Dear All

I know I have asked previously about the VRCT, but here's another.
Has anybody read a document "Enabling Excellence - Autonomy and Accountability for Healthcare Workers, Social Workers and Social Care Workers".
This document was presented to parliment by the secretary of state for health in February 2011.

People should take a look at page 9, point 1.15, which states:

"For Groups of staff that are currently unregulated, the first response will be not to impose national compulsory regulation, but to enable employers to take local repsonsibilty for the quality of the staff that they employ and to give a stronger voice to individual workers to speak up when they have concerns."

I thank-you

Next......

Thank you, Alan.

After thirteen years of unadulterated BS from the previous regime, it's encouraging (is it not?) to see those in charge getting a grip!

So that's it, then. As I said earlier, finito!

How do you claim the registration fee back? (Not that it applies to myself)

Be interesting to see what happens to job descriptions with the immortal phrase "membership of the VRCT is essential"...

For the past 8 years it has been a prerequisite to be a member of the VRCT if you want a job in the health board Im employed in. Having browsed through the document concerned it looks like this really is the death knell of the VRCT. Can anyone from the VRCT put some feedback on here regarding this latest news. I really do feel as if Ive thrown my money down the drain for the past 8 years.

What about the other sdections that mention agreeing with Voluntary registers.
Prehaps someone should read the document.

Actually its not finito by any means. The concept of regulation is a long and difficult one, where the primary driver is one of how much harm can be posed to the patient with respect to the role the individual has to perform.

This is in real terms a measure of the skill set. Those individuals using complex skills in enviroments that directly impact on patient care and pathways etc need some degree of competance bar / level / benchmark. Those working in equally important but lessor challenging roles that may impinge on patient care but not directly compromise it may also need some kind of bench mark agreed.

It is - I hope you will agree - not unrealistic to expect these benchmarks to be at differing levels, reflecting the degree of autonomy the role holder has.

It was in this sprit the the department of health conducted its recent review of the concepts of regulation / registration, to which the inital post in this strand refers.

The concept being that there are staff in bands 1, 2, 3, 4 type roles that by and large will be working with their work output checked in some format by a second individual . There is therefore a fair degree of certainity that any error made is likely to be picked up before it becomes serious. This is what is meant by internal employer asscessed competance and development.

The more senior roles in which staff are operating with very specfic skills and abilities, and more than likely without their work being routinely checked by some wise old gray beard, could need some form / degree of external benchmark. If you are wondering why just ask your self this question - does my trust really understand the skills and abilities that I bring to my role? Posting on this site to numerious mention clearly indicate not. Therefore in the real world how is the employer to be assured that you are actualy competant to practice? The answer is actually quite simple independant external asscessment.

The two principles mentioned above are the key elements of the modernising scientfic careers package, where employer led standards are set for low grade staff working mostly with protocol driven instruction and professional regulation being place for the higher banded posts.

I am sure that most reading this will think this is all a load of S H one T, but each and everyone one of you is a professional and should therefore welcome each and evry attempt to drive up standards and abilities I for one would welcome a system that ensures that those trained and operating in one part of the UK have the same levels of competancy and ability as those trained in other areas of the UK.

Not a load of [censored] at all, Paul (and thanks for your input).

But (and with reference to your closing paragraph) ... when is all this good stuff going to actually happen (independent assessment by external means, and all the rest)?

This whole issue has just been a Talking Shop for (insert how many) years now.

Meanwhile, life is passing us all by!

My vote says this:- abandon the VRCT, carry out a brief (but proper) consultation with "the troops", then re-launch the thing in a more up-to-date way, with clear aims, properly communicated ... and then just get on with it (and hurry up, too)!

The bottom line is this:- you can't just issue a diktat ... you have to carry the troops with you!

On the MPE mailbase "Paul" (Not Robbins) posted this in a discussion thread on Medical Herbalists being registered by the HPC

I think there are a lot of people frustrated by the time it has taken for the registration process to come in to force. I think this is leading to more and more discredit for the VRCT.
RoJo

Rojo, I think that has been the biggest problem for the VRCT

Whilst I am not for or against the VRCT, I am a believer in registration in a form.

