Executive summary

Sheffield Health and Social Care NHS Foundation Trust (SHSC) continue to provide strong evidence of educational quality improvement measurable against the quality framework. During their Senior Leader Engagement meeting, the trust provided an overview of their newly released 2025/2026 priorities which include a strong equality, diversity and inclusion (EDI) and wellbeing focus. 

Learners report positive experiences, and there is strong learner engagement in quality processes. Robust EDI policy and vision have no doubt contributed to positive learner experiences. The trust provided strong evidence of gathering, listening to and acting on feedback through their descriptions of how they have been managing their 3 open specialty concerns. 

Challenges around staff safety in high-risk environments remain, but robust plans are in place to ensure improvements. This has involved a review of existing policies and procedures and communication across team members at all levels. Following the meeting 1 of the specialty concerns for nursing was closed. The trust provided details of how previous poor survey data around facilities prompted significant investment in improving IT provision, learning spaces and patient areas; the trust expressed pride at the success of their improved Knowledge and Library Service (KLS). 

Challenges around funding for learning opportunities, managing placement capacity and meeting the requirements of learners declaring mental health and neurodiversity needs were explored. The trust described their ambition to become an anti-racist organisation and to embed the Safe Learning Environment Charter (SLEC) multi-professionally. The trust aspires to use its strong educational position to realise the benefits of having achieved university hospital status in 2019 by rebranding with the University of Sheffield as a University Partnership Trust later this year.

Review overview

Background to the review

Senior Leader Engagement (SLE) meetings aim to strengthen working relationships with senior leaders, to develop an understanding around the commitment to the education and training quality agenda.

Evidence 

• 2023 Senior Leader Engagement meeting outcome report
• 2024 National education and training survey (NETS)
• 2024 General Medical Council (GMC) national training survey (NTS) scores and ranks
• 2024 Trust self-assessment (SA)
• 2025 Quality intelligence summary
• 2024 NHS England Deans’ equality, diversity and inclusion committee summary
• 2024 Guardian of Safe Working Hours (GoSWH) report (October – December)
• Practice assessment record and evaluation (PARE) reports (01 March 2024-10 March 2025)
• 2025 Open concerns report

Who we met with

Trust attendees

• Head of Workforce Development and Training
• Acting Director of Medical Education
• Acting Medical Education and Staffing Managers
• Joint Medical Undergraduate Lead 
• Chief Pharmacist
• Deputy Director Allied Health Professions
• Equality, Diversity and Inclusion Lead 
• Director, Medical Directorate
• Professional Lead for Nursing
• Deputy Director of Nursing 
• Freedom to Speak Up Guardian 
• Guardian of Safe Working Hours 

Senior team attendees

• Chief Executive  
• Executive Director of Nursing and Professions 
• Executive Director of People
• Medical Director 

Review panel

• Adam Burns, Education Quality Review Lead, Quality Associate Dean (Chair)
• Lyndsay Murden, Speciality Exert, Programme Lead Practice Learning Quality
• Clair Clark, Specialty Expert, Strategic Learning Environments and Placements Lead
• Anthony Hann, Education, Investment and Commissioning Lead
• Kim Mills, Education Quality Manager, Quality Support Manager
• Melanie Ndzinga, Lay Representative
• Michele Hannon, Supporting Role, Quality Administrator

Review findings

Sheffield Health and Social Care (SHSC) provided a comprehensive overview of their newly released 2025/2026 priorities which they have organised into the following 4 main areas:

• to reduce inequalities
• delivery of outstanding patient care
• great place to work
• effective use of resources

In their last SLE meeting in May 2023, SHSC very ably demonstrated how important EDI is to the trust in terms of building a strong, cohesive workforce that feels welcome and supported. During this SLE, the trust displayed continued interest and investment in EDI and demonstrated progression through emphasising their ambition to stamp out racial inequalities as shown in their newly refreshed strategic priorities, the trust also has ambitions to become an anti-racist organisation. Recently there have been reports in the media of public challenge regarding recruitment to EDI related roles, the trust confirmed that they had not experienced this but had received some freedom of information requests around the spend on these roles.

