Buckinghamshire Chilterns University College
North West London Strategic Health Authority

November 2005

RG 212 11/05

Major review of healthcare programmes

The Department of Health, in partnership with the Nursing and Midwifery Council, the Health Professions Council and the Strategic Health Authorities have contracted with the Quality Assurance Agency for Higher Education (QAA) to carry out reviews of all NHS-funded healthcare programmes in England during the period 2003-06.

QAA helps to provide public assurance that the quality and standards of higher education are being safeguarded and enhanced by conducting academic reviews of higher education provision.

Major review

Major review is a peer review process. It starts when higher education institutions in partnership with their commissioning Strategic Health Authorities evaluate their provision in a self-evaluation document. This document is submitted to QAA for use by a team of academic and practitioner reviewers who gather evidence to enable them to report their judgements on the academic and practitioner standards and the quality of learning opportunities. Review activities include meeting academic and clinical staff and students, scrutinising students' assessed work, visiting practice learning environments, reading relevant documents, and examining learning resources.

Full details of the process of major review can be found in the Handbook for major review of healthcare programmes, 2003.

Judgements

The range of judgements that reviewers may utilise when they have completed a major review are summarised below.

Academic and practitioner standards

Reviewers make one of the following judgements on standards:

confidence, which may be expressed as
limited confidence, or
no confidence.

To reach this judgement, reviewers look at:

learning outcomes
the curriculum
student assessment
student achievement.

Confidence in academic and practitioner standards: a judgement that is made if reviewers are satisfied with current standards and with the prospect of those standards being maintained into the future. A judgement of limited confidence is made if standards are being achieved but the reviewers have doubts about the ability of the HEI and partner placement providers to maintain them into the future.

No confidence in academic and practitioner standards: a judgement that is made if arrangements are inadequate to enable standards to be achieved or demonstrated. If a failure to achieve standards has occurred in specific programme/s and/or mode/s and/or level/s only, and there is confidence in standards at other levels, the failing programme/s mode/s level/s will be identified separately.

Quality of learning opportunities

Reviewers make one of the following judgements for each of three elements of learning opportunities:

commendable
approved
failing.

The three elements of quality of learning opportunities are:

learning and teaching
student progression
learning resources and their effective utilisation.

Maintenance and enhancement of standards and quality

Reviewers also report the degree of confidence they have in the providers' ability to maintain and enhance quality and standards in the healthcare programmes under review.

Commendable - the provision contributes substantially to the achievement of the intended outcomes, with most elements demonstrating good practice.

Approved - the provision enables the intended outcomes to be achieved, but improvement is needed to overcome weaknesses. The summary report will normally include a statement containing the phrase 'approved, but...', which will set out the areas where improvement is needed.

Failing - the provision makes a less than adequate contribution to the achievement of the intended outcomes; significant improvement is required urgently if the provision is to become at least adequate.

Summary of the main review outcomes

Subject provision and overall aims

Health visiting and nursing programmes at Buckinghamshire Chilterns University College (the University College) in partnership with North West London Strategic Health Authority (SHA) were reviewed in the academic year 2005-06. Judgements were made about the academic and practitioner standards achieved and the quality of the learning opportunities provided.

The review covered the following programmes:

Health visiting

Pre-registration

Postgraduate Diploma (PgDip) Community Health Care Nursing, full and part-time**
BSc (Hons) Community Health Care Nursing, full and part-time**
Nurse Prescribing**
Return to Practice**.

Nursing

Pre-registration

BSc (Hons) Nursing, full-time (Adult Nursing, Children's Nursing, Mental Health Nursing)* **
Diploma of Higher Education (DipHE) in Nursing, full-time and part-time (Adult Nursing, Children's Nursing, Mental Health Nursing)* **
BSc (Hons) Nursing (Flexible Conversion), full-time* **
Dip HE in Nursing (Flexible Conversion), full-time* **.

Undergraduate

BSc (Hons) Community Health Care Nursing, full and part-time (District Nursing, School Nursing, Community Children's Nursing)**
BSc (Hons) Community Health Care Nursing Without Specialist Practice, full and part-time (District Nursing)
BSc (Hons) Critical Care with or without clinical course, part-time (Intensive Care, Cardiothoracic Care, Accident and Emergency Care, Cardiac/Coronary Care)
BSc (Hons) Nurse Practitioner, part-time
BSc (Hons) Cancer and Palliative Care, part-time
BSc (Hons) Professional Nursing Studies (by work-based learning), part-time
BSc (Hons) Nursing (DipHE entry), full-time
BSc (Hons) Epilepsy Care, part-time
DipHE in Epilepsy Care, part-time
Diploma Professional Nursing Studies (by work-based learning), part-time.

Post-registration

Postgraduate

MA Education (Nursing, Midwifery and Health Visiting), part-time**
PgDip in Education (Nursing, Midwifery and Health Visiting), part-time (Lecturer in Education and Practice Educator pathways)**
Postgraduate Certificate (PgCert) in Education (Nursing, Midwifery and Health Visiting), part-time**
MSc Community Health Care Nursing, part-time**
PgDip Community Health Care Nursing, full and part-time (District Nursing)**
MSc Advanced Practice, part-time (Cardiac Rehabilitation Cancer and Palliative Care)
PgDip Advanced Practice, part-time (Cardiac Rehabilitation Cancer and Palliative Care)
PgCert Advanced Practice, part-time (Cardiac Rehabilitation Cancer and Palliative Care).

* These programmes underwent Nursing and Midwifery Council (NMC) annual monitoring as part of the Major review of healthcare programmes.

** NMC approved programme.

Academic and practitioner standards

Overall, the reviewers have confidence in the academic and practitioner standards achieved by the programmes in health visiting and nursing at Buckinghamshire Chilterns University College in partnership with North West London Strategic Health Authority.

Strengths

The involvement of practice partners in the development of health visiting intended learning outcomes is extensive and effective. Communication between the University College and health visiting practitioners and managers is strong and collaborative, is based on regular and effective email contact and is reflected in the work of the curriculum development group and the link lecturer role (paragraph 7).
Intended learning outcomes reflect contemporary health visiting practice, with practitioners reporting high degrees of satisfaction with the currency of the provision and the degree to which they are able to assist the University College in maintaining contemporary relevance against the evolving public health agenda (paragraph 10).
A curriculum development group, which includes practice partners, has worked responsively and effectively on meeting the significant public health agenda component of the health visiting programme (paragraph 12).
The written work in health visiting scrutinised by the reviewers reflected a very high standard of student achievement, with marks for assessments high in comparison with those achieved on non-health visiting modules in the University College (paragraph 24).
The role of the link lecturer and the posts supported by the Strategic Health Authority, such as the practice placement facilitators, are significant factors in enabling the nursing intended learning outcomes to be communicated effectively and to inform practice learning (paragraph 28).
The nursing provision has strengths in the use of the partnership in the development and refinement of intended learning outcomes, and strategies to involve non-statutory services and service users in the development of learning outcomes are effectively utilised (paragraph 29).
Nursing students are provided with comprehensive information on the assessment process, are well supported through the process and report satisfaction that this is being done effectively (paragraph 39).
The achievements of students on the new portfolio of post-registration, nursing degree programmes are excellent (paragraph 45).
Primary Care Trusts are now employing significant numbers of newly-qualified nurses directly into community nursing posts and have developed a preceptorship programme to support this (paragraph 50).