Good Day

Further going back to the initial post it is worth the time to download and read the document being refered to. Whilst all of the document is worth reading chapters, 4, 6 and 7 should be fully understood - chapter 4 unregulated workers para 4.3 and 4.4 are key in these the need for assurance of workforce competancy is stated along with the enablement of of a system of assured volentary registration for groups not currently subject to statutory professional regulation.

So by default it will be come a reguire to be registered as it the simplist way for an employer to assure themselves that youa re competant is to ask for a copy of your volentary reg certificate.

So for the VRCT a death knell, its actually quite the reverse. The great advantage of volentary registration is that you don't need what has been the biggest stumbling block to date and the greatest slowing down in the process a statement in law i.e. statute.

There is therefore I hope now a real prospect of rapid forward advancement.

Reading through the document, section 4.9 is contradictory. it states:
No staff will be compelled to join these registers and employers will not be required to employ staff from these registers, though they could choose to do so. Where providers and those that they provide care for see benefit in employing staff who are nationally assured through a voluntary register, they will be able to do so, either by requiring registration when advertising posts, or seeking a commitment to join a register and training and developing existing staff so that they are able to do so.


Section 4.11 states:

Rather than a single statutory approach regardless of local needs and local approaches, quality assured voluntary registration will provide greater flexibility and give the public and local employers greater control and responsibility for how they assure themselves about the quality of staff. For the overwhelming majority of occupational and professional groups which are not currently subject to statutory regulation and which are generally not considered to present a high level of risk to the public, but where recommendations that regulation should be introduced have been made (including those groups recommended by the HPC for statutory regulation in the past, but not yet registered), the assumption will be that assured voluntary registration would be the preferred option.

This apparently gives the VRCT the green light to carry on albeit with much reduced authority.
What needs to happen now is that we (biomeds) as a whole take the VRCT to task and break it up into more appropriate sections. We need to ditch the "patient facing" technicians i.e. those who operate Gamma Cameras, Inject Radioisotopes, carry out Nerve Conduction studies etc. They can call themselves "Clinical whatever they want". Once we separate the VRCT into clinical and non-clinical sections we can start again. After all, the main reason for combinig what were two completely different professions was to get the numbers up so that the HPC would take notice. Now that is out of the window, the assured voluntary registers can be as big or as small as they want just as long as they can afford to run them, see appendix A of the document.

Most people assume that we need regulation, but is there a massive problem with incompitant techs and more importantly would regulation filter out these techs or improve them? As there will be a cost involved in regulation and it might mean that there may be vacances not filled witch otherwise might have been, then this needs to be considered.

Oh ... is there? Just where, exactly?

Vacancies filled, but with incompetent technicians? Which way is it?

I would suggest:- neither!

I don't think there a huge amount of incompitant techs either. People make mistakes and even engage in bad practices but regulation won't necessarily stop that.

And the second response later if they want will be?

This doesn't mean anything, from my interpretation of this it's just saying they won't immediately impose compulsory regulation, it doesn't really tell us anything we don't already know.

If anything section 4 seems to suggest what we already know that the renamed HPC will be able to hold voluntary registers and is basically old news.

Not the death knell - just another obstacle in the path which needs to be negotiated!

