Section 1: Introduction and background to the Partnership Quality Assurance Framework for Healthcare Education in England
1.1 Introduction
There are five sections to this document as follows:
Section 1: Introduction and background to the Partnership Quality Assurance Framework for Healthcare Education in England (pages 1-8);
Section 2: Approval (pages 9-14);
Section 3: The process protocol for undertaking OQME including the final action report (pages 15-30);
Section 4: The shared evidence base (pages 31-39);
Section 5: The Approval and OQME Standards Template for healthcare programmes (pages 40-70).
The purpose of this document is to support the prototypes of the OQME and Approval processes and shared standards that are taking place in seven HEIs and partner placement providers, between autumn 2004 and spring 2005. These processes and standards will be evaluated and, following completion
of the evaluation, revisions will be made. Full implementation will commence
in 2005.
1.2 Background
The DH has been working closely with education commissioners; education providers (HEIs and placement providers); the NMC; the HPC; and service users, to develop one shared framework for healthcare education that is robust and meaningful, and intended to reduce the administrative burden on education providers.
The Partnership Quality Assurance Framework for Healthcare Education in England (the Partnership Framework) has been developed as a result of collaborative working between these stakeholders over a period of time.
The collaborative arrangements included:
- national working groups - established to discuss, debate and formulate detailed proposals on the key elements of the Partnership Framework (for membership of these working groups please see Annex 6);
- local reference groups comprising all stakeholders - to secure the engagement and ownership of the Partnership Framework by the wider healthcare education community and to make sure that their views are reflected (for local reference group attendees please see Annex 7);
- expert groups - set up to capture specific expertise of key stakeholders;
- a consultation event involving students and service users;
- a consultation event with education commissioners, service providers and HEIs addressing placement learning.
We would like to thank members of the national working groups and reference groups for their significant contribution to the development of the Partnership Framework. The opportunity to have input from Trusts, SHAs/WDCs, HEIs and professional statutory regulatory bodies through membership of the groups was invaluable.
Table 1 (below) illustrates the principles underlying the development of the Partnership Framework and how these have been addressed.
Table 1: Underlying principles and how these have been addressed
| Principle | How? |
|---|---|
| Streamlining and reducing the burden to stakeholders |
|
| Recognition that healthcare providers are joint providers of healthcare education |
|
| Meeting all stakeholders' needs |
|
| Proportional approach |
|
| Approaches lead to quality enhancement, while meeting diverse stakeholder quality monitoring requirements |
|
| Aligns with Standard Model Contract in England |
|
The new Partnership Framework seeks to consolidate a number of existing processes by which monitoring and Approval information is obtained by external bodies. Currently, many bodies are engaged in collecting largely similar information, although in different ways and at different times. This leads to an onerous burden for staff who provide education.
The Partnership Framework will enable quality assurance information to be gathered in a co-ordinated way through an agreed process, against shared standards and with equitable responsibility for the process between the HEIs and practice learning providers. All organisations involved will draw upon the same evidence, gathered in the agreed format (template) and through the minimum number of events, thereby reducing the burden of bureaucracy for all.
The Partnership Framework is made up of five elements as follows:
- programme Approval;
- OQME;
- Major Review;
- benchmark and quality standards; and
- the shared evidence on which conclusions and judgements are based.
This Partnership Framework, depicted in figure 1 below, currently applies to both pre-registration programmes and programmes of learning beyond registration. In the first instance, the main focus is on NHS-funded professional education, i.e. programmes for nursing, midwifery and the allied health professions. However, it is anticipated that new developments will include exploring the ways in which the Partnership Framework might be applied to other, non-NHS funded health professional education and educational programmes for other healthcare staff.
As a result, the Partnership Framework will be an integral part of the new Standard Model Contract between education commissioners in England and education providers. The contract includes:
- contract between the SHA and the HEI;
- Learning Development Agreement between the SHA and the placement provider;
- partnership agreement between the HEI and the placement provider organisations;
- minimum HEI/SHA/WDC data set.
The Partnership Framework
The five elements within the Partnership Framework (see figure 1) are closely integrated. Each element addresses different aspects of quality assurance, which together provide a comprehensive and holistic picture of the quality of the provision. The elements are not isolated but inform, and are informed by, each other. The complementary nature of the processes and outcomes ensures that minimum effort provides maximum insights. Each element should be clearly understood as part of one Partnership Framework. All partners and stakeholders have their own unique requirements and obligations. The Partnership Framework provides for these requirements through agreed processes and shared documentation.
