KSF implementation — producing outlines for pharmacy staff
By Katey Hewitt, DipClinPharm, MRPharmS, Barry Jubraj, MSc, MRPharmS,
Desiree Cox, Dip JEB IT, and Suzie Ankrah, MRPharmS
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By September, NHS Trusts are required to have assigned Knowledge and Skills Framework outlines to each job and to have carried out their first review. This article describes one trust's experience of using a pragmatic approach to implement the KSF in the pharmacy department |
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Katey Hewitt is
deputy chief pharmacist, Barry Jubraj is lead pharmacist for academic
studies and professional development, Desiree Cox is trust KSF
consultant and Suzie Ankrah is lead pharmacist for education and
training at Chelsea and Westminster Healthcare NHS Trust
Contact information
For further details readers are invited
to e-mail Katey Hewitt
katey.hewitt@chelwest.nhs.uk |
In the new appraisal system performance is assessed
against KSF outlines |
Further reading
Articles on how the Knowledge and Skills Framework
operates and applies to hospital pharmacists (Hospital Pharmacist 2005;12:144–7
and 2005;12:221–2)
Using KSFs to support CPD
An article about using KSF outlines to record continuing professional
development is set to appear in the next issue of Hospital Pharmacist |
The NHS Knowledge and Skills Framework (KSF) describes the knowledge and
skills that NHS staff need to apply to their work in order to deliver quality
services. It provides a single, consistent and comprehensive framework on which
to base staff review and development. The framework aims to facilitate service
development, support the effective learning and development of both individuals
and teams, and promote equality and diversity of all staff.1 It also provides
a single system of pay progression across the NHS and is an integral component
of Agenda for Change.
Each NHS job will have a KSF outline consisting of six core dimensions plus
specific dimensions related to the post. For each dimension there are certain
levels that the post holder should meet no later than 12 months after appointment
(“foundation gateway”) and at a fixed point towards the top of
a payband (“second” or “full gateway”) in order to
achieve pay progression. Within these levels there are indicators that describe
how the knowledge and skills need to be applied to the particular job, with
practical examples (“examples of application”).
The Department of Health originally stated that KSF outlines for all NHS jobs
should be produced by September 2005, but last summer this deadline was extended
to 21 December 2005 for all broad outlines (ie, the dimensions with levels
and indicators but not examples of application). A deadline of 31 March 2006
was then set for the completion of examples of application within all KSF outlines,
although some trusts are still completing this step. The final deadline for
all KSF outlines to be assigned and the first review to have taken place is
the end of September 2006. The pharmacy department at Chelsea and Westminster
Hospital was one of the trust’s KSF implementation pilot sites. This
article discusses how we have implemented the KSF into our pharmacy department,
making it work within our current system of training and reviews.
Developing KSF outlines
Three staff members with training and operational backgrounds were selected
to write and produce the KSF outlines for all posts on behalf of the pharmacy
department line managers. It could be argued that line managers should have
written the KSF outlines for their own staff since this may engender a sense
of ownership and develop line managers’ own understanding of the KSF
process.
However, there were several operational reasons for our approach. First, the
large volume of KSF outlines to write and the short time to complete them in
would have placed unrealistic pressure on the line managers. Second, we felt
that our approach would allow us to map KSF outlines within the pharmacy department
and the trust, and against comparable posts from other trusts. This would improve
the efficiency of the approval process by the trust KSF review panel. Third,
we found that drafting outlines for line managers to review produced a faster
response than asking the managers to produce outlines from scratch. Providing
a draft for the line managers to work with also appeared to promote objectivity,
minimising the temptation to write the outline according to the ability of
the current post holder rather than the job description.
We initially drafted the outlines without including practical examples, since
the review panel were willing to approve the broad outlines first. We began
by producing outlines for all posts that had more than one post holder, such
as resident pharmacists, rotational technicians, rotational pharmacy assistants
and medicines management technicians. The next stage was to sort other jobs
into groups with similar bandings and responsibilities according to job title
descriptions, such as lead pharmacists and clinical specialist pharmacists.
We then wrote the outlines for other individual posts. Once agreed with the
line managers, the outlines were uploaded onto the e-KSF (see Panel 1) and
submitted to the review panel.
Panel 1: The e-KSF
The e-KSF is an internet-based system designed to
help manage the KSF and personal development review process. Chelsea
and Westminster Healthcare
Trust encourages all staff to use this system and is linking the system
with the trust’s payroll system to ensure the database of staff
is accurate.
Training sessions on use of the electronic system were held for all staff
in the hospital. A procedure was written and adapted to fit in with our
internal practices, such as the fact that “examples of application” were
input by the staff members facilitating the KSF implementation rather
than the line managers.
One of the challenges we faced when inputting KSF outlines and examples
of
application onto e-KSF was editing previous versions. Once information
has been put onto the system and approved by a panel this version can
no longer be edited or updated. To meet the phased deadlines of KSF implementation,
the outlines for each post were completed and approved and then examples
of application added at a later stage, as a second version. We therefore
had to adopt a nomenclature to signify which was the most recent version. |
Anecdotal discussion with pharmacy staff involved with implementing the KSF
in other trusts suggested some ambivalence. Comments received included
the perception that dimensions and levels were “meaningless” and
that their generic nature made it difficult to start the process of writing
outlines
for specific posts. We therefore decided to investigate how we could incorporate
the KSF into our existing structure of training and appraisal, rather than
making unnecessary changes to our schemes.
Our departmental training schemes were checked to ensure that they accurately
reflected the relevant job description. It was then possible to choose
KSF dimensions and levels that fitted these training schemes, thus providing
instant examples of application.