Good practice

In health visiting, the quality of feedback is of an exceptionally high standard, giving the student clear direction in terms of strengths and areas for improvement (paragraph 20).
In nursing, the quality of feedback is of an exceptionally high standard. It follows a consistent style using the Faculty's grading criteria and is clear in terms of terminology and direction for the student, highlighting strengths alongside recommendations for improvement (paragraph 41).

Weaknesses

In the written work in health visiting and nursing scrutinised by the reviewers, the weightings applied to grading criteria when work is being graded were not clear (paragraphs 20; 41).
The assessment workload across some post-registration nursing programmes is high in relation to the time-span of the course, including, as it does, a significant amount of written academic work, a wide range of clinical competencies and submission of a portfolio (paragraph 43).

Quality of learning opportunities

Learning and teaching

The quality of learning and teaching is commendable.

Strengths

There is a strong commitment to teaching quality within practice through the tripartite working relationship between mentors, practice learning facilitators and link lecturers (paragraph 55).
There is a clear commitment at Faculty, SHA and Trust level to the embedding of interprofessional learning within practice that is meeting with some success (paragraph 60).

Student progression

The quality of student progression is commendable.

Strengths

There is clear evidence of collaborative processes between the University College and its practice partners, with both parties expressing satisfaction with the development and maintenance of good relationships to enhance learner progression through the programme (paragraph 61).
The Faculty's success in achieving the aim of widening participation is reflected in a student entry profile that includes a significant proportion of students from ethnic minority groups and from non-traditional education and social backgrounds (paragraph 67).

Weakness

The part-time route for the DipHE in Nursing has suffered from a particularly high attrition rate (paragraph 64).

Learning resources and their effective utilisation

The quality of learning resources and their effective utilisation is commendable.

Strengths

There is a wide range of high-quality library and information technology resources at the University College, with excellent accessibility and availability both on and off-campus (paragraph 73).
Practice educators have a positive strategic role and provide contacts within the PCTs. The Strategic Health Authority provides funded posts to ensure adequacy of placement capacity, including a post for non-NHS provision (paragraph 76).

Maintenance and enhancement of standards and quality

Strength

There is a positive and effective working relationship between the University College and placement providers, both in the NHS and independent sector that contributes significantly to the assurance of standards and quality of health visiting and nursing provision (paragraph 80).

Introduction

1 This report presents the findings of a review of the academic and practitioner standards achieved, and the quality of the learning opportunities provided, in health visiting and nursing programmes at Buckinghamshire Chilterns University College (the University College) in partnership with North West London Strategic Health Authority (SHA). The review was completed during the academic year 2005-06.

2 The University College was created in 1999, the institution being previously known as Buckinghamshire College of Higher Education, itself an institution that could trace its origins, through many different manifestations, back to the nineteenth century. The Faculty of Health, in which the programmes under review are based, has offered nursing provision since 1981. The SHA, formed in January 2005, is the largest of London's five SHAs and looks after the health of nearly 1.9 million people in eight London boroughs. The SHA is responsible for eight Primary Care Trusts (PCTs), two Mental Health NHS Trusts and eight Acute Hospital NHS Trusts.

A Subject provision and overall aims

3 Health visiting and nursing are currently offered in the following programmes:

Health visiting

Pre-registration

Postgraduate Diploma (PgDip) Community Health Care Nursing, full and part-time**
BSc (Hons) Community Health Care Nursing, full and part-time**
Nurse Prescribing**
Return to Practice**.

Nursing

Pre-registration

BSc (Hons) Nursing, full-time (Adult Nursing, Children's Nursing, Mental Health Nursing)* **
Diploma of Higher Education (DipHE) in Nursing, full-time and part-time (Adult Nursing, Children's Nursing, Mental Health Nursing)* **
BSc (Hons) Nursing (Flexible Conversion), full-time* **
Dip HE in Nursing (Flexible Conversion), full-time* **.

Undergraduate

BSc (Hons) Community Health Care Nursing, full and part-time (District Nursing, School Nursing, Community Children's Nursing)**
BSc (Hons) Community Health Care Nursing Without Specialist Practice, full and part-time (District Nursing)
BSc (Hons) Critical Care with or without clinical course, part-time (Intensive Care, Cardiothoracic Care, Accident and Emergency Care, Cardiac/Coronary Care)
BSc (Hons) Nurse Practitioner, part-time
BSc (Hons) Cancer and Palliative Care, part-time
BSc (Hons) Professional Nursing Studies (by work-based learning), part-time
BSc (Hons) Nursing (DipHE entry), full-time
BSc (Hons) Epilepsy Care, part-time
DipHE in Epilepsy Care, part-time
Diploma Professional Nursing Studies (by work-based learning), part-time.

Post-registration

Postgraduate

MA Education (Nursing, Midwifery and Health Visiting), part-time**
PgDip in Education (Nursing, Midwifery and Health Visiting), part-time (Lecturer in Education and Practice Educator pathways)**
Postgraduate Certificate (PgCert) in Education (Nursing, Midwifery and Health Visiting), part-time**
MSc Community Health Care Nursing, part-time**
PgDip Community Health Care Nursing, full-time and part-time (District Nursing)**
MSc Advanced Practice, part-time (Cardiac Rehabilitation Cancer and Palliative Care)
PgDip Advanced Practice, part-time (Cardiac Rehabilitation Cancer and Palliative Care)
PgCert Advanced Practice, part-time (Cardiac Rehabilitation Cancer and Palliative Care).

* These programmes underwent Nursing and Midwifery Council (NMC) annual monitoring as part of the Major Review of healthcare programmes.

