Healthcare Science (HCS) Healthcare Science (HCS) … · 3.6 Future education and training requirements of Support Workers ... HCS SW AP – NHS Life ... Laboratory Ancillary Worker,

Healthcare Science (HCS) Healthcare Science (HCS) Healthcare Science (HCS) Healthcare Science (HCS) Support WorkersSupport WorkersSupport WorkersSupport Workers (SW) (SW) (SW) (SW) and Assistant Practitioners and Assistant Practitioners and Assistant Practitioners and Assistant Practitioners (AP): A (AP): A (AP): A (AP): A survey of survey of survey of survey of NHS NHS NHS NHS Life ScienceLife ScienceLife ScienceLife Science partners partners partners partners Amanda McKie1* August 2010

1 Research and Development Officer – Healthcare Science, Central Offices, NHS Education for Scotland *Address for correspondence: Dr Amanda McKie, Ground Floor, ONE Clifton Place, GLASGOW, G3 7LD. 0141 352 2928, [email protected].

Healthcare Science Support Workers and Assistant Practitioners: NHS Life Sciences

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Table of contentsTable of contentsTable of contentsTable of contents Page NumberPage NumberPage NumberPage Number Executive SummaryExecutive SummaryExecutive SummaryExecutive Summary 3 1.1.1.1. BackgroundBackgroundBackgroundBackground 5 2. MethodologyMethodologyMethodologyMethodology 6 3.3.3.3. ResultsResultsResultsResults 3.1 Survey response rate: NHS Board and Life Science discipline 7 3.2 The Role of the Support Worker and Assistant Practitioner in the Life Sciences 8

3.2.1. Job titles of Support Workers (NHS CF levels 2 and 3) 8 3.2.2. Job titles of Assistant Practitioners (NHS CF level 4) 9 3.2.3. Job descriptions and KSF outlines for NHS CF levels 2-4 10

3.3 Numbers of Support Worker and Assistant Practitioner Staff 11 3.4 Workforce Planning 15 3.5 Current education and training for Support Workers and Assistant Practitioners 16 3.6 Future education and training requirements of Support Workers and Assistant Practitioners 18 3.7 Future plans 24 4.4.4.4. DiscussionDiscussionDiscussionDiscussion 4.1 The Role of the support Worker and Assistant Practitioner in the Life Sciences 25 4.2 Numbers of Support Worker and Assistant Practitioner Staff 26 4.3 Workforce Planning 27 4.4 Current education and training for Support Workers and Assistant Practitioners 28 4.5 Future education and training requirements of Support Workers and Assistant Practitioners 29 4.6 Future plans 30 5.5.5.5. ConclusionsConclusionsConclusionsConclusions 31


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Executive SummaryExecutive SummaryExecutive SummaryExecutive Summary A survey of laboratory managers / training leads has been conducted to establish an evidence base of and for educational developments for Healthcare Science (HCS) Support Workers (SW) and Assistant Practitioners (AP) working in the Life Sciences in NHS Scotland. The survey was designed to gather information and views on a number of areas relevant to Support Worker and Assistant Practitioner education and training. There was a 87% response rate to the survey, with information and views being gathered from all NHS territorial Boards with the exception of NHS Borders, NHS Highland and NHS Tayside. Analysis of the survey data revealed the following:

� Support Worker and Senior Support Worker roles as described by NHS Career Framework (CF) levels 2 and 3 respectively, are covered by a number of job titles. Medical Laboratory Assistant (MLA) and Biomedical Support Worker are common to both of these NHS career framework descriptors

� Assistant Practitioners as described by NHS Career Framework level 4 are also

known as Associate Practitioners

� Over three quarters (76%) of survey respondents indicated they have no job description for the Assistant Practitioner role

� Over half (55%) of survey respondents indicated they anticipate the number of

staff working at NHS Career Framework levels 2-4 will increase in the next 5 years.

� The number Support Worker and Senior Support Worker staff currently working

towards an accredited qualification is very low compared to the total (6% of WTE posts in a number of selected NHS Boards)


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� Over 75% of survey respondents indicated that their NHS Board doesn’ t have or

they don’ t know if their NHS Board has a HCS Workforce Plan

� Most of the current learning of Support and Senior Support Workers is taking place in the workplace and is associated with the Life Sciences Modern Apprenticeship frameworks at levels 2 and 3

� More than 90% of survey respondents agreed or strongly agreed that future

formal education and training for Support and Senior Support Workers would be more appropriately delivered in the workplace, when compared to day release at College

� Almost two thirds of survey respondents indicated that Support and Senior

Support Worker education and training could be delivered by e-learning / distance learning

� Over 75% of survey respondents agreed or strongly agreed that future education

and training for Assistant Practitioners could be delivered in the workplace, at College or by e-learning / distance.

� Almost half of respondents (48%) indicated a preference for educational

provision by Colleges to be in a twilight session format

� Education provision by Colleges for Support Staff and Assistant Practitioners was more likely to cover underpinning knowledge rather than practical skills.