The trust actively seeks, analyses and addresses feedback relating to education and training.  Learners rate the trust positively with SHSC featuring in the top 3rd of regional and national data sets for the GMC NTS and NETS surveys. The trust’s proactive stance is demonstrated through the management of an ongoing speciality concern (25/0009) relating to the safety of learners. The specialty concern was opened following 2 instances of patient assault towards staff, 1 instance involved a postgraduate doctor in training (PDiT) and there was an incident involving a pregnant nurse. The trust has reviewed processes to ensure the safety of all staff and learners and has introduced formal risk formulation meetings for all new patients which involve the use of the Broset 2 risk management tool to determine the likelihood of a patient exhibiting violent behaviours. Improved access to personal alarms for PDiTs was implemented and they are encouraged to review patients with another member of staff present. A ‘New and expectant mothers’ policy has been developed whereby within 24 hours of a team member declaring a pregnancy, a risk assessment should be completed and associated mitigations and controls put in place. An oversight panel and steering group has been established to ensure that the changes are embedded, and the trust has taken and acted on guidance from the Health and Safety Executive. Additional training for managers around the changes will be introduced. The concerns and subsequent changes to process have been escalated to the clinical, medical and nursing directors demonstrating clear channels of communication to the senior team. In addition, all staff have been asked to complete a survey around their perception of personal safety while working on the wards. The trust will then implement change based on staff feedback. The trust advised that violence reduction is a priority and there is a strong wellbeing focus within this, the trust has commissioned TRiM (Trauma Risk Management) to support this. The nursing cohort have strengthened support via nurse advocates and the number of professional nurse educators (PNE) has been increased. The trust takes a zero-tolerance approach to discrimination and harassment and is working more closely with the police. The trust reported that data obtained from the governance officer for Endcliffe Ward (psychiatric intensive care unit [PICU]) between June 2023 and December 2024 shows a decreasing trendline for assaults, and a static trendline for sexual safety. It is acknowledged that this is dependent on the risk profile of the service users on the ward at any given time (particularly regarding sexual safety), and SHSC state that their PICU is not a significant outlier for these types of incidents.

The trust listed the high demand on specialist services nationally and the impact of reducing expenditure on the development of new roles as 2 key challenges. Linked to the financial constraints is the suspension of the Registered Nurse Degree Apprenticeship (RNDA), which the trust hope to reinstate in future. There is also a vacancy freeze which is impacting on infrastructure and reporting on both medical and some non-medical professions, but this may change in the new financial year. There has been significant increase in learners requiring additional support in terms of EDI and neurodiversity which has put pressure on teams to meet the needs, although the trust is currently successfully accommodating needs.

A further example of SHSC’s responsiveness to feedback is evident in the way in which the trust has addressed low survey scores pertaining to facilities. The trust expressed pride in the developments made to the Knowledge and Skills Library and further resources have been invested in improving digital systems to support doctors such as the fully implemented Health toolbox, face-to-face IT support at induction, improved digital day 1 readiness, ensuring sufficient IT equipment in clinical doctor offices, ongoing work to improve the digital equipment provided and to implement where appropriate the Fatigue and Facilities Charter. Extensive work has been done to improve service user experience by refurbishment of inpatient areas as well as the implementation of a new patient records system.

There has been a considerable increase in NETS response rates of all grades of PDiT placed within SHSC.  he trust is actively encouraging increased participation in NETS by nursing and allied health professions (AHP) students as response rates are low in these groups and it is noted that there are significant differences between the experience recorded in NETS to that recorded in PARE where the response rate is higher. The trust is working with Sheffield Hallam University to promote NETS to learners.

The trust described how it oversees postgraduate and undergraduate income and expenditure. While recent changes have improved visibility, demonstrating how money is spent within individual clinical service units remains challenging. It was reflected that this transparency would support educational and clinical supervision and help mitigate recent increases in trainee support needs.

Learning opportunities relating to nurses were discussed, including the RNDA which is currently being undertaken by 14 learners, and four nurse associates are currently studying towards top up degrees. Whilst more are interested in undertaking the RNDA, further places have been suspended due to training grants ending, the trust is looking at ways to address this. The trust confirmed that international recruitment has become well embedded, and the trust is managing to retain staff recruited in this way. Placement numbers continue to increase for AHP, and they have had their first 2 leadership placements and dietetic placements. Every 6 to 8 weeks an AHP Voices newsletter is published and disseminated across the organisation for information and educational purposes.

The trust provided an update on the 2 specialty concerns for nursing, 1 of which (25/0008) was closed following the meeting as no further students will be placed at Forest Lodge Assessment Ward. The trust updated on specialty concern 24/0009 which was opened following reports from students around low staffing levels, a reliance on bank and agency workers and uncertainty over supervision. It was reported that the Endcliffe team now have a full complement of staff and are less reliant on agency workers. There are adequate numbers of practice supervisors and assessors, and 2 deputy ward managers are sharing the role of Learning Environment Manager.

There are currently 2 trainee pharmacists working across primary care, the trust and a partner organisation. It was reported that there is no access to direct continuing professional development funding and that postgraduate funding is accessed through a bidding process. 

The trust is focussing on capacity in light of continued medical school expansion.  Last year, 72 students were surveyed, and it became apparent that students do not always feel part of the clinical team and work is being done to tackle this issue.

The trust plans to implement the SLEC on a multi-professional basis and stated that they do not currently have a lead for this area of work, but this is something the trust will investigate.  As part of the SLEC work the trust plans to review the available learning space available to the nursing and AHP cohorts as there is a disparity in access between these groups and the medical cohort. A further aim is the introduction of a learner reward and recognition scheme.

The trust reported that they are in the process of rebranding the organisation as a university partnership trust with the University of Sheffield.

Areas that are working well

Good practice

Areas for improvement 

Mandatory requirements 

Report approval

Report completed by: Kim Mills, Quality Support Manager

Review lead: Adam Burns, Quality Associate Dean
Date approved by review lead: 22 May 2025

NHS England authorised signature: Jon Hossain, Deputy postgraduate Dean
Date authorised: 30 May 2025

Final report submitted to organisation: 17 June 2025