WF 26
Ymchwiliad i gynaliadwyedd y gweithlu iechyd a gofal cymdeithasol
Inquiry into the sustainability of the health and social care workforce
Ymateb gan: Institute of Physics and Engineering in Medicine
Response from: Institute of Physics and Engineering in Medicine
National Assembly for Wales Consultation: Inquiry into the sustainability of the health and social care workforce
The Committee welcomes views on any or all of the following points:
Do we have an accurate picture of the current health and care workforce? Are there any data gaps?
Is there a clear understanding of the Welsh Government’s vision for health and care services and the workforce needed to deliver this?
How well-equipped is the workforce to meet future health and care needs?
What are the factors that influence recruitment and retention of staff across Wales? This might include for example:
· the opportunities for young people to find out about/experience the range of NHS and social care careers
· education and training (commissioning and/or delivery)
·
pay and terms of
employment/contract
Whether there are there particular issues in some geographic areas, rural or urban areas, or areas of deprivation.
Background
The Institute of Physics and Engineering in Medicine (IPEM)
IPEM is a professional association and Learned Society with 4,300 members across the UK who are physicists, engineers and technologists working with applications of physics and engineering applied to medicine and biology. Our members work in hospitals, academia and industry, and IPEM has a unique role in linking the three areas.
As a charity, IPEM’s aim is to advance the application of physics and engineering to medicine for the public benefit and to advance public education in this field. We do so by supporting and publishing research, and supporting the dissemination of knowledge and innovation through project funding and scientific meetings; and by setting standards for education, training and continuing professional development for healthcare scientists and clinical engineers.
IPEM’s Welsh members were circulated with consultation documents and asked to provide their views to IPEM. The response is based on the feedback received and specifically addresses the following questions posed by the Committee, namely: Do we have an accurate picture of the current health and care workforce? Are there any data gaps? How well-equipped is the workforce to meet future health and care needs? What are the factors that influence recruitment and retention of staff across Wales?
IPEM response
Do we have an accurate picture of the current health and care workforce? Are there any data gaps?
1. In response to these particular questions, IPEM carried out a census of the Radiotherapy Physics workforce in November, 2015. All three radiotherapy centres (North Wales Cancer Treatment Centre, South West Wales Cancer Centre, and Velindre Cancer Centre) responded to the census, and the results are shown in the table below:
|
|
Workforce/Whole Time Equivalent (WTE) |
Vacancies |
Vacancy Rate |
|
Clinical Scientists |
36.55 |
0 |
0% |
|
Clinical Technologists (Physics) |
25.56 |
3 |
11.7% |
|
Clinical Technologists (Engineering) |
19 |
2 |
10.5% |
2. In terms of the Rehabilitation Engineering workforce, insufficient responses were received to produce a table as above. Some issues that were highlighted included difficulties in recruiting trained staff and retention concerns. In order to increase the service as required, more staff will be needed.
3.
A 2014 survey of
Diagnostic Radiology found that no department had adequate
workforce resources in terms of establishment and some suffered
from on-going vacancy issues. There is very limited MRI physics
expertise in Wales (0.3 WTE).
4. IPEM holds no data on the following areas: Radiation Protection, Nuclear Medicine, Clinical Engineering (including Electro-biomedical Engineering) and Physiological Measurement.
How well-equipped is the workforce to meet future health and care needs? What are the factors that influence recruitment and retention of staff across Wales? The following forms IPEM’s response to these particular questions.
5.
Medical Physics and
Clinical Engineering (MPCE) training capability exists but capacity
is stretched; some training schemes (for example, imaging with
ionising radiation at Scientist Training Programme level) are not
offered locally due to resource limitations.
6.
