Laura Metcalfe : New industry recognised technology certification I’m Laura Metcalfe and I’m from NHS Greater Glasgow and Clyde. And I’m here to talk to you today about a customised award we’ve developed in healthcare technology management. Oops sorry I’ve already gone ahead. So in Glasgow we’ve got over 100 technologists working in equipment management and we have 12 of those in active training at the moment. So that would either be employed as a band 5 going through their IPM diploma or employed as a modern apprentice. And one of my roles within this is the training lead for our technologists. And part of that training role also involves a large amount of recruitment. So before I talk about the new qualification I’ll talk about the reasons we’ve needed to develop this qualification.

So what we’ve got here is an age demographic chart for our technologists in equipment management. So what does your demographic chart look like? This is quite a diverse room. I’m quite impressed. I thought there might have been a bit more grey hair in the room, but you look quite well represented. So we do need an age diverse workforce. We need to see people in all categories. And we need to make sure that experience that’s been gained by the older generations is passed on to the younger generations as they come in. You can see that in Glasgow we’re not too badly represented. We’ve got people in most of the age groups. We’ve got our apprentices sitting in that 16 to 20 age group. But you can also see from this chart that when we get to 50 and above that’s where the majority of our workforce is. And that’s about 38% of our workforce. So roughly equates to about 40 members of staff. And that is a problem for us, because over the next ten to 15 years those staff will be leaving. So how do we replace those staff? How do we get the new workforce, that younger generation in to work with us?

So we’ll talk about recruitment now. So in an ideal world we would advertise a post, the staff with the right skills apply for that post and they have now, and then we can employ them. But does that happen for you? You can put your hands up if these are the people that you find out may go to recruitment. So put your hands up if you can recruit easily into the medical equipment management field. So I don’t see a single hand up there actually so perhaps you have the same problems as we have in Glasgow, because I can tell you that doesn’t happen for us. Just a couple of months ago I was an interview panel and we, it was for a band 5 entry post for us, and we interviewed two people for that one post. And at interview it became clear that one of them really wasn’t suitable for us so we have a choice of one to fill that post. And that’s not good odds for us. We did employ that person under that circumstance but we don’t want to be going into recruitment with those sorts of odds. It means we’re not getting the right people.

There’s no technologist degree programmes in Scotland. So we don’t have staff coming in with equipment management experience, hospital experience. So we’re looking for people with engineering qualifications and we supplement that with our own in-house training. And this is why there’s been that need to develop this qualification. And we do have lots of vacancies in Glasgow. We currently have 13 vacancies at the moment and that’s a combination of band 4, 5 and 6. And that causes real risks to our ability to provide our service. If we’re 13 posts down that means we’re running with backlogs. It means we’re putting contracts out where we don’t want to put contracts out for. We want to do that in-house. And it also means that we’re liable to just outsourcing our service altogether. Because if you’re the chief exec and we can’t provide that service then they’ll find someone else who can provide that service for us. So we need to fix this problems ourselves, we need to be the people who put those solutions forward.

We’ve currently just been taking part in a Scottish-wide survey as well, looking at technologists’ training and recruitment, and those problems are shared throughout Scotland as well as this room as we’re just showing there. So in the past we employed staff from the electronics industry. In the west of Scotland there was a large electronics industry. We had IBM, we had Motorola but these companies don’t exist anymore in Scotland so these people don’t exist. We can’t pull from those industries. They’ve either retrained, reskilled or they’re past retirement age. So these days we have to look at the colleges and universities for our recruitment.

So we’re lucky in Glasgow, believe it or not. You can see that blue sky there. The sun always shines in Glasgow. People that have never been there might believe it. But what does make us lucky in Glasgow is that it is a large city. We’ve got over 600,000 people live within Glasgow. And if we move to Greater Glasgow that’s over a million people. And what that means for us is that we have four universities and we’ve got multiple colleges. So there actually are plenty of people out there with the right qualifications but what’s our experience in finding these people? So last year we had four band 5 vacancies. So we ran a large recruitment programme to try and attract people to those posts. So we went out to the universities, we worked with them. There was like Strathclyde University, Glasgow University, and we went out and we spoke to the students. We took equipment with us, we met them, we tried to explain what our job was, and it actually was a successful programme.

We had 48 applicants for our four posts. And we interviewed 14 of them and we offered out for those four posts. But our first experience in this process was that one of those people that we offered didn’t take up the job offer because they had a better offer from industry. They were a really high, top quality graduate. So our first experience is that actually we can’t attract, at the moment we can’t attract those best graduates. We can’t put a package together that competes with industry. Or the other thing that happens to us is that we have people that come into us who see us as a route into the healthcare scientist programme. I don’t want to detract from the healthcare scientist programme but we don’t want to be employing someone as a technologist for a year for them to move on because we’ve put a lot of effort into them for them to leave our service.