** NMC approved programme.

4 The overall aims of the provision are to:

work in partnership with the SHA, NHS Acute and Primary Care Trusts, and the independent and voluntary sectors to prepare practitioners who are competent, reflective and accountable both in delivering evidence-based care and in meeting changing healthcare service needs
deliver programmes of study that meet the requirements of the relevant professional and accrediting bodies and enable students to demonstrate their fitness for practice, purpose and award
encourage in all students a sense of personal responsibility for their continuing learning and professional development, through the promotion of learning both leading to and beyond registration
support applicants from diverse backgrounds in accessing appropriate qualifications in the disciplines of nursing and health visiting.

B Academic and practitioner standards

B1 Health visiting

Intended learning outcomes

5 The intended learning outcomes (ILOs) for health visiting are directly linked to the NMC requirements for pre-registration health visiting programmes (NMC 2002). ILOs also demonstrate good evidence of mapping with the Subject benchmark statement for health visiting and appropriately reflect The framework for higher education qualifications in England, Wales and Northern Ireland (FHEQ), both published by QAA.

6 ILOs are clearly set out in student handbooks and programme specifications. During visits to practice placements, health visiting students and community practice teachers confirmed their understanding of ILOs and that these directly related to learning and teaching in practice.

7 The involvement of practice partners in the development of ILOs is extensive and effective. Communication between the University College and health visiting practitioners and managers is strong and collaborative, is based on regular and effective email contact and is reflected in the work of the curriculum development group and the link lecturer role.

8 The use of electronic media to communicate learning outcomes development and other aspects of the curricula was particularly praised by practice staff, as this facilitated greater involvement from a wider range of practitioner partners. The remote access to a virtual learning environment (VLE), for students also contributes to the provision of up-to-date information.

9 The currency of the ILOs and their communication is maintained through an extensive matrix of support for students. Link lecturers play a significant role in their regular involvement and meeting with practice personnel in clinical settings. These roles are highly valued and are seen as helpful in maintaining consistency in the development and achievement of ILOs.

10 ILOs reflect contemporary health visiting practice, with practitioners reporting high degrees of satisfaction with the currency of the provision and the degree to which they are able to assist the University College in maintaining contemporary relevance against the evolving public health agenda.

Curricula

11 The University College has a strong tradition of community healthcare nursing programmes, and the current health programme has been reviewed to take account of recent significant changes in healthcare delivery. At a meeting with the reviewers, this was confirmed by health visiting students who spoke of the competency framework for health visitors in response to the public health agenda and how this was an integral part of their curriculum. Programmes are flexibly structured to enable students to study using a full or part-time mode. The curriculum design provides the opportunity to undertake practice in clinical settings in contrasting socioeconomic areas. Students and practice teachers confirmed, as is evident in curricular documentation, that service users are at the heart of the curriculum and its delivery.

12 A curriculum development group, which includes practice partners, has worked responsively and effectively on meeting the significant public health agenda component of the health visiting programme. Students are very positive about the programme and felt they were being adequately prepared for practice. Curriculum content and challenge reflect appropriately the differing levels of award, thus clearly demonstrating evidence of intellectual and professional progression. The pressures imposed by the considerable curricular content in the programme, given its length, have been resolved by providing increased study time.

13 A strategic approach to curriculum development demonstrates a process of consultation and reference to all stakeholders and national frameworks, for example, NMC, FHEQ and QAA subject benchmarks, and the means through which the curriculum is guided by and responds to these factors. The use of practitioners as visiting lecturers effectively brings contemporary practice into the curriculum and its delivery. Peer and practitioner involvement is an essential part of the process and, within the Faculty, curricula are developed collaboratively with partner NHS Acute and PCTs. They are also developed in accordance with the precepts contained within the Code of practice for the assurance of academic quality and standards in higher education (Code of practice), Section 7: Programme approval, monitoring and review, published by QAA, and the requirements of the NMC.

14 Health visiting students reported positive learning experiences in practice in relation to both skills and knowledge gained. Shared learning is a key component of the curriculum and promotes the requirement for interdisciplinary working within the community setting. The students' presentations of specialist final projects to Trust representatives are thought to be very beneficial and show the relevance of theory learnt. The reviewers judged that the curriculum for health visiting students provided an appropriate basis for ensuring that graduates would be safe and competent practitioners.

15 Community practice teachers are very well supported in delivering the curriculum throughout the programme, with a series of meetings at the University College to allow for necessary debate on issues related to health visiting, for example, the impact of specialist community public health nursing on the curriculum. The effective link lecturer system ensures there is a dialogue with the community practice teachers and that a partnership approach to the delivery of the curriculum is clearly visible to the students.

Assessment

16 The assessment strategy is appropriately designed and applied to enable students to achieve the ILOs, with timely explanations of the relationship between the assessment and learning outcomes to both students and practice staff. Assessment is conducted in accordance with the Code of practice published by QAA, with clearly-stated criteria fully explained and understood by students and applied in a rigorous and equitable way by staff. There is a wide variety of assessment methods that align well with the different learning outcomes and which promote academic and professional progression. These include portfolios, a community health needs profile of the student's practice area and an in-depth analysis of an aspect of health visiting practice selected from the practice profile.

17 There is an effective system for an early identification of students' learning needs in relation to assessment, with the submission of a formative assessment in the first semester leading to full and constructive feedback. Students are well supported through the assessment process throughout the programme. The effective preparation of community practice teachers for their assessment role is clear. Assessment is well planned and students and practice teachers are able to contribute to a developmental approach to the assessment and achievement of the competencies required for entry onto the professional register.

18 A collaborative approach is also evident in the drawing up of learning contracts and through the practice portfolio used to document the achievement of NMC competencies. There is a clear structure in place for identifying and supporting health visiting students and practice teachers/mentors, when it seems that the student is not achieving the competencies or is failing in practice.

19 Practice staff are actively involved in the development of assessment strategies in health visiting programmes. This ensures the currency of the programme and its assessment, while enhancing the good partnership arrangements that exist for the effective implementation of assessment methods.

20 The quality of feedback is of an exceptionally high standard, giving the student clear direction in terms of strengths and areas for improvement. Feedback is timely and well within the six weeks expected. The quantity of feedback is also of a good standard and is written under the headings of the University College's generic grading criteria. These criteria are used in a consistent fashion by staff in the marking and grading of work. However, in the written work scrutinised by the reviewers, the weightings applied to grading criteria when work is being graded were not clear. The reviewers were advised that new guidelines for the weighting of criteria would be operated for work submitted during the academic year 2005-06.

21 Internal moderation is rigorous and thorough, with appropriate samples of work seen by the external examiner for the programme, thus ensuring assessment processes are fair and transparent. External examiners consistently attest to the integrity and efficiency of the assessment regime and the excellent organisation associated with assessment.

