcare, our degree programmes develop core skills for progression in a hospital engineering or estates career. It is giving the opportunity to many to graduate and move up the promotion ladder.
Adopting UK standards
Our training programmes take us into most Acute Trusts in the UK, as well as hospitals and clinics around the world. Working alongside several significant hospital groups in the Middle East we have replicated our work delivering UK and international safety standards as many want to adopt safety guidance that is well respected and recognised within the NHS. Many countries are keen to adopt the engineering Health Technical Memoranda (HTMs) that provide best practice and guidance adhered to in the UK, supported by European and international best practice/guidance.
In Qatar, we have been working with the Hamad Corporation in establishing engineering systems through appointing and developing staff in accordance with International Standards and Codes of Practice in all eight of its hospitals.
Working with senior Hamad staff, we identified clear responsibilities and the required competencies for the maintenance, management and quality assurance of engineering and facilities systems, plant and hospital equipment including: medical gases, electrical, water, lifts, air conditioning and steam boilers. The roles of Competent and Authorised Persons and Authorising Engineers were adopted from our HTM’s and the competencies for these roles informed the training programmes that we developed.
Over 300 staff were appointed, trained and accredited with internationally recognised competency qualifications at the appropriate level to undertake these roles and up to 900 nurses were training as Designated Nursing Officers within Medical Gases. In addition to the training, engineering systems were audited, redeveloped and redesigned to ensure compliance to international benchmarks of good practice. Service improvements are being recognised and Eastwood Park has an on-going relationship supporting the Hamad Medical Corporation with continued support and refresher training.
With decontamination a huge priority, another significant international training programme has been our association with King Faisal Specialist Hospital and Research Centre in Riyadh, KSA. Here we have been leading a work-based programme within the Central Sterile Services Department (CSSD). An extensive programme, which included developing new CSSD policies and procedures; delivering a training programme to ensure the new procedures were understood and being followed. As part of the organisation’s succession planning, Eastwood Park also trained and qualified CSSD supervisors to support and assess their own technicians that were undertaking a 3 year Saudi National Diploma programme developed and delivered by Eastwood Park in the hospital.
On site training eases budget pressures
Training budgets will always remain under pressure in the NHS, with statutory guidance the driver for the majority of training. To help accommodate budget constraints we offer training on site at hospitals and also make special arrangements for larger groups. In the past several Trusts have pooled resources that has enabled us to deliver bespoke training geared to their specific needs.
Over recent years we have also developed our suite of estates courses that have addressed the needs of developing young estates officers, helping to enhance the development of aspiring managers/directors. To this end, Eastwood Park has been working closely with the HefmA’s South West training group to provide training and development days for management development. Day seminars have been delivered which have included understanding the importance of air quality and the role it plays in both staff and patient welfare; a focus on CQC inspections, both considering the preparation as well as the impact that follows. Later this autumn, the next workshop will provide a comprehensive introduction and overview to HTM guidance. The workshops have been well received and the approach/programme is being considered by National Council.
In short, the healthcare sector needs to develop clear strategies to ensure there is a well-equipped workforce that can support advances in technologies and the increasing demands for high levels of service. Developing effective recruitment strategies to attract the right quality of staff and a range of skilled staff remains at the start of the process. Our challenge at Eastwood Park is to work alongside the UK and international healthcare markets in developing staff skills and continue to develop training strategies that support best practice and continue to raise safety standards across the board.