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The following announcement was recently made to members of the professional bodies involved with the Voluntary Register of Clinical Technologists:

"At its meeting held on 13 May 2004, the Health Professions Council (HPC) agreed to regulate the Clinical Technologist profession, however, the decision was tempered because of the HPC’s need to have further evidence before making a final recommendation for regulation to the Secretary of State for Health. The paragraphs below provide further details.

The fundamental purpose of the Voluntary Register of Clinical Technologists is to demonstrate to relevant stakeholders the need to regulate the Clinical Technologist profession. Since the Register opened in October 2000 much work has been undertaken by the members of the VRCT’s constituent professional bodies (IPEM, ART and IIE) to ensure that this purpose is achieved.

The application for regulation was completed and submitted to the Health Professions Council in March 2004 (Copies of some the documentation submitted can be found on the HPC website at http://www.hpc-uk.org/council/meetings.htm under the details for the meeting held on 13th May 2004). Of fundamental importance in the application was the compromise reached between the VRCT and the Department of Health regarding the level and range of acceptable qualifications. Thus the VRCT went forward with a dual qualification application, that is, HNC/HND for engineering technologists and a degree in clinical technology for physics technologists.

The executive summary of the application can be found on the IPEM website at http://www.ipem.org.uk/clintech/clintech.html along with a copy of the detailed presentation made to the HPC. Only seven days before the May meeting the HPC issued their scoring of the VRCT application. The result of the scoring was particularly disappointing and left a lot of work to be done to address the issues raised and only a short time in which to do so.

According to the HPC, the two main weaknesses of the application were the failure to define the discrete area of activity displaying some homogeneity, and, the lack of a body of knowledge! (Note: if you wish to review the HPC application process for new professions, this can be found on the HPC website at http://www.hpc-uk.org/professions/new_professions.htm .) Other problem areas included the defined routes of entry and independent assessment of the entry qualifications. During the intervening seven days significant work was undertaken to ensure that the presentation made to the HPC addressed those issues as well as incorporating the entire application.

The VRCT representatives at the HPC were Mick Wingell (IIE), David Gandy (ART) and Jim Methven (IPEM), who made the presentation. The Council consisted of between 25-30 members and there were perhaps another 15-20 members of the general public also present. The presentation contained slides identifying the many and varied roles of the Clinical Technologist but equally emphasising the common threads between them. The intention was to explain to the HPC exactly who Clinical Technologists are, what they do, where they operate and with whom they work.

Once the presentation was finished there was then a period for Council Members to ask questions. These included questions about the education requirements, disciplinary procedure, membership and the results of the ballot of Registrants. Questions were also asked about the minimum educational requirements, the difference between Medical Physics and Clinical Engineering, Radiographers, Clinical Scientists and the Life Science Technicians, but eventually the majority of the questions revolved around the differences between the two routes of entry: the Medical Physics Clinical Technology degree route, and, the Clinical Engineering route using the HNC/HND model. After about forty five minutes of detailed and intense questioning a debate followed. Eventually after much angst and detailed discussion, the Council voted on a proposal to regulate the profession. They agreed that the practice of Clinical Technologists has the potential to cause harm and therefore requires to be regulated. However, there were conditions attached that would need to be satisfied before the Council could make a final decision.

Essentially they require clarification on two points: Firstly, that the requisite minimum level of education to work safely as a Clinical Technologist must be set at the same level across all of the disciplines and not set differently as in the application. Secondly, that further consideration should be given to the part of the HPC Register on which Clinical Technologists would be regulated (this may mean that perhaps consideration be given to joining with other groups such as Life Science Technicians working with technology, who might also fit onto the register).

They agreed to consider these matters at the HPC Council meeting to be held in September, when a final decision would be made. Apparently, the final decision on whether to regulate Clinical Perfusionists and Clinical Physiologists will also be made at the September meeting. It is uncertain at this stage exactly what the VRCT input will be to that meeting, although it was suggested that documentary evidence might be all that is required. Arrangements have been made to have a further meeting with HPC officials on 21 July. Before this meeting takes place it is hoped to meet with the Department of Health’s Chief Scientific Officer and representatives of the DoH Regulation Branch.

A number of tough decisions will need to be made soon which could have repercussions for the future development of the profession – especially with regard to minimum acceptable qualifications. IPEM members will be advised of developments. In the meantime, if you have any comments to make about the VRCT application please send these, in writing, to the VRCT Registrar at the IPEM Office.

Footnote:
The actual wording of the HPC decision is as follows:

“RESOLVED:

That clinical technologists should be regulated but that before a recommendation to that effect is made to the Secretary of State:

1. The VRCT submit further evidence to satisfy HPC that an appropriate Standard of Proficiency can be established for clinical technologists as a single profession; and

2. Further consideration is given to the Part in the HPC register in which clinical technologists should be regulated, having regard to the proposed re-structuring of the HPC Register.”

Jim Methven (IPEM)
David Gandy (ART)
Mick Wingell (IIE)"


Edited to resolve bad link - Huw
They don't seem to appreciate the difference in the rolls. A "scientist" obviously needs a higher level of academic qualification than a "technologist", where the emphasis is more on physical dexterity and skill as well as a basic "flair" for all things mechanical / electrical / electronic.

This is reflected in the different qualifications. A degree is a highly academic course whereas an HND is much more hands-on and practical. I've worked in manufacturing industries alongside people with degrees who didn't know one end of a soldering iron from the other and hadn't a clue how to tackle a circuit that wasn't working. They could analyse the design in great detail, but if a faulty component rather than a design fault was the source of the trouble, they were lost.

To insist that what are effectively two widely different jobs should have the same entry requirement seems ridiculous and unhelpful. In my side of things I need people who can repair things quickly and accurately, but not calculate X-Ray dosage or deal with Laser protection issues.

I know you can say I'm over-simplifying it and the boundaries maybe aren't that clearly defined or obvious in some places, but we've got to take an overview - or "chopper view" as my ex-boss liked to call it - and not back ourselves into a situation where the only people who we can consider for our technician vacancy are academically gifted people with no physical aptitude !

Maybe we need to divide the profession into two and push forward on two applications ? One for the Clinical Scientists and one for the Clinical Technologists. Both groups have the capability of causing serious harm to patients (and staff !) and I agree that everyone should be registered, but I think the insistance on a degree for a technicians job would be a serious mistake.