The survey findings will be used a foundation for the work of the NES NHS Life Sciences: HCS SW and AP education and training group.


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1.1.1.1. BackgroundBackgroundBackgroundBackground The first Scottish Government policy for Healthcare Science, Safe, Accurate and Effective: An Action Plan for Healthcare Science in NHS Scotland2 was published in 2007. Safe, Accurate and Effective set out 5 recommendations for NHS Education for Scotland (NES) to lead on. One of these recommendations was ‘ NES should explore how work currently being undertaken on meeting the education and support needs of healthcare support workers and assistant practitioners in HCS can be linked to the NHS Scotland Career framework’ . From an education and training perspective, strong emphasis was placed on the contribution of work-based learning. In February 2010, the four UK Health Departments published the document Modernising Scientific Careers (MSC): The UK Way Forward3. MSC describes in some detail the approach for the development of the HCS workforce and their education and training. Broadly, MSC sets out proposals for career pathways and education and training programmes for Healthcare Science Assistants and Associates (HCSA), who cover NHS career framework levels (NHS CF) 1 - 4; as well as HCS Practitioners (NHS CF 5 - 6), Healthcare Scientists (NHS CF 6 - 7) and Senior Healthcare Scientists (NHS CF 7 - 8) and Consultant Healthcare Scientists (NHS CF 9). This new three tier model seeks to unify education and training of similar staff groups who may actually work in the same sub-specialty, yet be subject to differing regulation standards. Over the past year, NES has reviewed some of the current and planned educational developments taking place for Healthcare Science Support Workers and Assistant Practitioners in the Life Sciences in NHS Scotland at the territorial Board level4.

2 The Scottish Government. Safe, Accurate and Effective: An Action Plan for Healthcare Science in NHS Scotland. Edinburgh: The Scottish Government, 2007. 3 UK Health Departments. Modernising Scientific Careers: The UK Way Forward. London: The Department of Health, 2010. 4 http://www.nes.scot.nhs.uk/disciplines/healthcare-science/advisory-group/meeting-on-031209/research-and-development-officer-mla_ap-developments Accessed 18th August 2010.


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A NHS Life Sciences: HCS SW and AP education and training group has been convened by NES as the next step of taking this programme of work forward. The NES led group aims to bring a consistent and cohesive approach to the education and training of HCS Support Staff working in the Life Sciences in NHS Scotland. It is intended that this area of work will be extended into the other HCS strands (physiological and physical sciences) in the future, if considered appropriate. 2.2.2.2. MethodologyMethodologyMethodologyMethodology A research exercise to establish an evidence base of and for educational developments for Healthcare Science Support Workers and Assistant Practitioners in the NHS Life Science disciplines was conducted in the form of an online survey. The survey was designed and developed using Questback5. The survey covered 6 areas: the role of the Support Worker and Assistant Practitioner in the Life Sciences, numbers of Support Worker and Assistant Practitioner staff, Workforce Planning, current education and training for Support Workers and Assistant Practitioners, future education and training for Support Workers and Assistant Practitioners and future plans. An electronic link to the published survey was sent via email to 23 laboratory managers / training leads who had indicated a willingness to participate in the survey. A named contact for each NHS territorial Health Board in NHS Scotland was obtained with the exception of NHS Borders. The survey was available for completion for a total of 41 days, with reminders for completion being sent 29 and 37 days after survey issue. Data was analysed using the report function of Questback.

5 http://www.questback.com/ accessed 9th August 2010.


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3.3.3.3. ResultsResultsResultsResults 3.1 Survey response rate: NHS Board and Life Science discipline Twenty (20) individuals responded to the survey giving an overall response rate of 87%. Figure 3.1 shows the number of responses received according to NHS Board / Special Health Board. More than one response for a particular Health Board indicates a Life Science discipline response for the Board, e.g. NHS Ayrshire and Arran, NHS Lanarkshire and NHS Lothian gave an individual response for each of the main Life Science disciplines i.e. Biochemistry, Haematology, Microbiology and Pathology. Other responses represent the collated data for all the Life Science disciplines in that Board or Board responses for a single life science discipline. Figure 3.1: HCS SW AP - NHS Life Sciences survey response according to NHS Board

(Note: A respondent from NHS Greater Glasgow and Clyde mistakenly clicked the tab for NHS Western Isles; accordingly NHS Greater Glasgow and Clyde should read three respondents and NHS Western Isles one respondent)

Figure 3.2 shows the number of survey responses received for each life science discipline, with each discipline being almost equally represented. Responses covered in the ‘other’ category included multidisciplinary laboratory services and blood transfusion medicine.