It's very difficult to pin down what we actually do. Some of us are more "hands on" than others i.e. some will assist medical staff with clinical issues and others may never see the inside of a ward. Therefore it is almost impossible to achieve a one-size-fits-all solution to our jobs. It is foolish to assume that we can. What we can do is address the parts of our job that are common to most and work up from there.
Not all Biomeds will be employed at band 5 or above. We, for example have technical staff on bands 3 & 4 who primarily work on low tech stuff and carry out PPMs on a selected list of equipment. I was against the idea originally but financially it made sense, a band 5 PPMing a flowmeter is a bit extravagant.
We need to look at our own departments and assess our particular needs i.e. how do we give assurances to our Trust (employers) that every member of staff is competent to do their job? A good starting point would be to adopt a Quality Assurance system (ISO 9000 type of thing). Within the QAS state the requirements for every grade of staff within your dept including A&C staff. For example an ATO might be required to attain C&G or NVQ2/3 in an appropriate subject coupled with manufacturers' training courses. A "working grade" biomed may be required to hold a suitable HNC or equivalent together with appropriate training.
Appropriate training could take the form of on-the-job assessment (in-house), ad-hoc courses relevant to the job i.e. basic human physiology, medical terminology etc. or short secondments (>1 week) to relevant departments i.e. Theatres, ECG etc.
This training would be assessed in the tech's annual performance review. This way training can be tailored to the individual at a time and stage suitable to their career progression. If further assurances were required, the individuals could always join the IET (or IPEM if the mood takes them) and apply for EngTech, IEng or CEng depending on their level of work.

One of the most important things we need to bear in mind is, how do we get the right staff in the first place? To avoid a shortage of biomeds we need to be able to recruit from a wide range of sources.
From experience I’ve found that the best biomeds come from other service industries. These people have the right skill set to apply themselves to the job in hand, something that cannot be taught at college/ university. If they do not have the educational qualifications required measures should be taken to allow them to achieve the required qualifications. This should be carried out concurrently with on the job training and manufacturers’ courses.
Obviously as a benevolent employer the NHS will insist on employing people directly from school or college. Starting with a clean slate as it were we need to ensure that the trainee gets the right engineering grounding. There is no point teaching a trainee how to set up an infusion or take an ECG if the don’t know their Amps from their Electrodes.
There is a shift away from pure electronics towards more IT involvement in our work so it would be useful to make sure that the trainee has a decent grounding in IT & electronics.

Oh! Hang on, that’s what we are doing already and have done for as long as I can remember. If it ain’t broke, don’t try and fix it!! (Unless it requires a PPM )

I do not wish to upset anyone, however, when reading the numerous posts to this excellent forum and particularly regarding the VRCT, I do hope a spelling and grammar test is not part of the required competency for registration!

If it was then maybe only Geoff Hannis would pass. I'm really not too sure about some of the other contributors.

Perhaps I am just pedantic or maybe it's just an age thing. Before you ask, I failed my eleven plus and left school without 'O' levels, but like the vast majority of us then, I could add up and spell with some understanding of grammar without certificates and registrations to prove it.

Never a more true word said Barney.

Barney then again after finding his blog I notice Geoff Hannis does have all day to write his posts since he's 'semi-retired'.

The rest of us of have got jobs to do and it does seem the adage more haste, less speed is often correct with posts, in a day with not enough hours in it.

WOW! nobody told me it was national bash Geoff week, is there a holiday involved?

Thank you Barney. But best be careful, Mate, else you’ll end up being vilified as well!

By the way, I’m told that (these days) "spelling doesn’t matter, just as long as you’re understood". Not that I agree with that point of view of course. But, there again, what does matter these days?

@Chris. What’s the matter with you Mate? If you need help, I can recommend a few avenues. But at least on this occasion you seem to have mastered the spelling checker, so it looks like there has been some improvement, then.

@Neil. Yes, it looks like it's "flavour of the month" time once again. Don’t worry, this is the sort of thing what sometimes happens when people with limited capabilities begin to lose an argument.

Meanwhile, back to the VRCT. Perhaps there needs to an interview to assess character before each prospective member can have his (her) name added to the list. Plus a hand-written application, of course (in joined-up writing)!

@Huw. OK ... are you going to lock down this one, too?

"needs to BE an interview"

Could someone explain a way through this conundrum please (This is a serious request - not a dig - as we have people in this situation)
From the Guidance for Applicants on the VRCT web site.