I apologise in advance to anyone who feels personnaly isulted by these comments. Remember I'm trying to look at it in a general way rather than worry about the exceptions to the rule - and I'm certainly not saying that everyone with a degree is hamfisted and useless - just the majority !
eek
Roy,

I think you are getting a bit confused, Jim's post splits Clinical Technologists into two groups. Engineering Technologists (MTO's working in EBME etc) and Physics Technologists (MTO's working in Radiotherapy, Nuclear Medicine, Radiation Protection etc.) Clinical Scientists are already state registered by the HPC and can be found in both Clinical Engineering or Clinical Physics specialties.

If the HPC are worried about the different educational requirements maybe they should look at whether the Physics Technologists minimum requirement should be HNC/HND and not try and force the Degree reguirement on Engineering Technologists. Remember this is only a minimum, if departments want to employ people with degrees they can still do so and write the job descriptions accordingly.
Bioman. Thanks - you're right - I am a bit confused !

Having read through Jim's posting and following the link, I just sat down and wrote my bit whilst I still had steam coming out of my ears ! mad

I just read through so much stuff I lost the thread.

Your point is a good one. The entry requirements are minimum, so the HNC/HND could easily be applied to both branches. If there aren't any HND courses which are relevant to the work done by the Physics Technologist, then they just ask for a degree instead.
Posted By: KM Re: HPC Agrees to Regulate Clinical Technologists - 23/07/04 11:44 AM
Question, if anyone can help. rolleyes
What happens where you have a group of staff, all graded at lets say MTO3***.
All have been employed at grade the same period of time.
All have had the exact same training on the job since taking up post.
All have exactly the same levels of responsibility and duties.
But one of them doesnt have a HNC eek , however they where accepted onto a post advertised as "HNC or equivalent" and the interview panel appointed because they considered that the experience the individual had was suitable.
Does this new suggestion mean that the bod without a HNC will be dealt with differently than the others ?
I don't think so - as long as they all were accepted for registration because of their length of service etc. How we deal with someone who we know is perfectly capable, but doesn't get registered on a technicality, is another question !

There must be lots of EBME / Medical Electronics / Medical Engineering departments around the country where not a single technician has a degree/HND - and maybe not an HNC either - because the staff were trained in the days when industry ran apprenticeships and if you wanted to mend electrical / electronic things you did a City & Guilds. I don't think anyone is saying that these departments haven't been doing the work properly all these years - at least I hope they're not - so why do we have to change to an accademic based entry requirement ? Many clinical staff are assessed for promotion etc on competency and much of the technical training provided by the companies is competency based. There's a system in place which would enable Trusts to assure themselves that the technical staff were competent to do the job - something which the gaining of a degree or similar qualification certainly does not.

If everyone has to have a higher qualification to stand any chance of getting any sort of job, then the criticism that degrees etc have been de-valued by the upgrading of so many establishments to University status and the massive increase in students studying in them, will be well founded.

Are skill and aptitude things of the past ?
Posted By: Anonymous Re: HPC Agrees to Regulate Clinical Technologists - 23/07/04 7:12 PM
Roy,

I think the point of the original "two-tier" application to the HPC was to allow for a vocational entry route and academic entry route into the profession and allow both Degree and vocational qualified individuals routes to registration. However it seems that the HPC wants a consistent level of entry i.e. for Engineering Technologists to be at the same academic-level as the Science Technologists. My view, reading between the lines is that level for technologists will have to be pitched at Degree I think.

Quote:
A number of tough decisions will need to be made soon which could have repercussions for the future development of the profession – especially with regard to minimum acceptable qualifications.
The statement above gives me the impression that this might be the case. I cannot see the HPC allowing Engineering and Physics Technologists to be included on a state register after the VRCT panel has already argued successfully that the appropriate Physics Technologists entry level is Degree. Plus the fact that most, if not all, of the other healthcare professions have Degree entry into the profession.

If the VRCT panel does not accept and argue to the HPC that Engineering Technologists enter at this level then I would not be surprised if Engineering Technologists lose the chance of becoming state registered professionals at all. i.e. Engineeering Technolgists as a group may be excluded from the register because the entry level is not pitched high enough.

If this happens then, in the future, equipment maintenance in the NHS, as we know it, may only exist in Medical Physics Departments that have Physics Technologists carrying out equipment maintenance as state registered professionals - allowed to perform the full range of duties and tasks in clincal areas unsupervised. Wheras the Engineering Technologists of the future might have more limited roles that are not regulated.

I suspect this is why there are two sets of profiles in AfC for 'Medical Engineering Technicians' and 'Medical Physics Technicians'. Both groups with very similar job-roles and almost identical scoring for AfC matching but I suspect one group may be state registered in the future (Physics Technologists) and the others not (Engineering Technologists), with salaries and AfC grades commensurate. Of course I hope I'm wrong.
Posted By: Anonymous Re: HPC Agrees to Regulate Clinical Technologists - 29/07/04 8:21 AM
I agree
Hang on here, Yes there are two sets of profiles one for medical engineering technicians and one for medical physics technicians. At first glance yes they do look the same, are they the same NO! How do I know this because I in conjunction with others wrote them. If you carefully at these profiles you will see that the major differance is that the medical physics profile allows for equipment design and development issues, whilst the medical engineering profile does not. This is the only real differance! Effectively the medical physics profiles apply to clinical engineering EBME posts (what is the differance may I ask) that have equipment design and development aspects amongst the job function. Therefore there is no reasion why in a large department be it CE or EBME you could not have staff with both ME and MP profiles working within the same department - remember the profiles are about what the job content is. In deed if you have a medical physics equipment service which does just conventional ppm and repair activity then those staff should be using ME and not MP profiles.

Looking at Academic qualifications these are set along the degree route for both sets of profiles quite deliberately, as the profiles have been writen for today and tomorrow with a view to the major changes that ARE GO TO HAPPEN in the next couple of years, yes there are going to have to be some hard choices namely at what - for a better way of putting it - profile/pay band will state reg for CE/EBME - (call it what you will) - will registration apply bearing in mind that the band 4 profile for example is a "training grade"

The question to be asked is a simple one "Do we wish to remain in the Dark Ages or are we bearing in mind what should be our professional ethic of professional development going to move into the 21st Century?"

I for one know which way I want to go
Hear! Hear!

