Modernising Scientific Careers

Transcription

1 December 2008 Discussion paper 2 The healthcare science workforce forms the largest group of scientists in a single employment sector in the UK. Its work informs more than 80 per cent of all clinical decisions and is seen as critical to delivering the vision set out in the NHS Next Stage Review. The Department of Health (DH) has published a consultation document, The future of the healthcare science workforce. Modernising scientific careers, the next steps, setting out proposals to transform the future training and career pathways of the healthcare science workforce and NHS Employers is seeking your views. This Discussion paper provides a summary of the consultation document and asks employers to help shape and develop this important segment of the workforce to meet the future needs of the health service. Background The healthcare science workforce is formed of some 51 professions employing 52,000 staff in England, representing about 5 per cent of the total healthcare workforce. It can be split into three recognised divisions: life sciences, physiological sciences, and physical sciences and engineering. While the common perception of the healthcare science workforce may be staff in white coats working in the laboratories of large teaching hospitals, in fact, this staff group provides a wide range of patient and health services across a range of care settings. Some healthcare scientists undertake roles and responsibilities similar to medical consultants, while others provide services essential to the provision of safe, effective and efficient diagnostic and therapy procedures. They also contribute to research, innovation and the education of other healthcare professionals. The more vocational areas of science, such as medicine and pharmacy, have experienced strong growth in recent years. However, this has not been matched in science, technology, engineering and mathematics (STEM) subjects. (The STEM subjects relevant to healthcare are chemistry, physics and mathematics, together with electrical, mechanical, electronic and computer engineering). Employers need to use and develop these talents to ensure the long-term viability of both clinical and technological services. A clear and simplified career framework for healthcare A part of the NHS Confederation working on behalf of the

2 scientists is needed to make it easier to attract and recruit the right people for a more flexible workforce that also allows latent talents to be realised. The framework would need to improve recruitment for the future while being careful not to have a negative impact on retention in the present. The proposed model, outlined in The future of the healthcare science workforce consultation document, offers three clear entry points into healthcare science careers with the ability to progress between them (subject to achieving requisite entry requirements). They are healthcare science assistant, healthcare scientist practitioner and healthcare scientist. It sets out to address three major challenges: improving workforce planning creating education and training pathways that are sustainable and produce broader-based practitioners implementing consistent regulation across the healthcare science workforce. Recognising and releasing the potential of healthcare scientists to have a positive impact on patient care, other professions, and service delivery is essential if we are to build a healthcare science workforce to meet the changing demands of the future. Policy and social drivers Service provision The NHS is seeking greater plurality in the provision and location of acute services while, at the same time, concentrating expertise in specialist centres for those services that need specific skills. The healthcare science workforce has traditionally been employed and trained in large teaching and acute hospitals that use expensive, highly complex equipment and specialist techniques. Service level agreements are usually in place with primary care or independent sector organisations where healthcare science services are needed. Do you anticipate changes in the number of healthcare scientists your organisation directly employs as a consequence of the type, provider or location of future services? Changing technology As part of government initiatives to reduce waiting times and improve patient care, large investments have been made in technology, resulting in increased capacity, improved diagnostic or therapeutic techniques, and improved outcomes for patients. However, the introduction of advanced technology can also affect the skill base of the workforce, either creating training needs or reducing the amount of technical knowledge individuals need to use. Has the current training of the healthcare science workforce constrained either the benefits of increased technological capacity or the introduction of improved techniques? Demographics In the UK there is a good understanding of the ageing population and its associated health problems. Along with this is the need for workers to remain in employment for longer, and expectations for high standards of care and access to clinically effective technologies. The healthcare science workforce has specific demographic demands. From 1999 to 2004 full time equivalent (FTE) students in medicine, dentistry and 2