On the IPEM web site there are no "approved" B.Sc's in Clinical Engineering (EBME or call it what you like). How do people in this field get on an approved course if there is no degree to go with it?
Are there any "accredited" training courses in our field (there are medical physics technologist ones)? I know of none but it does not mean they do not exist.
If there is only a few "accredited" centers are older, industry (military) served, experienced engineers expected to leave home and family and go away to university for three years? With the presumably lower pay of a trainee.

I think the assumption that we will only be training school leavers is making the current, time served, but perhaps not paper qualified, people wary of this whole scheme.

Are there other ways to become registered for recently employed, experienced people other than seemingly non-existant training programmes?

Many thanks
RoJo

Darn it, Dan ... I had left that one for Chris to spot!

@Rojo: Jim (Methven) took a stab at answering the question "where are the training courses"? on the other (recently locked) thread.

Rojo,
This is yet another area where the the VRCT needs to amend its ways. Most of my colleagues came into EBME from other service industries and were trained on-the-job. The problem with that is the fact that there is no "accreditation" for the knowledge they have gained over the years. This knowledge could be the equivalent to a masters degree but it goes unrecognised.
But I still beleive that the VRCT will have to relax it's entry criteria under the new registration paper because it will no loner be statutory or be allowed to legally hold a protected title.

I think that you may find that most of us came from different service industries. Myself included.
I think that that is a good thing as they bring in ideas that the NHS need as they have been too long in their Cocoon.
As for the accreditation for prior knowledge, this definately has to be addressed.
This should all be on your training record held in your bosses/education department . The problem we have are with some manufacturers in that they have a caveat on their training that it is only valid for the Hospital that you were employed with when training was conducted.
Records of training should be held locally but also freely available for others (with your permission) to look at and transferable between sites.

@Geoff I'd rather have 3000 people feel free to post a hurried post than have just one person talking to themselves. I have had people tell me that they would post to ebme but you actually put them off!

Getting back to the VRCT I also noticed while reading your blog, that you’re not even what they call these day a stakeholder in VRCT so don't see why your even bothered with it, unless like your blog suggests you’re a agent provocateur, may explain those anti-NHS posts and strange points of view!

One thing I have noticed in the past few weeks, some trusts that are involved in staff redeployments due to the PCT redundancies have restricted clinical scientist part 1 training to existing trust employees. Something I haven’t seen previously but it is supported under the new Modernising Scientific Careers. This same framework also supports training up of lower grades to practitioner level so it might mean that until training is in place trusts have to recruit more lower grade apprentices . Which is does seem is going to limit the available workforce for at least a couple of years.

Why not name them (the poor, sensitive souls)? ... perhaps we could come to some sort of understanding.


Yes, why don't you? Although perhaps I should thank you for finding time in your busy day to peruse my (ancient) blog!

And (lastly), I don't know anything about "stakeholders", but (as far as I am aware) you don't have to be registered with the VRCT to post to this forum (yet)! But, to be fair, no doubt many within the NHS will find your final paragraph to be of great interest.

If need be yes. Why on earth would you think I wouldn't?
(Rhetorical question.)

One more personal remark or off topic post and another useful thread gets locked.

Can I take an opportunity to explain a couple of other issues around the VRCT which are continually raised on the Forum?

Firstly, there are many calling for competence-based training which reflects the previous skills, knowledge and experience of an individual. This already exists! The IPEM Training Scheme provides a number of routes: one of which is the fast track route which takes account of the prior experience and learning of an individual. Thus if a new entrant to the profession has, for example, fifteen years experience working in the engineering industry as an electronics technician and holds an HNC in electronic engineering they will be credited with that experience and knowledge. Following a training needs analysis they will then follow a competence-based training programme in medical engineering which will be externally moderated by an independent IPEM assessor (who will be an experienced Medical Engineer). How long this takes depends on the individual and the effort their Department provides in supporting the training programme. This will be without the need to take a degree or post graduate education programme as the necessary bridging knowledge should be delivered as part of the training programme. The successful end point means the individual will be awarded the IPEM Diploma in Clinical Technology (Medical Engineering). They will then be eligible to join the VRCT. (Note: Training departments must be accredited by IPEM. Hence the responsibility to take the first step rests with the organisation that employs you.)