I'm all for raising the level to the same as other groups but, the only problem is that at the moment there are very few clinical/medical technology courses around which encompass the right sort of engineering.

Without this, we could end up with lots of highly educated people with no idea of how to carry out the normal everyday functions required to ensure that equipment is safe to use.

No-one seems to be adressing this little anomaly. Even the IPEM based courses seem to be biased towards the physics side of things.
May I point out that there is no formal link between the Agenda for Change process and the regulation of Clinical Technologists. The profiles developed for Agenda for Change have not been used or considered by the VRCT team.

Additionally, the criteria used by the HPC to decide whether a profession should be regulated or not are based on the profession's "potential to cause harm", not on its educational qualifications!

Finally, IPEM, ART and IIE are currently working hard to develop partnerships with educational providers in order to produce relevant clinical engineering degree courses for Technologists.
Regarding the point that new graduate staff often lack the necessary practical, abilites that's just a fact of working life in general. Most youngsters come out of Uni very green and it takes a good year for them to be of any real use. I've trained a couple of graduates in fault finding before now and I only have (very) old C & G qualifications.

Anyone who has ever studied knows that a lot of what they are learning is just jumping through hoops to demonstrate their academic ability. The proportion of what they study that will actually later be used is often quite small. So they will need to learn a lot of new stuff when they get into a particular area of work. The degree shows they are good learners.

So once the graduate staff settle into the real world they should be a lot more able than an oldies like me in the long run.

If we are developing the profession, that's the way to go!

Marc
Marcel

Just to support what you say, I came into the field as a graduate and I can confirm that I probably use less than 5% of what I learnt at University (or Polytechnic as was back then). Most of my knowledge and skills I use now is gained from on the job learning, from colleagues, courses or what I have to go out and learnt myself.

Doing a degree gives you a foundation with which to improve, it certainly doesn't make you competent or valuable once you have just graduated, that has to earned through hard work.
Yes, being a graduate indicates a propensity and ability to learn. Fine. My main concern is that we are now looking at a potential training period of 5 - 6 years (inclusive).

Compare that with what we have had - on the job training at the same time as the academic bit. At the end of 2 - 3 years you have someone who has experience and a qualification (HNC/D) which is relevant. Or as some of us did - an apprenticeship.

It is the change to having this in conjunction with a degree that needs addressing.
The HPC have agreed to regulate but........

Has anybody heard anything since that statement was made?

Rome waen't built in a day
There is a lot of talk of having to have a degree but how many places actually do a degree in Clinical/Biomedical engineering? You would ideally need this rather than a generic electronics degree as it would lessen the further training required.
U of Kent at Canterbury did one and I think still do it but how many more are still going?
Robert
I thing Glasgow do one and there used to be a joint effort between Derby and Nottingham (or Nottingham and Leeds . . . . or somewhere). I'm fairly sure I saw something advertised in South Wales not too long ago - might have been Cardif.

But they're few and far between.

Perhaps the NHS University will be putting a suitable course on ? ? ?
I started working in Medical Physics as a technician three and a half years ago. I was employed at the low end of MTO2 with an HND in Electrical and Electronic Engineering. I had no previous experience in electrical/electronics as a career. I am still an MTO2. There has not really been a training scheme for me to follow. I recently applied to join the voluntary register. I was rejected because apparently I need four years' experience unless I have been completing a registered training programme. I have been trained up in-house on a wide variety of equipment, attended manufacturer's courses and studied (and passed) the post-graduate Anatomy and Physiology module of the Medical Physics MSc at Leeds University. I have been calibrating all the audiometers and tymps for the last eighteen months, and I carry out PPMs and repairs on a daily basis. I would really appreciate a scheme that can recognise my training and that of others, so that we can be registered properly. It would also help us to be promoted to the working grade.
yes, yes, yes, but where are we now with regard to HPC and registration?

It will affect us all but..... confused
The University of Cardiff School of Engineering do an MSc in Clinical Engineering, part time, distance learning, which is well worth looking into for those looking to extend or formalise their career in biomedical engineering. Only problem is, Cardiff town centre is too damn close!!!!!!!!!
Clare and everyone
My posting was put out as I feel that there needs to be a structured training plan in place for technicians. It is all very well saying you need this and that but there needs to be the infrastructure in place to provide it.
And when the compulsary registration scheme is in place those going throught the training to get their experience and qualifications will need to be able to be released from "normal" duties for a periods of time. Will these posts be supernuminary? Will there be new training posts created like the grade A medical physics training posts?
I am all for registration and the training and experience that goes with it......as long as it can be properly provided.
Robert
So it's back to the discussion about whether someone with a degree is equiped with the knowledge and skills required to become a Medical Equipment Technician. There seems to be general agreement that the answer is "no" unless there is a proper training scheme in place - or maybe a specialised degree course which would hopefully include some on-the-job training.

Most department heads I know agree that taking on a new starter with no previous hospital experience places a huge strain on the department and seriously effects "productivity". The New Boy is a drain on limited resources - at least for a time, untill they can safely be left to get on with it by themselves. So "proper" training can only realistically be provided by the large departments - who must be funded accordingly and must accept that they will lose the majority of the people they train to other hospitals.

If such training isn't available and there aren't enough graduates coming through the specialised degree route, then registration is going to mean either lots of vacancies or lots of departments struggling to train people with limited resources, limited budgets and limited time.

Result = poorly trained technicians who take years to aquire the knowledge and skills necessary to allow them to achieve their potential.
Posted By: Anonymous Re: HPC Agrees to Regulate Clinical Technologists - 20/09/04 9:06 AM
Rojo's right in my view. Not all departments are big enough to support the demands of structured training or provision of adequate supervision to trainees or supernumeraries full-time. Plus there may not be the knowledge-base and skills mix of individuals on-site to give that training and support whilst trying to keep the on-site EBME or Medical Physics services ticking over.

I think structured training can only be provided for all entrants to the same standards, nationally, if accredited centres, located around the country at sites that can support on the job training and continuing professional development are used.

Until then managers in Medical Physics or EBME will always face the dilemma between balancing the manpower and other available resources available to keep the services going and the need to train technicians. The situation we are in now I think.

However, in the future because of regulation, we might not have the flexibility of employing low grades, calling them 'trainees' or to employ 'less than ideally qualified individuals' on working grades that don't reflect their initial value and receive on-the-job training that varies considerably from department to department.