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Figure 3.2: HCS SW AP – NHS Life Sciences survey response according to life science discipline

3.2. The Role of the Support Worker and Assistant Practitioner in the Life Sciences 3.2.1. Job titles of Support Workers (NHS Career Framework levels 2 and 3) Figure 3.3 shows the job titles of roles covered by the Support Worker descriptor (NHS Career Framework level 2). The job titles of most of the Support Worker roles are those of Medical Laboratory Assistants (13 respondents) and Biomedical Support Workers (11 respondents). Clinical Support Workers is another job title that is used. Job roles covered by the ‘other’ category were: Laboratory Ancillary Worker, Clerical Assistants, Phlebotomy Service Workers and blood sample collection Porters. Figure 3.3: Job titles of roles covered by Support Worker - NHS Career Framework level 2

Most job titles covered by the Senior Support Worker descriptor (NHS Career Framework level 3) are those of Medical Laboratory Assistant (18 respondents), with eleven (11) respondents indicating that these roles are also covered by Biomedical Support Workers. Job titles in the ‘ other’ category were: Supervisor Biomedical Support Worker and Phlebotomist. Interestingly, five (5) respondents indicated that


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their NHS Board did not have these posts (Figure 3.4). Figure 3.4: Job titles of roles covered by Senior Support Worker – NHS Career Framework level 3

3.2.2 Job titles of Assistant Practitioners (NHS Career Framework level 4) Figure 3.5 indicates the job titles covered by the Assistant Practitioner descriptor (NHS Career Framework level 4). Interestingly, most respondents (16) indicate that their NHS Board do not have these roles. Of those NHS Boards that do, four (4) respondents indicated that the job titles for these roles are Associate Practitioners rather than Assistant Practitioners which were indicated by two (2) respondents. Cytoscreeners were covered in the other category as a job title being covered at NHS Career framework level 4. Figure 3.5: Job titles covered by Assistant Practitioner – NHS Career Framework Level 4


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3.2.3. Job descriptions and KSF outlines for NHS Career Framework roles levels 2-4 Figure 3.6, indicates NHS Boards having job descriptions for each of the roles covered by NHS Career Framework levels 2 - 4. Two thirds of respondents (16) indicated that they have job descriptions for the Support Worker Role (NHS Career Framework level 2). While thirteen (13) respondents indicated that they have job descriptions for the Senior Support Worker role (NHS Career Framework level 3). Sixteen (16) respondents indicated (76%) they have nononono job description for the Assistant Practitioner role at NHS Career framework level 4. Figure 3.6: Job descriptions for NHS Career Framework levels 2-4

Figure 3.7 indicates that the majority of survey respondents have not used National Occupational Standards for drafting job descriptions for roles covered by the NHS Career Framework levels 2-4. Figure 3.7: Use of National Occupational Standards (NOS) for drafting job descriptions at NHS Career Framework levels 2-4


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Figure 3.8 indicates NHS Boards having KSF outlines for each of the roles covered by NHS Career Framework levels 2-4. The majority of NHS Boards have a KSF outline for roles covered by NHS Career framework levels 2 and 3, i.e. Support Worker and Senior Support Worker respectively. However, fifteen (15) respondents indicated that they do not have a KSF outline for the Assistant Practitioner role (NHS Career Framework level 4) and this correlates with most NHS Boards indicating that they do not have a job description for this role. Figure 3.8: KSF outlines for NHS Career Framework levels 2 - 4

3.3 Numbers of Support Worker and Assistant Practitioner Staff Table 3.1 indicates the number Whole Time Equivalent (WTE) posts at NHS Career Framework levels 2-4 in a selection of NHS Boards. The NHS Boards selected are those that have returned responses for all four Life Science disciplines (with the exception of SNBTS). The table illustrates the different staffing numbers for each of the NHS Career Framework level 2-4 roles in the NHS Boards selected; a total of three hundred and twenty one point sixteen (321.16) WTE posts. Unsurprisingly, the Scottish National Blood Transfusion Service (SNBTS) has the largest number of Support Worker roles, in support of the delivery of this national service. The rural Health Boards (NHS Orkney, Shetland and the Western Isles) have the smallest number of staff working at NHS Career Framework levels 2-4.


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The number of Assistant Practitioners currently employed in the selected NHS Boards is low (three in total, excluding Cytoscreeners), when compared to the numbers of Support and Senior Support Workers (318.5). Interestingly, there is an Assistant Practitioner employed in NHS Orkney. Table 3.1: Number of whole time equivalent (WTE) posts at NHS Career Framework levels 2-4 in a selection of NHS Boards.

NHS Board Support Worker Senior Support Worker Assistant Practitioner

Ayrshire and Arran 24.66 6.6 0

Lanarkshire 2 57.2 2

Lothian 94 6 0

National Services Scotland (SNBTS)

>120 0 0

Orkney 0.7 0 1

Shetland 0 4 0

Western Isles 3 0 0

TOTAL 244.36 73.8 3

The number of current staff working towards an accredited qualification in a selection of NHS Boards is very low; twenty (20) (Table 3.2) when compared to the total number of WTE staff (321.16); this represents 6% of the WTE numbers (Table 3.1). Table 3.2: Number of current staff in NHS Career Framework level 2-4 posts working towards an accredited qualification in a selection of NHS Boards.


