1. Business Case for PTP Training in Clinical Engineering Mike Cox Emma Bowers and Regional Clinical Engineering Departments

2. Structure Background What is Clinical Engineering? Clinical Engineering in the NE Clinical Engineering & Accredited Voluntary Registration Accredited Voluntary Registration and Accredited Service Provision Past ‘PTP’ Current PTP Career Pathways Future PTP The Problem Possible Actions Preferred Option

3. Background Based on: 15 year Strategic Plans MSC the UK way forward Francis Report NHS Business Plan 2014/15-2016/17 Regional Clinical Engineering Meeting 11 th November 2015

4. What is Clinical Engineering? Within Modernising Scientific Careers the PTP specialisms are: –Medical Engineering –Renal Technology –Rehabilitation Engineering –Radiation Engineering

5. Rehabilitation Engineering * Radiation Engineering Renal Technology Medical Engineering Clinical Engineering in the North East *Note, Regional Service All staff employed by NuTH Satellite centres based in: James Cook University Hospital (South Tees) University Hospital of North Durham (Durham and Darlington) Cumberland Infirmary in Carlisle (Cumbria). Trust NuTH South Tees Cumbria Northumbria Sunderland Durham & Darlington South Tyneside North Tees & Hartlepool Gateshead

6. Clinical Engineering and Accredited Voluntary Registration Practitioners within Clinical Engineering make decisions that can affect patients’ health, safety and welfare. The public need to be assured that these individuals have been fully trained and assessed, and that their skills are regularly updated. Formed in 2000 Formerly the VRTC Requires an undergraduate degree Formed in 2014 Known as the Accredited Voluntary Register for Practitioners Two routes: 1)Completion of accredited PTP programme 2)Equivalence

7. Accredited Voluntary Registration and Accredited Service Provision Three Healthcare Science service accreditations schemes currently approved by United Kingdom Accreditation Service (UKAS) –Clinical Pathology Accreditation (CPA) –Diagnostic Imaging Services Accreditation Scheme (ISAS) –Improving Quality in Physiological Services (IQIPS) Approved for use within the CQC hospital inspection methodology Expecting iCEPSS to imminently be approved by UKAS. All accreditation schemes expect: “There are systems in place to check that qualifications and professional registration of relevant staff are up-to-date”

8. Past ‘PTP’ Career Pathway Before MSC: –Practitioners in Clinical Engineering were referred to: Medical Technologists Medical Engineers –Individuals would often enter the profession via the Advanced Apprenticeship route: 4 years working Gain a level 4 qualification (between A’ level and foundation degree) –The profession valued the Advanced Apprenticeship route as it gave individuals the practical skills necessary to perform the job. Now a clearer career framework, increasingly difficult to defend people working at Practitioner level without a degree or equivalent experience - unable to become part of a regulated workforce.

9. Current PTP Career Pathway 2 accredited PTP Clinical Engineering courses –Bradford University Offers all four specialisms 10 PTP trainees per year Last cohort 2015 –Middlesex University Offers two specialisms (Medical Engineering and Rehabilitation Engineering) 6 PTP trainees (2014 cohort – first cohort) 10 PTP trainees (2015 cohort) Neither offer P/T or distance learning options (unsuitable for in-service PTP trainees based in the NE) Graduates from Bradford course have remained in YH and NW Graduates from Middlesex course anticipated to remain in London area

10. Future PTP Career Pathway University of the West of England (UWE) Intends to provide a distance learning PTP course in Clinical Engineering (all specialisms) For in-service trainees only Complements its existing distance learning PTP courses in Life Sciences 1 st cohort to start in October 2016 Will expect students to: –Spend a day a week within work time studying –An evening a week outside work studying –Majority of the work-based placements will be covered through day-to-day working within the department Very flexible Good APEL policy Awaiting accreditation from the NSHCS Awaiting for registration as part of higher apprenticeship programme (eg if employer pays fees, they are cheaper)

11. Identified 12 individuals across the region who are in this position Those who were appointed a long time ago: –now gained enough experience to get registered through the equivalence route with AHCS Those who are recently appointed: –cannot currently get registration as they neither have a degree or enough experience Those who will be appointed in the future: –will be expected to complete the PTP programme after completion of the Advanced Apprentice programme –Advanced Apprenticeship programme to be adapted so that individuals can go straight on to 2 nd year of PTP programme –Individuals likely to be appointed at band 5 annex U, on completion of Advanced Apprenticeship (salary difference will pay for fees for PTP programme) –will become registered with AHCS on completion of PTP course The Problem In Clinical Engineering a number of people are in Practitioner posts without degree qualifications (as until now, no suitable degree available)

12. Possible Actions (1) Do Nothing Advantages –Investment saving –On-the-job experience will ultimately result in individuals being able to apply for voluntary registration via the equivalence route Disadvantages –Clinical Engineering services unable to become accredited until 2023-2025 –Not realistic –Morale of staff decrease/loss of staff Cost –None Timescale –8-10 years

13. Possible Actions (2) Employ Graduates from the Existing PTP degree courses Advantages –Will result in Registered Practitioners working within the Clinical Engineering services –Clinical Engineering Services in the North East will be able to become accredited immediately Disadvantages –Will have to get rid of existing unregistered workforce –Not realistic –Morale of remaining staff low –Very few graduates available Cost –Redundancy payment for unregistered staff –Recruitment costs for new staff –Legal costs for contravening employment law Timescale –Immediate

14. Possible Actions (3) Enrol employees to complete the PTP qualification via the full time degree course at Middlesex University Advantages –Existing accredited course –Employees get on to the Voluntary Register within 3 years –Clinical Engineering Services in the North East will be able to become accredited 2019-2020 –Can include caveats in contract for retention Disadvantages –50 fixed weeks over a three year period where individuals have to attend Middlesex University –UCAS application required –Not part of an apprenticeship programme so course fees are £9000 per year –Unable to train Renal Technologists and Radiation Engineers –Requires Trust/HENE funding and approval for course fees, salary, accommodation & travel Cost –Total HENE investment = £558,000 (course fees/expenses) –Total Trusts investment = £1,583,490 (loss of work from employees as studying) Timescale –3-4 years

15. Possible Actions (4) Enrol employees to complete the PTP qualification via a distance learning degree course at UWE Advantages: –Each applicant is considered individually to determine APEL –Aiming to secure course as part of Higher Apprenticeship Programme therefore cost per year would be £1850 –Only requires ~1 month over a 3 year period during which individuals are to attend UWE –Distance learning is very flexible –All specialisms taught –University engaging employers, to ensure curriculum is relevant and appropriate –Can include caveats in contract for retention Disadvantages: –Not currently an accredited course –Not currently part of Higher Apprenticeship Programme –Requires Trust/HENE funding and approval for course fees, salary, accommodation & travel Cost: –Total HENE investment = £114,600 (course fees/expenses) –Total Trusts investment = £269,898 (loss of work from employees as studying) Timescales: –3 to 4 years

16. Preferred option The Clinical Engineering community prefer Possible Action (4): “Enrol employees to complete the PTP qualification via a distance learning degree course at UWE” Reasons: –offers best value for money –will start to encourage a change in culture within Clinical Engineering workforce: Recognition of importance of bachelor degree Recognition of importance of registration –proactive step in readiness for introduction of iCEPSS Actions by Clinical Engineering workforce: –will encourage experienced members to gain registration through equivalence –will start to work towards gaining iCEPSS accreditation for their service

17. Asks that the subgroup: supports this business case so that it can go to the Partnership Council.