It seems to me, that the workforce is in it's current state because many Trusts have not and do not want to invest in skilled NHS personnel who are employed in a job-role that's in demand like we're told ours is. Those who might be lost as soon as they're trained; to other Trusts prepared to 'dangle a carrot'.

The infrastructure is there in Regional Medical Physics Departments, to some extent, for the Clinical Scientists training and I suppose this could be expanded to Clinical Technologist training. Whether trianing facilities like these will be extended to 'cover' EBME services or made available to them or not I don't know.

I'm still of the opinion that EBME engineers may face a different training and possibly career path than those employed in Medical Physics. Hence my concerns about the original HPC application for regulation that initially divided 'Physics' and 'Engineering' and did not include any reference to 'life-sciences' qualified individuals at all; as far as I'm aware.
Posted By: Anonymous Re: HPC Agrees to Regulate Clinical Technologists - 20/09/04 9:25 AM
Roy,

In my opinion qualifications - i.e degree or no degree is not the issue - we need to get away from that 'old fashioned' thinking. Eventually all trained technicians will have or should have a degree or degree equivalent qualifications that satisy everybody concerned. It's not about experience versus qualifications anymore - it should be about having the same level of skills and competences based on the training you've received fullstop.

Whether the training started out with a degree and developed experience and skills (possibly academic route) or whether it started out as a hands-on experience and skills being practised and ended up with an academic qualification (the vocational route). Both equivalent - no arguments. The training needs of, initially, degree qualified and those of non-degree qualified entrants being satisfied and competence proven at the end of training.

I think we have to admit that most departments' training is simply not up to it for various reasons. A 'Lack of resources' and 'no requirement to provide structured training to a nationally accepted standard' are convenient terms that must be forcing managers to go for the cheapest option every time in my opinion.
Clinical scientists are registered with the HPC.
From what I understand the route is via the Grade A training scheme, the entry requirements being a first or upper second class degree.

http://www.nhscareers.nhs.uk/nhs-knowledge_base/data/4842.html

The traing scheme involves the completion of a masters degree

http://www.medphys.soton.ac.uk/
Quote
leads to DipIPEM and is open to graduates with a good honours degree in an appropriate science or engineering discipline, with or without an accredited MSc. Those not already holding an accredited MSc will pursue such a course in Medical Physics or Bioengineering at the University of Surrey, full-time, during the first year of training.
Unquote

From this I deduce that registered clinical scientists hold a masters degree and have a dedicated training route that can be sponsored by the NHS.
Posted By: Anonymous Re: HPC Agrees to Regulate Clinical Technologists - 20/09/04 11:58 AM
Yes, I think the Grade A training provides graduates with a relevent postgraduate qualification e.g. M.Sc in Medical Physics and training under supervision. At the end of this the trainee will have been assessed for competence by exam and assessment I think. Training and assessment is done by placements within relevent departments. A candidate completing the grade A training is eligible to apply for grade B posts and then progress through the system.

Quote:
The infrastructure is there in Regional Medical Physics Departments, to some extent, for the Clinical Scientists training and I suppose this could be expanded to Clinical Technologist training.
What I was getting at about extending the training to Clinical Technologists is that the Clinical Scientists could help provide the academic stuff and are usually involved in the provision of Medical Physics equipment maintenance (including Radiotherapy and Diagnostic X-Ray) and have links with Universities and other departments. They are set up, in some respects, to branch out into training, or at least the organisation of Technologist training, by Technologists, in their departments. Certainly for 'Physics' Technologists anyhow.
Just to let everyone know.
I contacted IPEM on 22/10/04 and enquired what was happening with regard to registration. I was told that they had no information yet, they where waitng to be told.

Nice to be keep informed.
Registration agreed.

This is from http://www.ipem.ac.uk/ipem_public/article.asp?aid=1171&id=

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Earlier this year the VRCT Assessors Panel wrote an article in the IPEM Newsletter to provide news of progress with the application for regulation of Clinical Technologists by the Health Professions Council (HPC). Since that article appeared much has happened.



The first important development is that, at its meeting held in October 2004, the HPC agreed that the Clinical Technologist profession should be recommended for regulation, without condition. The next stage of this process is for the Department of Health (DH) Regulation Branch to undertake public consultation. Then formulate the necessary legislation, which will be laid before the Scottish and UK Parliaments in 2005. This will mean that the profession will be regulated by the HPC in late 2005 or early 2006. At this point the voluntary register will close. In addition a three year transitional period, expected to end in 2008/2009, is anticipated. However, before we reach that summit, there are a number of key issues that require to be resolved. Including the impact of this decision on: future entrants to the profession, those currently in training, employers, commissioners, and education providers.



Reaching this position has not been straightforward as, prior to this decision being made, the officers of the VRCT held numerous meetings with both the HPC and the DH to discuss and agree aspects of our application. At those meetings important issues such as educational standards, standards of proficiency, scope of practice, agenda for change and the healthcare science career pathways were raised as important indicators of the way forward for the profession.



A key point to report is that the dual entry qualification model of a Medical Physics Clinical Technology degree or Clinical Engineering HNC/HND has now been abandoned. The constituent professional bodies of the VRCT have accepted that the educational standard required by the DH is a qualification that can be independently assessed using the Quality Assurance Agency for Higher Education (QAA) assessment system. As this assessment process does not oversee HNC/HND courses, there is now no case to pursue the dual entry qualification model. Thus we have agreed that the minimum entry qualification for the profession will, in the future, be an honours degree in Clinical Technology. This degree will be divided into two branches: Medical Physics and Clinical Engineering, and will be vocational in nature, comprising academic modules and competence-based practical training.



It should be stressed, that those already on the voluntary register or, currently aspiring to join, do not require to possess a degree in Clinical Technology in order to be regulated. However, by 2008/2009 all new entrants to the HPC statutory register will require to hold a degree in Clinical Technology.



Another important issue has been concerns raised by others regarding the need to regulate Clinical Technologists working in Clinical Engineering. On 26 November 2004 the Chief Scientific Officer, Professor Sue Hill, organised a meeting with all interested stakeholders to discuss this issue. In attendance were representatives of: the VRCT, the devolved UK administrations, NHS Estates, DH Regulation Branch, NHS staff side trades unions, educational providers, Strategic Health Authorities, Heads of NHS Clinical Engineering departments, IHEEM, ART, IIE and IPEM. The outcome of the meeting was extremely positive. All attendees agreed that it was of fundamental importance to ensure that those working in clinical engineering were regulated and that the appropriate qualification should be an honours degree in Clinical Technology.