Ayrshire and Arran 4 0 0

Lanarkshire 0 0 2

Lothian 8 4 0


2 0 0

Orkney 0 0 0

Shetland 0 0 0

Western Isles 0 0 0

TOTAL 14 4 2


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The number of staff working in NHS Career Framework level 2-4 posts who would like to gain an accredited qualification in the future in a selection of NHS Boards is indicated in Table 3.3. The demand for attaining formal qualifications in the future varies considerably according to NHS Board. For example, NHS Lothian indicates that 50-70% of Support Worker staff in post (50-70 individuals) would like to gain an accredited qualification. Table 3.3: Number of staff in NHS Career Framework level 2-4 posts who would like to gain an accredited qualification in the future in a selection of NHS Boards.


Ayrshire and Arran 7.5 1 0

Lanarkshire 8 14 8

Lothian 50-70% in post 6 0


15 0 0

Orkney 0 0 1

Shetland 0 1 0

Western Isles 2 0 0

Over half (55%) of survey respondents indicated they anticipate the numbers of staff working at NHS Career Framework levels 2-4 will increase in the next 5 years (Figure 3.9). Thematic analysis of free-text responses in relation to this question revealed three common themes: evaluation of job description and post outlines, financial constraints driving Biomedical Science (BMS) posts to be replaced by Support Worker and Assistant Practitioner roles in the future and concerns that 24 hour service requires HPC registered BMSs and Support Workers and Assistant Practitioners are not currently HPC registered.


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Figure 3.9: Anticipation that numbers of staff working at NHS Career Framework levels 2-4 will increase in the next 5 years

Survey respondents indicated that the future supply of Support and Senior Support Workers and Assistant Practitioners could come from a variety of sources (Figure 3.10). Figure 3.10: Supply of Support Workers, Senior Support Workers and Assistant Practitioners the NHS Life Sciences workforce in the future.

There was a common theme regarding graduates being employed as Assistant Practitioners and Support Workers, the following free text comments were received from five respondents. ‘Some of the Higher support workers currently involved would be interested in moving to practitioner currently we have graduates who have the wrong degree to be a BMS so can't get trainee posts, working as MLAs…’ ‘There should be entry routes available for all of the above groups although graduates are generally over qualified and have unrealistic expectations of the job’ .


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‘Graduates - sadly / unfortunately as APs’ ‘As the skill mix changes downwards ( is economically pushed downwards ) there will be fewer opportunities for graduates to be employed as BMS staff leaving their only option, during economic downturn , as APs or even MLAs’ . ‘Pressures for jobs in the UK will result in more graduates and college leavers applying for jobs that they may otherwise have considered themselves over qualified for. I already have had PhD students applying for MLA posts in the last 18 months or so’ . 3.4 Workforce Planning Fifty six percent (56%) of survey respondents indicated that they have a workforce plan for their Life Science discipline. The following free text comments were received in relation to Workforce Planning and data.

‘Previous workforce predictions have disappeared into a vacuum’ . ‘Although we have a plan the amount of contradictory pressures on the department makes sensible planning much beyond next year nigh on impossible’ .

‘We are frequently requested to contribute our work force planning but these have largely been ignored year upon year’ . Twenty four percent (24%) survey respondents indicated that their NHS Board has a Healthcare Science (HCS) Workforce Plan. Thirty six (36%) of survey respondents indicated that their NHS Board had no HCS Workforce Plan; with forty percent (40%) of survey respondents indicating that they did not know if their NHS Board has a HCS Workforce Plan. Finally, in relation to Workforce Planning, fifty percent (50%) of survey respondents were aware of resources to help develop a HCS Workforce Plan.


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3.5 Current education and training for Support Workers and Assistant Practitioners Figure 3.11 shows the extent to which the current education and training for staff working in NHS Career Framework levels 2-4 leads to a formal accredited qualification. For both Support Worker and Senior Support Worker staff, the number of respondents indicating that these staff will gain a formal accredited was less than those indicating that no formal accredited qualification would be gained. For Support Worker staff seven (7) respondents indicated that this group of staff would gain a formal accredited qualification compared to ten (10) respondents who indicated that no formal accredited qualification would be gained. For Senior Support Worker staff the number of respondents indicating a formal qualification would or would not be gained was five (5) and ten (10) respectively. For Assistant Practitioners, the majority of survey respondents (15) indicated that this question was not applicable to them, which correlates with low numbers of Assistant Practitioners being employed in NHS Boards. Only two (2) respondents indicated that Assistant Practitioner education and training would lead to a formal accredited qualification. The main formal accredited qualification being studied by Support Workers are Scottish Vocational Qualifications (SVQs) at Level 2 / 3 (no specific information was given on which SVQs are being studied by Support Workers). Some are also following a part-time route for a BSc in Biomedical Science. Senior Support Workers are studying SVQs at Level 3; Laboratory and Associated Technical Activities (LATA) was specifically mentioned. The part-time route to a BSc in Biomedical Science was listed by one respondent as was A1, an assessment qualification (Assess Candidates using a range of methods). The formal accredited qualifications listed as being studied by Assistant Practitioners are the Cervical Cytology Certificate of Competence and Higher National Certificate (HNC).


