EBME Forums Forums Management Professional Issues Agenda For Change AfC and VRCT

I have always been the lower grade Technician wherever I've worked.

Mr Ling,

The main reason trusts employ people on trainee grades is so that the wage bill remains low, for as long as possible. As you have rightly said, the trainee would be put through a "general" Clinical Technologist training scheme (funded by the employing Trust) with no guarantee that this person will give anything back once they've finished.
When I left my previous profession, a well informed and senior physicist did offer me a post in his department repairing linacs (on my current grade) as he recognised the electronic similarities between an aircraft radar system and that of of linac. I already had proof from my previous employer that I knew one end of a screwdriver from another and that I could follow work instructions and procedures. The Trust would have had to pay for me to attend a 3-4 week manufacturer's course and provide some supervision - that's all. I would not have had to sap a great deal of the cash-strapped NHS's budget by attending a lengthy basic engineering training course.
In this day and age it makes sense to utilise other industries training schemes, topped up with relevant short (and comparitively inexpensive) training courses.
If in-house training schemes are in place, fine, but stay open minded.

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I agree with Rojo - just being able to walk into a post and be informally trained in a job because you have a bit of experience and a good level of education, when others have to go through specific routes of entry and accredited training schemes, just doesn't happen. Certainly not in the other professions that are allied to medicine e.g. radiographers, physiotherapists or Clinical Scientists.
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The problem with this route is that many professions allied to healthcare are exactly that. Radiographers, Physios, Occupational Therapists etc. Are trained at University and the fees are paid by central funding. Their choice of work placement is limited to "professions allied to healthcare'

A Graduate with a technical based degree does not have this limitation and is able to work in any profession that recognises the value of the degree syllabus.

We could sponsor and train biomedical engineers. A free technical degree will be swamped with applicants. Those successful will have a degree qualification geared towards medicine. However after training their skills will still be useful to other non medical professions who can build on this training. If the NHS will not pay for technicians at present, they are hardly likely to pay for their training, if this training is easily poached by other non medical professions.

Occupational therapists. After training there is not much choice other than NHS or social services. Radiographers, NHS or companies developing this technology. I noted 18 OT's at dinner the other day and a night out for radiographers would at least need a large coach. We are six!

Blondie, and a few others,

Stop having a go at grads. A tool training program may be needed. One of our team did not know what a bearing extractor was, let alone how to use it. It does not mean he is useless, just hasn't been exposed to that type of tool. Just as before I started I had not seen a;
Defib tester.
ECG tester
Diathermy tester.
IDA
Gammex
And a host more test equipment.

Richard,

I'm all for developing your team. The consensus here is that although my colleagues had to "hold my hand' when I started, the same situation would occur with a newly promoted MTO 2. The same would occur in developing the MTO 2 prior to promotion. The only difference is salary.

Safety and the potential to do harm, very true in the NHS. However a radar tech that incorrectly sets up the ILS at an airport could kill a planeload of passengers before the error was spotted.
The senior helicopter engineer, who signs for the maintenance does the check test flight with the pilot. This ensures that the work is of the highest standard.
I don't think that an EBME tech is going to test most of the equipment he services on himself.

Radiotherapy and radar engineer yup. Or medical physist was very impressed that I could deduce the frequency of the Linac in less than one minute just by looking at the waveguide size. I was then able to point out the major components. E.g. the TWT.

An engineer from another industry has been exposed to many facets involved in engineering, more so that a new grad or junior MTO2. Often they have a proven track record of achievement. All they need is the opportunity to learn a few new skills on top of their already vast experience. It would be a shame if VRCT closed the door to this.

I would say it would be safer for me to recruit engineers that have experience in like technologies than try and bring an engineer across from the biomedical side to work on Radiotherapy and some x-ray type equipments. To get these people with experience we would have to pay enough to make us competetive with other industries.
All I'm asking is that we don't close the door for registration completely and have the ability to remain open minded. Possibily with peer review after a shorter period for technolgy that isn't heavily biomedical.

Kerry

Eagle,

I'm not sure tha you appreciate what I'm getting at:

All because of demand and a lack of regulation - trainees is the wrong term for these people and it's unfair use of labour to put them in this position. Shame on the 'professional' managers that employ individuals, long-term, under the guise of training.

Yes, at the moment and there's nowhere for them to go because they're not being given the skills to progress - plus they're not really trainees are they? - possibly 'bodies' (a less than flattering description used by a previous manager of mine) employed to carry out relatively 'simple' tasks. Unfortunately the problem lies with a dearth of highly skilled staff capable of doing the more complex stuff and the possibly by the NHS employer and HPC to mitigate associated risk.