3 veterinary subjects increased rapidly by 9,700, while for the same period FTE students in chemistry, bio-sciences and physics decreased by 2,100. While there is now a modest rise in STEM subjects, there has been even more significant rise in medicine, and the growth of subjects such as medicine and pharmacy places demands on the STEM subject areas. Research and innovation Healthcare scientists, at all levels, may be key contributors to both research and innovation in the NHS and their work is often closely linked with other healthcare professionals, academic and industrial partners. Healthcare scientists are often leading translational research or service developments where new techniques developed elsewhere are introduced locally. Can the research and innovative skills of the healthcare science workforce be used more cost effectively? Are there constraints that hinder this sector of the workforce making greater contribution to research, innovation and development? What formal research training framework would you like to see to encourage innovation to be exploited? Education The NHS seeks to involve organisations other than university teaching hospitals in the training and education of healthcare professions. Healthcare scientists contribute to accredited undergraduate and postgraduate teaching programmes for other health professions. In addition, the healthcare science workforce contributes informally to the knowledge base of organisations and is a general resource for obtaining scientific and technological information. What are the current constraints within your organisation to healthcare scientists contributing to the training and education of other professions? Workforce planning Workforce planning is notoriously difficult in the NHS and this is equally the case for the 51 healthcare science professions. At a national level there is moderate confidence in the accuracy of the numbers of healthcare scientists within each division. However, there is a lack of confidence in the accuracy of numbers at the specialty level, which is partly due to inaccurate coding of posts and insufficient descriptors in the Electronic Staff Record (ESR). In order to improve education commissioning, a healthcare science sub group of Medical Education England (MEE) is being convened to work with the Centre of Excellence introduced in the Next Stage Review. It is expected to produce robust workforce planning tools and associated information on which to base decisions. Are there specific problems in workforce planning for healthcare science staff that you believe need to be addressed? How would your organisation improve the financial arrangements to meet the education and training needs of your workforce plans? What improvements would you recommend to improve the accuracy of coding healthcare scientist jobs? Are there particular specialist areas for which there is a skills shortage within your organisation? 3

4 Regulation Within the healthcare science workforce two professions (bio-medical scientists and clinical scientists) are regulated and registered through the Health Professions Council (HPC). Other professions have set up voluntary registers and there are five aspirant groups that are seeking regulation and registration through HPC. These are: clinical perfusion scientists clinical physiologists clinical technologists medical illustrators maxillofacial prosthetists and technologists. This inconsistency across different groups and a move towards healthcare scientists taking on more patient-facing roles potentially puts quality and safety at risk. DH is looking at evidence about the risks and how to reduce them and will be consulting separately on a new regulatory framework. What are the benefits and challenges of increasing regulation? Modernising Scientific Careers: future career framework The vision of the Modernising Scientific Careers (MSC) programme is to produce, and raise the profile of, a world-class workforce, integral to multiprofessional teams, delivering high-quality innovative patient care, in a range of settings. In particular, the MSC programme envisages that there will be more healthcare scientists undertaking roles in primary care and the independent sector, together with a more flexible and multi-skilled workforce better able to assist employers to respond to changing demands. The MSC programme uses the following principles: protection of the public and delivery of safe and effective services standards and quality underpinned by assessment explicit training and career structures improved workforce planning sustainable and secure funding raising the profile of the workforce and associated careers adding value to healthcare. Are there any additional overarching principles you would add, in modernising the HCS workforce? In support of the consultation document, The future of the healthcare science workforce, DH published a career framework for healthcare science and developed, in conjunction with Skills for Health, a suite of national occupational standards. The career pathway envisages three new titles, which will be used consistently within the three divisions of healthcare science: Healthcare Science Assistant (HCSA) Healthcare Scientist Practitioner (HCSP) Healthcare Scientist (HCS) Do you foresee any problems in the choice of these titles? What are the key issues to address in the transitional arrangements for the current science workforce? How can we make careers in healthcare science under MSC as attractive as possible for HCSA, HCSP and HCS roles? 4

5 The MSC Model Pathways for Healthcare Science Assistants, Healthcare Scientist Practitioners and Healthcare Scientists Career Framework Stage Management and Training/ Educational Career Pathways Healthcare Scientist Practitioner (HCSP) Regulation as a Healthcare Scientist Practitioner Practitioner Training Programme (PTP) Healthcare Scientists (HCS) ASE* Senior Healthcare Scientist Healthcare Scientist Regulation as a Healthcare Scientist Scientist Training Programme (STP) Direct entry Higher Specialist Scientist Training (HSST) 3 2 Healthcare Science Assistants (HCSA) Learning and Development Framework Direct entry 1 *Accredited Specialist Expertise NOTE: SIZE OF BOXES NOT PROPORTIONAL TO SIZE OF WORKFORCE Source: The future of the healthcare science workforce. Modernising scientific careers, the next steps: a consultation. Practitioner Training Programme The career model proposes that HCSAs will build up competencies to undertake a range of task and protocol based roles. In terms of career development it is envisaged that the employer will support the HCSA workforce, as appropriate, obtaining educational qualifications and other development for competitive entry into Practitioner Training Programme (PTP). It is anticipated that completion of the one- to two-year funded PTP will enable the individual to become part of a regulated HCSP workforce with competencies in a defined role, enabling the delivery and reporting of quality assured tests, investigations and interventions on patients, samples or equipment, with the potential to provide therapeutic interventions. 5