Although all of the major hurdles to regulation have been cleared there is still much to undertake. The main issues to be resolved are listed below along with the steps being taken (in italics):



1. There are insufficient Clinical Technology degrees in existence. By September 2005 there needs to be an increase in the number of courses available. Our conservative estimate is that between 80 to 120 places will be required per year.



There are already a range of Clinical Technology degree programmes in place which mainly support those working in medical physics areas such as nuclear medicine, radiotherapy and radiation protection but Clinical Engineering has only a few. The VRCT and the DH have now established a VRCT Education Providers Group. This was primarily done to support the development of clinical engineering degrees. A number of universities have expressed interest, including: Paisley, Swansea, Bradford, Nottingham, Leicester, Bournemouth, Teesside, Kings College London, NESCOT and the Open University. We also expect others to become involved. This group has held two encouraging meetings and are now working with the National Occupational Standards project to develop the work further. A third meeting will take place in January. We anticipate that by then substantial progress will have been made.



2. We require to develop processes to accredit prior experience and learning which will count towards the acquisition of a Clinical Technology degree.



The education providers have indicated that it is entirely feasible to introduce such processes. Thus those wishing to join the profession who have HNC/HND or equivalent will be able to acquire a Clinical Technology degree in a reasonable time scale. This will be achieved through the accreditation of prior and experiential learning, and the acquisition of additional educational modules and workplace training.



(Note: This means that we will continue to attract into the profession those holding HNC/HND/equivalent qualifications or specialist practical skills. It also ensures that, in the future, all entering the profession will be guaranteed structured, competence-based education and training which is independently assessed.)



3. The IPEM Clinical Technologist Training Scheme, which will play a key role in the transitional period, requires to be updated.



It is anticipated that the IPEM training scheme (under the auspices of the VRCT constituent professional bodies) will be used to accredit training and education processes through the transitional period up until 2008/2009. The IPEM Clinical Technologists' Education and Training Panel are currently actively reviewing and rewriting the Training Scheme in readiness for regulation.



4. In order to meet the needs of the HPC we require to develop Standards of Proficiency for the profession. These describe safe and effective practice which registrants are required to meet. We also need to describe in more detail the scope of practice of the different strands of the profession.



These tasks are currently being undertaken by the VRCT Assessors' Panel and will be completed in early 2005.



5. We need to agree guidance with the DH on the processes required to deal with those in training or not eligible to join the Register at the time of regulation.



The VRCT's constituent professional bodies are working with the DH to agree the necessary processes. Once agreed, this information will be widely circulated.



6. We need to encourage all who are eligible, who have not already joined the voluntary register, to do so.



The VRCT's constituent professional bodies will work with the DH to enable recruitment of all who are currently eligible to join, and to encourage those who are not to become registered on the IPEM Training Scheme.



7. There needs to be a campaign to raise employers awareness of impending regulation and to ensure that financial support is in place to support trainees undergoing degree programmes and workplace training.



Again, the VRCTs constituent professional bodies will work with the DH to educate employers on developments and to ensure that NHS Workforce Development Confederations provide funding for the degree programmes. This will include the associated work based clinical placements.



As you can see there is still much to do before regulation occurs but the future well being of the Clinical Technologist profession is assured. We would urge you to embrace these developments and raise awareness with your colleagues, within your organisation and with all other interested parties.





The VRCT Assessors' Panel:

Jim Methven (IPEM)

David Gandy (ART)

Mick Wingell (IIE)

Andy Mosson (ART)

Andy Iles (IPEM)

David Burrell (IPEM)

Stuart Slade-Carter (IIE)
What is happening to all those techs out there with just ONC.

ONC is the entry level to get into this job, dose this mean it will be changing to degree standard.

Will ONC be aloud to work after 2008, or will I still be working and getting some one else to sign of the job.

It will be handy if the Open University dose runs coarse in clinical technology, as this will be the only way forward for a lot of people.

A.M confused
It doesn't look as if the onc, hnc, hnd, or the level 3 C&G's will be good in the end.
so why not force everyone to get A Deg. in Clinical Technology and inforce CPD on Everyone.
No cop outs for BEng.or anything else.
That way everyone jumps through the same hoops,
i bet the degree,ers will not like that
The main focus of interest must be the "arrangements" for staff currently employed who do not meet the voluntary register requirements and will not meet the statutory requirements of registration.

It would be totally wrong to force perfectly competent technicians who are in their 50's to spend several years studying for a degree which many of them would just aquire in time for their retirement ! Is the Dept. of Health going to give them early retirement once the 3 year transition period has expired ?

Why isn't it acceptable for someone to be happy in their job ? Why is there always pressure applied to try and force them to "develop" ? If a technician want's to work out his time servicing Oxygen therapy equipment, suction machines and nebulisers, then why do we have to force him to learn about ultrasound, X-Ray, surgical diathermy etc etc etc ? mad
May I thank Graham Driver for posting the VRCT update - I had planned to do so later this week. May I also ask people to read the information very carefully, especially where it points out:-

"It should be stressed, that those already on the voluntary register or, currently aspiring to join, do not require to possess a degree in Clinical Technology in order to be regulated. However, by 2008/2009 all new entrants to the HPC statutory register will require to hold a degree in Clinical Technology."

This means that if you are currently working in the profession you do not need a clinical technology degree either now or in the future! Thus if you have gained entry to the Register with an ONC, C&G, HNC or any other similar qualification that is acceptable now and for the foreseeable future.

Jim Methven
It sounds like you are certain that members to the VRCT will be transfered en-block ?
That comes from establishing a voluntary register - all on the register are automatically transferred to the statutory register!
2 points ;-

Surely it cannot be guaranteed that everyone on a voluntary register will be transferred ? There must be some check that the entry requirements are sufficient, otherwise we could set up a voluntary register which was open to anyone who could demonstrate an ability in knitting, cross-stitching or paperfolding confused

There is still the problem of how to deal with the existing, long serving technicians who have absolutely no formal qualifications at all - not even "O" levels - so cannot apply for the voluntary register.

Alex has a relevant point about Trusts moving towards external service providers. In the future, when the existing technical staff have retired (which according to the survey done a few years ago won't be that many years away for the majority of staff) and we can't recruit enough people into the profession because there aren't enough people with the specialised degree, there won't be any option but to contract the service out !