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Figure 3.11: Education and training staff of support staff leading to a formal accredited qualification

Figure 3.12 shows the workplace-based delivery of qualifications for Support Worker and Senior Support Worker staff is the greatest according to survey respondents; eight (8) and nine (9) respectively. Day release at College is also used for the delivery of formal qualifications for Support Workers and Senior Support Workers, with six (6) and four (4) respondents indicating this mode, respectively. One respondent indicated that Assistant Practitioners undertake day release at College, along with workplace- based training; this correlates to Cytology Screeners attending the Cytology Training School in Edinburgh, followed by 5000 smears under supervision in the workplace. A small number of respondents indicated that Support Workers and Assistant Practitioners use distance or e-learning as a mode for delivery of formal qualifications. Finally, nine (9) respondents indicated that this question was not applicable to them with respect to the delivery of formal qualifications for Assistant Practitioners, again this correlates with low numbers of Assistant Practitioners working across the Life Science disciplines in NHS Scotland. Adam Smith College in Kirkcaldy and Forth Valley College in Falkirk are heavily involved in the delivery of formal accredited qualifications for Support Worker staff, both of these Further Education Colleges were listed by six respondents. Additionally, Lothian and Stow Colleges, along with Glasgow Caledonian University were listed once by respondents.


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Figure 3.12: Delivery of qualifications for Support Worker and Assistant Practitioner Staff

3.8 Future education and training requirements of Support Workers and Assistant Practitioners Figure 3.13 indicates survey respondent attitudes to where Support Worker formal education and training would be most appropriately delivered. Ninety two percent (92%) of respondents agreed or strongly agreed that formal education and training for Support Workers would be more appropriately delivered in the workplace, when compared to day release at College. Sixty three percent (63%) of respondents agreed or strongly agreed that e-learning / distance may be appropriate to the delivery of education and training for support workers, while twenty five percent (25%) were neutral in this regard.


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Figure 3.13: Attitudinal data indicating where Support Worker formal education and training would be most appropriately delivered

The workplace setting is also that preferred for the delivery of education and training for Senior Support Workers (with 40% and 50% of respondents agreeing or strongly agreeing with this setting, respectively); compared to day release at College (with 35% and 14% agreeing or strongly agreeing with this setting, respectively). Distance and e-learning may also be an option for the delivery of education and training of Senior Support Workers with thirty eight percent (38%) agreeing and twenty eight percent (28%) strongly agreeing that this may be appropriate to delivery of Senior Support Worker education and training; thirty four (34%) of respondents were neutral in this regard (Figure 3.14).


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Figure 3.14: Attitudinal data indicating where Senior Support Worker formal education and training would be most appropriately delivered

Interestingly, survey respondent attitudinal data for appropriate delivery for formal education and training of Assistant Practitioners indicated that eighty eight percent (88%) of the respondents in total agreed or strongly agreed that distance / e-learning was appropriate for the delivery of Assistant Practitioner education and training. High preferences were also indicated for the other modes of delivery for this group of staff, with seventy eight percent (78%) and seventy two percent (72%) of total respondents agreeing or strongly agreeing that the workplace and College setting respectively, could be used for delivery of Assistant Practitioner education and training (Figure 3.15). Figure 3.15: Attitudinal data indicating where Assistant Practitioner formal education and training would be most appropriately delivered


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Ten (10) survey respondents (48%) indicated a preference for twilight session release (2-7pm) as a format for formal delivery of education and training at a local Further Education College. Six (6) respondents indicated a preference for whole day release, three (3) indicated a preference for morning session release and two (2) indicated blocks of day release to College. Twenty two (22) respondents (92%) indicated they agreed or strongly agreed that the workplace was an appropriate setting in which underpinning knowledge and practical skills could be delivered to Support staff (Figure 3.16). Figure 3.16: Attitudinal data indicating appropriateness of work-place based learning being used to

deliver; underpinning knowledge only, practical skills only or both

However, sixteen respondents (16) (88%) agreed or strongly agreed that Further Education Colleges could be used to deliver underpinning knowledge only. Five (5) respondents disagreed that Colleges could be used to deliver practical skills only and a further four (4) respondents were neutral in this regard. Nine (9) respondents in total agreed or strongly agreed that Further Education Colleges could deliver both underpinning knowledge and practical skills as part of Support Worker and Assistant Practitioner education and training (Figure 3.17).


