NHS e-learning developments

Barriers were also encountered to accessing and using e-learning resources as information sources, so again it is relevant to provide a brief account of NHS e-learning initiatives. At the time of this study, education and training delivered within the NHS could be categorised in terms of 1) professional pre-registration and post-registration training 2) statutory and mandatory training delivered to all Trust staff 3) other Trust-based or externally sourced training relating to

organisational learning and staff development needs. Statutory training was that which the Trust was required to provide by law, or where a statutory body had instructed organisations to provide training on the basis of legislation, and was required for all staff groups. Requirements for

mandatory training were mainly determined by the individual Trust, but included initial and annual refresher training on information governance for all staff, delivered via e-learning (NHS England, 2014). Mandatory training was concerned with minimising risk, providing assurance against policies, and ensuring compliance with external standards, and was generally specific to roles or

departments. The content of statutory and mandatory training had been partly standardised nationally via the North West Core Skills Programme and subsequently the UK-wide Core Skills Framework produced by Skills for Health. The statutory and mandatory training provided by all the Trusts in the study was aligned to varying degrees with the Core Skills Framework.

18 LKSL: http://www.libraryservices.nhs.uk/.

All of these forms of education and training could involve e-learning. On grounds of

cost-effectiveness it had become common practice across the NHS to deliver mandatory and statutory training via e-learning, at least in part. The document Supporting best practice in e-learning in the NHS: a strategic framework (NHS National Workforce Group, 2005) identified a clear need to establish the wider adoption and deployment of e-learning across health care services. The

subsequent report Modernising healthcare training: e-learning in the healthcare services (e-mpirical, 2006) outlined a number of recommendations and strategic elements considered essential for the effective management and deployment of e-learning at national, regional and local levels (Bingham

& Wright, 2008). It noted that “barriers to access to computers and a supportive learning

infrastructure remain and probably represent the biggest barriers to the effective implementation of the use of new learning technologies” (p. 10).

Wright and Bingham (2008) cited the need to meet the DH’s Standards for better health

(Department of Health, 2009c) and the NHS Litigation Authority’s Risk management standards (e.g.

NHS Litigation Authority, 2013) as a key driver for the introduction of technology-enhanced learning within the NHS.

The publication of the DH’s Framework for technology enhanced learning in November 2011

encouraged the wider adoption of learning technologies given their potential for patient and service delivery, development of the workforce, flexibility for training delivery and cost effectiveness (Department of Health, 2011a). From 2008-2009 onwards, the DH had made significant central investments in e-learning. Significant national initiatives had been put in place to drive forward the e-learning agenda forward within the English NHS, including the -Learning Repository;¹⁹ the National Learning Management System (NLMS)²⁰, a new module of the national Electronic Staff Record (ESR), designed to enable and track employee access to e-learning); the Skills for Health e-Learning

Readiness Toolkit²¹ and NHS Core Learning Unit²²; and the setting up of e-Learning for Healthcare (e-LfH), which develops e-learning content in partnership with medical royal colleges and other professional health care organisations (Bingham & Wright, 2008). In November 2013 the online networking platform My Health Skills was launched as a “platform [for members] to voice opinion,

19 E-Learning Repository: http://www.elearningrepository.nhs.uk/

20 NLMS: http://www.esrsupport.co.uk/nlms/index.html

21 E-Learning Readiness Toolkit: http://www.elearningreadiness.org/index.php

22 NHS Core Learning Unit: https://corelearning.skillsforhealth.org.uk/local/sfhadmin/login/index.php

access relevant information, build capability and seek advice from fellow colleagues within the healthcare sector”.²³ Latterly e-LfH, which became a part of Health Education England, had planned the creation of a Technology Enhanced Learning (TEL) Hub, a platform designed to be a first port of call for TEL information and resources; it was intended to launch this in 2017.²⁴ The governance structure for e-learning comprised a national E-Learning Strategy Board, the E-Learning

Management Group, and the Strategic e-Learning Leads group (Ward, Sutton, Divall, & Hull, 2008).

Facilities or guidance for checking the suitability of local PC infrastructure existed for some of this content, e.g. the ESR PC Check,²⁵ and e-LfH’s Technical requirements for accessing all e-Learning for healthcare products (e-Learning for Healthcare, 2008). In September 2016, e-LfH added the e-LfH Hub to the list of OpenAthens resources to facilitate access for certain professional groups.

E-learning encompasses a range of delivery methods and content types, including re-usable learning objects in various formats, virtual learning environments (VLE), learning management systems (LMS), social networking environments and tools including forums, wikis and blogs, audio- and video conferencing, e-portfolios, podcasts, video clips, online simulation and educational gaming (NHS East of England, 2009). Other than “official” NHS e-learning material, a wide range of other e-learning content existed, produced by higher education institutions, professional bodies and publishers, that NHS professionals might have wished or needed to access for professional development purposes;

(Childs, Blenkinsopp, Hall, & Walton, 2005). E-learning was also widely used in the pre-registration education of health professionals, creating a need for students on placement to access such content from within NHS networks (Bilham, 2009; Clarke, 2009; Walton, Smith, Gannon-Leary, & Middleton, 2005; Ward & Moule, 2007). As well as carrying out mediated searches and information literacy training, NHS librarians had an important early role in facilitating e-learning at local level, both in terms of strategic planning and particularly through their provision of support to staff accessing e-learning material using library computers; they were well placed to report on problems with PC system or requirements and with network, authentication or usability issues (Beaumont, 2005;

Childs et al., 2005; Sutton, Booth, Ayiku, & O’Rourke, 2005).

23 My Health Skills: https://www.myhealthskills.com

24 HEE Technology Enhanced Learning: https://www.hee.nhs.uk/our-work/research-learning-innovation/technology-enhanced-learning

25 ESR PC Check: http://www.esrsupport.co.uk/nlms/pccheck.html. There were problems with this in practice:

see Section 6.2 below.