I think it's called "shooting yourself in the foot".
Surley even external service agents will have to be compendent otherwise isn't the whole thing a farce.
and no I don't think manufacturer training is good enough for site repairs.
I thought the idea of EBME department was cut down the number service agent used. Hopefully this would them bring the running cost down.

Dose this mean in 2008; the entry level for all technicians will be band 6. This is not a fair system and will not help the shortfall clinical technologist.

A.M frown
I've been following the debate over professional registration for some time and have mixed views. Encorage professional registration but do we really need compulsory state registration? It could be a good thing in the very long term, but there seem to be some key issues still to resolve:

Exactly what activities will require state registration? For example would an in-house tech servicing an anaesthetic machine need to be registered? Somewhere there must be crystal clear definition of who needs to be registered to do what. Which brings me to the second question.

What about the private sector and manufacturers design, sales and service staff?
- If the answer to my first question is 'yes' then surely a visiting service engineer would also need to be registered. - and if not the exercise is pointless as Clinical Technologists would only exist as a group within the NHS and not really be a profession.
I'm sure there will be lively debate over the next year or so but I guess it's about time I joined the 'volutary?' register.
Graham
As i implied earlier people on the VRCT may not be accepted en-block.
I did not dwell on this as it was talked about else where in the forum.
Why join the Voluntary Register of Clinical Technologists now?
The experience of other professions recently registered, and now under the regulatory regime of the HPC, indicates that some form of grandparenting arrangements will be introduced to facilitate the initial establishment of the legal register. Professions that had voluntary registers of good standing have been able to have their registrants transferred to the new register as one group. It is hoped that similar principles will apply to those who join the VRCT before a date yet to be specified when a new HPC register is formed that will include Clinical Technologists.
Ref. http://www.ipem.ac.uk/ipem_public/default.asp?id=456
Let me reply to the points raised recently:

1. Question:
"Surely it cannot be guaranteed that everyone on a voluntary register will be transferred. There must be some check that the entry requirements are sufficient, otherwise we could set up a voluntary register which was open to anyone who could demonstrate an ability in knitting, cross-stitching or paper folding"

Answer:
Over the last two years the Voluntary Register of Clinical Technologists has gone through a rigorous process overseen by the Health Professions Council and Department of Health. This has involved preparing and submitting a detailed application (running to over 150 pages of information). This was followed by a detailed examination of our application through numerous meetings and a presentation to the entire HPC. As part of the process we had to convince both organisations that we had in place certain criteria, these included:

* A defined body of knowledge
* Establishing that the practise of the profession is based on evidence of efficacy
* The establishment of a Voluntary Register
* The establishment of a body to oversee the Voluntary Register
* Defined routes of entry into the profession
* Independently assessed entry qualifications
* Standards relating to conduct, performance and ethics
* Disciplinary procedures to enforce standards
* A commitment from all in the profession to be committed to, and undertake, continuous professional development

Having established these criteria it stands to reason that all on the voluntary register will transfer to the statutory register.

2.Question:
"There is still the problem of how to deal with the existing, long serving technicians who have absolutely no formal qualifications at all - not even "O" levels - so cannot apply for the voluntary register."

Answer:
This statement is entirely wrong and mischievous! It would have helped if the author of the statement had read the VRCT application criteria. The plain facts are: unless you were first employed as a Clinical Technologist after 1st August 2001, there is no requirement to hold formal qualifications. Thus long serving Technologists with no qualifications have access to the Register.

3. Question:
What about the private sector and manufacturers' design, sales and service staff?

Answer:
It is my understanding that all service staff working as Clinical Technologists will require to be regulated regardless of who employs them. There are already significant numbers of private sector workers on the register.

Finally, can I just say that the debate regarding regulation has been raging for many years but as far as Clinical Technologists are concerned is now over? The Government wants all healthcare staff to be regulated regardless of what they do (from ancillary staff to medics. Regulation will be a fact in the near future. Thus for all who are wary of what is happening - please accept that change is inevitable, embrace the process and start contributing to the development of the profession!
Hello to everybody, I would like to chip in to the debate with my first posting.

I work in an EBME dept with 9 technicians, of which 8 people qualify to join the VRCT. So far I am the only person to register, although the others have now been frightened into joining, and are frantically downloading application forms. Whilst the general feeling is that in principle registration will be a good thing, the degree standard required for new technicians does seem excessive. Do MTO2 bods who only safety test equipment really need a degree????

Our 9th person has been with us for only 12 months, has adequate C&G certificates, and is on the first year of a HNC part time Electronics Engineering course. In 2 years time, with 3 years experience and a HNC under his belt, he will meet the criteria to join the VRCT. The only problem is that it will probably have closed, so he will then have to reach degree standard. How many more people are in this situation?

We have also recently advertised for an MTO3 technician. Unfortunately we haven’t specified a degree as the required qualification. But even if we had, the new guy would still have to attain a degree in clinical engineering within the next few years. Bit of a no win situation. Good luck to all the new guys.

Jeff
My posting certainly wasn't mischievous ! The information sheet I have in front of me clearly states ;-

"The criteria for entry onto the voluntary Register for those appointed on or after 1 August 2001 will be as follows :
1. There must be evidence of a pass at BTEC Higher National Certificate or Higher National Diploma or Degree or an equivalent qualification in a subject deemed appropriate to the candidate's specialist area of work.
2. There must be evidence of not less than 3 years work experience . . . .
3. There must be evidence of current employment . . . . "

I admit that this guidance is a couple of years old, but I haven't seen an update anywhere and it was apparently issued by IPEM (Fairmount House, Tadcaster Road, York ?).

So for people with no qualifications, who haven't registered yet and hence are after the August 2001 deadline, there is no route onto the voluntary register.
Thanks Jim for clarifying that registration will apply equally to the private sector. I'm encouraged to hear this as it could also impact on the viability of the univestity courses which will need to be developed. But going back to my other point re who will need to be registered to do what? Has anything been published or is there any draft guidance on this? There are some staff working as low grade technicians for whome registration would be not be achievable and who will not be eligible for registration. Surely there must be some way they can continue without registration but perhaps under supervision. I realise it's early days for any clear definitions linked to grades but this group of staff are very worried. I guess it comes down to the definition of a Clinical Technologist.
Graham
Roy said:- “So for people with no qualifications, who haven't registered yet and hence are after the August 2001 deadline, there is no route onto the voluntary register”

Another incorrect statement! To satisfy the argument Roy only provided an extract of the VRCT entry criteria in his post. Yes, there are different criteria to be applied to those appointed on or after the 1 August 2001 (which I mentioned in my post). However, all appointed to a Clinical Technologist post before that date do not need to provide evidence of qualification! Thus those long serving technicians with no qualifications, of whom Roy was concerned (I will assume that long serving means more than three years), are eligible to join the register.

