Healthcare Science - Update
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Introduction
This paper is intended to inform the Board about the current activity of the NES Healthcare
Science work stream. It includes a description of a new and extended role to address quality
management obligations; a forward look at Scottish Government’s new Delivery Plan for
Healthcare Science (May-June 2015); and it highlights an emerging risk concerning Higher
Specialist Scientific Training in Scotland.
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Background
2.1 Healthcare Science at NES commissions clinical scientist supernumerary trainees (20 pa)
on three year programmes and supports other staff at postgraduate level totalling about 150
trainees. We also support some NHS undergraduate trainees in clinical physiology and clinical
technology. We cover laboratory sciences, medical physics and clinical physiology services.
The Healthcare Science workforce is about 5% of the NHS Scotland workforce, but considered
the fourth largest clinical group and estimated by Government to contribute to 80% of all
diagnostics and treatments. We run national events for the HCS community and specifically
postgraduates.
2.2 We also offer face-to face learning via the NES Training Development and Support Unit
that is absolutely vital to our presence and engagement with the workforce. These short
courses on leadership, early career and train the trainer have been instrumental in establishing
healthcare science networks and are generally over-subscribed. We engage with Scottish
Government and UK-level agencies to ensure the interests of NHS Scotland are secured –
particularly as we are moving from a transition period begun 5 years ago with the introduction of
new training curricula.
Figure 1 illustrates the Healthcare Science workforce and career framework.
Figure 1
The Healthcare Science Workforce
Approximately 45 specialties, in 3 divisions, 5% NHS workforce, 4th largest
clinical group and present in 80% of patient episodes.
Life Sciences
Clinical Physiology
Physical Sciences
(Laboratory
diagnostics...)
(Cardiac physiology,
Audiology,
Neurophysiology....)
Medical Physics
Clinical engineering...
Higher Specialist / Consultant Clinical Scientist
PhD / Royal
College Fellow
Postgraduate Scientist including Clinical Scientists, Advanced/Specialist
Biomedical Scientists and Clinical Physiologists
MSc
Healthcare Science Practitioner including Biomedical Scientists, Clinical
Physiologists, Clinical Technologists
BSc
Healthcare Science Assistants / Support Staff
HN / SVQ
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Developments in Healthcare Science and the implications for NES
3.1 Since 2010, Modernising Scientific Careers, a UK-level project for healthcare science
training, has introduced new curricula at all career-levels – but particularly for postgraduates
undertaking the NHS Scientist Training Programme (STP). A deanery-like agency, the National
School for Healthcare Science has been established in England to recruit and then monitor
these STP trainees throughout their masters-level three-year development. STP Curricula are
arranged in ‘themes’ (blood sciences, genetics, neurosensory sciences and so on), with
trainees undertaking specialty rotations to give a broad scientific appreciation of their theme
before committing to a particular specialty (biochemistry, radiotherapy physics, cardiac
physiology and so on). There is also a suite of corresponding doctoral-level curricula for
consultant clinical scientist-level training termed Higher Specialist Scientific Training (HSST)
which is backed by medical royal colleges and leads to fellowship of the associated royal
college.
3.2 NES Healthcare Science has worked closely with the School and the Academy for
Healthcare Science to define our respective roles in regard to training in Scotland. The
Academy issues completion of training certification that allows HCPC registration as a Clinical
Scientist; we have also secured a pathway for ‘equivalence’ recognition by the Academy for
those scientists who have not undertaken STP training and who may wish also to register as
Clinical Scientists. This pathway is available for any UK candidate but was in-part driven by us
in response to specific needs in Scotland.
3.3 STP trainees in Scotland are included in the National School’s remit in terms of monitoring
progression, use of the On-line Learning and Assessment Tool, and Observed Structured
Final Assessments. However, Scottish recruitment and practice placement monitoring is a
matter for NES. This monitoring forms the basis of new and essential activity.
