St John Ambulance’s rapid Covid response

St John Ambulance has trained a volunteer army to support the NHS throughout the pandemic, carrying out mass vaccinations, responding to emergency calls and assisting in hospitals and communities. This has meant a rapid rethink of traditional learning and development, embracing eLearning and innovating like never before.

A snapshot of training at St John Ambulance during 2020/1

    • 4,000 volunteers were trained in 2020 in a new Covid Care course that was created in just nine days. To date, trained volunteers have provided 380,000 hours of patient care
    • Ambulance crews, trained using eLearning as part of a blend, have responded to thousands of  999 calls and have spent hundreds of hours transporting patients
    • Around 30,000 vaccination volunteers have so far been recruited and trained, carrying out 650,000 hours at vaccination centres around the country.
    • St John people have contributed more than one million hours to frontline health services since spring 2020.

Figures from July 2021

Volunteer first aid training is a huge undertaking at St John Ambulance. To give an idea of scale, Carl Makins, Head of Training (Community Operations), has responsibility for 52 different curriculums. There might be 10 different products within each curriculum, which means hundreds of different courses. These range from 25 minutes long to a 25-day course, with everything in between. In the past, the focus had been on a traditional classroom based approach, but Covid meant a rapid transformation to a blended, hybrid training model. 

Covid care
For a subject like first aid training, there are still some things that have to be classroom based – like being observed taking people’s blood pressure and temperature. But, as Carl explains: “We knew that we had to be as Covid secure with our learning as possible, which meant that we needed to reduce the amount of contact, reduce the amount of travel and reduce the amount of time that people were together.”

Carl and his team started by creating a new Covid care module for volunteers at the charity. This was the first course of its kind and included 10 hours of eLearning – delivered via the Moodle platform provided by the Charity Learning Consortium – with a further 16 hours in the classroom. The entire course was created in just nine days.

Approximately 4,000 volunteers have now completed the Covid course. Those volunteers have gone on to deliver a staggering 380,000 hours of patient care, which is ongoing. More recently they might have moved from Covid care to other areas, to help reduce the impact on the NHS. 

Emergency ambulance training
Alongside that, the team also developed a new Emergency Ambulance Crew course, which had previously been fully face-to-face in the classroom. Using what they had learnt from creating the Covid care module, Carl and his team again used a blended, hybrid approach. The course includes 80 hours of digital learning and 120 hours face-to-face, at a simulation centre as well as on the job. 

“We wanted to give people an opportunity to do as much of the learning as possible both independently and online,” explains Carl.

They worked with stakeholders to design something that respected and reflected the wide range of St John Ambulance volunteers, which was then signed off by all partners. Crews trained this way have since responded to thousands of emergency 999 calls. They’ve also provided hundreds of thousands of hours transporting patients. 

Vaccination response
Vaccinating the nation was a whole new challenge. The charity set out to recruit and train 30,000 new volunteers. Everything was new: St John Ambulance had never trained any volunteers to administer vaccines or use needles before. In fact, jokes Carl, “I’ve spent my entire life telling people to keep away from anything that’s sharp!”

A brand new training programme was quickly put together, made up of 12 hours of online learning with eight hours in the classroom. 

“We’d got more confident with designing and developing our online learning, to the point where we’ve seen a shift to more hours online, away from the classroom,” says Carl. 

Around 30,000 people had been recruited and trained by March 2021. They have gone on to serve 650,000 hours at NHS vaccination centres throughout the country so far in the charity’s biggest mobilisation in peacetime.

Retraining trainers
About 1,200 volunteers around the country support the training team. A new approach to blended learning has meant retraining trainers. Carl and his team have supported both staff and volunteers to become proficient in a new way of delivering learning.

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    “It’s about having the confidence that trainees have this knowledge and have this skill already. What we’re looking for in the classroom is the application of that knowledge and skill – and that’s been a real challenge.”

    The answer has been to create a new, defined role as a demonstrator. This clarifies the role of building upon learning which has already been done away from the classroom, supporting trainees at simulation centres to practise their skills.   

    Michelle Parry-Slater talks to Andrew New of St John Ambulance about their digital transformation during the lockdown.

    Watch the interview here. 

    Innovation
    Although eLearning was used at St John Ambulance before the pandemic, it was secondary to a more traditional, classroom approach to learning and development (L&D). The pandemic meant that the learning team had to think differently. 

    They were already using a defined development cycle, based on five Es: Engage; Explore; Engineer; Educate and Evaluate. This approach was central to the team being able to deliver what was needed super fast. 