To help those who may be now totally confused, the full criteria for eligibility to join the Register are reprinted below. May I urge all who wish to joint to read the information carefully? Application forms are available from the IPEM, ART or IIE websites.

“The primary criterion for entry onto the Voluntary Register is as follows:

Successful completion of the Training Scheme for Clinical Technologists specialising in Physics and Engineering in Health Care organised by the Institute of Physics and Engineering in Medicine.

Grandparenting Provision
Alternatively, candidates may apply through the Grandparenting provision. The criteria for entry onto the Voluntary Register through Grandparenting provision are as follows:-

1. There must be evidence of employment in a technical role involving work in health care areas such as medical physics, clinical engineering, medical equipment maintenance or medical equipment manufacturing, or, biological science, physical science or engineering related to health care within an academic institution, and,

2. There must be evidence of not less than three years work experience in a technical role (as in 1 above) including at least two years appropriate, formal in-service training provided by a suitable organisation, or, in lieu of the formal in-service training, evidence of not less than four years relevant work experience, or, registration as an Incorporated Engineer or Engineering Technician.

All individuals who meet the conditions of the Grandparenting provision and who were in post on 31 July 2000 qualify for entry onto the Voluntary Register. All who were in post on 31 July 2000 and who did not meet the conditions of the second point of the Grandparenting provision will be eligible for inclusion on the Voluntary Register once all of the conditions of the second point have been met. All who were employed between 1 August 2000 and 31 July 2001 will be deemed eligible to join the Voluntary Register once they have met the conditions of the second point of the Grandparenting provision. The criteria for provision for entry onto the Voluntary Register for those appointed on or after 1 August 2001 are as follows:

1. There must be evidence of a pass at BTEC Higher National Certificate or Higher National Diploma or Degree or NVQ/SVQ Level 3 in an appropriate subject, or, an equivalent qualification in an appropriate subject.

2. There must be evidence of not less than three years work experience in a technical role including at least two years appropriate, formal in-service training provided by a suitable organisation, or, in lieu of the formal in-service training, evidence of not less than four years relevant work experience, or, registration as an Incorporated Engineer or Engineering Technician.

3. There must be evidence of employment in health care, working unsupervised, within medical physics, clinical engineering, medical equipment maintenance or medical equipment manufacturing, or, biological science, physical science or engineering related to health care within an academic institution.”
Hi Jim,
What about technicians who were appointed after August 2001 and who have ONC, but not HNC?
Anyone appointed on or after 1 August 2001 needs to complete the IPEM Clinical Technologist Training Scheme, or, hold an HNC or equivalent qualification and to have completed a programme of structured in-service training. An ONC is insufficient! This information has been in the public domain for over four years.

I anticipate that more detailed guidance will be published early next year to guide all who may not meet the current criteria.
Jim - the argument seems to be one of interpretation of the word "appoint".

I read it as refering to technicians being appointed onto the register by August 2001 - because later in the same paragraph one of the necessary criteria is for the person to be in employment - which they obviously would be if they had been appointed to a job in Clinical Technology !

Your interpretation is that they have been appointed to a job on or after 1st August 2001.

As Topper has pointed out, this interpretation leaves new starters who haven't got a degree and don't have access to formal, 2 year training courses, in a very sticky position, because the clock is now ticking and it's unlikely they can get their 4 years experience in before the State Register comes into force.

I'm not trying to make mischief or score points - just trying to understand how the system is going to be applied and how we are going to deal with the excellent technicians who don't appear to be able to meet the criteria without having to go back to school and do a degree.
Roy

As I said in my previous post, we are very concerned that we do all that we can for those who will not meet the criteria before the Register closes. However, there will be a tranisitional period lasting until 2008/2009. Only after that time will a Clinical Technology degree become mandatory.

The details are being sorted out between the VRCT and the Department of Health. A further meeting is scheduled for early January, hopefully to resolve some of these matters. As soon as information is available it will be published widely.
I am eligible to join the VRCT, but why should I join the "voluntary" register and not just wait to join the "compulsory" one?

The reasons I hear/read to join the VRCT are as follows:
1. Join if you're eligible & you'll move onto the compulsory register, it will be more hassle if you don't! - Why? If I'm eligible now and these are the criteria the HPC will use, I'll be eligible to join the compulsory register. (£10.00 VRCT fee saved!)

2. It will involve more work to join later on. - My wife's profession became registered recently, she had to complete just one form (sent to her by the regulating body - she did not have to complete a CV, send a J.D and get her completed form signed by two seperate individuals). Also her employers pay!!!

3. The cost will rocket! - Can you assure me that, should I pay the VRCT £10.00, the regulating body won't come and ask me for the difference when they agree a fee?

I look forward to some positive replies.
If everyone took the view 'why should I join the voluntary register, why don't I just wait and save £10', then quite simply there would be no compulsory registration and our profession would remain unregulated.
One of the points that had to be proven was that there was a wish for med techs to register. This was achieved by showing how many had signed up for the voluntary register. If only a small number had signed up then the whole registration process would have died out in the early stages.
No decisions have been made regarding the process of transferring registration, however, the information below can be treated as a guide:

The fee currently payable to HPC by other regulated groups is paid biennially (two-yearly) and is currently £120. This can be paid by £30 instalments every six months. (Note: The HPC determines the cost of their fees - please do not harangue me over the size of the fee.)

I understand that when the voluntary register is transformed to a statutory register this fee becomes payable.

If you are not on the voluntary register at that time I believe that you will have to apply to join the HPC Register using their "grandparenting" arrangements. A process which costs £200 per application. Once accepted you will then have to pay the £120 fee.

It currently costs £10 to join the VRCT. The arithmetic is very easy! If regulation occurs in late 2005/early 2006 it is unlikely that current Registrants will be asked to pay further fees beyond this year's renewal. All new applicants will still be required to pay £10.
That's a good point - but isn't what Eagle was asking.

