EBME Forums Forums Management Professional Issues The Alliance for Patient Safety

And just what might be 'their own work' Geoff? This is a major issue in that different Trusts consider various work the responsibility of one department where as another Trust would place that responsibility with another department.

Take Photo therapy for instance, from the MDA alerts I notice that some Trusts consider these are just light boxes and the responsibility is often with estates, where as other Trusts the responsibility is with the biomeds. In other cases they are considered as treatment machines, in these instances Medical physics get involved to such extent that they are only handled by the medical physics department.

I hate to say patient safety as this concept doesn't go over well here, but from my perspective it seems that the VRCT only really effects those biomeds in the higher grades where their actions can effect the dose that the patient receives.

Thanks for reinforcing my earlier comments there, Chris.

Not so sure about "patient safety" and "higher grades", though.

As I must have said on here many times before:- "patient safety" is what "biomed" is all about, and anyone who thinks differently just doesn't cut the mustard (as far as I'm concerned). Why do you think those guys I mentioned got shown the door?

But in regard to "higher grades" ... what are you talking about Chris? IQ? Medical Physics staff?

Who are the "lower grades" then - those with "only" an ONC or City Guilds? Or are you thinking of NHS Pay Grades (a pretty poor indicator of actual worth, in my experience)?

And ... how does the VRCT model overcome any of this stuff?

But at least you've mentioned patient dosage there, so thanks for that:- at long last we've heard a sensible hint at what all those thousands of risks to patients could actually be. Do we have any more?

No amount of regulation or registration will prevent someone from incorrectly calibrating a device to allow an excessive dose (radiation or otherwise). The only incident I can remember was many years ago when a physicist at a radiotherapy centre incorrectly calibrated a machine with 10 times the dose (as he had his decimal point in the wrong place). He was at the top of his scale and fully registered but still made a mistake with serious consequences.

As previously stated qualifications and regulations are meaningless in improving safety. These can only be properly tackled by proper supervision, processes and practical (hands on) training backed up by proper management.

Maybe the VRCT needs to re-think the whole idea and switch to compulsory management regulation and registration rather than going after technicians and engineers?

VRCT needs to re-think, now where have I heard that before?

Well Geoff I'm sure the guy servicing the x-ray unit, anaesthetic machine or ventilator to name a few has far greater potential to do harm than the neb king! Obviously there's going to be a big difference between training required for the tasks.

Another thing I've noticed in the NHS is the response to call for yet more management as a answer to any problem. It reminds me of the old story of the Japanese/American boat race. In risk management particularly using the swiss cheese model supervision is only a factor, you can't supervise your way out of a problem. Also you'll find in the private sector that many of these management roles are actually incorporated into engineering and technician roles, therefore a register of managers is a very bad idea.

My mother always told me to shop for the best quality you can afford, I think she had a point. Throwing more tiers of management at a problem never works.
Allocating the right person, with the right skills, and the right experience is a Managerial responsibility.
The NHS code of practice for professional Managers, coupled with opening the market, will ensure that if you are not up to the job, competitive tendering will take place. If there are those who can perform your task better than you, for a more competitive rate thats okay with me. Successful bidders should be NHS, OEM or private sector. Regulation is not about patient safety, but about advocating a closed shop, and it does not encourage best value. Those who are competent have nothing to fear.
Allowing fly by nights and Cowboys? Some will rage..

Read that first line again, best quality you can afford, with the appropriate vetting processes and safeguards in place.

"Thus on 24th April 2013 a group of organisations, including the VRCT, representing nearly 10,000 unregulated healthcare professionals" Quick question "how and by who's authority can you represent unregulated healthcare professionals if they are not members of your club" I doubt that you have 10,000 members in your club.

Democracy isn't very democratic Neil, even in government you'll only get less than 15% of who can vote supporting the winning side. (Jim might have more authority than a Tory lead coalition! :-) ) That said opposition isn't great either, who can say this site represents the views of biomeds, I remember a vote I attended recently where there seemed to be a popular vote but when it came to voting it was 10 to 3000 against. No democracy is the minority who vote verses the loud mouths.

That said the important phase here is alliance, you can get far more support if groups band together and also last time I looked the VRCT did have a rather surprising large number.

"Membership is drawn from the disciplines of clinical physiology, clinical technology (which includes medical physics and clinical engineering), cardiology, medical illustrators and photographers".

To be fair Neil, when you lump together all the diverse groups that The Alliance For Patient Safety includes, the figure must approach 10,000. (On paper, I think the VRCT must have at least 3500 members).

The Alliance For Patient Safety represents the aspirations of its members, much like the VRCT. (I don’t have any issue at all over this premise). What I do take issue with, is the way in which they imply that those who are not part of their alliance, the unregulated professionals are subjecting thousands of patients a year to risk.

The term "professional" is defined as
Adj.1. a. Of, relating to, engaged in, or suitable for a profession: lawyers, doctors, and other professional people.
b. Conforming to the standards of a profession: professional behaviour.
2. Engaging in a given activity as a source of livelihood or as a career: a professional writer.
3. Performed by persons receiving pay: professional football.
4. Having or showing great skill; expert: a professional repair job.

The term "unregulated" is defined as
Adj. 1. unregulated - not regulated; not subject to rule or discipline; "unregulated off-shore fishing"
regulated - controlled or governed according to rule or principle or law; "well regulated industries"; "houses with regulated temperature"
2. unregulated - without regulation or discipline; "an unregulated environment"
unstructured - lacking definite structure or organization; "an unstructured situation with no one in authority"; "a neighbourhood gang with a relatively unstructured system"; "children in an unstructured environment often feel insecure"; "unstructured inkblots"

It appears that the phrase "unregulated professional" is contradictory, and insulting. The implication is that anyone not registered with its constituent groups are putting patients lives at risk.

Before VRCT members signed up, were they subjecting thousands of patients a year to risk? Look at your colleagues who are not VRCT members, do they subject patients to risk, by virtue of non-membership of the VRCT?

The viewpoint expressed may be deemed indicative of the esteem in which the Alliance For Patient Safety, and the VRCT views non-members, and thus an overview of our Biomedical profession as a whole.

It all depends what folk actually want:- a small group for biomeds, or being lumped together with a load of "odds and sods"!

My own vote (still says):- neither. None of it. Stay clear.

Or:- what's the point of any of it?

@Chris: who wants Democracy? It's a flawed concept, in my opinion; where the gang - better make that gangs - you (that is, I) don't like get to be the majority just by breeding. Myself, I much prefer a Benevolent Dictatorship, or an Absolute Monarchy ... where those who actually know what they are doing get to be in charge.

Or, if you like ... where your vote (the thoughtful, well-informed voter) gets cancelled out (and more) by the low-life trash living just down the road (or worse still, just next door) ... that is, by those whose votes have effectively been "bought" by promises of more "benefits", "special considerations" (for "minority groups" or what-have-you) etc., etc.. I could go on, but won't. But suffice to say that our famous Liberal Democracy is, in fact, a con. Let the Revolution begin soon!

And that's really why I'm not into "gangs" (of anything, biomeds included) myself. They usually start off with (what sound like) good intentions, only to end up as a Power Trip for those in charge. The last thing I would be interested in would be yet another "community" crying out for (bleating, expecting, demanding) special treatment.

"Safety in numbers" is a myth. Just carry a Big Stick! And who wants to be simply one of the herd (or perhaps more accurately, the flock), anyway?