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Figure 3.17: Attitudinal data indicating appropriateness of Further Education Colleges being used to deliver; underpinning knowledge only, practical skills only or both

Figure 3.18 indicates the type of qualification that survey respondents feel would be most appropriate for the needs of Support Workers. Sixty eight percent (68%) of the total survey respondents agreed or strongly agreed that a SVQ 2 (SCQF level 5) would be most appropriate for the educational needs of support workers, compared with forty one percent (41%) of the total survey respondents who considered an SVQ 3 (SCQF level 6) to be appropriate for this group of staff. Twenty seven percent (27%) of the total survey respondents disagreed that an SVQ 3 was appropriate for Support Workers. Figure 3.18: Attitudinal data indicating the type of qualification most suited for the needs of Support Workers


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Eighty percent (80%) of the total survey respondents agreed or strongly agreed that an SVQ 3 (SCQF level 7) was appropriate to the educational needs of Senior Support Workers, compared to fifty percent (50%) agreeing or strongly agreeing that a Higher National Certificate (HNC) (SCQF level 7) was appropriate for this group of staff (Figure 3.19). Figure 3.19: Attitudinal data indicating the type of qualification which would be most suited for the needs of Senior Support Workers

Seventy seven (77%) and seventy four percent (74%) of total survey respondents agreed or strongly agreed that an SVQ level 4 (SCQF level 8) or a Higher National Diploma (HND) would be most appropriate, respectively for the education needs of Assistant Practitioners (Figure 3.20).


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Figure 3.20: Attitudinal data indicating the type of qualification which would be most suited for the needs of Assistant Practitioners

Between five and twenty percent (5-20%) of total survey respondents indicated that they did not know what level of qualification was appropriate for the education needs of Support Workers and Assistant Practitioners (Figures 3.18 - 3.20). Free text comments relating to gaps in formal accredited education provision for Support Workers and Assistant Practitioners revealed three common themes: the gap between vocational qualifications and BMS degrees, delivery for Remote and Rural areas and provision of underpinning knowledge to support the practical skills already gained in the laboratory.

3.7. Future plans With regard to combined Support Worker and /or Assistant Practitioner roles across the Life Science disciplines, eight respondents (8) indicated combined roles are planned across Biochemistry and Haematology disciplines. One respondent indicated that combined roles across the other Healthcare Science strands are planned

‘Yes - within the diagnostics field primarily to cover basic duties between administration, simple equipment maintenance & testing’ . This role development is within the Remote and Rural context.


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Finally, nine respondents (9) indicated new members of Support Worker and / or Assistant Practitioner staff would meet induction standards and codes from December 2010 through corporate and local induction. Eleven (11) respondents indicated that no provision had been made to meet these induction standards and codes. 4.4.4.4. DiscussionDiscussionDiscussionDiscussion The aim of the research was to establish an evidence base of and for educational developments for Healthcare Science Support Workers and Assistant Practitioners in NHS Life Science disciplines. The survey covered six areas: the role of the Support Worker and Assistant Practitioner in the Life Sciences, numbers of Support Worker and Assistant Practitioner staff, Workforce Planning, current education and training for Support Workers and Assistant Practitioners, future education and training for Support Workers and Assistant Practitioners and future plans. Consequently, the views of laboratory managers and training leads in the major Life Science disciplines in the NHS in Scotland were sought via an online survey. The evidence base generated from the HCS SW and AP survey in the NHS Life Sciences will be the foundation for the work of the NHS Life Sciences: Healthcare Science Support Worker and Assistant Practitioner Education and Training Group which has been convened by NES HCS. 4.1 The Role of the support Worker and Assistant Practitioner in the Life Sciences The Support Worker and Senior Support Worker roles as described by NHS Career Framework levels 2 and 3, respectively, are covered by a number of job titles. Common to both the Support Worker and Senior Support Worker role are the job titles of Medical Laboratory Assistant and Biomedical Support Workers, with a number of other ad-hoc job titles being associated with these job roles. Assistant Practitioners as described by NHS Career Framework level 4 is the job title used in two NHS Boards, whereas the job title of Associate Practitioner is used in four NHS Boards.


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Over three quarters (76%) of survey respondents indicated that they have no job description for the Assistant Practitioner role. The agreement of a set of role descriptors / parameters and job titles for Healthcare Science Support Workers and Assistant Practitioners may help to give clarity and consistency across NHS Life Sciences through the development of a set of common job descriptions and associated KSF these roles in the Life Sciences (which can be contextualised according to Life Science discipline if required). Role parameters for Healthcare Support Workers, Senior Support Workers and Assistant Practitioners are documented in the NES publication: A Guide to Healthcare Support Worker Education and Role Development6 and should provide a useful starting point for role development of the Assistant Practitioner in the Life Sciences. Indeed, the development of a common job description (using National Occupational Standards, if appropriate) and KSF outline for the Assistant / Associate Practitioner role in the Life Sciences may be a useful starting point for the work of the NHS Life Sciences group, as over 75% of NHS Boards have no job description and KSF outline for this role. 4.2 Numbers of Support Worker and Assistant Practitioner Staff Over half (55%) of survey respondents indicated they anticipate the number of staff working at NHS Career Framework levels 2-4 will increase in the next 5 years. The number of current Support and Senior Support Worker staff working towards an accredited qualification is very low compared to the total. The low numbers of Support Staff currently working towards an accredited qualification may be a reflection that NHS Boards, for a number of years, have struggled to develop this group of staff.