6 Do you agree with the proposal for healthcare science assistants to have opportunity to gain formal awards and qualifications? To support the PTP, should there be a greater provision of HE/FE academic programmes with NHS-funded workforce placements aligned to the outcomes of the PTP? How can FE contribute to the learning and development of HCSA and HCSP? How broad-based should the PTP be: single specialty or broader related disciplines? Scientist Training Programme Following further professional development it is envisaged that HCSP members of staff wishing to do so might compete for entry onto a three-year funded Scientist Training Programme (STP), which will include a Rotational Training Programme (RTP) around disciplines and education to Masters level. The outcome of the STP should enable a person to become a regulated HCS with competencies that enable a broad range of complex scientific and clinical roles to be undertaken, together with contributions to research, innovation and education within a specific division of healthcare science. Do you agree with the broad indicative themes in the consultation document laid out for the RTP? Higher Scientific Specialist Training and Accredited Specialist Expertise programmes The emphasis of both the PTP and STP is that entry is competitive and satisfactory completion is based on competence and outcomes. Although there will be minimum entry educational qualifications, prior experience and learning will also be a contributing factor in the supernumerary appointments for the respective training programmes. Those successfully completing the STP will have choice in either seeking employment as a regulated HCS or competing for entry onto a four- to five-year Higher Scientific Specialist Training (HSST) programme. Those appointed onto the HSST programme will again be supernumerary positions and should be encouraged to pursue research training to attain academic credentials (ie. PhD). Those regulated HCSs who choose substantive employment may follow a programme of Accredited Specialist Expertise (ASE). Successful attainment of either ASE or HSST should enable the person to be regulated with a mark on a Higher Specialist Register and undertake such roles that provide consultant level advice, leadership, leading research and education programmes, etc. Will there be challenges in matching the number of substantive positions available to the number of supernumerary posts undertaking training? Would you be able to provide the training capacity to support the three training programmes for the three healthcare science divisions? Do you envisage that the potential career pathway for a member of staff oscillating between substantive and supernumerary positions will be attractive? Do you agree with the proposals in the consultation document for HSST programmes? Should there be others and why? Are there existing programmes that could be used for ASE? 6

7 Pay and conditions of service Pay and conditions of service of the healthcare science workforce will continue to be covered by the Agenda for Change framework. As new roles are developed they will have to be evaluated to determine the appropriate pay band, which may include changes to the published healthcare science job profiles. Where there are changes to the shape and composition of the workforce locally these will have to be managed with proper consultation with staff and staff representative organisations. General questions Are there any other challenges faced by the healthcare science workforce that have not been outlined? Are there any other potential benefits that have not been outlined in the consultation document that can be achieved by modernising the HCS workforce? Do the proposals in the consultation document enable sufficient flexibility for the workforce to meet the anticipated changes in: patient care and changing population; technology and scientific advances in the disciplines; service provision? How to get involved This Discussion paper has been published to provoke thought and discussion about proposals to modernise scientific careers in healthcare, and to engage employers fully in the discussion of the consultation document. Your views on this paper and the consultation document will help inform our response. We would welcome detailed responses to the questions, but alternatively you may wish to use them simply to prompt your thinking and respond on the key issues. Please your comments to or respond online at workforce-3741.cfm NHS Employers is planning events during January/February 2009 to further discuss this topic. See our website for more information NHS Employers has set up a joint reference group with the Association of UK University Hospitals chaired by Ron Kerr, chief executive of Guy s and St Thomas NHS Foundation Trust, with members from across the NHS. The reference group will work with us on the agenda. Further information The future of the healthcare science workforce. Modernising scientific careers, the next steps: a consultation. Strategically important and vulnerable subjects. Final report of the 2008 advisory group. Better healthcare through partnership: a programme for action. PublicationsPolicyAndGuidance/DH_ A review of UK health research funding. uk/d/pbr06_cooksey_final_report_636.pdf A career framework for healthcare scientists in the NHS. Department of Health and Skills for Health. PublicationsPolicyAndGuidance/DH_

8 NHS Employers supporting promoting representing NHS Employers represents trusts in England on workforce issues and helps employers to ensure the NHS is a place where people want to work. The NHS workforce is at the heart of quality patient care and we believe that employers must drive the workforce agenda. We work with employers to reflect their views and act on their behalf in four priority areas: pay and negotiations recruitment and planning the workforce healthy and productive workplaces employment policy and practice. NHS Employers is part of the NHS Confederation. Contact us For more information on how to become involved in our work, getinvolved@nhsemployers.org enquiries@nhsemployers.org NHS Employers 29 Bressenden Place London SW1E 5DD This document is available in pdf format at Published December NHS Employers This document may not be reproduced in whole or in part without permission. The NHS Confederation (Employers) Company Ltd. Registered in England. Company limited by guarantee: number Ref: EINF Brewery Wharf Kendell Street Leeds LS10 1JR When you have finished with this briefing please recycle it This briefing is printed on 50% recycled paper