We decided to apply a liberal interpretation to each of the KSF dimensions,
taking a pragmatic approach depending on the post under review. Once dimensions
had been chosen for a particular post, the dimension levels were selected.
We found that this was best achieved by reviewing the highest level first
(level 4) to check for appropriateness and working backwards, to level 1.
We were
then able to review a job description and, relatively quickly, achieve a
sense of what levels would be appropriate for each dimension.
Examples of application
Incorporating examples of application into each outline is critical to relate
the broad KSF outline to each individual post. Review of our in-house training
programmes found that the objectives and competencies already defined in the
training manuals could be used as examples of application.
There were certain dimensions not covered in the training manual (eg, equality
and diversity), so we had to identify suitable examples of application for
these to ensure that they were included in the KSF outline.
For each staff group examples of application were identified from statements
in the job descriptions. These were then circulated to each line manager to
review and to add further examples.
Within our department, there was considerable debate around how many examples
of application to include for each dimension and outline. Our early observation
of e-KSF was that many outlines contained numerous examples and we found this
highly time consuming. We therefore decided to provide relatively few examples
and leave it to line managers and post holders to negotiate additional examples
which would be recorded as evidence at KSF reviews. This approach would rely
on staff familiarising themselves with KSF dimensions and levels, assisted
by ongoing support from the pharmacy education and training team.
We appreciate that staff groups and pharmacy departments will vary in opinion
of what constitutes acceptable numbers of examples of application for KSF outlines.
Managing expectations
An important step in integrating the KSF into existing training programmes
(see Panel 2, p171) was to manage the expectations of staff, particularly of
those participating in rotational training schemes. Before the introduction
of the KSF, staff would achieve a grade and/or pay progression once certain
criteria were met. A fundamental difference in the KSF system is that demonstration
of knowledge and skills is now associated with pay progression only and is
not associated with a grade change. Several staff were concerned about how
their progression would be affected by the implementation of the KSF. Workshops
were held to explain the nature of Agenda for Change bandings and its relationship
with the KSF.
Panel 2: Integration into existing training programmes
The Chelsea and Westminster Hospital has a number of training programmes
for staff groups, each with an associated training manual, appraisal
paperwork and assessment
methods. We felt it important to retain these schemes and so adapted
them to encompass the KSF. Careful integration of the KSF into the existing
training manuals also helped to reassure staff that the KSF would not
mean unnecessary extra work.
The first step was to ensure that training programmes reflected the revised
Agenda for Change job descriptions. We made use of existing timetables
of assessment where
possible, with mini-KSF reviews replacing, for example, elements of “end
of section” appraisals. Section heads were provided with copies
of KSF paperwork to complete at these appraisals, which could then be
forwarded to the line manager for use at formal KSF reviews, which would
involve using e-KSF (Panel 1, p170).
We were able to clearly illustrate that if the demands of a training
scheme were met the post holder would automatically meet the KSF outline.
This also helped the line
managers to feel more confident in assessing the individuals against
their KSF outline. |
Review and appraisal
As part of the trust’s KSF implementation programme, new trust-wide
personal development review paperwork was developed. Before the introduction
of KSF, the appraisal paperwork consisted of the following sections:
· Pages to define the individual’s
objectives
· A personal development plan to
document any training needs
· Comments pages to document feedback following quarterly reviews and end of
year appraisals
The new appraisal system focuses on a review of performance against the individual’s
KSF outline and any personal development actions identified from gaps in the
KSF. Agreement was obtained from the trust KSF consultant to use the new paperwork
but to incorporate elements of the existing pharmacy paperwork such as the
objective sheets. Retaining our record of objectives enables us to link back
to the pharmacy department and trust business plans.
Another key change to our practice related to the timing of reviews and end
of year appraisals. Historically, objectives were set for all non-rotational
staff at the start of the financial year irrespective of their start date and
reviews took place every quarter thereafter. For rotational staff, objectives
were set at the start of each new rotation with appraisals taking place at
the end of each rotation and an overall review at the end of each year. Under
the KSF system, matching individuals (rotational and non-rotational) to their
outlines and setting objectives occurs on appointment and there is a minimum
of two meetings with the line manager per year to review progress and produce
a personal development plan. These key changes in the review process had to
be incorporated into in house practices and all staff trained accordingly.
The KSF annual review, including the assessment of eligibility to progress
through KSF gateways, now includes a financial dimension in terms of pay progression.
This may alter the dynamic of the reviews and our early experience found some
level of anxiety amongst staff. Both line managers and post holders will need
support to ensure that examples of application are clearly agreed and assessed.
This process has begun by the updating of in-house appraisal training. The
trust KSF consultant has visited the pharmacy to train staff in these areas
and to identify any problems.
In addition, the introduction of mandatory recording of continuing professional
development means that the KSF outline can be used to identify suitable CPD
entries.
Conclusion
The KSF is having a significant impact upon pharmacy staff within the NHS.
Other than for new posts, the task of writing outlines for the department is
largely a one-off exercise and we have been able to share our experience and
outlines with other trusts. The KSF has added structure to our training schemes
and we have been careful to promote an aspirational rather than an impositional
approach to KSF. In practice, this has meant promoting the KSF as an opportunity
to define and measure progress in the acquisition of knowledge, skills and
attitudes.
We have been open about the obligations of KSF but have presented these as
a secondary issue. We hope that the approach of making KSF work for us, with
appropriate support from all staff, will have minimised any potentially negative
impact of implementing the KSF in the pharmacy department at the Chelsea and
Westminster Healthcare NHS Trust.
ACKNOWLEDGEMENT Thanks go to Aamer Safdar, principal pharmacist lead for education
and development at Guys and St Thomas’ Foundation Trust for sharing valuable
early experience. |
Hospital
Pharmacist