East Kent Hospitals NHS Trust

East Kent Hospitals NHS Trust Case Study - Implementing NLMS has reduced training costs and improved mandatory training uptake


East Kent Hospitals University Foundation Trust is a large acute Trust based on the Kent coast employing over 7,800 staff across a number of sites.

Following successful implementation of the core ESR solution in April 2007 the trust commenced roll out of Oracle Learning Management (OLM) shortly after. Jacqui Siggers Head of HR explains; “As an organisation we have always been a major supporter of the complete ESR solution, being active members of the local Special Interest Groups and participating in the National SIGs and the National User Group. Recognising its potential, we piloted NLMS in 2008 and in November 2010 we became an early adopter of the ESR UIM interface by which time we had issued more than 7,000 Smartcards”.

E-Learning had been well established within the trust for some years but the content was provided by a number of third party providers at additional cost. Courses completed via e-learning required manual input into OLM as ‘external learning’ so that trust-wide compliance statistics could be produced for the board and senior management. Considerable resource was needed for this inputting and also in providing help-desk support to staff who had forgotten their many e-Learning usernames and passwords. Fiona Stephens, Head of Learning and Development explains; “By late autumn 2010 we felt that the NLMS product was sufficiently robust for us to implement. Audiology and End of Life Care staff were requesting access to e-Learning courses which were only available through NLMS, and we were also aware of the pressure to access, record and report Information Governance (IG) training as part of the IG Toolkit”. Heather Loader, Workforce Information Manager says; “The trust was incurring significant costs in providing, recording and reporting e-Learning but there were still problems; manually inputting over 2,500 course completions every month was both time consuming and error prone; training compliance had to be reported more than a month in arrears to allow time for the inputting; and the quality of the management information produced was constantly debated.” Jacqui and her team also became aware that e-Learning courses had been developed or procured by individual departments and that this learning was not being captured onto the centrally held learning records in ESR.

Against this background the trust implemented a major re-organisation at the start of the 2011/12 financial year and workforce metrics were being given a significantly higher profile in the new structure, with particular emphasis being placed on mandatory training. The trust wanted to reduce expenditure and they knew that implementing NLMS could help them achieve recurrent cost savings and allow them to produce high quality management information in a much shorter time frame. July 2011 The licence renewal with their main e-Learning supplier was due to expire on 1st April 2011 so they had to ensure that their project to implement NLMS was complete by then to ensure continuity of e-Learning provision for staff.

Their Approach

They initially piloted NLMS in three departments during December 2011 and from those pilots they developed useful learning materials. They took advantage of the one-off opportunity to use the McKesson upload of all their e-Learning usernames and passwords and e-Learning User Responsibility Profiles (URPs) in February 2012. Jacqui explains: “We considered how best to implement the NLMS solution and had to make some difficult decisions because of the time and resource constraints that we were under. We decided that the majority of staff would access NLMS using a Smartcard; that most of the courses on offer would be national ones; that we would rely on the trust email, intranet and news bulletins to communicate the change; and that we would use a ‘big bang’ approach rather than implement one course or one department at a time”.

A small project team was set up which reported in to the Education and Training Steering Group. Benefits derived from the project were reported to an ESR Benefits Realisation Group which was chaired by the Head of HR who also acted as the Project Sponsor. No extra resource was available for this project so the Workforce Information Manager acted as Project Lead and other members of the project team were called upon as necessary. These team members included subject matter experts, the Learning and Development team, the Communications Team, the Smartcard Team, the Trusts’ ESR NLMS Account Manager and both the Kent & Medway Health Informatics Service (HIS) and local Information Technology (IT) department.

Jacqui continues: “The project has had a high profile in the trust because all our employees have to use the system, including very senior managers and consultants. There has been a more significant impact than anticipated on HIS, the Smartcard Team and Workforce Information because of the number of queries that were raised, particularly in the first three months after implementation”.

Benefits to Date

On-going project evaluation is through the ESR Benefits Realisation Group, but to date the trust has reported a number of significant benefits:

  • By the end of February 2012 more than 6500 (83%) staff had successfully accessed NLMS;
  • The Learning Activity using the ESR Data Warehouse reports shows the trust at or near the top of the national list for e-Learning completions every month since June 2011;
  • The trust has reported more e-learning completions using NLMS than with their previous e-learning suppliers every month since August 2011;
  • Management information regarding mandatory training is available four weeks earlier than previously;
  • They have saved admin resources previously required to manually input e-Learning and maintain usernames and passwords of staff;
  • The trust is saving £20,000 a year in payments to their previous e-Learning suppliers;
  • Compliance reporting is more robust and is helping the trust to retain its NHSLA Level 3.

“As well as the benefits listed above there are other benefits that we are starting to realise from the use of NLMS. It is being used not just for our mandatory e-Learning courses but also for Blood Transfusion, Audiology, End of Life Care and many others. Those responsible for delivering learning are encouraged to look at what is available through NLMS before requesting either classroom based courses, attending external courses or procuring other types of training and all of this extra training is being recorded automatically.

Initial uptake of e-Learning through NLMS was quite slow, but it is steadily increasing as staff get used to using NLMS. By the end of June 2012 compliance rates were up to ten percentage points higher than before the project started. This is good news for many reasons, not least because of the link between high rates of Health & Safety, infection Control, Manual Handling, Information Governance, Equality & Diversity and Safeguarding of Children and Vulnerable Adult training and improved care and patient outcomes.

Members of the HR Senior Team have had to draw up on all of their leadership and influencing skills to convince their colleagues of the benefits of changing our e-Learning provider to NLMS and keep the project on-track.

The Team has produced a ‘troubleshooting’ guide which has been published on the trust intranet. Members of Workforce Information collaborated with the HIS to test a script by which staff could install the correct versions of various software packages. They also worked with the Communications Department to update the trust intranet with guidance notes; access to the ‘PC Checker’; updating the mandatory training pages; and giving staff the all-important NLMS web link.

Workforce Information is very small team but they have worked closely together and been instrumental in making the implementation of NLMS a success. They continue to work tirelessly to help colleagues throughout the trust complete their e-learning”.

Lessons Learned

  • The most significant barrier to successful implementation will be IT issues. In East Kent the usual problems were exacerbated because: IT support is not provided in-house; Smartcards had been issued but they were not being used regularly; and a standard desk-top had not been deployed throughout the trust;
  • Manage expectations at a senior level; it is likely that completions and compliance levels will reduce in the early stages after implementation;
  • A ‘one-stop-shop’ help facility would have been the best option for users but East Kent were not able to put this in place with their IT support service.

Advice to other Trusts

  • Keep your Executive Sponsor fully informed of project progress and issues so that they can answer queries by senior colleagues;
  • Do not underestimate the number of IT problems that will emerge;
  • Communicate as widely as possible and make training materials available through various types of media;
  • Have a well-trained team of people available who can offer a help desk facility to users;
  • Ensure that any Smartcards that have been issued are in use or re-certified by the start of the project;
  • Hold regular project meetings to make sure problems and issues are openly discussed by all concerned.

The Future

The trust has recently completed a Training Needs Analysis for the whole organisation which looks at all the elements covered by the minimum dataset for NHSLA Level 3 and they are currently adding a combination of National and Local Competencies into ESR so that their training compliance reporting is even more robust.

They have recently implemented an e-Rostering/Time and Attendance system trust-wide and so are now able to look again at ESR Self Service to see if benefits can be derived from its use.

For More Information

If you have questions or would like to learn more about the project and their approach to implementing e-Learning please contact Heather Loader, Workforce Information Manager at heather.loader@nhs.net