The anatomy of learning

A choice of modules provides a flexible education that suits both individuals and services. Peter Rolland and Sue Staples describe how an academic pathway was set up

The health service is changing fast, with increasing client expectations and altering patterns of care delivery combined with a variety of capacity and resource issues.

There has been huge investment and advances in the delivery of clinical care, including new roles and ways of working, which have blurred professional boundaries, necessitating innovative approaches to educating staff.

Health service managers and staff need their post-registration learning to be responsive, collaborative, flexible and multiprofessional. It must also address the needs of patients.

With this in mind, in 2005 Leicestershire, Northamptonshire and Rutland healthcare workforce deanery set about establishing a new and collaborative way of commissioning learning beyond registration for clinical professional staff.

Led by the deanery's director of workforce and education commissioning, we believe this collaborative is innovative in a number of ways.

Its multiprofessional nature and interprofessional ethos mean it is an excellent starting point for post-registration learners accustomed to working - and now learning - in teams. Its collaborative nature and flexible approach ensure it is in a strong position to meet the learning needs of both services and individual professionals.

Many clinical staff already have - or do not yet wish to undertake - a degree or a Master's qualification, but they do want to improve their knowledge and skills in a particular aspect of care and treatment.

All modules are therefore provided as standalone units. They may be part of a programme of study for a predetermined award, accumulate to form an award or simply be an individual piece of learning beyond registration.

With only limited exception, modules and programmes delivered as part of the collaborative must be accessible and appropriate for learners from all professional groups.

Expressions of interest to provide multiprofessional learning beyond registration needs was sought from all the local universities. A contract was placed with all five that expressed an interest: De Montfort, Leicester, Luton, Northampton and the Open University.

We envisage a future that is learner led, where a pick-and-mix menu of modules create pathways of learning for the individual and for the services.

To support this, as well as flexibility and credit sharing, the deanery and universities are mapping academic pathways to support learners and meet service needs.

An important aspect is that the universities do not waste resources competing for a limited pool of learners. Within the collaborative, it is agreed which university will provide each course. Where there is a high demand - such as in teaching and assessing pre-registration learners - several universities might provide the education. Where demand is limited or there are specialist factors, only one university provides the training.

The universities each have certain academic stipulations on the sharing of credits with other institutions. While this is not going to be resolved overnight, the deanery has requested that credits should be shared between the institutions as much as possible, and the universities have responded positively.

To ensure the viability of each module, there is an agreed minimum number of registrations for each one.

However, some modules are essential for service, but have only a limited number of registrations. In such cases, the costs can be offset against modules with high numbers of registrants.

The option is also there to negotiate an increase in the module price where specialist modules are, by their nature, essential to service but only appropriate for a small number of learners. For the majority of modules, if demand is high and registrations exceed available places, modules can be repeated. Wherever possible, they are multiprofessional.

Some learning is best done in teams looking at whole systems, processes or pathways. To this end, the deanery has commissioned team-learning events.

Relevant to all staff from healthcare assistants to consultants, these events may follow a client pathway through the healthcare system or explore a topic such as diabetes or mental health for a whole team.

Modules can be suggested by services to the collaborative and there are mechanisms for staff within non-NHS healthcare organisations to gain to the access courses.

Peter Rolland is education development manager at Leicestershire, Northamptonshire and Rutland healthcare workforce deanery; Sue Staples is head of nursing education at University Hospitals of Leicester trust.