6 NHS Education for Scotland. A Guide to Health Care Support Worker Education and Role Development. Edinburgh: NHS Education for Scotland, revised 2010.


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However, the advent of Scottish7 and UK8 Healthcare Science policy to underpin the education and training of Healthcare Science Support staff, along with a national focus for the education, training and on-going professional development for Healthcare Science staff working within NHS Scotland through NES HCS may facilitate and support NHS Boards to take educational developments for this group of staff forward using a nationally consistent approach. Indeed, the establishment of the NES NHS Life Sciences: HCS SW and AP Education and Training group is seen as the first step in this process. The work of this group will build on the educational developments that some NHS Boards have taken forward locally up until this point9 Interest in the educational development of Support and Assistant Practitioner staff by NHS Boards may also reflect the advances in technology, particularly automation and this is stimulating Laboratory Managers to look at the skill mix in their laboratories for delivery of an effective and efficient service for their users. Also, as identified by a number of survey respondents, the current financial constraints in NHS Boards are encouraging Laboratory Managers to evaluate whether a vacant Biomedical Scientist posts should be replaced like with like or whether an opportunity exists for these posts to be replaced with a Support Worker or Assistant Practitioner role and for BMS roles to be developed further. 4.3 Workforce Planning The survey of NHS Life Science Laboratory Managers and Training Leads indicated that fifty six percent (56%) of respondents have a Workforce Plan for their Life Science discipline. However, a total of over seventy five percent (75%) of respondents indicated that their NHS Board doesn’ t have or they don’ t know if their NHS Board has a HCS Workforce Plan. Fifty percent (50%) of survey respondents were aware of resources to develop a Workforce Plan.

7 The Scottish Government. Safe, Accurate and Effective: An Action Plan for Healthcare Science in NHS Scotland. Edinburgh: The Scottish Government, 2007. 8 UK Health Departments. Modernising Scientific Careers: The UK Way Forward. London: The Department of Health, 2010. 9 http://www.nes.scot.nhs.uk/disciplines/healthcare-science/advisory-group/meeting-on-031209/research-and-development-officer-mla_ap-developments Accessed 18th August 2010.


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It is suggested that all strands within Healthcare Science (Life, Physiological and Physical Sciences) need to get better at Workforce Planning to ensure that as far as possible and practicable, the right skill mix of staff is achieved for the optimum delivery of service and that staff are appropriately educated and trained to undertake their job of work safely and effectively. It is essential that any educational developments for all groups of Healthcare Science staff, including support staff are considered in the context of Workforce Planning. It is pointless to spend considerable amounts of time and effort on educational development for staff, if in the future; they are unable to move into positions that will utilise their education and training. As well as considering the future supply for the laboratory workforce, demand also needs to be looked at and this can start to be achieved through more formal Workforce Planning. A considerable number of resources exist to support Workforce Planning with www.workforceplanning.scot.nhs.uk being an excellent place to start. 4.4 Current education and training for Support Workers and Assistant Practitioners Some excellent educational developments for Support Worker and Senior Support Worker staff have been undertaken at the local NHS Board level10. Most staff are working towards an SVQ 2 or 3; these vocational qualifications are embedded in the Modern Apprenticeship frameworks in Life Sciences at Levels 2 and 3 developed by the Sector Skills Council for Science, Engineering and Manufacturing Technologies (SEMTA). Most learning is taking place in the workplace. Use of the Life Sciences Modern Apprenticeship framework in the NHS would appear to indicate that this is considered fit for purpose in terms providing the correct balance of underpinning knowledge and practical skills for Support and Senior Support Worker roles in the Life Sciences in NHS Scotland. 10 http://www.nes.scot.nhs.uk/disciplines/healthcare-science/advisory-group/meeting-on-031209/research-and-development-officer-mla_ap-developments Accessed 18th August 2010


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Currently, very low levels formal accredited education are being followed by Assistant Practitioners in NHS Scotland and this correlates to the only three APs being employed in this role (excluding Cytoscreeners). Educational developments to support this group of staff could be an area of initial focus for the NHS Life Sciences group. 4.5 Future education and training requirements of Support Workers and Assistant Practitioners A range of attitudinal data was collected from laboratory managers and training leads in the major Life Science disciplines in the NHS in Scotland with respect to future education and training for Support Workers and Assistant Practitioners. More than ninety percent (90%) of respondents agreed or strongly agreed that future formal education and training for Support and Senior Support Workers would be more appropriately delivered in the workplace, when compared to day release at College. Almost two thirds of survey respondents indicated that Support and Senior Support Worker education and training may be delivered via e-learning / distance learning. In terms of delivery of future education and training for Assistant Practitioners, over three quarters of survey respondents agreed or strongly agreed that this educational provision could be delivered in the workplace, at College or by e-learning / distance learning. Almost half (48%) indicated a preference for educational provision by Colleges to be in a twilight session format. It was considered that education provision by Colleges for Support Worker and Assistant Practitioner staff was more likely to cover underpinning knowledge rather than practical skills. It is important that this attitudinal data is shared with Further Education College partners to ensure ‘ fit for purpose’ education for Support Workers and Assistant Practitioners working in the NHS Life Sciences. The development and subsequent delivery of e-learning for Support Workers and Assistant Practitioners may present a solution for access to accredited qualifications for small numbers of staff working in Remote and Rural locations. This delivery solution could also be combined with other methods where there may be difficulties releasing staff from the workplace.