That's exactly what I'm criticising if you read the postings carefully but if there were accredited schemes then it's a two-way process. The trainee gets an education and valuable training and the employer gets someone qualified at the end of training if they want to use them. If not then the trained professional has the recognised skills to move-on or be promoted through the system elsewhere - the evidence of competences and that requirements are being met travels with them. Just like the other NHS professionals.

No, not at all, what I was getting at is that, is the outside entrant, despite being highly academically qualified and involved in design, might not actually be the best choice candidate, for the job given as an example. If there were a trained professional available with a speciality in the job then surely this experience is more appropriate or relevent. There's no guarantee either way - let's be open minded about it.

Fair enough - but as I said - you would have still had to undergo some training and still be in your current position where you are only just now eligible for VRCT. The relevent experience aspects i.e. actually working hands-on with linacs, in healthcare, might still be an issue with VRCT.

None of my business but If your skills were more relevent to linacs then why were you not offered a higher grade? MTO3**/*** and MTO4 tends to be the working grade salary for Radiotherapy Engineers because of specialist skills (HV systems, RF, Electrical engineering bias and power electronics engineering) demand from what I see advertised. Most of the adverts I see are for 3-5 years actual experience on specific linacs working in the NHS.

Do you see it as a dead-end or did you just 'fancy' working on something elsem that you weren't as experienced in working with? You would still have needed specific training, to be aware of other aspects of the job - informal training woud have to be given. This still doesn't mean you would be eligible for entry onto VRCT and the State Register any easier or any quicker - which is the point of your postings previously, I think.

I do not doubt and never even implied that you don't know one end of a screwdriver from another but can you repair, test and perform QC on a portal-viewer fitted to a linac to manufacturers specifications without the relevent in-house training, manufactureres training and supervision? This takes time for a variety of reasons - like the machines need to be available for patients, not trainees and they need to be turned around quickly most of the time.

How do Radiotherapy Engineers out there feel about this comment? After some years service I would have thought that there are some that think this attitude devalues their level of skills to a 3-4 week course.

Having prevented 'maverick' managers from taking on anyone they feel like taking on and giving 3-4 week course attendees the ipression that they're fully qualified Clinical Techologists hopefully demand for appropriately trained staff would then drive the career process i.e. training and career development in the direction it should be going. Upwards not sidewards and downwards giving us a 'lottery' of skills and professional attitudes.

Given that regulation might tend to drive training and career development, possibly salaries to some extent (as is the case with other professions) I would have thought that eventually the resources to provide staff who meet the necessary requirements would have to be made available at some point.


It depends whether you are training for a career, where Clinical Techologists can move between roles and jobs for promotion or a change in job role (given specialist training) or whether you just want to train an individual to do a specific range of routine/repetitive duties on the same/similar equipment.

There is probably room for both approaches but when external entrants accept jobs on the basis of training for specific tasks and not 'professional' training then they can't really complain if they aren't given the same level of recognition.

The difference between the trained and registered 'professionals' in a 'career' and those non-registered 'professionals' employed in 'job roles', for a want of a better description, might be that one may have more mobility and be able to work, unsupervised, up through the system and the other may have less mobility and be monitored/supervised more closely in the future. Employment of either of these sort of candidate depends on the demand, which is there, as we all seem to agree on. Just my thoughts on the issues you raise Eagle.

Col,

So the NHS shouldn't train Clinical Technologists for fear of losing them? Perhaps then we should rely only on direct entry from industry (and not bother to train NHS employees) leaving anybody who fancies, with a degree in electronics of course, just get on with it.

We could then let previous experience in anything to do with electronics or engineering count and allow these entrants onto a professional register, without checks and safeguards, and then, as fully qualified practitioners, we could let them carry out any of the diverse range of duties performed by Clinical Technologists unsupervised.

There is not much need for setting up the ILS on the way into our theatres. You and Col keep using previous experience such as this to help with your argument and it does not.

Your basic skills/engineering skills in that career are not in question - you can demonstrate them using paper and training records - you have taken responsibility and are no doubt trustworthy. However this won't necessarily be accepted as a substitute for the clincially relevent knowledge and relevent experience that is proposed in the requirements to be registered and considered as a fully qualified Clincial Technologist by IPEM for example. You still need to meet the requirements of the VRCT currently, or the HPC in the future, if you want to be registered.