Student achievement

22 The programme enables students successfully to achieve the NMC requirements for registration as a health visitor. The lead external examiner confirms that the standards reached by health visiting students are appropriate and compare well with those reached elsewhere. Assessments for health visiting enable students to achieve their ILOs at the required academic level. On the basis of student achievement reflected in the range of assignments submitted by students in their final assessments, health visiting students clearly are fit for practice, purpose and award.

23 The programme enables students to develop and achieve skills in critical enquiry which are underpinned and supported by excellent feedback on assessed work. Achievement in practice is greatly facilitated through the commitment to education from clinical practice teachers (mentor/practice educator) as well as link lecturers.

24 The written work scrutinised by the reviewers reflected a very high standard of student achievement, with marks for assessments high in comparison with those achieved on non-health visiting modules in the University College. Statistics in Table 1a show that 40 per cent of students achieved a First or Upper Second class honours degree, and all students on the PgDip programme successfully gained an award. High achievement is further reflected in the fact that there has been no attrition from recent cohorts.

25 Achievement at PgDip level has proved challenging for some students, despite their meeting the entry criteria. This is recognised by the University College and support has been provided for the development of academic skills. A formal procedure is currently being developed to enable master's students to transfer to the BSc route should this be required in the future to prevent attrition.

26 As indicated in Table 2a, all students have been offered posts and many are employed within surrounding PCTs. Students and employers report that they are fit for practice and lifelong learning.

Summary of academic and practitioner standards for health visiting

Overall, the reviewers have confidence in the academic and practitioner standards achieved by the programmes in Health Visiting at Buckinghamshire Chilterns University College in partnership with North West London Strategic Health Authority.

Strengths

The involvement of practice partners in the development of health visiting intended learning outcomes is extensive and effective. Communication between the University College and health visiting practitioners and managers is strong and collaborative, is based on regular and effective email contact and is reflected in the work of the curriculum development group and the link lecturer role (paragraph 7).
Intended learning outcomes reflect contemporary health visiting practice, with practitioners reporting high degrees of satisfaction with the currency of the provision and the degree to which they are able to assist the University College in maintaining contemporary relevance against the evolving public health agenda (paragraph 10).
A curriculum development group, which includes practice partners, has worked responsively and effectively on meeting the significant public health agenda component of the health visiting programme (paragraph 12).
The written work scrutinised by the reviewers reflected a very high standard of student achievement, with marks for assessments high in comparison with those achieved on non-health modules in the University College (paragraph 24).

Good practice

The quality of feedback is of an exceptionally high standard, giving the student clear direction in terms of strengths and areas for improvement (paragraph 20).

Weakness

In the written work in health visiting scrutinised by the reviewers, the weightings applied to grading criteria when work is being graded were not clear (paragraph 20).

Table 1a: Completion and achievement statistics for award-bearing programmes in health visiting

Programme	Cohort	Diploma programmes Pass		Diploma programmes Fail		Degree classification
						1		2i		2ii		3		P		F
		No.	%	No.	%	No.	%	No.	%	No.	%	No.	%	No.	%	No.	%
PgDip Community Health Care Nursing (Health Visiting)	October 2003	2	100
BSc (Hons) Community Health Care Nursing (Health Visiting)	October 2003					1	20	1	20	2	40	1	20

Table 2a: Employment statistics for all pre-registration programmes and exception reporting only for post-registration/post-qualification programmes

Programme	Further study		Local employers		Employers elsewhere		Unemployed		Other unknown
	No.	%	No.	%	No.	%	No.	%	No.	%
PgDip Community Health Care Nursing (Health Visiting) October 2003 Cohort					2	100
BSc (Hons) Community Health Care Nursing (Health Visiting) October 2003 Cohort			1	20	4	80

B2 Nursing

Intended learning outcomes

27 The ILOs for nursing are appropriately aimed at developing safe and competent practitioners and are aligned with the Subject benchmark statement for nursing, published by QAA. ILOs also adhere to the Standards of Proficiency for pre and post-registration nursing education set by the NMC. ILOs are up to date and reflect current practice requirements and significant aspects of healthcare strategy such as National Service Frameworks (NSFs), National Institute for Clinical Excellence guidelines and the public health agenda.

28 ILOs are communicated to students and mentors through a variety of media, and are clearly understood by all partners. The role of the link lecturer and the posts supported by the SHA, such as the practice placement facilitators, are significant factors in enabling the ILOs to be communicated effectively and to inform practice learning. During practice visits, mentors repeatedly stated their satisfaction with mentor support and with programme documentation, noting in particular the clarity of ILOs for the various levels of learning.

29 The provision has strengths in the use of the partnership in the development and refinement of ILOs, and strategies to involve non-statutory services and service users in the development of learning outcomes are effectively utilised. Service-user and expert-patient involvement is a challenging activity and requires sensitivity and reflection on the burden placed on service users and patients. The University College and its partners are to be complimented on the sensitive approach taken to this important area of learning development for students.

Curricula

30 The validation and periodic review of nursing programmes carried out by the University College and its partners, conducted in accordance with the Code of practice, have resulted in curricula that successfully meet the changing demands of the health service for highly-trained nurses offering a range of specialist expertise in different settings. These reviews have also been key in the setting of appropriate standards for programmes of study. Previous reports provide assurance of the quality and standards of the Faculty's NHS-funded healthcare programmes. The University College prospectus is seen to be very clear and helpful in enabling students to identify the course content and to understand the structure and organisation of the curriculum.

31 Curriculum development is well informed by the University College's strategic plan and has been clearly responsive to the evolving NHS agenda. Curriculum development also demonstrates an effective process of consultation with local and regional stakeholders and with national frameworks, for example, the NSFs, NMC regulatory requirements and the Academic Infrastructure. Practitioner involvement is considered an essential part of the process of curriculum development and, within the Faculty, nursing curricula are developed collaboratively with partner NHS Acute and Primary Care Trusts.

32 The curricula position the patient and client at the centre of the educational experience and accord with the NHS modernisation agenda with its emphasis on the patient experience. The greater involvement of service users in the development of curricula is being addressed in a number of ways, for example, a member of the pre-registration academic staff attends monthly meetings of a local Patient Advisory Liaison Service and brings back information to inform the curriculum content.

33 The currency of post-qualifying programmes is ensured through staff academic and professional activities external to the University College. Use of practitioners as visiting lecturers brings contemporary practice into the classroom. There are processes to convey information/requirements of Trusts back to the institution to help with the development of the curriculum. There is clear evidence of collaborative working to ensure future needs are being incorporated into future delivery, for example, Intravenous Therapy.