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Sixty eight percent (68%) of the total survey respondents agreed or strongly agreed that a SVQ 2 (SCQF level 5) would be most appropriate for the educational needs of support workers, compared with forty one percent (41%) of the total survey respondents who considered an SVQ 3 (SCQF level 6) to be appropriate for this group of staff. Twenty seven percent (27%) of the total survey respondents disagreed that an SVQ 3 was appropriate for Support Workers. This is an interesting response, as nationally agreed educational requirements for Support Workers have been bench marked to SCQF level 6, rather than SCQF level 511. To aid consistent application of the national guidance for Support Worker education, it may be that a stepwise approach has to be taken to the education of Support Workers so they finally attain a formal qualification at the correct SCQF level, this could also be taken forward by the NES NHS Life Sciences group. Survey respondents agree or strongly agree that Senior Support Worker and Assistant Practitioner education and training should be benchmarked to SCQF levels 7 and 8, respectively and this agrees with the national guidance as mentioned above. Employers will decide which type of qualification will most suit their needs in terms of what needs to be covered i.e. underpinning knowledge and / or practical skills and it would be prudent for this work to be undertaken in partnership with local Further Education Colleges. SEMTA have indicated an intention to expand the Modern Apprenticeship framework to include Level 4 and if NHS Life Science laboratories feel that this would be a useful educational development, this could also be taken forward in partnership with SEMTA. In relation to the delivery of work-place based training it may be beneficial for members of the NES NHS Life Sciences group to explore SCQF credit rating of their current lab-based training. 4.6 Future plans Approximately a third of survey respondents indicated an intention for combined Support Worker and Assistant Practitioner roles in the Haematology and Biochemistry disciplines. A combined Support Worker role is planned across the Healthcare Science ‘strands’ in the Remote and Rural context.

11 NHS Education for Scotland. A Guide to Health Care Support Worker Education and Role Development. Edinburgh: NHS Education for Scotland, revised 2010.


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More than half of survey respondents indicated that no provision has been made to meet the mandatory induction standards and codes which new Support Worker and Assistant Practitioner staff will be required to meet from December 2010. NES is supporting NHS Boards in this regard via the Healthcare Support Worker toolkit12; as well as providing current information, resources and ideas to meet the induction standards and codes. Healthcare Support Worker roles, learning and development and policy are also covered. 5.5.5.5. ConclusionsConclusionsConclusionsConclusions As a result of surveying laboratory managers / training leads in the Life Sciences in NHS Scotland the following conclusions are made.

� Support Worker and Senior Support Worker roles as described by NHS Career Framework levels 2 and 3, respectively are covered by a number of job titles. Medical Laboratory Assistant (MLA) and Biomedical Support Worker are common to both of these NHS career framework descriptors

� Assistant Practitioners as described by NHS Career Framework level 4 are also

known as Associate Practitioners

� Over three quarters (76%) of survey respondents indicated that they have no job description for the Assistant Practitioner role

� Over half (55%) of survey respondents indicated that the number of staff working

at NHS Career framework levels 2-4 will increase in the next 5 years.

� The number Support Worker and Senior Support Worker staff currently working towards an accredited qualification is very low compared to the total (6% of WTE posts in a number of selected NHS Boards)

� Over 75% of survey respondents indicated that their NHS Board doesn’ t have or

they don’ t know if their NHS Board has a HCS Workforce Plan

12 http://www.hcswtoolkit.nes.scot.nhs.uk/ accessed 18th August 2010.


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� Most of the current learning of Support and Senior Support Workers is taking

place in the workplace and is associated with the Life Sciences Modern Apprenticeship frameworks at levels 2 and 3

� More than 90% of survey respondents agreed or strongly agreed that future

formal education and training for Support and Senior Support Workers would be more appropriately delivered in the workplace, when compared to day release at College

� Almost two thirds of survey respondents indicated that Support and Senior

Support Worker education and training could be delivered by e-learning / distance learning

� Over 75% of survey respondents agreed or strongly agreed that future education

and training for Assistant Practitioners could be delivered in the workplace, at College or by e-learning / distance.

� Almost half of respondents (48%) indicated a preference for educational

provision by Colleges to be in a twilight session format

� Education provision by Colleges for Support Staff and Assistant Practitioners was more likely to cover underpinning knowledge rather than practical skills.

Documents

Healthcare Science (HCS) Healthcare Science (HCS) … · 3.6 Future education and training requirements of Support Workers ... HCS SW AP – NHS Life ... Laboratory Ancillary Worker,