MODERNISING HEALTHCARE SCIENTIST CAREERS

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MODERNISING HEALTHCARE SCIENTIST CAREERS
ACUTE CARE CLINICAL PATHWAY BOARD
MICHELLE GALLIFENT
JANUARY 15, 2009
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ACUTE CARE CLINICAL PATHWAY BOARD
KEY WORK AREAS
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(No Transcript)
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STROKE SERVICES - CURRENT

• Seven hospitals in East of England have an
  Acute Stroke Unit,
• Eight have a Combined Stroke Unit.
• Four hospitals only have a Rehabilitation Unit.
  
• East of England compares poorly to other parts of
  England in terms
• of National performance in
• Availability of CT scanning
• Number of sites with Acute Stroke Units with
  the following key features

• - continuous physiological monitoring
• - access to scanning within three hours of
  admission
• - access to Brain Imaging within 24 hours
• - policy for direct admission from Emergency
  department
• - specialist ward rounds at least five times a
  week
• Acute Stroke protocols/guidelines.
• - Thrombolysis

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Workforce Development
Service Modernisation
Workforce Development
The Past
Workforce Development
The Future?
by Michelle Gallifent
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STROKE SERVICES THE FUTURE

• Since the LTTF (Looking to the Future)
  recommendations were produced
• the National Stroke Strategy has been published.
  
• This contains
• A clear set of key quality outcomes measures
  
• A clear vision about how Stroke Pathways
  might be developed.
• The vision set out states that
• people with suspected Stroke must
  immediately be transferred to
• a receiving Hospital providing Hyper Acute
  services 24/7.
• Hyper Acute Services include
• - A Stroke Triage system
• - Expert Clinical Assessment, Rapid
  Imaging and Thrombolysis
• where clinically appropriate
• - Early Assessment, Swallow Screening,
• identification of cognitive and
  perceptive problems
• - Prompt access to a high quality Stroke
  Unit.

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Issues causing delays for Thrombolysis and Hyper
Acute Care Delays in patients seeking urgent
medical attention or insidious onset (25
occur at some point in the night and dont wake
people from sleep) Fast access to scanning
particularly out-of-hours Availability of an
Acute Stroke team assessing and diagnosing
24/7 (including nursing and consultant capacity).
Staffing ratios and skill mix on Stroke
Units historically very low and hinders the
ability of Stroke Unit nurses giving drugs and
post 48 hours care.
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Healthcare Scientists Workforce Challenges and
opportunities!

• The potential for the advances in Radiology are
  crucial in taking forward
• some of the thinking outlined in future
  pathways for Stroke.
• Picture Archiving and Communications Systems
  (PACS) offering faster
• delivery, more flexible viewing of images
  from multiple terminals
• Tele-Radiology allows images to be viewed and
  reported remotely,
• second specialist opinions to be sought.
• Skill mix under the overall control of a
  Clinical Radiologist can promote
• extended Radiographer roles within the team.

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Healthcare Scientists Workforce Challenges and
opportunities! Cont.
Anaesthetics/level 3 critical care, available
24/7 Imaging, especially CT, available
24/7 Laboratory services available 24/7
Haematology, Pathology
Bio Chemistry, Blood Bank

• 24/7 Service Cover requires both additionality
  and substitution of
• Workforce
• Key areas of shortage identified for Acute Care
  Pathways
• ? Diagnostic Imaging including MRI
• ? Emergency Care Practitioners
• ? Current CPD Portfolios able to deliver to
  specialist professional groups

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• Capacity (supply) v Demand (known shortages,
  gaps)
• Lack of Diagnostic skills availability across
  the range of
• Practitioners to cover 24/7
• Lack of Pre hospital Emergency Care
  Practitioners across the
• range of disciplines to cover 24/7
• Lag time / logistics to make it happen

• What risks have been identified for the existing
  workforce?
• The existing workforce will be key to making the
  vision happen in the
• short / medium term.
• What needs to be different? Changed?
• Targeted specialist CPD to upskill current
  workforce.
• Modernisation of the delivery of Education
• Clarity around competencies not titles

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• Cross Cutting Themes
• Build Education and Training infrastructure
  within Organisations
• Ensure that there is enough capacity and
  capability within service
• to meet the new/additional clinical placement
  requirements to
• deliver the new Workforce
• Ensure the modernisation of modes of delivering
  Education to
• maximise numbers trained

• All of these changes must also be seen against
  the backcloth
• of changes in the way in which Healthcare
  Professionals will
• be educated in the future. i.e. Modernising
  Healthcare Careers

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START
Workforce Development
Person left behind Go Back 3 Spaces
You take time to make a decision Miss a turn
Pick up people Miss a turn
Delays Expected Miss a turn
Move Back 3 spaces Bus Broken Down
Obstacle in the way! Take footpath Miss 2 turns
Pick up people Miss a turn
Footpath
New route planned Miss a turn
Everyone on board Look to the future