Our second experience is when we’re tackling these graduates they lack the practical skills to do the job. Our job is changing but we still need core practical skills to be able to do our job. We do do practical tests when we interview people but we still get people get through the net who just don’t have those practical skills. So we need to make sure we’ve got those base skills we need for the job. And our third experience is in the past we have tended to lower our bar to fill our posts and that’s created real problems for us. Now in terms of employability of that member of staff, their skill mix. And nobody has time for dealing with those issues. We’re all busy people. We don’t want to be dealing with personnel issues. And our fourth experience in trying to recruit graduates is that when we go to the colleges these college students don’t want a job. I went and spoke to college tutors. The college students are doing their HNCs and HNDs to get into university. That’s their interest. It’s an entry level qualification as far as they’re concerned. And one of the college tutors told me that they have to drag the students to meet perspective employers because that’s not what their focus is.

So these are all the problems we have between an aged demographic and our recruitment problems. So how are we fixing these problems and what’s this got to do with this qualification we’ve developed? So we’re looking at modern apprentices. So the apprenticeship funding is different in Scotland so I’ll not bore you with the details. If anyone is really interested I could tell you the differences later. But we’re focusing on employing school leavers. So we’re looking for that 17 to 19 age group. And what we’re trying to do is put a package together that’s as attractive as a university package for them so that they come to us and they get their needs met and they’re paid while that’s happening. So currently our apprentices go to college and do an HND in electronics. They complete their vocational training. It’s a compulsory part of the apprenticeship and they also complete our new qualification that we’ve developed.

So why do we need a training programme? Why do we have to do something bespoke? Why can’t we use what’s already out there? Well we’re looking for these apprentices to become now fully trained technologists. But if you think back to an age demographic that over 50 age group, that’s our band 6s, 7s and 8s. So we actually have to be taking these people in at 17 and 19, and we’re trying to develop them to be our future 6, 7s and 8s. We’re not thinking about our 5s; we’re thinking about the future. So we’re wanting to embed those skills right at the very start of their career. So I’m going to tell you a little bit about this qualification we’ve created.

So it’s called a customised award and it’s named a diploma in healthcare technology management. It’s rated a degree level, which I believe is English level 6. But I do definitely know it’s Scottish level 9. And actually that was our brief at the start of the qualification. When we started this journey it was create a degree level qualification. And the reason we wanted that was because it matches the national job profile for a band 5. So for us that was essential. And that means for our apprentices that they have their HND in electronics, they have their vocational qualifications and we’re topping this up with a degree level qualification now. And that means we know they’re meeting the knowledge and skills framework for a band 5.

For many years we’ve been using the IPEM clinical technologists training programme, and we will continue to do that. We have found it useful. It gives us entry into the RCT. This is what we were talking about earlier. And what for our trainees that means is they still, they create the one portfolio that is marked by the two different groups. So their portfolio would be still submitted to IPEM but in the background to that we would be marking and assessing towards our own customised award. And this customised award, because we own this qualification it means we’ve developed it to meet our needs. It’s very specific to what we want our technologists to have. And also this formal programme, it means that across our nine hospital sites we know that any trainee in any of those sites is getting the same training, the same assessment standards as every trainee in every other site. And that’s because, because we own it we have to do our own internal verification and we also get external verification as well.

I’ll give you a wee bit on the journey to the qualification. So I’ve got two journeys here. So the journey on the right-hand side here is the first journey that we thought it would be. So we’re subject matter experts now. We’re all experts in this room in medical equipment management and medical physics. So we thought that this would be quite an easy journey for us. It wouldn’t take us too long surely? How hard can this be to develop a qualification in our expert field? The second journey though you can see was much longer and a much more variable journey. And that’s because it actually is a very large training programme and it took a lot of learning for us to develop that programme.

So I was the one that was tasked with developing this qualification. So for most of the development I was trying to do it while doing my day job. You know, typical NHS. Now there’s another job for you to do Laura on top of everything else that you’re doing because hey, that’s what we all do. And we had set a deadline of the 31st of March 2018 for submission. But what I did find in the process was that the amount of work that I should have got was starting to slip against that deadline. So we actually did agree and I did get a short secondment so we did do something different and I got to focus on this purely for a few months. Another option would have been to bring other people in to help with it but we wanted to keep the benefit of one person working on it because it meant that our learning outcomes are consistent in format and style. We’ve got this consistency throughout that helps the trainees. Like I said before, we do have our IPEM training programme will all the learning outcomes that we developed for that. But each unit within that was written by a different person so the formats were different, the styles were different and our trainees struggled with it.

