The Background

Hertfordshire Community NHS Trust has achieved these impressive business and user benefits, in just 3 months, with their intelligent and focused implementation of Totara Learn (supported by Think Learning):

  • The Trust has achieved and maintained 94.4% compliance across a rigorous, complex set of national statutory and mandatory training requirements.
  • The administration team have seen first-line support queries reduce by 80%!
  • Surveyed users said that elearning, booking and compliance management was easier and quicker in Totara than in their legacy LMS.
  • Classroom training non-attendance rates have dropped from 10% to 4.7%.
  • The new LMS saves the L&D team up to 3 days per week in staff time!

We have been so pleased with the benefits that the Totara system has brought us, particularly in terms of improving our users’ experience, which was our primary objective in implementing the system.

Jane Trundle | Head of Learning & Development

The Trust provides Community Care across Hertfordshire, with c2,000 employees working in homes, schools, clinics and community hospitals. 97% of patients would recommend their services to friends and family.

Best Healthcare Implementation 2019 image

The Challenge

The L&D team need an LMS to deliver over 250 in-house courses, manage the induction of 30 – 40 new starters each month, and provide access to a further 250 elearning courses, mostly provided by e-Learning for Healthcare.

Prior to implementing Totara, the Trust had used a legacy commercial learning management system, and to report on compliance, they needed to combine data from that system with HR/ESR data in a separate business intelligence tool, which was a time-consuming process. The team spent many hours each month manually manipulating data (e.g. to exclude staff on long-term sick or maternity leave from compliance figures). Despite the effort required, the legacy LMS was still considered an improvement over the centrally procured NHS Oracle LMS.

As one stakeholder observed…’When you are working with something every day that hasn’t been developed to keep up with NHS L&D processes and learners expectations, you aren’t aware of creating time-consuming workarounds – you just make it work!’

A major challenge that Totara Learn has been able to help with is to provide LMS access via mobile devices. 1700+ staff at the Trust use mobile devices to access and update the clinical system; this offered a huge opportunity to engage with learners, and provide content and educational support away from Trust sites, which is critical for community-based staff. The legacy LMS was unable to meet that challenge.

It is just SO MUCH BETTER than the old system which was verging on impossible, particularly when only used infrequently!

A Trust User

I can be confident now in how much time to allocate to staff to complete their training because they can see exactly what they need to do.

A Trust Manager


Consulting closely with the neighbouring Hertfordshire Partnership NHS Trust, who had recently completed an LMS procurement (also partnering with Think Learning), Hertfordshire Community were able to make a robust assessment of LMS providers and systems, which informed their decision to procure Totara Learn with Think Learning.

The Trust were impressed with Think Learning’s understanding of NHS requirements, IT infrastructure, data and reporting structures…and their extensive network of 26 NHS customers, with whom the Trust can share knowledge, developments and experience.

NHS decision-makers are encouraged to find efficiencies in back-office functions and the ever-closer strategic partnerships across Strategic Transformation Partnerships and Integrated Care System. This supported the business case to partner with Think Learning, who now support 4 Trusts in Hertfordshire (covering Acute Services, Mental Health, Community Health, and the East of England Ambulance Service).

Screenshot of the homepage of the Hertfordshire Community NHS Foundation Trust Totara Learn site.

The Solution

Having implemented Totara Learn at over 25 NHS Trusts, Think Learning were able to effectively migrate existing education data and configure reports. It was essential that the switchover from the previous system to Totara went well, and that compliance reporting was available within the same month that the legacy LMS was de-commissioned.

The availability of extensive compliance reporting from go-live (from high-level divisional/cost centre reports down to individual user dashboards) saved the workforce team time, where they’d previously had to manipulate and manually issue reports.

Supporting NHS Streamlining activities is essential and within a week, national Core Skills Training Framework competency data was being uploaded into ESR on a weekly basis. Since going live, the L&D team have further refined the data load process, with changes to both ESR and Totara reports to speed up the process.

Having full admin access to Totara and the confidence to use the system, the L&D team created a specific ‘service administrator’ dashboard, to enable managers and administrators to monitor training compliance and book training for their team members.

Hertfordshire Community NHS Foundation Trust Totara Learn homepage on a mobile device.

Staff Engagement

A SurveyMonkey questionnaire was set up, and a link from the front page of the LMS encouraged people to take part. Over a short period of time, there were 119 responses.

A series of questions gauged satisfaction with the system, scored from -2 (much more difficult/longer) via 0 (no change) to +2 (much easier/shorter).  Narrative feedback was also sought.

All measures showed a positive improvement, and the ‘Overall Time Taken’ rating shows that staff have found that the new system takes a lot less time to navigate.

Measure Average score
Ease of booking training compared to previously 0.71 – significantly easier
Ease of completing e-learning compared to previously 0.68 – significantly easier
Ease of monitoring personal compliance 0.88 – significantly easier
The overall time taken for e-learning, booking etc. compared to previously 1.77 – much shorter


When asked about what they liked about the system, 36 staff talked about it being easy to use, and where feedback indicated a learner needed further support, the simple user guides were immediately updated.

I just clicked on the icon with the Owl symbol – can’t remember getting an email about that icon – but as there was an owl on the bottom of the email from training promitying me to do the online training – I just followed the owl symbol and everything was there.  Love the fact that there was a link to take me to the right course and I didn’t have to select from a choice and risk spending hours doing the “wrong” one.  Love it so far – thank you and well done.

A Trust Users


The Results

The Trust has delivered a learning and technology solution that meets its complex training requirements. Compliance (a key measure for Trusts, which directly relates to risk for employees and patients) has increased.  Mandatory training compliance for the past 4 years shows an average compliance of 91.8%, comfortably meeting Trust targets.  Since September 2018, average compliance has risen to 94.4%, a significant and maintained increase.   More importantly, data accuracy and timeliness of information are no longer an issue for managers, saving time that was previously spent on monitoring and following up individual non-compliance.  In addition, there has been an 80% drop in queries from learners.

The reporting and audience setup has enabled more granularity between requirements and completions. This is a real win for the Trust and more competencies and courses are being set up to accurately target a wider set of professional and clinical courses, and support Mentorship programmes. Access to wider education, particularly personal and professional development courses can impact on staff retention so this is a key area to improve.

The L&D team have noticed a change in the culture at the Trust as well, as learners and managers take ownership of their compliance data. Prior to using Totara Learn, the central administration team had to manually enrol 2000 course bookings a month to support learners. 3 months in, they now have a huge reduction in manual course bookings and this continues to drop as a culture of self-service is embraced (helped by engaging site design, clear compliance blocks and navigation). The non-attendance rate has dropped from 10% to 4.7% allowing more effective management of spaces on courses

Overall the Trust has saved 0.6 of a WTE, around 3 days a week, in administration time since the move to Totara, and the L&D team are delighted with the new system.

We asked for feedback from staff and most staff tell us they find the system either ‘easier’ or ‘much easier’ to use and we can see this in huge fall in the number of queries we receive.  We estimate this is saving us up to 3 days per week in staff time.  On top of this our compliance has risen to its highest ever.

Jane Trundle | Head of Learning and Development

Hertfordshire Community NHS Foundation Trust Organisation Compliance Report

Next Steps

Extending their blended learning offering, the team are creating:

  • Certifications for key documents that need to be read during induction, as part of the Hertfordshire Unicef Breastfeeding Accreditation.
  • Links to other training offerings including the NHS IT training Portal, local University course applications and other elearning offerings.
  • A full Leadership blended Learning Programme where groups of learners can upload their assignments for marking.