Where numbers of
staff are very small, accurate workforce planning is difficult and
the availability of vacancies to match training course outputs is
unpredictable. This is a major issue. Some good staff are
‘lost’ and Health Boards should be encouraged to
provide flexibility. Nevertheless, recruitment to vacancies
for Clinical Scientist posts, suitable for newly-qualified Clinical
Scientists, remains challenging as graduating trainees return to
England, undertake PhD study etc. A ‘lock-in’ for
both trainee and health board/trust might be explored.
7.
Innovative solutions
to recruitment are developing, for example, recruitment of
Assistant Physicists (not yet qualified as Clinical Scientists) to
support the scientific service and subsequently pursuing
‘Route 2’ training schemes to Health and Care
Professions Council (HCPC) Registration; but this is not a
universal solution and has limited capacity.
8.
Outreach activities
to schools and work experience for students are activities
supported by departments as an aid to advertising and recruiting
the best students but it is too little and needs formal support.
Unfortunately it is an activity that is under severe pressure as
the working schedules of staff become ever more crowded.
9.
Some engineering
disciplines are stretched, for example, linear accelerator
engineering, and in-service training schemes to
‘grow-your-own’ need to be available at Career
Framework Level 3-5. Fully qualified engineers are in increasing
demand.
10. Extending roles into previously
‘medical functions’ (for example, radiotherapy
treatment volume and Organ At Risk outlining, nuclear medicine scan
reporting). This extends the role of staff and follows prudent
healthcare principles. This has particular promise for
medical disciplines with recruitment shortages (for example,
radiology, oncology).
11. Need for supporting newer
modalities, for example, the provision of MRI safety expert advice,
which remains a particular challenge in Wales.
12. Need to respond to the evolving
technology of healthcare (for example, CT scanning on linear
accelerators, diagnostic systems vastly more complex than just a
few years ago etc.) where MPCE has the knowledge and skills to
optimise safe and effective use but has limited resources with
which to develop, advise and implement evolving technologies.
13. The growth of private healthcare
providers in Wales, and particularly the recent X-ray and Proton
Radiotherapy Centre under construction in Newport, has potential to
impact on the NHS especially where highly specialist staff are
scarce e.g. radiotherapy physicists. The Newport Centre has
already recruited staff from the NHS. It would be good to
encourage private providers to have a stake in the formal training
of scientists and practitioners.
14. Some disciplines are working
extended hours and thus staff presence during normal clinical hours
can be limited with potential compromise in the service. The impact
of extended hour working, and particularly if weekend services are
to be provided, needs to be recognised as additional work and
supported through an appropriate change to the Whole Time
Equivalent (reliance on overtime payment is not a viable long term
solution).
15. The workforce can be equipped for the future given the opportunity for development through protected time; the time available for training has become increasingly short in order to accommodate greater clinical workloads.
16. Further ideas being considered by the Clinical Engineering Profession Specific Group include:
16.1 To
develop and strengthen the clinical engineering Assistants and
Associates workforce by providing centrally funded supernumerary
apprenticeships aimed at attracting school leavers and those
seeking career changes to clinical engineering within the
NHS.
16.2 To establish readily accessible in-service clinical engineering Practitioner training across Wales based upon the following:
16.2.1 Top up routes for those already employed as Healthcare Science Assistants and Associates specialising in clinical engineering
16.2.2 Fast track conversion routes for graduates from non-Practitioner Training Programme medical engineering degree courses such as those offered by Cardiff and Swansea universities.
17. Consultant Clinical Scientists specialising in Clinical Biomedical Engineering to be based in every Health Board in Wales and to lead the adoption of medical technologies and the associated development of innovative practice within each Health Board. As such, each will provide the expert link with the Wales Health Technology Hub on behalf of that Health Board. This will be achieved via:
17.1 Strategic
commissioning of Higher Specialist Scientific Training (HSST)
Clinical Biomedical Engineering on an all Wales basis.
17.2 Centrally funded consultant level Continuing Personal and
Professional Development (CPPD) to support in-service equivalence
routes to registration on the Academy for Healthcare Science (AHCS)
Higher Specialist Scientist Register (HSSR).
Ends