Epic): Evaluation of Impact of Learning and Development Activity and Resources
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Equal Partners in Care (EPiC): Evaluation of impact of learning and development activity and resources NHS Education Scotland March 2015 Authors: Glenys Watt, Director Ian Christie, Consultant Sarah Richard, Consultant 54 Manor Place, Edinburgh, EH3 7EH T: 0131 225 5600 E: [email protected] www.blakestevenson.co.uk Blake Stevenson Ltd EPiC: Evaluation of learning and development activity and resources CONTENTS Chapter Page Executive Summary ...................................................................................................................... i 1. Introduction and context ..................................................................................................... 1 2. Summary of national and local EPiC activity ......................................................................... 8 3. The impact of EPiC activity ................................................................................................. 24 4. Sustainability considerations.............................................................................................. 40 5. Conclusions and recommendations ................................................................................... 43 APPENDICES: Appendix 1: Research tools Appendix 2: List of consultees in case study areas Appendix 3: List of Stakeholder Interviews 0 Blake Stevenson Ltd EPiC: Evaluation of learning and development activity and resources Executive Summary Introduction NHS Education for Scotland (NES) commissioned Blake Stevenson Ltd in August 2014 to undertake an evaluation of the impact of the Equal Partners in Care (EPiC) learning and development activity and resources. The research questions the evaluation sought to address were: To what extent have expectations around EPiC been realised? What has been the impact of learning related to EPiC in terms of: -staff confidence and capability in relation to working with carers and young carers? -staff values and attitudes in relation to supporting carers or young carers? -changes in work practice, processes and policy as a result of using the EPiC core principles? -changes in the workplace environment as a result of becoming more carer aware? What are the facilitators and barriers to applying EPiC core principles? To what extent has good practice in relation to carers and young carers been disseminated and used by other colleagues and team members? What are the perceptions of the sustainability of any changes in practice? The evaluation team used the following methods: a review of documentation from the five demonstrator sites followed by site visits to these areas, plus two additional areas where it was known implementation activity had taken place, to interview a range of staff and stakeholders; a survey to individuals to follow up on “pledges” they had made at three learning and sharing events; interviews with 21 stakeholders; and attendance at events to undertake further consultation. Activity undertaken The report provides a summary of activity undertaken at national and local levels. At national level it focuses on the reach of the centrally developed resources and events including three learning and sharing events, the development of an email network (964 members), a range of printed resources (over 10,000 copies distributed) and the development of an online Level 1 e- module (with Levels 2 and 3 currently in development). At local level the report sets out a summary of activity undertaken within the seven areas visited during the fieldwork. The areas were: NHS Dumfries and Galloway; NHS Grampian; NHS Greater Glasgow and Clyde; i Blake Stevenson Ltd EPiC: Evaluation of learning and development activity and resources NHS Highland; Inverclyde CHCP; North Lanarkshire Carers Together; and Prince and Princess of Wales Hospice, Glasgow. In addition the report provides examples of other areas and organisations where activity to implement the EPiC core principles and framework has taken place. Findings The findings from the evaluation focus on the impact of all of this activity. They cover: the impact on staff; the impact on organisations; and the impact on carers The findings also describe the enablers and challenges associated with the implementation of the EPiC core principles and framework learning and development activities. Impact on staff In relation to the impact on staff the report highlights the following: improved confidence and ability to identify carers and refer them to appropriate support; There are examples where staff are reported to have greater confidence in having the conversations with carers as well as knowing the appropriate sources of support to refer them to. improved understanding of the issues that affect carers; Staff who had taken part in training reported that they were more able to identify carers and the range of people who may be carers (including young carers). Some of those who had taken part in training had recognised that they themselves/or a member of their family were carers for the first time. involving carers as equal partners in care; There are examples of improved awareness of the importance of involving carers as equal partners and in some instances practical action to ensure that this happens. In some cases action was already underway prior to the EPiC core principles being developed but these have reinforced what is being attempted. engaging staff beyond the health and social care sectors. While the main focus has been on awareness raising within the health and social care sectors there are examples where staff within education settings have used EPiC to raise awareness of young carers. ii Blake Stevenson Ltd EPiC: Evaluation of learning and development activity and resources Impact on organisations EPiC has assisted organisations to implement other strands of work they are involved with such as dementia strategies and Reshaping Care for Older People. It is seen as helping to provide a consistent approach to working with carers for the health and social care integration agenda. The raised levels of awareness among staff have in some cases led to changes in processes and practice. For example: changes to documentation to remind staff to ask about carers; adapting electronic records to record if a patient is a carer; commissioning processes that require organisations to show what they are doing to raise awareness of carers. As staff become more aware of carers and carers’ issues they see what else has to change or could be changed. Impact on carers The evidence of impact on carers is limited to date but there are some examples of increased involvement of carers in hospitals and some evidence that EPiC has helped increase carers’ own understanding of their entitlements. Enablers and challenges The report identifies a number of facilitators and challenges relating to the implementation of the EPiC learning and development activities. The key enabling factors include the credibility of the EPiC core principles as having been developed with involvement from carers and as having the double branding from both NES and SSSC. Interviewees like the fact that the principles are written in plain language and are easy to follow. People also like the fact that they can adapt the resources to suit their own local circumstances. Many interviewees commented positively on the support from the central project team. In some areas partnership working between the public and third sector was perceived as having facilitated the implementation of the EPiC core principles. Some areas had found that making the training mandatory was helpful while other areas had built the EPiC training into other training they were undertaking and found this a useful approach. Where strategic level staff have been closely involved this was seen to have helped in implementation: for example in Highland they used EPiC core principles to help develop the Carers Strategy and in North Lanarkshire it was used to inform Reshaping Care for Older People (RCOP) planning. The main challenges identified included the competing priorities for training time, although a number of areas had found ways to overcome this challenge such as taking the training into wards and building it in with other training that was being delivered. There was recognition that there is a huge cultural change required and that involvement of those at strategic level will be essential. Some areas faced challenges with the compatibility of e-learning platforms and software which made it impossible to use the e-module directly. iii Blake Stevenson Ltd EPiC: Evaluation of learning and development activity and resources Sustainability Interviewees perceived the EPiC core principles to be sustainable in that they will not go easily out of date. The EPiC core principles are seen to fit well with a range of national policies but some interviewees thought that this strategic alignment needs to be better communicated. While training is one aspect of promoting change it is recognised that structures, systems and processes also need to be in place. However the new Carer Positive Employers Kitemark is seen as a key development to sustaining the impact of the EPiC resources as it is hoped that employers will be directed to the core principles and framework. It is hoped that initial efforts made to date to build the EPiC training into further and higher education courses will continue. There was also concern by a number of consultees that without the central project team in place the momentum that has been developed will be lost.