Now that regulation has been achieved and State registration is on the way, why do we need to join the voluntary register ?

Never mind the £10, that's neither here nor there, but all the paperwork that's required is horendous. It will probably be simpler to apply for the full registration because our employers will provide support information.

Surely waiting till the state scheme kicks in won't weaken our case in any way and shouldn't make any difference to the entry requirements because of the 3 year transition period.
So it looks like the VRCT is only people who have ONC and will need the extra leg up to get on the compulsory register?

I wonder if you get your money back if they do not let you in

A.M
confused
Excuse my ignorance this is due to us not having to comply with the HPC but what’s the difference between a Btec National Certificate level3 and a SVQ level 3. I Know there was a big shake up in 1999
So how do people who don't have access to a "recognised...training course" go on? Will anyone publish a training scheme, I'll teach my staff once I know what to teach!
I can't believe that some of the postings criticising the registraion of our profession are genuine. Whilst I agree that there are details to sort out surely to have our profession recognised and regulated can only be to our benefit. For a long time I have looked at the pathology departments and their pay and conditions with envy. Regulating our profession will put us on an equal footing with other professions such as these.
We are being given the opportunity to show how important our role is in the healthcare environment and I can not understand why some med techs are not wanting this.
I would like to thank Jim Methven and colleagues for working towards this aim. I would also welcome constructive criticism on this topic but I can't understand the reasons for knocking the registration scheme.
Well said Ken and I echo your comments regarding the efforts being made by Jim and his colleagues to get our profession recognised and regulated
Ken. The situation you describe in Path Labs is a good example of a profession shooting itself in the foot ! A local hospital laboratory ended up in a totally uncompetitive situation because everyone had done the courses, got the certificates, attended the lectures, got their promotions etc - so the lab was staffed by Senior Senior Team Leaders all pipetting urine from patient sample bottles into test tubes.

Not surprisingly, Ciba Geigi or ICI or somebody could tender for the work a lot cheaper by employing part time people with no qualifications.

We're in danger of making our profession so difficult to get into that Trusts will have no alternative but to subcontract the work out.

I'm not against registration as such. I honestly don't agree with the argument for insisting on a degree as proof of a persons capability to do the job. A degree proves a persons capacity to learn facts and to re-gurgitate them on demand. I don't need Techs who can explain in detail the function of a digital comb filter or a phase lock loop circuit. I need Techs who can mend broken equipment, with minimal information and no technical support from the supplier.
They will only be able to subcontract work out to people who are regulated the same as the existing staff. There will no doubt be provision for lower grade unregulated staff who can carry out the basic work ie equivalent to an existing MTO1 or possibly MTO2.
There are parts of the argument that I don't agree with but overall I think regulation is a good step to making it known that our role in healthcare is as important as other healthcare professionals.
i have to agree with everything roy has said,i see no need for registration on the terms at present, and i dont buy the pay and conditions argument either,agenda for change sorts out pay etc. going down this path could see us become uncompetative.
This then leads us on to the question of who regulates the quality of work and technicians from oputside compnies.
If this register is for patient safety reasons, should the service techs from companies not have to be registered as well so the bad ones can be removed?
This will then level the playing field.
Will wholely outsourced departments have to have registered techs the same as NHS ones?
I have asked these questions before and there does not seem to be an answer. Does this mean no-one has thought about this, it has been ignored or there has been a slip-up in the planning of the register? Or have the companies thrown their weight around as they realise this may be a costly exercise for them?
I would worry if a tech was struck off the register, could only get employment through a company and then came back in the hospital to service kit.
Robert
Robert
I am under the impression that once we are registered as a profession, if it is a requirement to be registered in order to carry out the job function, then this will apply across the board.

As with other professions, it should not make any difference who you work for, you still need to be registered in order to practice.
There has been so much debate on this issue that perhaps I have missed the answers to these questions:- 1) Who is going to “police” this system? 2) Who is going to “allow” private firms to service equipment, and how are such businesses to be “evaluated and monitored”? 3) Are we going to see individuals and firms “struck-off” the register? And what sort of "offence" would justify such an action, and 4) How would offenders be able to gain re-instatement?

Probably enough to be going on with for now, methinks. smile
On point 2
As I said before I feel all service techs whether they work privately or for the NHS or for multi Nationals such as GE should all be on the official register. This causes problems if the multinational company techs haven’t got the relevant certs. And are allowed to dictate terms e.g.. “Only we can repair this equipment” the government should lay down guidelines.
Trusts should have Equal rights to circuit diagrams and parts etc. and if not the company should be removed from the master indemnity register.
That way all of our techs in hospitals will have the level playing field needed to get better conditions and pay with out fear of being under cut financially.
All the large companies will be able to get some one struck off if his work is not up to standard and that does away with most of their case for not supplying.
But who enforces as Geoff says in point 1 and 3.

I have got to admit although I tend to sit on the fence a lot and put constructive criticisms in for both sides, I strongly feel for patient sake we should all be accountable individually but competent techs shouldn’t be hindered by bureaucracy techs should be registered by the “ prove it” method. Not by bits of paper. I know some techs that are very intimidated by formal written tests etc., but are among some of the best techs you’ll ever see.
Sorry guys, but am I missing something here? Isn’t everybody accountable (for his or her actions) always and anyway (or have things changed more than even I could imagine during my absence from our Sceptred Isle)? wink

And, by the way, what are all those managers doing, if not taking responsibility for their people? Surely even the mighty NHS must have a way of “letting-go” incompetent technicians (and, for that matter, incompetent managers)?

And do all these “service companies” habitually employ a load of idiots, then? I was always under the impression (misguided, obviously) that factory-trained service engineers were the “bright boys”, and us first-line types the (how should I put it?) “others”.

But you’ve made an old man very happy, Mr. Leonius, but advocating registration by the “prove it” method. Sounds like a call to “technician values” to me. So perhaps I haven’t been wrong all these years after all! smile
I thought the NHS did not get rid of anybody.

You promote them out the way and then get some else to do the job.

A.M
eek
I was once told by a wise man “everyone is promoted to his or her level; of incompetence”
Another words if your good at your job you will promoted onward and upward until you are piss poor at your job
This obviously doesn’t apply to Tech’s as good techs are held back because they are to honest and call a spade a spade, incompetent bosses can’t take criticism.
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