There are a number of other routes. One involves undertaking a relevant educational programme in conjunction with the IPEM Training Scheme. The educational programme need not be accredited by IPEM but it must be a relevant programme in Medical Engineering.

It is with regret that we still have not identified any Higher Education Institute whose degree programme in Medical Engineering (biomedical engineering, etc) can be accredited as an approved vocational degree programme. IPEM have been striving to rectify this anomaly and are currently working with a number of educational providers to achieve this end. Furthermore, ART has reached agreement with Bradford University to provide appropriate educational modules for Renal Technologists. These are taken in conjunction with the ART Training Scheme. Additionally, the professional bodies are working with the Department of Health, through the Modernising Scientific Careers programme, to develop vocational degree programmes. It is hoped that a number of these programmes will be available later this year.

Secondly, there are continual calls for registration with the Engineering Council (EC) to be the benchmark to join the VRCT. The VRCT Assessors’ Panel comprise a majority who are registered with the EC. If it were that simple we would have followed that route years ago. Unfortunately, engineering registration is generic. You can gain registration in any area of engineering. For example, if you are EC registered in Aircraft Engineering you cannot then simply transfer to Medical Engineering and claim to be registered in that field. Your competencies and knowledge would not fit! You would then have to follow some form of formal bridging education and training – the IPEM Training Scheme for example.

Additionally, engineering registration is set at a higher level than that of registration with the VRCT. VRCT registration is set at the entry point to the profession. If you were new to engineering, completed your training and registered with the VRCT, you would have to wait some additional time before you could accumulate the necessary experience to become EC registered! Thus, although engineering registration with the EC is an essential attribute for any engineering professional, it cannot be used as the benchmark for engineering professionals wishing to register as healthcare professionals with the VRCT or other regulator in the future. This is because protecting the patient starts at day one when appointed to a responsible position!

Finally, I believe the VRCT and its associate professional bodies need to strive more to explain these issues in their literature and websites. I apologise that this has not always been the case and will do my best to ensure that the information resources available to you are improved.

Jim Methven

VRCT Registrar

Jim,
Thank you for this I have just seen this: on the IPEM site, I must have overlooked it before.

I am finding it hard to find any detailed information on either the IPEM or VRCT site for training paths. Is this because of the guidance from MSC taking so long to come through?
RoJo

Or could it be that they are making it up as they go along?

How many more years need to pass before all this stuff is finalised? How long does it take?

Maybe this is what they mean by "grandfathering"?*

* That is, by the time it's sorted, new entrants will have become grandfathers!

As a grandfather who was 'grandfathered' on to the VRCT I'd like to pay tribute to Jim and the other IPEM volunteers who have persevered with this scheme. I'm sure if Jim could push a button and everything would fall into place then he would...but the world doesn't work like that. When my grandchild asks 'Are we nearly there yet?' I say 'we're getting there as quickly as we can!'

Good answer.

I believe in the background Jim and Co at IPEM and ART are actually fighting hard for technologists and scientists against the Government and the Chief Scientific Officer who want to implement a unthoughtout and unworkable plan on us all.
The problem is that we are having to try to fit in to hal made guidelines at the moment.
I think the initial official view was that it should all be handled by the universities with no "practical" input the same way nursing has gone - now do't get me started on that.
RoJo

Down the too posh to wash route!!!

Full of head knowledge but no practical experience (use?)
RoJo

Educated idiots?

Or, as my Dear Old Dad used to say (sometimes about Yours Truly, I'm afraid):- "neither use nor ornament"!

But don't worry, there will be plenty of Romanians, Bulgarians et al ... plus (I guess) a few from North Africa.


Will they need to bother about the VRCT?

No HE courses available? It’s not an anomaly, it’s basic economics, med eng is a highly specialised field and will never get enough interest from students to make it worthwhile. Another issue that will go against med eng courses is the high tuition fees. Students will be looking for the best career options when deciding their course, a med eng course will close a lot of doors to them whilst an electronics or computer engineering course will allow them to apply for a much wider range of jobs.