Figure 1: The Partnership Quality Assurance Framework for Healthcare Education in England
The five elements, in detail, are:
Benchmark and quality standards - these cover all the criteria used to assess and measure standards and outcomes of healthcare programmes including regulatory and professional body requirements; published subject benchmark statements produced by QAA; NHS National Service Frameworks; the Code of practice for the assurance of academic quality and standards in higher education and the FHEQ. These benchmark and quality standards are established documents that have been consulted on and tested previously, and, therefore, their assessment is not part of the prototypes.
Approval - the purpose of Approval is to ensure a systematic process for arriving at decisions about the ability of a proposed programme to meet, over time, the requirements of regulatory bodies, academic awarding bodies, education commissioners and service users. This element of the Partnership Framework consists of agreed shared standards and processes and covers the learning that takes place in both campus and practice based settings. The standards articulate with standards for OQME.
OQME - this is a process by which education commissioners and regulators satisfy themselves that the quality of education programmes provided by the HEIs and placement providers is maintained and improved in the interim period between:
- Approval and the first Major Review; and
- one Major Review and the next.
This process and standards replaces all activity that previously occurred on an ongoing basis (for example, internal annual monitoring by HEIs, standards for practice placement audits, contract monitoring by education commissioners and annual monitoring by regulatory bodies).
OQME takes place continuously but is formally monitored annually. In exceptional circumstances, evidence of a serious failing to maintain a given standard may require immediate review and action.
OQME is based on a set of standards within 10 categories or aspects. Eight
of these aspects are shared with the elements that make up Major Review, although the nomenclature varies slightly.
Major Review - this is the periodic process by which a team of external peer reviewers assesses healthcare education provision against a number of reference points. The term Major Review encompasses what was previously known as QAA subject review together with education commissioners' fundamental or contract review and regulatory bodies annual review. A streamlined process for Major Review, which includes scrutiny of practice as well as theoretical education, was prototyped in 2002. Following positive evaluations and some refinements, the QAA is now reviewing all NHS-funded healthcare education programmes on behalf of the DH, the NMC, the HPC and education commissioners. These Major Reviews are taking between 2003 and 2006. Major Review is not part of the prototypes.
Evidence base - evidence is the information on which conclusions and judgements for Major Review, Approval and OQME are based. The evidence base underpins Major Review, Approval and OQME and addresses the 10 aspects that have been identified as shared themes to the Partnership Framework.
1.3 Relationship between the Partnership Framework and the Standard Model Contract
The Partnership Framework will form an integral part of the Standard Model Contract which is being developed in partnership with stakeholders within the NHS and HE. Subject to ministerial approval, this will be implemented from 2005. This replaces the previous range of different contracts that SHAs/WDCs had with HEIs. The Standard Model Contract consists of three sets of partnerships that together ensure the total education needs of students are met (see figure 2 below). The elements of the contract are:
- the contract between the SHA and the HEI;
- a Learning and Development Agreement between the SHA and the placement provider organisation;
- a Partnership Agreement between the HEI and the placement provider organisations;
- a minimum HEI/SHA/WDC data set.
The Partnership Framework will underpin all of these documents.
Figure 2 below demonstrates the nature of the partnership between education commissioners, the HEI and placement providers through the new Standard Model Contract, local Partnership Agreements and the Learning Development Agreement.
Figure 2: Standard Model Contract and model agreements - key partnership relationships
*National quality specification using the Partnership Framework and the national minimum dataset
All partners in the relationship will use the national quality specification and an agreed minimum data set. Quality assurance, contract monitoring and management will all take place through the OQME process within the Partnership Framework.
1.4 Approval and OQME standards and process protocols
Through the local and national working groups a set of standards for both OQME and Approval has been identified. This is known as the Approval and OQME Standards Template and is shared by all the key stakeholders. The template includes standards that are to be monitored as part of OQME and standards that are monitored as part of the process of programme Approval. The standards that are identified include those related to programmes and learning that takes place in both HEIs and placements.
The standards have been clustered into 10 aspects as follows:
- management and organisation;
- effective use of resources;
- curriculum;
- learning outcomes;
- student selection, progression and achievement;
- student support;
- learning and teaching;
- assessment;
- quality enhancement and maintenance;
- values, equalities and diversity.
Each aspect (not each standard) is signed off separately by the individual(s) responsible as designated in the Standards Template, according to the locus of responsibility (see section 5).