34 The emphasis on skills development within the current curriculum structure allows for extended practice in a simulated environment. This facilitates development of the underpinning knowledge and skills to a level of complexity relevant to each stage of the programme. Practice staff relate how students appear more confident in clinical situations following time in the skills laboratory. Theory to practice links are made effectively, using a range of strategies, crucially including the input from link lecturers. Practice mentors are aware of consolidating the students' theoretical learning with clinical practice.

35 There are examples of development of the programme to cover primary care as a first post after qualification. There are longer placements and intensive assessment of students who identify a desire to seek a post in primary care. If third-year students are assessed as competent, they are allocated a small caseload. Evidence of academic and intellectual progression can be found in module learning outcomes for each year, levels of which reflect the FHEQ descriptors. Pre-registration nursing students are enabled to achieve their full potential by offering them the opportunity, at the end of year two, to progress to level 3 study and achieve a BSc (Hons) Nursing. Feedback from employers, practice facilitators and mentors confirms that programmes meet the needs of Trusts in preparing students for their continuing careers in healthcare.

36 The majority of post-qualifying courses are specialism-based and reflect contemporary practice requirements such as those informed by changes in policy or service delivery. A successful example of this flexible approach to continuing professional development is the BSc (Hons) Professional Nursing Studies (by work-based learning), which is evaluated positively by students and visiting lecturers.

37 Nursing curricula actively and successfully address interprofessional learning (IPL) in both the academic and practice settings. A significant number of modules within the pre-registration curriculum include aspects of interprofessional approaches to patient care, and teams involved in the development of new programmes or in the review of curricula are required to state explicitly where IPL is being addressed within the curriculum. In addition to the incorporation of IPL within the curricula experienced on-campus, a major strategy has been the embedding of IPL within the practice environment through the Joint University Multi-Professional programme. Along with three other higher education institutions, the University College has been working with the SHA to establish common learning outcomes for IPL and to enable these to be achieved during practice placements. A significant factor in the growing success of this project is the role of the IPL facilitator in each of the Trusts.

Assessment

38 The links between the ILOs, NMC standards, the subject benchmark statements and the assessment process are clearly demonstrated. This also applies to the practice learning competencies that the students work towards when undertaking placement learning. A wide range of assessment methods that appropriately match the learning outcomes is evident. These include essays, skills laboratory projects, portfolios and posters.

39 Students are provided with comprehensive information on the assessment process, are well supported through the process and report satisfaction that this is being done effectively. Formative and summative assessment are used appropriately in both pre and post-registration nursing programmes, in theory and practice. Assessment is evaluated well by the students, who are clear about the relationship of assessment to the ILOs. Practice mentors are clear about the practice assessment in relation to the learning outcomes that students need to achieve in clinical practice.

40 Students and staff are very clear about the process and the actions that need to be taken in relation to the management of failing students in practice. Extensive guidance for mentors is provided for pre and post-registration programmes, with good support from the Faculty in ensuring the reliability and fairness of assessment of practice through the operation of effective models of mentoring for both full and part-time students. The Faculty is committed to the enhancement of the placement learning environment in partnership with the SHA to ensure the robustness and relevance of assessment in practice. The effective assessment of interprofessional learning and working is evident in theory and in some sections of the practice assessment tool.

41 The quality of feedback is of an exceptionally high standard. It follows a consistent style using the Faculty's grading criteria and is clear in terms of terminology and direction for the student, highlighting strengths alongside recommendations for improvement. This clearly allows for progression. However, in the written work scrutinised by the reviewers, the weightings applied to grading criteria when work is being graded were not clear. The Faculty is now addressing this issue with the publication of guidelines and weightings for the grading of work in the future.

42 The quantity and timeliness of feedback are good, allowing students to maximise their use of feedback. Assessments are moderated and sampled by the external examiner, thus ensuring fairness and integrity of the assessment process. External examiners on the pre-registration nursing programmes have begun to visit practice on an annual basis. Weighting of criteria is not evident, although the Faculty is addressing this for 2005.

43 The assessment workload across some post-registration nursing programmes is high in relation to the time-span of the course, including, as it does, a significant amount of written academic work, a wide range of clinical competencies and submission of a portfolio. This been brought to the attention of the Faculty and programme leaders through external examiners' reports. The course teams and Faculty Board are currently considering this.

Student achievement

44 Achievement of module and programme learning outcomes is clearly demonstrated through the students' assessed work seen by the reviewers. External examiners have commented on the excellent quality of feedback given to students which enables them to develop and successfully achieve their intended qualification. Assessments are appropriate to the award and meet the requirements of the NMC and subject benchmark statements.

45 The achievements of students on the new portfolio of post-registration nursing degree programmes are excellent. The completion and achievement statistics in Table 1b demonstrate that the majority of students are completing their programmes, with a good proportion gaining First or Second class honours degrees. Failure rates are very low.

46 Strong emphasis is given to the development and achievement of clinical skills both in the classroom and practice setting. Skills laboratory sessions are available and timetabled. Students report these to be extremely valuable and they may request additional time to practice skills as needed. Induction and orientation to the initial placements is commendable, and was valued by both students and mentors.

47 The management of students who fail to achieve in practice is successfully addressed by both the University College and the Trusts. The subject is raised within the Mentorship in Practice module and mentor updates. One Trust has developed and implemented an in-house policy to clarify this process. Mentors are also supported by the clinical link lecturers and practice learning facilitators.

48 There appear to be low numbers of students registering for degrees. However, this is due to the contracting arrangements with the SHA and Trusts, who purchase individual modules as part of ongoing, post-basic education for large numbers of nurses. Individuals are able to negotiate extra funding or to self-fund to complete their degrees. Degrees leading to a practice qualification are purchased in full.

49 Personal development planning has become an integral part of the pre-registration portfolio, commencing with the September 2005 intake. It is also being addressed within post-registration programmes. This approach will promote lifelong learning and the maintenance of a professional portfolio.

50 Practice partners confirm that pre-registration programmes produce students who are fit for practice, and they currently employ the majority of students on registration. Table 2b shows that 52 per cent of the 2001 degree cohort and 61 per cent of the diploma cohort were employed locally. Only around 6 per cent of students remained unemployed at the time of the survey. The students are confident and equipped for lifelong learning. Placements aim to provide quality learning environments which encourage students to apply for posts within their home Trusts. PCTs are now employing significant numbers of newly-qualified nurses directly into community nursing posts and have developed a preceptorship programme to support this.

51 Employers report satisfaction with the achievements of students completing post-qualifying courses. They feel prepared for lifelong learning and the programmes can be directly linked to an improvement in patient care. Trust clinicians have direct input into programmes at all levels. Students report that the programmes are hard, but understand that it is a necessary part of their final achievements.