Regarding registration with the ECUK. It is generic which is why it is a good thing, your professional status is personal to you. Just because you change jobs does not make you less of an engineer or technician! The important thing to take from the ECUK’s code of conduct is that you do not cause harm to others as a result of your work.
As regards retraining when coming into the EBME field surely this is a matter for the individual employer. As I have stated many times every EMBE organisation is different and the needs of the employer vary. So it is essential that staff are trained in what is relevant to their particular job. I fully appreciate that there is a deal of commonality in what we do but the basics can be taught at a “lower” level. Places such as Eastwood park have done this for as far back as I can remember. Do not forget that technical staff employed on lower grades such as ATO’s need a certain amount of basic knowledge such as Electrical Safety Testing and how the equipment they are working on affects patients etc. It is worth remembering at this point that Oxygen Flowmeters, Nebulisers and countless other “low end” medical equipment can cause significant harm to a patient as well as the higher end stuff. How do we assure that this equipment is safe if the repairs are carried out by unregulated staff?
If the IPEM were to offer basic training at say NVQ2/3 level then I’m sure they would get a decent uptake.
Engineering Registration does not have to be at a higher level than the VRCT (IPEM diploma) EBME staff working on basic equipment can be registered as EngTech. The working grade biomed will have no problems registering as IEng so long as they have HNC or above WITH relevant experience (grand-parenting without a closing date if you like!). Senior biomeds and EBME managers would in many cases be able to apply for CEng accreditation. I have had these points confirmed by the IET.

I’d like to address the matter of training for Renal and Radiology Equipment. The engineers who service this type of equipment should be of a senior level. Within the NHS it would be expected that they are on a pay band 6 as a minimum & many are on band 7. According to the VRCT and the ART it seems that these engineers can operate at band 5! How is that improving the status of the engineer?

What about lab kit, Bill?

Oh, I forgot, NHS techs don't usually touch that, either.

What's wrong with:-

1) Junior Technician (trainee)
2) Technician
3) Senior Technician
4) Chief Technician
5) Master Technician

And (if you must):- 6) Manager

Lower grades that are supervised don't have to bother until they want to progress.

There's a sliding scale of risk here, remember that the Sinclair Z80's also did quite a bit of harm when their power supplies caught fire, but you didn't need to be on a voluntary register to use them! But this does pose the question what would need to be repaired by regulated staff and what could be repaired by lower grades?


Speak for yourself Geoff, maybe that was the case when you did a stint in the NHS, but it's another thing that shows that departments can be different. Plenty of lab equipment here and probably more at other trusts soon with the demise of the HPA.

One thing that Jim didn't point out was that some years ago the ECUK tried to regulate the whole of the Engineering field like Professional Engineer status in the USA, unfortunately this fell flat on its face and since then Engineering status has been just that a status. Just try searching for ‘struck off chartered engineer’ and see what results you get (you actually get back to this forum or a wiki article criticising the fact it hardly ever happens). It's an achievement but doesn't seek to regulate therefore it wouldn't really be an alternative to the VRCT.

But what about the Romanians, Bulgarians ... and all the rest? What does the VRCT have to say about them?

BTW, those of us (Angus, Bill, Neil, Tony et al) who have had the pleasure of working in hospitals in places like Saudi Arabia would have been used to taking care of all the kit in the lab (invariably the largest department in terms of the amount of equipment), plus the CSSD, radiology and all the rest. In a word, everything.

WE look after ALL the equipment, and when I say we I mean the team, because that is what we are are, a team, no juniors, no seniors, just a team.

I heard a quote the other day that I think could apply to the VRCT:

Insanity: doing the same thing over and over again and expecting different results.
Albert Einstein

How many times have Medical Physics tried to create an educational progamme to combine all of the aspects of technicians who work for them? The VRCT is the latest in a line of similar ideas that have failed in the past. Listen to your Uncle Albert!

Have you read the devils dictionary, I think the quote is in there