The standards, and therefore the aspects, are designed to be used in all healthcare education quality assurance activities, i.e. Major Review, Approval and OQME. In Major Review, eight of the aspects are shared with the review elements (see table 2 below) and, therefore, will be used in the preparation of the Major Review self-evaluation document. The outcomes of OQME and Approval - the final action plans and implemented changes - and the final Approval documentation also provide additional evidence for the self-evaluation document and subsequent review visits. Equally the outcome from Major Review - the report - can be used as evidence in the verification that standards have been achieved in relation to OQME.
Table 2: Relationship between the Major Review elements and the Approval/OQME aspects
| Major Review elements | Equivalent Approval/OQME aspects |
|---|---|
| Academic and practitioner standards: Learning outcomes Curricula Assessment Student achievement |
|
| Quality of learning opportunities: Learning and teaching Student progression Learning resources and their effective utilisation |
Learning and teaching Student selection, progression and achievement Effective use of resources Quality enhancement and maintenance |
| Maintenance and enhancement of standards and quality | Management and organisation |
| Student support | |
| Values, equalities and diversity |
Process protocols have been written on how to undertake Approval and OQME. Each process protocol provides guidance for undertaking programme Approval and OQME. Both the standards and the process protocols are for both HEIs and placement providers, thereby recognising the role that each plays in the provision of quality healthcare education.
1.5 The consultation
The consultation was undertaken between March and June 2004 for all stakeholders to comment on elements of the Partnership Framework: the Approval process, OQME, the evidence base, the Standards Template and the glossary of terms and acronyms that support these. The consultation document was widely distributed by email and on web sites, and a total of 104 responses were received from a variety of organisations including HEIs, Trusts, the independent sector, national standing committees, professional bodies, statutory regulatory bodies and education consultants. Four 'roadshows', designed to provide an opportunity to give feedback directly on the consultation document, were attended by 140 individuals. A report outlining the outcomes from the consultation document was published at www.qaa.ac.uk/health/health_home.htm Responses to the consultation were given due consideration by the DH, partners and stakeholder representatives and this revised document was produced to be tested in the prototypes. A list of the amendments following the consultation can be found in annex 8.
Major Review has already been confirmed by a previous consultation exercise. The cycle of reviews has begun and will continue until 2006. In addition, 11 subject benchmark statements, published by the QAA, currently exist and a further six have been developed, consulted upon and will be published shortly.
1.6 Summary
The Approval and OQME processes are designed to reduce the burden of previous quality assurance arrangements and achieve streamlining of current, multiple quality monitoring arrangements. Current arrangements often result in a number of different stakeholders separately undertaking their own Approval and quality assurance activities for education within any one academic year in both the HEI and placements. These new arrangements for Approval and OQME are intended to reduce duplication of effort by joining up the processes of the commissioners/funders of healthcare education, the education providers and the regulators. The new Partnership Framework seeks to eliminate duplication of effort and reduce the burden of regulation, while at the same time increasing the contribution to educational improvement.
At the moment, the Partnership Framework applies to nursing, midwifery, health visiting and allied health professional education programmes, but it is anticipated that this will be extended in the future.
Section 2: The process protocol for programme Approval
2.1 Introduction
Approval is the recognition of a programme by the regulator(s), where appropriate, the commissioner and the programme providers. The reasons for Approval may be:
a New provision
b Approval of existing provision triggered by:
- request agreed by partners due to significant change; or
- result of OQME and/or Major Review processes.
Due to the cyclical nature of the review processes, these triggers may occur at any time and will replace any previous fixed term for re-approval, except where this is required by a regulator.
Purpose
Through the systematic process of Approval, decisions are made about the ability of the proposed programme to meet the requirements of:
- regulatory bodies;
- programme providers;
- health and social care providers;
- service users; and
- education commissioners.
An additional purpose of Approval is to provide systematic processes for accommodating future needs of the different systems of health and social care. Judgements for all of these are supported by appropriate evidence.
2.2 Four core areas within the Approval process
The Approval process is designed to answer four key questions:
- Does the education, training and assessment meet the requirements for the award, the requirements of regulators, the requirements of commissioners and the needs of the student?
- Is there evidence that the providers' systems and processes meet the requirements of the Partnership Framework for OQME and for Major Review?
- Do the providers' systems and processes operate in a fair, just and open way?
- Is there evidence that the provision is sustainable?
2.3 Approval standards
Within the Standards Template (see Section 5) are the standards that have been identified for the Approval process. The standards for Approval are designed to address the four key questions identified above. Some of the standards are solely within the remit of the Approval process, while other standards apply to both Approval and OQME.
Any Approval event for NHS-funded programmes must demonstrate achievement of the Approval standards. These standards represent:
- academic requirements;
- requirements of education commissioners through the national contract or any other contractual arrangements;
- relevant professional, statutory and regulatory bodies' requirements.