Summary of academic and practitioner standards for nursing

Overall, the reviewers have confidence in the academic and practitioner standards achieved by the programmes in Nursing at Buckinghamshire Chilterns University College in partnership with North West London Strategic Health Authority.

Strengths

The role of the link lecturer and the posts supported by the SHA, such as the practice placement facilitators, are significant factors in enabling the nursing intended learning outcomes to be communicated effectively and to inform practice learning (paragraph 28).
The nursing provision has strengths in the use of the partnership in the development and refinement of intended learning outcomes, and strategies to involve non-statutory services and service users in the development of learning outcomes are effectively utilised (paragraph 29).
Nursing students are provided with comprehensive information on the assessment process, are well supported through the process and report satisfaction that this is being done effectively (paragraph 39).
The achievements of students on the new portfolio of post-registration, nursing degree programmes are excellent (paragraph 45).
PCTs are now employing significant numbers of newly-qualified nurses directly into community nursing posts and have developed a preceptorship programme to support this (paragraph 50).

Good practice

The quality of feedback is of an exceptionally high standard. It follows a consistent style using the Faculty's grading criteria and is clear in terms of terminology and direction for the student, highlighting strengths alongside recommendations for improvement (paragraph 41).

Weaknesses

In the written work scrutinised by the reviewers, the weightings applied to grading criteria when work is being graded were not clear (paragraph 41).
The assessment workload across some post-registration nursing programmes is high in relation to the time-span of the course, including, as it does, a significant amount of written academic work, a wide range of clinical competencies and submission of a portfolio (paragraph 43).

Table 1b: Completion and achievement statistics for award-bearing programmes in nursing

Programme	Cohort	Diploma programmes Pass		Diploma programmes Fail		Degree classification
						1		2i		2ii		3		P		F
		No.	%	No.	%	No.	%	No.	%	No.	%	No.	%	No.	%	No.	%
BSc (Hons) Nursing	October 2002					2	8	6	24	5	20	1	4	9	36	2	8
DipHE in Nursing	October 2002 p/t	22	92	2	8
DipHE in Nursing	October 2001 p/t	9	100	0	0
DipHE in Nursing	February 2002	83	98	2	2
DipHE in Nursing	October 2002	208	98	4	2

PgDip Community Health Care Nursing (full-time)	October 2003	5	83	1	17
PgDip Education (Nursing, Midwifery & Health Visiting (part-time)	October 2002	6	100
PgCert in Education (Nursing, Midwifery & Health VIsiting) (Part-time)	October 2003	1	100
BSc (Hons) Community Health Care Nursing (full-time)	October 2003					5	28	5	28	4	22	4	22

PgDip Cert Advanced Practice	October 2003	9	100
Dip Professional Nursing Studies (work-based learning)	October 2002	1	100
Dip Professional Nursing Studies (work-based learning)	February 2003	0	0
BSc (Hons) Critical Care	October 2002					1	20	1	20	3	60
BSc (Hons) Nurse Practitioner	October 2002							2	40	2	40			1	20
BSc (Hons) Cancer and Palliative Care	October 2002					3	25	2	17	2	17	1	8	3	25	1	8
BSc (Hons) Nursing Studies (Dip HE Entry)	October 2003							12	44	7	26	3	11	1	4	4	15
BSc (Hons) Professional Nursing Studies (work based learning)	October 2002					1	14	1	14	3	43			1	14	1	14
	February 2003					1	50	1	50

Table 2b: Employment statistics for all pre-registration programmes and exception reporting only for post-qualification programmes

Programme	Further study		Local employers		Employers elsewhere		Unemployed		Other unknown
	No.	%	No.	%	No.	%	No.	%	No.	%
BSc (Hons) Nursing October 2001 cohort	0	0	15	52	12	41	2	7	0	0
DipHE in Nursing (October 2001 cohort	0	0	104	61	40	23	11	6	16**	9

**Not responded to survey.

C Quality of learning opportunities

Learning and teaching

52 Learning and teaching are curriculum driven and occur in campus and practice settings. The programmes use a wide variety of teaching methods, such as skills laboratory sessions, seminars, lectures, enquiry-based learning (EBL) and the VLE to support learning. The patient is at the centre of learning and teaching in both health visiting and nursing programmes, and the practice assessment tool directly underpins learning in practice. Students are encouraged to take personal responsibility for their continuing learning and professional development, as seen through reflective exercises and portfolio development across pre and post-registration programmes, and in the study skills module. The role of the academic tutor in supporting students is crucial in promoting learning and professional development. Students across pre and post-registration nursing programmes were very satisfied with teaching and learning at the University College.

53 There is a clear commitment to the enhancement of learning and teaching, with the Faculty taking a strategic approach to research, staff development and scholarship that informs learning and teaching in theory and practice. Research is generated from the Research Centre for Health Studies and from the teaching staff, which informs teaching across a range of programmes. The Accident and Emergency Care programme illustrates how scholarly activity has informed teaching, with changes made to the programme to ensure that learning and teaching are supported and enhanced.

54 Peer review of teaching is undertaken as part of the staff development policy, with colleagues working together to support each other through feedback and to extend their teaching practice. A partnership approach to teaching exists, whereby clinical staff are invited to deliver teaching sessions within the skills laboratories on-campus, and work with the students in clinical practice to support them in developing their clinical competencies. The link lecturer works with staff and students in practice to ensure that learning and teaching are supported.

55 The quality of placement learning is maintained in partnership with the Trusts, taking into account the Code of practice, Section 9: Placement learning. There is a strong commitment to teaching quality within practice through the tripartite working relationship between mentors, practice learning facilitators and link lecturers. The link lecturer provides a bridging role between the Faculty and practice, with one-third of teaching hours being spent in clinical practice, thus ensuring that placement learning is supported. Trust-based practice learning facilitators have a key role in supporting learning in practice. Practice educators have a strategic role and provide contacts with the PCTs. There are several forums for discussion around placement provision and quality of learning experiences.

56 Practice placements are subject to ongoing monitoring to ensure that there are adequate numbers of placements, spanning an appropriate range and being of suitable quality. The auditing process is a partnership approach between the Faculty and the Trusts, with feedback and dissemination of issues and good practice. Health and safety policies are available to all students across all Trusts.

57 Nursing students are adequately prepared before begining their placements through the induction process, the practice learning handbook and the clinical placements handbook. The link lecturer provides a further mechanism for continuing support in the clinical area.

58 Models of mentorship seen across the Trusts visited by the reviewers ensure that students are supported in developing the competencies required by the programme they are undertaking. Mentorship preparation and regular Trust-based mentorship updates ensure that mentors are clear about their roles and responsibilities to students. The tripartite relationship between the link lecturer, Trust-based placement facilitator/practice educator and student, supports students through their learning in practice.