So the next part of after creating all these learning outcomes was to peer review them, and that was really critical in our process. Because at this point it was only me, it was my ideas of what we needed our technologists to have. So we got, we spent a week with me bringing different people into a room and group discussions about what was needed and the material was also emailed out to colleagues and on a shared drive. And what was also important in that peer review process was to get people with different knowledge. So we had the band 5s who were on that training programme. We had band 5s who had recently finished. We had band 6s, band 7s. So we got lots of different perspectives into that training programme. Because there was no point it just being 7s sitting in the room because they’re not in touch with what it’s like to go through that programme. So it was a really valuable exercise for me. And like a very obvious change but it was a band 5 that suggested it was that going into this peer review process we had a unit on pulse oximeters and we had a unit on non-invasive blood pressure, and the band 5 says why don’t you make that a vital signs unit instead? And you go well that’s really obvious. So sometimes it takes someone else to point out the obvious to you. So once we were through that peer review process it was then submitted to the SQA.

So the SQA is the Scottish Qualifications Authority, which I’m sure probably none of you have heard of. So the Scottish Qualifications Authority provides accreditation for qualifications and our awarding body. I could see a wee Scottish hand popping up there, because actually the SQA are the body that oversees all your school exams. So if you lived in Scotland you would know who the SQA are. And they really are the experts on qualifications within Scotland. And that’s why it was important for us to work with them. And they also work with countries from all over the world so they bring that expertise to us as well.

Another benefit that we’ve discovered in the last few months from working with the SQA is that they’ve given us credibility beyond our speciality. So they’ve developed a case study out of work. They’re really pleased at having worked with the NHS, the size of the qualification and the level of the qualification. So they use their case study to advertise our customised award and they put it into magazines and now they’re sharing this, what we do with other people. And actually just the other week I had a magazine drop through my door and it was for the Institute of Directors in Scotland and there was our case study in there. And there are people that would never have even heard of medical equipment management but there we are showing people that there is these engineering experts within the NHS.

From our own perspective, Greater Glasgow and Clyde were already an SQA approved centre. So that made our process much easier. If they hadn’t been that we would have had to have applied to become an education centre ourselves. And that’s also meant our learning and education department has been instrumental in helping us through this process. They’re the experts and they’ve been helping us on that internal verification side, the external verification side. And it’s the SQA that comes in and provides that external verification to us. And again they’re bringing in that world level expertise. So you see the whisky glass here. They work with the Scottish whisky industry. They work with hospitality in Nepal. They work with engineering universities in China. So our external verifier is bringing in that knowledge and skills to us to help us improve what we’re doing. So it has been a really valuable partnership for us and one that will continue for a few years yet.

So we’ll get down to the some of the units now. It’s only a sample of units I’ve put up here. It would look too cluttered if I put them all on. So we have three trainees currently on the programme. We’ve just recruited a fourth. That one I was talking about. So he’ll join the programme next. The whole award comprises of 18 units. And that’s 77 SCQF credit points but what that means is it’s equivalent to 770 hours of learning. So it is quite a substantial body of work. And it’s 770 hours of learning at degree level. Our trainees, all units are compulsory and our trainees have to pass all 18 units to achieve that award at the end. So there’s different areas within the units. So we’ve got four units that are focused on equipment management processes. So we’ve got commission, we’ve got procurement, we’ve got medical device alerts, and like I said this is us trying to embed those skills early on that we want to see in our band 6, 7s and 8s. So we get them to think critically, to do risk assessments, to understand the procurement process, because they need the skills now for the future. We also have 12 units that are focused on medical equipment. So, because we have to remember these are still entry level technologists for us. These are still the people who will be doing the infusion pumps, who will be doing our vital signs monitors. So what we look for is an understanding of clinical background, engineering principles and practical skills.

So, for example, for the engineering principles it would be things like being able to explain how now ultrasound and line detection works or drawing a block diagram of an infusion pump and explaining the function through that. So we’re not diluting those core engineering principles, they’re still fundamental to what we do. And we also assess practical competences as well. We’re very lucky in Glasgow that we’ve got a full-time technical trainer for us as well. So he actually provides all the theoretical training for us and provides a lot of the practical training for us as well. But equally important too is a focus on clinical understanding.

