Research

1,091 NHS staff took part in the training survey.

Almost half of respondents worked in acute trusts. 17% worked in community settings and 12% worked in mental health settings.

The majority of respondents said they were nurses. ‘Other’ made up the second largest category and included roles such as ambulance staff, pharmacists and people working in psychological therapies.

Have They Had Training?

One of the first things we did was to explore whether people had had training in these areas. If so, how and when did they have it – and did they find it useful?

We found there was wide variation in whether or not people had had training, and how they got it. Almost all respondents had had some training in information governance. However, more than half had only had training at induction or via mandatory online training. The Data Security and Protection Toolkit requires at least 95% of staff have information governance training annually, but notes that online training may only be suitable for staff in their first year. Participants in our survey generally reported negative feelings about online training

Conversely less than 50% had had any training at all in whistleblowing; conflicts of interests; email management; policy development; or meeting management.

Was The Training Useful?

Fortunately, the vast majority of people said overall that the training they had received was at least a little useful, and the largest single cohort of respondents were those who found their training very useful.

Our statistical analysis found that, as you might expect, the context people worked in and the role they had affected what training they found most useful.

When examining roles, we noted managers were statistically more likely to rate their information governance training as the most useful. Nurses were significantly more likely to find training in email management most useful.

By setting people in acute trusts were more likely to report their training in whistleblowing and in meeting management was valuable. For GP staff training in conflicts of interests, information governance and policy development was statistically more likely to have been considered valuable.

Our analysis did not find any other statistically significant relationships between work setting or role and whether training received was considered valuable. This means that regardless of who they are or where they work, people as a whole find training valuable.

People’s Views

One area we also wanted to explore what relationship, if any, there was between people’s training and their views of the importance of governance to both them and their organisation.

The first step was asking people about governance’s role in local systems. We asked people if (yes/no/don’t know) governance systems where they worked effectively supported. We will look at how training affects people’s views later.

We explored whether people found their training useful, and what factors might have influenced that.

Setting and Delivery

There was a strong correlation between how the training was delivered and whether people found it useful. We explored training delivered in four contexts or settings:

• induction

• mandatory training

• an in-house course

• an external course

Perhaps unsurprisingly the greater the focus or depth of the training the more useful people found it. It is likely this is because more in depth training contains some of the features people want to see in future training (see below).

However, the results of our research also shows two important things

1. any training is generally useful, regardless of setting; and

2. for some cohorts it its likely the beyond a certain point there are no gains to additional or more focused training.

People’s Views

One of the key things to come out of the training research is the impact on people’s views of their organisation. Alongside the confidence training gave people, the more useful they found the training the better they thought their organisation was run.

We found this by testing people’s experience of training with their views about how well they thought linked but separate activities were managed by their organisation. For example we asked people who had training in risk management how well they thought their organisation managed its finances; and how well their organisation provided safe and effective care of people who’d had training in meeting management.

This gave us a large number of data points which showed:

• no matter what training people had received it had a positive impact on their views

• the more useful the training for people, the greater the impact.

This means that training doesn’t just give people skills and confidence – it also makes people view their employing organisation more positively.

You can find more detail about this analysis and the statistical methods we used to define these results at the foot of this page. 

One of the most important things we wanted to learn was how important people thought the governance areas we explored were.

As noted above training has a purpose: to give staff the knowledge and skills to deal confidently and effectively with situations that may arise in their work.

For governance, like many areas, training has another purpose. That is: giving staff a sense of why governance is necessary and important. Training helps embed good governance by making it part of an organisation’s culture.

So far we have seen that people value training, it has a positive effect on people’s levels of knowledge and their confidence in certain situations. However, we have also seen that training itself does not necessarily give people the knowledge they need to act correctly. Clearly method of training delivery matters – it must teach them the things they need to know to do their jobs and make the right decisions.

The next part of our analysis focusses on that second purpose. After having training do people value governance or have an insight into the impact good governance can have?

View of Importance

Overall there are similarities between the level of importance people attach to an area for both themselves and their organisations, suggesting a link between importance and organisational culture or training offered. However, we noticed a significant difference between people’s views of the importance of both whistleblowing and policy development to them; and the importance to their organisation.

5% said it was not important at all to their role; and 10% said it was not important at all to their organisation. Conversely 25% said it was essential to their role, and 35% said it was essential to their organisation.

People in acute trusts, GP surgeries and commissioning organisations all were statistically more likely to consider meeting management important. Commissioners were also more likely to attach importance to email management – as were staff working in community services. Staff in mental health trusts were statistically more likely to attach importance to risk management.

The Impact of Training

As with other areas there was a positive correlation between how important people thought, for example, information governance was with whether they had received training in it.

The effect was lowest for information governance, and highest for conflicts of interests. Interestingly, whistleblowing had an outsized impact on people’s view of its importance compared to other areas. This may be due to people being more likely to report that whistleblowing is unimportant to their organisation than it is to them,

Having training is one things, but do people get the skills and knowledge they need from it?

To explore this we asked people to answer some test questions across the governance areas we explored in the research survey. The rate at which people answered correctly was variable.

For example,

We asked people to rate how confident they were agreeing with this statement:

“If the police asked for the medical records of a patient admitted to hospital after an assault, I would know whether or not I should share them”

Anyone with a good understanding of the lawful bases for data sharing should understand if and how this can be done.

Overall 80.35% of the respondents said they were confident or very confident that they knew what to do. 10.16% said they were not confident at all or only slightly confident. The remainder answered ‘don’t know’.

We also saw a correlation between training and how confident they would be in the scenario we posed. Significantly the proportion of people answering don’t know decreased from 15.91% to 3.7%.

At a minimum it appears that staff must complete their induction training, although this in itself does not increase confidence as much as other training methods. In house or external training probably have a greater effect than mandatory online training because they go into greater depth and may involve a range of learning techniques e.g. group working or question-and-answer sessions, rather than background reading and a short test.

We were particularly interested to see that although 95% of respondents have had training in information governance, nearly 20% said that there were no consequences for individuals for breaching the Data Protection Act (DPA). Overall by role only managers were statistically more likely to identify at least one consequence of breaching the DPA.

This may be due to some people not having training within the last year. We believe that the root cause of this issue is the type of training received. The vast majority of people who had training received it through induction or through mandatory annual training. It may be that this training isn’t giving people the core information that they need to retain and utilise.

We found a lot of demand for training. Ideas for training from people who took our survey include:

• Budget or financial management

• Clinical governance

• Complaint handling

• Computer literacy skills

• Customer service

• Document retention periods

• Duty of candour

• Freedom of information

• Whistleblowing

• HR policy

• Leadership and management

• Root cause analysis

• Safeguarding children

Overall the ideas for further training from people who took our survey can be grouped into three broad areas: financial management; openness and learning from incidents to protect patients; and management systems.

As we focused on our survey on eight areas of governance, we asked people to rank future training in those areas in order of priority.

It is notable that despite 95% of people reporting they had received training in information governance more than 70% of respondents indicated further training in it is one of their top three priorities.

How People Want To Learn

In keeping with the consistent theme throughout this research that training is both valued and valuable, respondents indicated they were open to learning through a range of different methods.

People also had their own ideas about ways of receiving training. They included:

• Real life examples, and ideally case studies from within their own organisation.

• Email follow up with tests on knowledge.

• Feedback from trainers.

• Web-based seminars in order to help people manage time.

It is interesting that there is a relatively high demand for training in governance areas, and people are readily able to come up with ideas and suggestions for the type and medium of training that would suit them best. A quick win for organisations might be to explore this further with their own staff and develop a training approach that is more bespoke to their needs.