59 Feedback from both full and part-time students on the quality of learning and teaching opportunities is sought both formally and informally, at campus level and in the practice settings. All students have equal access to learning support, with students expressing their satisfaction with this aspect. There is a clear procedure outlined for dealing with complaints within both campus and practice settings.

60 IPL and teaching across pre and post-registration programmes are clearly evident in theoretical modules, with students meeting the learning outcomes in practice. There is a clear commitment at Faculty, SHA and Trust level to the embedding of IPL within practice that is meeting with some success. Across each Acute and Primary Care Trust, IPL is supported by facilitators who have developed approaches to IPL to suit their staffing and student numbers. Examples across West London Mental Health Trust, Hammersmith Hospitals NHS Trust, West Middlesex Hospital NHS Trust and Hounslow PCT demonstrate the different approaches to IPL. These are proving to be effective, with sensible action plans in place for the future.

The quality of learning and teaching is commendable.

Strengths

There is a strong commitment to teaching quality within practice through the tripartite working relationship between mentors, practice learning facilitators and link lecturers (paragraph 55).
There is a clear commitment at Faculty, SHA and Trust level to the embedding of interprofessional learning within practice that is meeting with some success (paragraph 60).

Student progression

61 There is clear evidence of collaborative processes between the University College and its practice partners, with both parties expressing satisfaction with the development and maintenance of good relationships to enhance learner progression through the programme.

62 During discussions with the reviewers, practice partners and organisation managers expressed significant satisfaction with the calibre, quality and competence of the University College diplomates and graduates across the range of provision. They noted the clear intellectual and professional progression of students through their programmes and, in particular, the acquisition of critical-analysis skills and their application to clinical situations.

63 The reviewers noted the significant work involved in the recent Ongoing Quality Monitoring and Enhancement (OQME) prototype review recently undertaken by the University College and its partners. There was evidence that the Final Action Plan from this process is beginning to bear fruit, with practice partners articulating a consistent view that partnership relationships have been strengthened and that a positive sense of involvement is now evident in selection and recruitment.

64 The reviewers were aware that nursing programmes, both the full and part-time routes, face significant attrition challenges, and this is reflected in Table 3a. The part-time route for the DipHE in Nursing programme has suffered from a particularly high attrition rate. However, the reviewers acknowledge that, in some instances, given the small numbers recruited, the percentages of students shown in Table 3a as withdrawing can give a misleading impression.

65 It is evident that the University College and its practice partners are putting in place measures to understand the reasons for attrition and are developing support services to maintain students on the programme who otherwise may have left for reasons other than course failure. Appropriate statistics are collated on the reasons students give for leaving the BSc Nursing programme; these only identify one student as leaving for financial reasons in the 2001 cohort. The University College has investigated this further and revealed that students may choose to transfer to other, more local institutions or transfer to the diploma programme to alleviate financial difficulties. The University College is able to refer students to the Student Money Advisor for help.

66 A consistent message from practice personnel and students is that the University College campus is a friendly and helpful one, which enables students to secure the help and support needed. It was reported that accessing clear and helpful information on the range and content of the University College programmes was a significant factor in students choosing to study health care at the University College.

67 The University College states an aim to widen access and participation in learning. To facilitate achieving this aim, the Faculty holds a range of open days, summer schools and support programmes. The Faculty's success in achieving this aim is reflected in a student entry profile that includes a significant proportion of students from ethnic minority groups and from non-traditional education and social backgrounds.

68 Student progression in practice is clearly demonstrated in portfolio records. Progression is promoted by clear mentor guidelines, good partnerships between the University College and the NHS Trusts, and comprehensive module practice handbooks. Partnership arrangements between the University College, the SHA and practice providers are robust. There are a number of substantive posts which aid student progression and access to a wide range of placement settings, including placement development manager posts.

69 Consistently applied induction programmes help students in the University College setting and at each stage of practice placement. This induction process informs students of the range of facilities that support them to make the most of their study opportunities. The induction process to clinical placements is appropriate, consistent and welcomed by practice managers and mentors.

70 All provision has an agreed process for the identification of poor performance and a programme to support early intervention and action-planning to redress underachievement in practice. Consistently, the reviewers received information that this process was well understood and coherent in its articulation of devolved responsibilities, and considered to result in an appropriate set of actions aimed at supporting student progression.

71 The role of the link lecturer was praised consistently as an appropriate bridge between the theoretical and practice components of the pre-registration programmes. These roles are seen as important strands in the progression support for students.

The quality of student progression is commendable.

Strengths

There is clear evidence of collaborative processes between the University College and its practice partners, with both parties expressing satisfaction with the development and maintenance of good relationships to enhance learner progression through the programme (paragraph 61).
The Faculty's success in achieving the aim of widening participation is reflected in a student entry profile that includes a significant proportion of students from ethnic minority groups and from non-traditional education and social backgrounds (paragraph 67).

Weakness

The part-time route for the DipHE in Nursing has suffered from a particularly high attrition rate (paragraph 64).

Table 3a: Recruitment and attrition statistics for pre-registration and NMC-recordable qualifications

	Recruited	Withdrawal		Transfer in		Transfer out		Discontinuation
		No	%	No	%	No	%	No	%
PgDip Community Health Care Nursing (Health Visiting) October 2003 Cohort	2
BSc (Hons) Community Health Care Nursing (Health Visiting) October 2003 Cohort	5
DipHE in Nursing (October 2003 cohort)	235	23	10	46	20	47	20	0	0
DipHE in Nursing (October 2003 p/t cohort)	18	4	22	1	6	1	6	0	0
DipHE in Nursing (February 2004 cohort)	174	14	8	28	16	22	13	0	0
DipHE in Nursing (February 2004 p/t cohort)	27	3	11	3	11	1	4	0	0
DipHE in Nursing (October 2004 cohort)	212	23	11	20	9	8	4	0	0
DipHE in Nursing (October 2004 p/t cohort)	30	3	10	0	0	0	0	0	0
DipHE in Nursing (February 2005 cohort)	205	7	3	7	3	1	1	0	0
DipHE in Nursing (February 2005 p/t cohort)	24	1	4	2	8	0	0	0	0