If you think about it, most of these recruits coming in have probably never, well only set foot in a hospital as a patient. They’ve not worked in a hospital. They don’t understand how a hospital works. So we want them to understand that clinical aspect of the job. It’s really important for them to see their role as part of that clinical team, not for us to be separate from that clinical team. So we have units like a patient pathway unit. And that’s about, so going into the hospital, experiencing those different routes that those patients come through. And again it’s thinking about the clinical risk in those areas. It’s thinking about how does that equipment interact in that patient journey? What are the risks to the patient if that piece of equipment didn’t work? So we’re just trying to get that thought process going with them.

So we’ll just talk a wee bit about the development. Oh sorry that was the case studies. We’ll talk a wee bit about the development now. I’m not pressing this hard enough. Right sorry. So again it is the NHS after all so what else can we do with this? Now that we’ve got it how do we take it further, how do we develop this? So as has already been highlighted just by about everybody today, healthcare and technology is constantly changing and we need to be able to adapt to those changes. So the real beauty of this qualification is that we own it. So we don’t have to go to universities. We don’t have to go and speak to the Academy for Healthcare Science or something about what that curriculum is. It is our curriculum. We can own it and we adapt it as we see the need for it. And our job is adapting and it is changing.

So at the moment an example is we send our staff to college to do IT courses. But this qualification gives us the ability to add units like that into it. So what we’d be looking to do would be add units in on cybersecurity or connectivity or things like that so that we can develop that future workforce that we need. Or whatever else comes up in the future that we have to develop our staff for. It’s not a static course, it’s a changing course. And we are the experts and we know how we need those skills to develop and we know what training we need our staff to get. So I think that’s one of the key points actually of this.

We do have a particular problem with recruiting staff but not, another problem added to that is that when we train our staff they’re poached from the other health boards. I don’t see anybody quite in our surrounding health boards, talking surrounding health boards here. So actually having this qualification gives us an ability to actually partner with our surrounding health boards. We want to come to a solution together. An example, I just took a phone call yesterday. One of our band 5s that’s been with us for a year, so only halfway through their IPEM training has been offered a band 6 on another health board. And their view was that well it means I’ll get to be a band six quicker than I ever would in Glasgow. And we would say well, you shouldn’t be a band 6 yet, you don’t have the specialist skillset to be a specialist so that’s why it would take longer for us. So we would hope to work with these health boards to stop that leak of our staff to these other health boards.

There’s also possibilities around once graduate apprenticeships are up and running because we have this degree level qualification that we would be able to link in with universities. It has been accredited by the SQA. So it’s not just us it’s in degree level, it’s formally accredited at degree level. So the graduate apprenticeships exist in IT and some engineering fields but they don’t exist in our field yet. But they will come eventually and it gives us that opportunity to take our training and be able to use that for that sort of programme.

So in conclusion what was the point of all of this and will it help us? Well the feedback from our trainees has been very positive so far. They really have liked the formality of the training programme. They have liked the consistent learning outcomes that we’ve put together, the consistent assessment methods. So we’ve found that feedback’s really good. I think one of the biggest benefits is that it’s an attractive package that we’ve put together for school leavers. And actually this would be our fourth intake of apprentices and we’ve always found we’ve had over 100 applicants for our apprenticeship posts. But this time we’re putting an even stronger package together so we would hope for even better recruits to come into us because we are, they are getting that degree level qualification. They are getting a salary while they’re training with us. I don’t know if any of you have been involved with apprenticeships, recruiting apprenticeships but it’s also what the parents think, it’s very much parental involvement. So again we’d be hoping to sell this package to parents saying well you’re still getting degree level qualification at the end of this. You don’t have to go to university.

The benefit from a management perspective for us is that hopefully we’re increasing our pull of applicants so we can pick the best. But also it’s about addressing that age diversity problem that we’ve got. We’re wanting to take these apprentices an we’re wanting to give them the skills for the future. We are looking at 6s, 7s and 8s, and this is the package that allows us to build that. And like I’ve said a few times now, the other benefit is it’s the flexibility of owning that qualification. So we can adapt it as we see the need as our job changes over the next five to ten years.

Our biggest threat probably at the moment is that it still relies a bit too much on me, so I need to work to hand over that skills and knowledge to my colleagues. But what I would say is that it is still early days. We’re still new to this. We’re still improving and developing this system but we really are pleased with what we’ve done so far and our managers are pleased. And perhaps more importantly our own staff are pleased with what we’ve done. So that’s what we’re wanting to do.

 

Laura Metcalfe's presentation at the EBME Expo New Industry Recognised Technology Certification