The Background

We live in an increasingly regulated world where compliance is a statutory and regulatory requirement for many organisational sectors and none more so than UK Healthcare, taming compliance across healthcare organisations is essential. The Care Quality Commission (CQC) is the independent regulator for health and social care in England. They monitor, inspect and regulate services to make sure they meet fundamental standards of quality and safety to ensure safe, effective and high-quality care is being provided. They publish their findings, including performance ratings to help people choose care providers.

The Challenge

Compliance poses several challenges for healthcare organisations. These include:

  • How to streamline learning and development (L&D) processes to maximise operational efficiency and reduce costs in departments working at capacity.
  • Funding employee focused IT systems in an environment where the focus, understandably, is on patient facing systems.
  • How to maintain a clear and accurate audit trail of compliance training to manage organisational risk and achieve regulatory standards.
  • Cultural change around learning and compliance – using technology to empower managers and learners to manage their education
  • Creating and providing real-time access to compliance reports to allow managers and staff to proactively manage compliance and risk.
  • Creating accurate organisation or department wide reports to evidence individual attendance on courses for the CQC for performance assessments This is further complicated when there is a high staff turnover or many temporary / bank staff working.
  • Providing learners with clear information on what they are required to complete by when, whilst also providing information on multiple learning pathways to achieve compliance.
  • Mapping and maintaining compliance using a complex range of HR criteria to give a detailed, granular picture of compliance
  • How to maintain and keep up with complex and fast changing requirements. When new mandatory training requirements are established, this needs to be rolled out to a workforce across multiple job roles and locations in real time.

The Solution

Think have customised and implemented Totara Learn as a solution to these challenges in 18 healthcare organisations.

Using their extensive knowledge of healthcare organisations and a collaborative, solutions focused approach, Think created a healthcare user group that has facilitated a number of key custom developments to Totara Learn. These developments have allowed specific healthcare compliance needs to be effectively managed in a cost-effective way, including crowdfunding of key developments. These developments include:

Systems Integration

A core part of managing compliance effectively is having new starters, leavers and changes to job roles reflected accurately in the LMS. Think have successfully linked Totara Learn with the NHS HR system, Electronic Staff Record (ESR) to achieve real-time data accuracy (refreshed daily). Real-time information is resulting in better decision making and better use of resources.

Management Hierarchies 

One of the difficulties many organisations face is keeping on top of manager/staff hierarchies. Within Totara Learn, Think have created a function for learners to be able to choose their own manager. This triggers a workflow that notifies the old manager, the new manager and the learning administrator who can verify this selection. This functionality provides up to date information that can be used to improve the data quality in their HR system.

In addition to this Think have also developed a new hierarchy to allow clinical supervision, where staff working on a rotational basis creates further challenges around data confidentiality and compliance requirements, can be effectively managed by Totara Learn.

Compliance Reports and Dashboards

Think have applied their knowledge of healthcare reporting requirements and developed a suite of specific compliance reports and dashboards. These enable organisations to have a complete picture of which staff have completed and passed assessments and compliance training. Reports and dashboards are: graphical, aggregated and interactive. By providing direct access to these allows managers to prioritise mandatory learning and manage team compliance.

A core part of compliance dashboards are customised blocks developed by Think. These allow staff to see at a glance, their compliance against training requirements and can book on activities directly.

Screenshot of a block showing user compliance.

Screenshot of a compliance block by Think Learning

Figure 1: This is an example of the compliance dashboard developed for learners in the healthcare sector. 

Figure 2 – This is an example of a collapsible compliance report showing ‘Compliance’ and ‘Non-compliance’ with links that open in a new window and contain specific staff member details.

Management of Target Audiences

Think’s experience of analysing workforce data sets allows them to work effectively with learning and development teams to map specialist training requirements for extended, role-specific training and competency compliance. They have designed a dynamic maintenance-free approach to establishing target audiences on Totara Learn which then tracks compliance. Targeting can utilise all available HR fields, including job role, pay band, cost centre, occupational codes, and professional registration status. As a result, healthcare organisations using Totara Learn have confidence that new starters and new positions within the organisations will have compliance requirements set automatically and this will reflect in reports accurately.

Nurse Revalidation

Forms which replicate the NMC Revalidation templates (CPD Log, Practice-Related feedback, Reflective Accounts, Practice Hours), have been replicated in Totara Learn. This enables organisations to launch an NMC-compliant e-Portfolio solution very quickly.

Enhancements to IT infrastructure

Healthcare organisations were facing issues tracking their e-learning as a result of their IT infrastructure and browser compatibility issues. Think worked through these issues so that national e-learning now reports accurately and is easier for learners to access. Think have worked to provide an integrated e-learning solution for compliance integrating content from e-LFH, NSA, BMJ and NHS IT skills.

The Results

Think conducted a survey on the impact Totara Learn has had on compliance across their healthcare clients. Below are some highlights:

  • 100% of respondents stated that targeting training to specific audiences was easier in Totara Learn than in legacy systems.
  • 75% of respondents felt staff and managers find the compliance reports and blocks useful (25% didn’t know).
  • 75% of respondents stated that learners are more engaged with learning and development after implementing Totara Learn.
  • 100% of respondents have experienced an increase in staff taking online learning courses.
  • 75% of respondents stated that they had seen a reduction in the time required to administer courses, manage compliance requirements and support learners (25% didn’t know).
  • 100% of respondents stated Think’s additional compliance features, for example compliance blocks, RAG report, compliance reports, and collapsible reports were valuable. (37.5% ranked them as critical, 50% very important and 12.5% as important).


Below are some additional insights from healthcare organisations using Totara Learn:

“Learning is more accessible to staff and sophisticated compliance data has driven our Core Skills compliance rate to 92%.Ensuring staff are trained has to be good for patient care. Our processes are more time and cost efficient using the Totara Learning Management System customised specifically for the healthcare market by Think.”  Deborah Tarrant,Director of People and OD,Barking Havering and Redbridge University NHS Trust & President of HPMA


 “Totara Learn has enabled us to provide “just in time” compliance training to our people out in the field, reducing the need for them to come into the office for the more traditional classroom training. We finally have a true “Blended approach” to our core training needs and the rest of our business is beginning to follow suit”. Chris Hartley, LMS & E-Learning Manager, Allied Healthcare


 “We are extremely pleased that Totara Learn is enabling us to deliver mandatory training compliance in an engaging and user-friendly way that puts staff and their managers in control. This fits really well with the culture we are trying to develop in the Trust to give local teams more control over how care is delivered.” Dr Adrian Whittington,Director of Education & Training, Sussex Partnership NHS Foundation Trust


“Our initial roll-out of Totara Learn has given us the foundation to improve the Trust’s management of role-specific training, appraisal and supervision, personal development planning, study leave and funding applications and competency assessments.  Think’s understanding of the healthcare environment and especially the requirements of the NHS has been invaluable in creating a tailored platform which serves our growing needs.” Lucy Reid, Head of Learning and Knowledge Systems, Education and Development Department, South London and Maudsley NHS Foundation Trust

Next Steps


Think have understood the financial constraints of healthcare organisations and delivered a cost- effective solution that translates complex organisation compliance requirements into a powerful, user-friendly learning solution. Totara Learn is accelerating change, reducing the burden of compliance training, decreasing organisational risk and engaging the workforce in learning and development.