3.4 Without a credible and robust quality management system for trainee admissions and
practice placement, STP trainees in Scotland will not be able to register as Clinical Scientists
with the regulator – irrespective of individual merit. Therefore, to ensure appropriate quality
management of postgraduate trainees NES Healthcare Science will be taking a new role in
terms of ensuring our admissions standard applies to postgraduate scientist trainees and that
workplace practice placement is a consistent and high standard. Both these standards are
traceable to HCPC Standards of Education and Training. Our approach to quality
management borrows from that of the medical directorate and NMAHP directorate’s practice
placement toolkit. Figure 2 illustrates the relationship between quality management
arrangements for postgraduates in Scotland and in England.
3.5 We are recruiting specialty leads on a sessional basis to assist with this new quality
management role. The appointees will also boost our workforce intelligence.
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Figure 2 Healthcare Science Postgraduate Quality Management
The Health and Care Professions Council
The Academy for Healthcare Science
Acts as UK ‘STP education provider’ for HCPC. AHCS
issues completion of training certification .
SCOTLAND: NES Healthcare
Science
Postgraduate Scientist trainee
community includes STP trainees
and others in postgraduate
development in receipt of
competitive NES support
NES Recruits STPs in Scotland and
does QM of practice placement
ENGLAND: The National School for Healthcare Science
(NSHCS)
Postgraduate trainee community is STP trainees only
NSHCS Recruits STPs in England and does
QM of practice placement
NSHCS Monitors / examines individual
trainees on STP programmes (England and
Scotland)
3.6 In Scotland, our approach to postgraduate scientist development has gone beyond new
STP candidates, to include all those involved in equivalence applications, and graduateregistered staff (such as Biomedical Scientists and Clinical Physiologists) who are undertaking
postgraduate scientific development but with no intention of clinical scientist registration. We
currently support around 150 postgraduate scientist trainees ranging from those with direct
supernumerary salary support to those receiving a single bursary award: regardless of type,
they are all scientist trainees.
3.7 Departments supporting these other types of trainee, (i.e. out with STP), are not ‘obliged’
to demonstrate participation in this type of training quality management, but our soundings
strongly indicate that difficulties could arise for individuals attempting equivalence applications
from departments below our proposed threshold. Therefore, we intend to require any
department taking NES sponsorship to adhere to our quality management monitoring. We have
a plan and self-assessment template to address this need. Training leads are broadly positive
about the development.
3.8 We are in dialogue with The National School for Healthcare Science and with The
Academy for Healthcare Science about our proposed approach: they are also supportive of it
and both have given constructive advice on a way forward. We anticipate a 3-way
memorandum of understanding between the School, the Academy and NES – to clarify roles,
information sharing and response to any training deficiencies.
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The Scottish Government Delivery Plan for Healthcare Science
4.1 Separately, Scottish Government has also launched its 2015-2020 Delivery Plan for
Healthcare Science. Unlike its 2007 predecessor, this Plan has less content directly
concerning education and training. The major elements of the Delivery Plan centre on
harnessing the contribution of healthcare scientists in more senior leadership to assist Boards
meet multi-factorial challenges that straddle professional, improvement and organisation
boundaries. The Plan comprises five implementation programmes covering: Health Technology
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Management; Point of Care Testing; Demand Optimisation; Service Sustainability; and Clinical
Physiology Services.
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Higher Specialist Scientific Training
5.1 Higher Specialist Scientific Training for consultant-level clinical scientists remains a
challenge in Scotland. This training involves new curricula – backed by the medical royal
colleges and recognised as such by Fellowship awards. It intersects neatly with the Service
Sustainability programme of the National Delivery Plan. The position in England is that around
200 HSST trainees are now in training on the five-year doctoral programme. At present there is
no central resource to fund the training in Scotland. We are becoming aware of recruitment
difficulties developing in some laboratory specialities as able early career candidates decline a
move to Scotland on account of there being no HSST support. An overture to Scottish
Government has been made. Unanimous support for our plan to co-fund and manage HSST
trainees was given by the Government’s Diagnostic Steering Group in mid May 2015. We may
have a decision by the time this paper is presented to the Board.
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Recommendation(s) for Decision
The Board is recommended to note and discuss the information contained in this report.
NES
10-06-2015
RF DF
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