Member blog: The value of systems wide working

11 June 2021

The past 18 months has been the most challenging time in healthcare education, with significant impacts of the pandemic on university and practice based learning. At the University of Brighton, we have worked closely with our practice providers, to ensure students could remain in practice wherever possible, including for some students paid placements. We drew on our internal and external networks within our system, to manage effectively during this crisis.

We are delighted that this resulted in very few delayed students, thanks to the hard of work of our staff and partners. However, there was lots of variation within the region in terms of service impacts and consequences for students. A systems approach to supporting learners in practice was lacking for two main reasons; Firstly, it is not always the chosen approach in an emergency situation and secondly, the health and care systems were undergoing significant change, with Integrated Care Systems coming on stream. Fast forward to the 14th January 2021, when the Secretary of State for Health and Social Care formally asked the NMC to reintroduce emergency standards to allow third year nursing students to support the workforce and undertake extended, paid clinical placements. This time, decisions as to whether or not paid placements were to be offered, or ‘normal’ placements would continue, could be made locally. Not all practice education leads or Directors of Nursing in our region agreed paid placements were desirable and there was a real risk that we would end up with a differential offer and experience for our students.

At this point I called on our Integrated Care System, Sussex Health and Care Partnership. As a HEI provider we had not had contact from the ICS during the pandemic, and I felt a systems approach to decision making was crucial. I wrote to the Chief Nursing Officer and Chief People Officer and we agreed to have a systems wide meeting, to discuss the advantages and disadvantages of offering paid placements, and come to a consensus. This was truly the most effective systems level decision making I have observed for some time. Practice educator leads (who we had met earlier that week) had been lobbying their respective Directors of Nursing and we came to the conclusion that paid placements were a) not needed at that point across the region (other than in a few small pockets), and that b) it was more desirable to provide students with the best possible experience to progress, complete and join the NHS registered workforce. We wrote a joint statement, which went to all eligible students, which avoided complaints.

The legacy of this systems wide working during a crisis, came from a second conversation I arranged, in which we reflected on the value of the HEI partner at the right table within the ICS. Essentially, I invited myself and my Head of Practice Learning and Development, onto their People Board. So far, we have attended a small number of their monthly meetings, which have been really insightful and instrumental in building on our partnership working. For example, we can now directly contribute to discussions about the BAME disparity reduction programme, workforce planning projects, violence prevention and reduction, and so on. We look forward to strengthening this partnership working with the ICS.

Prof Paula Kersten, Dean of School of Sport and Health Sciences at the University of Brighton

Dr Channine Clarke, Head of Practice Learning and Development

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