    “The speed and scale of what we were doing was nothing like anything that we’d ever seen before and of course we didn’t know what was going to happen next,” says Carl. “There was no rule book for this. We didn’t have the knowledge, we didn’t have the insight and we didn’t have the tools. But what we did notice was that if any of those five E elements were not there, things were going to come to a stop immediately.”

    Engage is the foundation stone of developing learning products at St John Ambulance. It means listening to and understanding the needs of key stakeholders. When it came to creating a new Covid care course, this meant speaking to health care professionals for key knowledge, but also engaging the design team with a completely new way of working and creating courses.

    In the Explore stage Carl and his team examine desired learning outcomes as well as assessment criteria, and then start to think about the right sort of content to meet those needs. Ultimately, volunteers need the same standards of learning and skills that can be applied to a variety of care settings at any hospital across the country. Pre-Covid this Explore stage might take several months, as it involves so many key stakeholders. When it came to creating the Covid care course, they had just hours. And they also had to start thinking about what could be delivered digitally. 

    Previously online learning had mainly been based around PowerPoint slides. Now, in the Engineer and Educate stages, the team introduced interactive elements for learners. The charity made full use of its increased volunteer base – collaborating throughout the development phase with volunteers. This included those who were shielding and many young people. In some cases volunteers created design elements themselves, which helped to produce more products at speed. 

    In the past, courses would have been completed and then tested. As Covid hospitalisations were accelerating so rapidly there wasn’t the luxury of having time to do this. Instead they decided to ‘test as we go’. As soon as an element of a course was completed it was used, with the team then making rapid changes from feedback. This meant that the Covid care course went through a number of changes within just a few months, to adapt to the skills that volunteers needed.  

    As well as listening to feedback from trainees, a five-point check is used to Evaluate all L&D at the charity, both in the classroom and on the job. For example, people might learn online how to correctly put on personal protective equipment (PPE). When they come into the classroom to practise, trainers then use a five-point check. Another five-point check would also then be used for assessing the same skills on the job. 

    That established evaluation process quickly led to tweaks and changes to online learning, as well as entirely new materials being created. Feedback has led to creating new modules on patient dignity, the five Cs care approach, how to feed somebody, nutrition and health, mental wellbeing and support. Listening to its people is at the heart of St John Ambulance’s approach, which has enabled the charity to achieve so much in such a short space of time.

    “It’s been a really unusual 12 months at St John Ambulance and we’ve needed lots of support from the Charity Learning Consortium and it’s always been there. We’re extremely thankful for that. The service we’ve received has been exceptional and really helped us get through what’s been a really difficult and emotional time but one that all of us at St John Ambulance are really proud of,” said Carl.

    “Huge thanks to the team at the Consortium – we couldn’t have asked for any more support. It didn’t matter whether it was late in the day or first thing in the morning, that service was always there. What that support has meant of course is that thousands of people have been trained in a new digital world. This has had an impact on our finances at St John Ambulance, on the safety and well-being of our people, and ultimately has meant that more people have been able to volunteer. The platform, the tools and the passion from everyone involved has helped us enable volunteers to deliver hundreds of thousands of hours of care, and support the mass vaccination of the nation.”

    Carl’s top tips for L&D

    Be brave: L&D today is about being brave, exploring the very different ways that people learn. For example, we designed an online programme specifically with volunteers in mind who might be shielding, so they can still train to support the NHS vaccination programme without having to go into a classroom. We send a PPE kit to their homes and everything else is done virtually. While I’d never go back to everything being face-to-face, there are definitely scenarios where everything can be delivered online, although application is vital. 

    Don’t wait for perfection: In terms of design and delivery, we’ve learnt very much on the job, testing as we go and then reflecting and reshaping. I’d really advocate that approach now but it does mean being brave.

    Have simple processes: Whether that’s having a five Es development cycle, a five check evaluation, or a five step approach for new trainees to navigate a learning management system, have a process – but keep things simple. 

    Think about the learning journey: People – not products – should be at the heart of everything. Think about their learning journey and experience, have a roadmap, guide them using learning pathways and make learning as easy as possible.  

    About Carl Makins

    Carl Makins is Head of Training (Community Operations) at St John Ambulance. He has worked for St John Ambulance for more than 16 years and has also volunteered for the charity for more than 33 years.

    The extraordinary work of St John Ambulance has been recognised with a silver Learning Award for its Covid Care training programme. You can read more about digital transformation at the charity in this spotlight interview with LNTV and this article about the use of eLearning at the charity.

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