SQAS London CST and Screening Technician Workshop10 November 2016-CST Survey Results Beverley Annan, QA Officer and Modupe Omonijo, Senior QA Advisor, SQAS (London)

Public Health England leads the NHS Screening Programmes

Introduction• Screening Quality Assurance Service (SQAS), London asked London AAA

Clinical Skills Trainers (CSTs) and Ultrasound leads to complete an online survey using a PHE survey tool.

• Purpose:

To obtain their views in order to inform a review of current service delivery models

To support the identification of areas for improvement

To contribute to the development of a consistent London-wide CST role delivery framework

2 Results from CST Survey 2016

Data Collection• Participants identified using National SQAS contacts database

• Questions were based and grouped around areas of the Clinical Skills Trainers (CSTs) role; QA image review, accreditation and training, equipment checks

• Mixture of open/closed ended questions

• Survey emailed to 11 participants (9 CSTs and 2 Ultrasound Leads)

• 100% survey response rate, however response rate per question varied (some questions were skipped or unanswered )

• Suspected reasons for variable response rate could be the lack of flexibility with survey; ambiguity of some questions or reluctance to provide information

3 Results from CST Survey 2016

Summary of survey findings

4 Results from CST Survey 2016

Job descriptions

6 out of 9 have no job plan

Job plans

Contract type

“Originally contracted 2 days

per calendar month. Now with new IQA 4 days

per month “ (comment)

Job description/sessional commitment

2 did not respond

6 out of 8 have no

job description

3 did not respond

Summary of survey findings

5 Results from CST Survey 2016

“Ad hoc. Weekly response to

workload demand. Work allocated

through ultrasound lead.”

“Trying to put one in place and it is

dependent on the staffing levels in the

vascular lab. At present, I am available to go to clinic when needed to check on scans. The

QAs are done during the day in between vascular

lab duties.”

“We support QA clinics as required by NAAASP with

three CSTs. Clinical lead books in CST for QA clinics but

some CSTs may do more than others.”

4 out of 8respondents

have ring-fenced

sessional commitment

WTE ranged from half a

day to ad hoc commitment

Job description/Sessional commitment

Summary of survey findings

6 Results from CST Survey 2016

I have done 1 feedback this year

to all screeners and I am working on

doing this every 3-6 months (however I am limited on time)

After each review, feedback is given to head of department

and then passed on to head of

screening

Once a month I check on a

daily basis

QA image review

Variation in frequency of image review and feedback of outcomes

9 = average normal scans

randomly selected each

month

Summary of survey findingsAccreditation and Training

• 7 respondents were accredited between 2010 and 2015

• Some are waiting to go on new accreditation process

7 Results from CST Survey 2016

6 out of 7respondents have the time to attend CPD

events and training

4 did not respond

Summary of survey findings Screening Technician Training

• Responses indicate variations in training and clinic observation of screening technicians

8 Results from CST Survey 2016

5 out of 6 respondents

spend between 1-5 hours attending

clinics with screeners

I am not involved with training (don't have the capacity)

I check images or re-scan aortas to compare

measurements and enter the data in their logbook. I also try to observe them

scanning so as give feedback, particularly in

aortas that are more complicated

5 did not respond

Observation and in-house assessments in

addition to training programme. CSTs observe in rotation

and provide feedback

Summary of survey findings Equipment Checks

9 Results from CST Survey 2016

We have recently started to do

equipment checks following the

guidelines provided

External safety checks (visual examination of wires/cables,

machine casing, transducer/probe casing and probe

surface for cracks, holes

Monthly phantom checks according

to NAAASP protocols

5 out of 6 respondents have SOPs to

guide equipment

checks

4 out of 7 respondents are routinely

checking equipment

Summary of survey findingsMonitoring workload

10 Results from CST Survey 2016

“Ultrasound lead monitors workload

through Northgate and allocated excess QA requests to CSTs if

needed”

“Difficult to say as ad hoc hours”

“Done by the manager”

“I keep a personal log. the CSTs also laisse with the

clinical lead so as to make sure commitments are

equally shared”

“Record hours spent working on or actively scanning in the AAA

program... Time spent working on all aspects of

training including developing assessment

plans and writing up assessments, and my

own assessments tasks for becoming a formal

assessor”

“I don't monitor workload”

Summary of survey findingsMonitoring non-visualised images

• Monitoring of non-visualised images varies

11 Results from CST Survey 2016

I am not involved with

this…AAA screening

manager does this, not sure

This is something we are looking

into

I write feedback for all screeners within the QA worklist…

any recurring pattern of non-vis patients coming from a screener

would be noticed

Done by the managerOngoing concern

in programme…fed back to

technicians at team meetings

Discussion• The role of the CST is key to delivering a safe and high quality screening

programme

• Our survey respondents provided comments which were very helpful to obtain an in-depth knowledge of the issues or challenges faced by these key professionals

• We would recommend more work and closer engagement with CSTs and ultrasound leads to:

o increase awareness of the significance of their roleo standardise ways of working across London in line with national

guidance (allow local variation if required)o support their continuous professional development and peer learningo facilitate their interactions with other screening stakeholders particularly

screening technicians

12 Results from CST Survey 2016