Table 3b: Recruitment and attrition statistics for post-qualification programmes

	Recruited	Withdrawal		Transfer in		Transfer out		Discontinuation
		No	%	No	%	No	%	No	%
PgDip Community Health Care Nursing (full-time) October 2003 Cohort	7	1	14
PgDip Education (Nursing, Midwifery & Health Visiting) (part-time) October 2002 Cohort	8	1	13					1	13
PgCert Education (Nursing, Midwifery & Health Visiting) (part-time) October 2003 Cohort	1
BSc (Hons) Community Health Care Nursing (full-time) October 2003 Cohort	18
BSc (Hons) Community Health Care Nursing (part-time) October 2003 Cohort	2
BSc (Hons) Nursing (October 2002 Cohort)¹
DipHE in Nursing (October 2000 p/t cohort)
DipHE in Nursing (October 2001 p/t cohort)
DipHE in Nursing (February 2002 cohort)²
DipHE in Nursing (October 2002 cohort)³

Note 1: 8 students from BSc (Hons) October 2001 cohort continue into year four

Note 2: 6 students from Diploma February 2002 cohort continue into year four

Note 3: 56 students from Diploma October 2002 cohort continue into year four

Learning resources and their effective utilisation

72 Centrally-provided learning resources are underpinned by the Faculty's learning resource strategy to ensure they are curriculum-driven. Student satisfaction surveys consistently rate all aspects of the learning resource centre facilities as very satisfactory. The support provided by course leaders, link tutors, clinical practice teachers and practice mentors enables students to utilise effectively the range of learning resources available.

73 There is a wide range of high-quality library and information technology resources at the University College, with excellent accessibility and availability both on and off-campus. The VLE effectively integrates library resources, email discussion and lecturers' notes. The librarian maintains a substantial teaching role in the course provision. Renewal services are commented upon positively by students as are the 'pick up-drop off' arrangements at local hospital libraries. Placement libraries maintain records of usage by placement students and these data are fed into quality assurance processes. The library support manager at the SHA is to develop further library provision across the wider health community. An important learning resource at the Chalfont campus is the provision of clinical skills laboratories where pre and post-registration students can practise, review and develop their skills.

74 Students report that they are well prepared for their programmes through their induction to learning resources, and are made aware of the range of learning materials available for modules and practice learning. They report support from their organisations in study time and expenses. Pre-induction courses, provided by both the Faculty and practice, were positively evaluated.

75 Students reported positive learning experiences in practice in relation to the resources available to enable them to develop the professional skills and knowledge needed. An active learning environment is achieved in practice through the provision of clinical supervision of good quality and the use of learning contracts. Theory-practice links are clear and are reinforced by the effective use of staff available in the Trusts to promote effective clinical learning.

76 Practice educators have a positive strategic role and provide contacts within the PCTs. The SHA provides funded posts to ensure adequacy of placement capacity, including a post for non-NHS provision. New appointments have recently been made of an Associate Head of Practice Learning and a Senior Lecturer of Practice Learning, who will have a strong association with link tutors and practice placement facilitators. There are several structured forums for discussion around placement provision and the quality of the learning experience.

77 Practice staff appreciate support from the University College; the link lecturer spends one day a week on clinical placement. A good range and quantity of learning resources are available on practice placements and there is generally good access to the University College's VLE facility.

78 Appropriate and effective continuing professional development for practice staff is readily available. All partner Trusts maintain 'live' registers of mentors and enable staff to undertake annual updating. Further mentorship courses have been commissioned as a result of the shortfall in mentors.

79 Extensive research activity is generated from the Research Centre for Health Studies and this contributes considerably to the development of teaching resources and source material for learning. In addition, the research and practice activities of the teaching staff inform learning and teaching across the range of programmes.

The quality of learning resources and their effective utilisation is commendable.

Strengths

There is a wide range of high-quality library and information technology resources at the University College, with excellent accessibility and availability both on and off-campus (paragraph 73).
Practice educators have a positive strategic role and provide contacts within the PCTs. The SHA provides funded posts to ensure adequacy of placement capacity, including a post for non-NHS provision (paragraph 76).

D Maintenance and enhancement of standards and quality

80 There is a positive and effective working relationship between the University College and its placement providers, both in the NHS and independent sector, that contributes significantly to the assurance of standards and quality of health visiting and nursing provision. The SHA has provided funding for a substantive practice learning facilitator post within each Trust and has an identified practice learning manager and practice development manager with lead responsibility for quality assurance within clinical learning at the SHA.

81 A clear process is evident for contracting and contract review between the University College and the SHA. Quarterly contract review meetings are held which feed into the annual review meeting. In this process, the recruitment of students and pre-registration contract targets are monitored and evaluated, and any required action taken.

82 Link lecturers have a designated timetabled day a week for visiting their link placements. This is valued by both students and Trust staff, ensuring a continuous and supportive line of communication.

83 The University College has an effective strategic approach to quality as stated in its quality policy. Course committees are required to produce an Annual Review and Evaluation Course Report, which is fed through to the Teaching and Learning Committee and Faculty Board. Students met by the reviewers expressed the view that they were fully involved in the quality assurance processes and that their views received serious consideration by the institution. There is good evidence that student and other evaluations are considered at course committees. Students are represented at course committees, and feedback is given at subsequent meetings. An external student satisfaction survey has been carried out with a good response rate and evidence that students are satisfied with their programmes.

84 A range of improvements to the quality of the provision is being implemented as a result of the OQME prototype. Placement learning is given a high priority and will become a standing agenda item at the Teaching and Learning Committee. The minutes of this committee are then presented to the Faculty Board.

85 Practice mentors have a strong working relationship with link teachers and practice placement facilitators, which ensures that informal evaluation and improvement are undertaken continuously. The University College has no mechanism for mentors formally to evaluate practice. However, this is part of the role of the practice learning facilitator who can then raise issues at the practice learning facilitator meeting with the institution. A formal system is being developed by the University College and Trusts.

86 There is evidence of all placements undergoing an annual audit, which concludes with an action plan to address any quality issues, with designated dates for completion. Action plans are implemented by the link lecturers, in partnership with mentors/managers and practice learning facilitators.

87 Comments from external examiners have been acted on to improve the quality of assessments, and these are now reported to be of a high standard. The Community Specialist Practice programmes are commended by external examiners for their efficiency, organisation and collaborative working with practice.

88 The self-evaluation document was written in a clear and evaluative fashion, and provided an excellent basis for the review, with comprehensive and systematic referencing and well-delineated signposting to the relevant evidence. It gave the reviewers confidence that healthcare provision had been subject to properly rigorous, internal as well as external scrutiny by all partners, and had clearly benefited from the OQME process that had been undertaken.

Strength

There is a positive and effective working relationship between the University College and placement providers, both in the NHS and independent sector that contributes significantly to the assurance of standards and quality of health visiting and nursing provision (paragraph 80).

Action plan

Major Review of healthcare programmes

November 2005