2.4 The Approval process
The Partnership Framework describes Approval as a process with the following stages:
1 Commissioning
2 Programme development
3 Approval
The flowchart illustrates this process. (opens in a new window)
Stage 1: Commissioning
- A decision is taken to commission a programme of healthcare education and training. This decision may or may not be the outcome of a tendering exercise. It involves service and programme providers.
- When a programme is commissioned, there must be evidence that it reflects service user and carer needs, wants and expectations.
- In cases where the qualification leads to eligibility for entry to a professional register, the programme providers and the commissioner jointly and formally notify the appropriate regulatory body of this intention.
- Where the qualification does not lead to entry to a professional register, the responsibility for approval rests with the programme providers and commissioner.
Stage 2: Programme development
Jointly, the commissioner and the programme provider convene a PDG that uses the following documents as its points of reference:
- when the proposed qualification leads to eligibility for entry to part of the HPC register, the PDG will utilise the appropriate professional body curriculum guidelines;
- HPC approval documents that cross reference to its Standards of Proficiency and Standards of Education and Training;
- when the proposed qualification leads to eligibility for entry to part of the NMC register, the PDG will utilise the relevant NMC documents detailing programme specific requirements, for example, Statement of Compliance;
- Approval standards (from the Standards Template);
- subject benchmark statements and the Code of practice for the assurance of academic quality and standards in higher education (the Code of practice) produced by the QAA;
- the FHEQ.
The PDG produces documentation for submission to the Approval panel within an agreed pre-determined timescale. This documentation is signed jointly by all stakeholders.
The recommended membership of the PDG is outlined below.
Stage 3: Approval
- The documentation submitted by the PDG is considered by the Approval panel.
- The programme provider leads and co-ordinates the Approval visit in consultation with the statutory regulator(s), for example, HPC and/or NMC in cases where the qualification leads to eligibility for entry to a professional register. Where practice placement sampling is required as part of Approval, placement providers would need to be included in these arrangements.
- Responsibility for writing the report of the approval event will lie with the programme provider in agreement with the HPC/NMC, as appropriate.
- The panel will share its final report with all stakeholders.
The recommended membership of the Approval panel is outlined below.
2.5 Stakeholder involvement
This section summarises the involvement of stakeholders at the different stages of the process.
Recommended membership of Programme Development Group
- HEI 'host' faculty, department or school
- Expert/professional advice, for example, professional body as appropriate to the provision
- Service users
- Commissioner representative
- Service management representative(s)
- Practice learning providers
- Representation from students (in cases where there is a comparable pre-existing programme in the HEI)
Recommended membership of the Approval panel
- Appropriate representative(s) of the HEI granting the academic award
- Representative of the regulatory body/bodies appropriate to the provision, (for example, NMC, HPC, GSCC, etc) in cases where the qualification leads to eligibility for entry to a professional register
- External professional peer expertise
- Other external expertise as required, for example, higher education and/or commissioning expertise
2.6 Evidence to support Approval
The purpose of the evidence for the Partnership Framework is to provide a set of common, transparent, measurable data acceptable to all stakeholders that can be used to:
- give validity to statements and thus invite confidence in claims;
- allow consistent judgements to be made against quality standards;
- allow improvement and enhancement of quality standards to be measured;
- suggest appropriate sources of qualitative evidence that might be used to support/verify claims;
- ensure commonality/consistency of the evidence for the Partnership Framework.
The evidence for quality assurance is an integral part of each core element of the Partnership Framework, i.e. Approval, OQME, and Major Review.
It includes all the information and data offered by the educational providers (in HEIs and in practice settings) in support of their self-evaluation and, in the case of Approval, for use by the Approval panel in order to verify the quality of provision.
Core evidence will consist of:
Quantitative student data
- statistical data relating to student recruitment and progression (as specified in the Standard Model Contract for pre-registration students) and equivalent data relating to learning beyond registration;
- contract numbers;
- numbers for which programme approval is sought or given.
Staff data
- WTE teaching staff significantly contributing to each programme;
- support staff.
Practice learning data
Evidence of the range, quality and adequacy of practice learning opportunities (placements), including arrangements for preparation and provision of assessors/mentors and other individuals supporting practice learning.
Qualitative evidence
- Programme specifications;
- definitive information given to students about the programme (for example, student handbook);
- strategic plan/business plan;
- strategic plan of placement provision.
Additional evidence
The panel may request suitable forms of other evidence to support the submission as suggested in the Standards Template.
Next >> Section 3: The process protocol for undertaking OQME including the final action report
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