Never having worked on radar or linacs - therefore being less desirable to Kerry as a candidate for working on them - Even I can work out the frequency of a TWT based on it's dimensions - most electronics degrees with RF Comms options would cover this - mine did. Sorry but I'm not that impressed. The aspect that are probably important are that you have worked on Power RF and HV (safety) and have a knowledge and appreciation of the circuitry involved. Specifically you have more direct relevent experience to Radiotherapy maintenance.

Richard,

No, my point is in comparision with other professions allied to health care.
If the NHS trains a radiographer for example there is not much choice in where they will be employed, especially after graduation. HPC membership is achieved straight after graduation. VRCT wants 3-4 years experience at present post training, fair enough I don't have an issue with that. If VRCT moves to HPC formal registration, the graduate would achive membership on award of their degree, not after 3-4 years post degree experience.
I support you views on a defined training route, but with the wide variety of jobs requiring engineering skills verses those requiring radiographer skills, I hope you can see that the potential engineer has a wider market choice on where to use their degree qualification. A fully HPC'd medical technologist will be able to move out of the profession, and back in if they so choose.
The Engineering council are pushing to acredit all Engineers and make the title of 'Engineer' a protected title. I really feel this is the way forward, rather than confine it to a narrow field.
Skill migration will occur, as people see the green grass elsewhere. If the grass looks lush in the NHS, engineers will not be allowed in under the proposals for VRCT, unless the accept a training grade.

The loss of generic engineers with transferable skills is a good point. I think the HPC and NHS employer want Clinical Technologists to be more specific to the Healthcare environment. Hence the skills will be less transferable in the future and most relevent in the Healthcare sector.

Why should they move out of their chosen career, given that it's worthwhile, they've committed themselves to it for years, the prospect of working in a recognised profession and hpefully appropriate banding in a pay structure that's commensurate with this?

Just like other health professions in fact. It looks like it's being pushed that way whether we, the HPC, or NHS employers like it or not.

And this is 'fair' (MSR) if you consider that the NHS trained professionals will have shown their commitment to the profession and gone through the mill, so to speak, and will therefore not be considered as 'new-entrants' being fully qualified. Same as any other job or career that sets minimum standards to be achieved on entry, post qualification, whatever.

Richard,

You fail to miss the point.
Skill migration; where can the Radiographer go, Occupational therapists and I mean in large numbers, the physio- maybe sports teams. As engineers we are few in the NHS, a niche market that is smaller compared to all the opportunities elsewhere. Why would they move - money perhaps?

I mention previous experience to illustrate that engineers outside the NHS can do harm if allowed to "roam free'. We too had training, trained others, had to follow procedures and are safety conscious, all the attributes to claim for yourself. These skills are very relevant. That is one of the things I have said here at work and on this forum. Calibre of the individual counts, I believe more that absolute paper qualifications. An ideal would be both. People do not leave training with all these attributes. They are developed over time. Often under the guidance of experienced senior professionals. You are correct, invest in the individual and provide routes for promotion and they will be less inclined to leave.

Hang-on you said we, as Engineers, had transferable skills (into the profession? Out of it?) - now medical engineers are in a niche market? Make your mind up Col.

Value placed on a job is linked to heavy demand for it and a lack of transferability into the job market - you're now talking about transferability out of it - this argument only works if you're not prepared to try to bring in appropriately trained staff in at the same rate as the leavers are doing a flit.

Clincial Technology or Clinical Engineering is the niche, not electronics, exclusively - that's all around us. Everybody's doing electronics these days. My interest is in Clinical Technology not just Electronics, or Medical Physics, for the sake of it. You wanted to get into it because you see it as a niche perhaps - a way of earning money once you got those transferable skills - this might rely on registration however - perhaps that is your worry now you're doing the job.

I believe we certainly are in a niche, as you put it - Clincial Technology - if the role were 'protected' surely the demand hence the salaries and pressure on need to train new staff would increase within the NHS not decrease? To be met by apporpriatelty trained and experienced new starters and those already in the 'profession' elswhere - career progression.

You miss my point, the system is being set up to protect the supply of Clinical Technologists not that of 'generic' engineers, in my opinion, whether we like it or not. Encouraging the provision of appropriate new-starters at the bottom and protecting the job (job-titles, as Clinical Technologists, whatever, of those professionals at the upper-end) and possibly as an aid to recruitment and retention given that future supply can meet demand for registered professionals. The reverse of what you seem to be suggesting will happen (and what has actually been happening for years).

If you have this view then why should the requirements e.g. VRCT, HPC, besides the previous skills, attributes and training they have got that is relevent, not apply to new entrants when they decide to change career? Eagle and yourself seemed to raise concerns about the 'bigots' and 'elitists' in the VRCT and HPC who are ensuring this.