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

RL

Hussarr !!, Blimey Richard isnt it ?, thought you were Bob for some reason, you tell those ex armed forces interlopers, except the Special Forces chaps, theyre ok in my book !

Actually theres a lot of agreement going on here and its not just a case of winning argument, you may well have identified how and why certain things have come about, historically being in the mix so to speak.

On an earlier point Richard,I think that now more than ever that its most important and always worth training in house or otherwise, not only as a professional obligation to continue development but to establish and create records of relevant training.

As a collective of individuals working in the same or similar areas, for the future, we often seem not to do ourselves many favours though do we?

Devalued by proxy ?, as an ex RAF Biomed, I cant agree this is the case here at all, we all have much to contribute, In general, Ex Military, your talking about at least highly skilled technicians and probably managers, but it touches on what I think is at the heart of many of all our problems, value, perception and worth, representation and how to demonstrate this.


Darren

I think we would be isolating ourselves too much if we had no mechanisim to recognise experience from other industry. It would hamper the recruitment of people with proven experience in equipment manitenance and management and make it harder to retain staff who have taken years to train when they can move to other industries for more.
Even within the current sphere of medical technology there is so much diversity in what is being repaired that I don't honestly think a common educational background can be fitted to us all. For example all I do is Radiotherapy, because of it's nature I would be more likely to recruit an ex forces radar tech than someone thats been doing other biomedical work.

At the end of the day it's going to have to be a local decision made by management on what experience counts and because many places are simply not set up to train in numbers some of that experience has to come from people new to healthcare.

Kerry

Quote,
"From what I have picked up on the grapevine, the future HPC entry will require a Clinical Technology degree. How alternative qualifications and experience fit with this remains to be seen."
As for our tech. with a university degree who asks for an allen key to undo a pop rivet and then says that I have given her the wrong size one because it`s a ballend one makes you wonder what you need to obtain a degree.

Kerry,

Valid points I think but the discussion is concerning VRCT, state registration (if it comes about) and the possibilty of future regulation that may (or may not) influence the employers decisions in the future. I'm certainly not suggesting that new-starters from other industries should not be employed if they have some relevent experience e.g. basic engineering - the relevence of previous experience and suitability of candidates is decided by the employer, of course.

So if an employing manager wants to employ, for example, a radio-officer from the Navy who has not done much hands-on repairs for 15 years but is considered to have enough relevent experience and relevent qualifications (radio-operators licence) to work in general equipment maintenance, then that's up to the employer. This is an actual, real-life example - engineer from outside with less relevent experience, qualifications and basic knowledge employed at a higher grade than others with more relevent experience on the job, etc, etc, because the manager was desperate to employ someone. It was easier to employ someone, who was less than ideal at that time , on that grade than promote a suitable applicant and fill the remaining post for a lower salary.

Meanwhile everyone (including the lower grade) had to chip in and train the new-starter on the job. This is why we need regulation that is adhered to - during the period that the new guy was learning the specifics he was in a position to do harm and others careers were being compromised. Regulation might have ensured that evidence be provided before the individual were allowed to be left to get on with it without proper assessment of training needs for example.

I hope the grade that new satrters are employed on has nothing to do with VRCT and State Registration but there will be some correlation I think; so the source of supply of fully qualified Clinical Technologists could actually be 'dictated' by the requirements laid down by the HPC not the employer. Depending upon how the regulation is applied of course.

This could cause a few problems (like it does now with the Whitley Council guidelines because managers circumvent the guidelines because of demand for staff). What level would you start the ex-radar engineer at? How much previous experience counts as relevent experience? Should they first meet a set of standards that's equivalent to other Radiotherapy engineers out there in the NHS (possibly working, fully qualified, trained specifically by and for the NHS) meeting the requirements of the VRCT - if they are to be employed on the same grade/have the same responsibilities?

The other problem is that trainees may as well not work toward job roles if external applicants, who may not have to meet criteria on entry, are employed in posts that the trainees and lower grades are working towards (training and gaining experience) - they usually leave when they realise they shouldn't have bothered coming in on the 'convoluted-route'. (again problems caused by Trusts making their own decisions). We have to recruit and retain trainees and the lower grades working through the system and give them somewhere to go.

I'm afraid that my view is to 'look after your current staff and invest in their future - then, if necessary, bring in those, who've had one career already, and make sure they meet the same requirements and that their future is invested-in). I wonder how easy it will be for individuals who are not state registered to move into more senior positions, take on different job roles and give evidence of competence when considering a move into departments that do insist on state registration in the future.

One potential problem I can see is that if individuals come into the job and are trained to carry out specific roles then they may be disadvantaged with regard to the ability to move between jobs or for promotion. For more senior posts other employers may insist on the postholder having state registration.

I don't think regulation is there to prevent individuals entering the 'profession' - I think the the idea of it is to set up a framework, for Clinical Technologists whatever their background, to ensure they can provide evidence that they have the required core-knowledge, skills, experience, etc, etc, to whatever their job role is and do it safely to a particular standard.

Richard,

Were you the lower grade in your story per chance?

This posting was about the compulsory register for techs and I think the compulsory and voluntary registers are being mixed up.
Under the voluntary register experience counts. Under the compulsory register there will be a minimum qualification with a probable get out clause for experience. Most of us are in a position or will soon be in a position to get on the voluntary register those who do not try have only themselves to blame.

I am good at DIY and especially carpentry but I would not apply to be an orthopedic surgeon as I know that I need to be a qualified doctor as well. In the days of leaches, well meaning barbers and saw-bones I might have been allowed to do an amputation or two. But I now know that I am in the safe hands of a well qualified person.
If in the future I wanted to be a registered medical technician and I only have a cycling proficiency certificate I know I cannot apply. The public then know that the machines keeping them alive are looked after by someone who is able to do it safely.

There are going to be training grades as part of the registered technician scheme for people who do not have the qualifications but want to get them and for people who do not have the right experience. What is "right" is for the assessors of the registration scheme to decide. Each application is individual so each person will have to argue their own case.

A certain qualified doctor (David Southall) seems to have been saying things that were outside his remit and is being investigated about his actions. In the same way we do not want general technicians messing around in things that they do not know about.
A good technician from a different field should be able to pick things up easily during their preregistration training period to convince the panel they know what they are doing, and a bad one will not.

The initial posting was about degrees and AfC banding and gateways. Each person will have to have an agreed personal development plan. If they fall short they can not progress. If their employer does not provide the facility for the person to progress they cannot be held back. Only those who do not try to get through the gateway will fail. So if you agree that you need a degree to pass though, your employer must allow you the facility to do it. But That will be a very long term plan and I do not think anyone will be planning that far ahead. But if you agree to it that is your decission.
Robert

Guys,

Managers in any industry will only pay what they can get away with. If they can employ a missile guidance system design engineer at MT01 level then sure enough they will. Who cares if that person has no previous experience in Clinical Engineering, they can be trained.

This is however a very unlikely scenario because there is a shortage at the moment of MTO's as with many other proffessions in the NHS. I do not believe state registration will do much to help this shortage, it is more likely to hinder it as the supply of perfectly competant engineers from other industries will dry up leaving only the official route for entry.

It will probably lead to a scenario where one hospital poaches from another due to a shortage in Clinical Engineers coming through the formal training routes. If I were leaving school and thinking of starting out in a technical career of sorts, I would probably study for a degree in Electronics as opposed to Clinical Engineering as this would leave my options open. An electronics degree weighted on a scale of 1 - 20 in levels of difficulty scores a hefty 20, so has to be recognised as a worthy qualification for an MTO.

We should welcome engineers from other backgrounds as we need to evolve and change the way we think and do things. Without new ideas and new devlopments where would we be today, probably taken over by a PFI company.

The reality of the situation is that there are always people who are going to be stepped on or stepped over by new starters where ever you work especially when demand out weighs supply but this should not be just enough reason for introducing VRCT. VRCT should be a means to an end and a way to promote and encourage CPD of Clinical engineers already in post regardless of their background. It should not dictate the level of pay that new entrants are offered, as we need to remain fairly competitive with other industries if we are to continue to attract applicants whilst we wait for the flood of fully trained MTO's from the Universities.

You are Right Rojo,

Even I have confused the difference.

My last paragraph should have read as follows :- The reality of the situation is that there are always people who are going to be stepped on or stepped over by new starters where ever you work especially when demand out weighs supply but this should not be just enough reason for introducing Compulsary Registration. Compulsary Registration should be a means to an end and a way to promote and encourage CPD of Clinical engineers already in post regardless of their background. It should not dictate the level of pay that new entrants are offered, as we need to remain fairly competitive with other industries if we are to continue to attract applicants whilst we wait for the flood of fully trained MTO's from the Universities.

OK
That's it then. We need to have a structured career path for graduate entrants, and recognition of qualities offered by Technicians with experience (in other fields).

If there was a starting salary for new graduates, say MTO2; experienced technicians, say MTO3, and as both sets progressed up the Medical Engineering ladder they could both reach eligibility to become registered, approx 3-4 years they would then achieve MTO4 level.

If you look at A4C this is roughly how it is worked out. Band 4 for entry level, Band 5 Medical Engineering Technician & Band 6 for Specialist Medical Engineering Technician. What is required is registration, so as to make these definitive grades.
I.e. you are banded as per what you know and do, and your CPU qualifications, NOT because of financial constraints of Trusts; but equal to your Professional Status.

That's a thought, perhaps A4C isn’t all bad.

David,

Yes it is all about demand and I have explained why I think there is a lack of appropriately trained staff, trainees in post and training schemes in departments around the country - an attitude of short term thinking and short-sightedness. Train enough staff at an appropriate level, in the relevent disciplines, to meet your needs and the problem of demand may disappear in the medium to long term.

Don't forget VRCT, regulation and banding is all about career development and setting up the framework for a profession - not about preventing the right sort of entrants to the workforce (the HPC may set the requirements in the future not me).

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.

Poaching of staff is going on now and it has done for years - it's nothing new. The Trusts aren't willing to pay for the Technicians at all - the levels of Technician grades are static or actually going down for the level of responsibility required in my opinion - they have been for a few years now.

Still doesn't stop desperate Trusts from employing engineers from outside the NHS on relatively higher salaries than existing lower grades already in post though when they could promote. Regulation might ensure that Technicians with the appropriate skills in Clinical Technology have to be employed if the Trust wants to use those skills.

What is the point of employing any junior grades and trainees in the specifics of the job then employing candidates at higher grades because of high demand and having to train them whilst paying a higher salary? It costs more to bring people in because of demand than it does to use lower grades and trainees to work their way through the system and for us to produce what we require from these Techncians. At the end of it the trainees may have the benefit of being eligible to be registered as well.

The point is that we need Technicians trained specifically to do the job and a career structure to go with it. If regulation forces a career structure, formal training schemes and a higher standard of Technician education them I'm all for it.

Would you expect a perfectly competent missile guidance system designer to start work on day one in the NHS, employed servicing linear accelerators, to start on the working grade be allowed to pick up a manual and get on with it? No of course not - the new starter would be trained under supervision and sent on manufacturers courses, etc.

This person would be relatively unproductive for a quite a while and where is the guarantee that a designer would be any better at servicing linacs than someone who has worked up through the system as a trainee, specialising in linacs after completing general Clinical Technologist training to a recognised, accredited, standard?