Developing and Supporting Associate Practitioners (Band 4)

1. Developing and Supporting Associate Practitioners (Band 4) Ian Legg Blood Sciences Manager Mid Yorkshire Hospitals Trust

2. Where Mid Yorks was in 2005 • 2005 – Mid Yorks most overspent Trust in England • Years of Attrition via job freezes • Chief / Senior and BMS staff labelling samples • No-one had time to address CPA/MHRA • Management consultants appointed – need more staff • CPA / MHRA inspections – need more staff • We needed “Pairs of hands” • Our solution must be found within budget.

3. MLA to BMS gap • Huge gap between MLA and BMS • Higher turnover of MLAs and “freezes” created top heavy structure. • BMS staff spending significant time doing less complex tasks • MLAs did not have scientific education for more complex tasks • Limited scope for progression within Pathology

4. Analysing Job Roles • Fundamental review of what is required • Younger BMS staff particularly unhappy doing lower tasks • MLA JD only required “good secondary education” • Intermediate “technical” role became obvious • Fitted in with DH philosophy at the time. • We want to deepen the Specialist BMS role to expand our test range.

5. What’s in a Job? • Core Job – what the job was designed to do • what you’re paid for • Lower Tasks – Tasks you need to do because there are insufficient support staff • BMS labelling samples / data input • “Aspirational Tasks” – when aiming for a higher role • Tasks that stretch / what one’s training for.

14. Skills Gap • We all have great MLA’s • We also have Scientifically challenged MLA’s • When you say “Do you understand?” “Oh yes” • But what do they understand? • Complex Scientific language in an SOP is akin to Swahili. “Hatari – Carcinogenic” • How could you tell the best MLA’s? • By their leaving parties!

15. Associate Practitioner • Technical support for BMS staff • Good Science education HNC, Foundation Degree or BSc. • A stepping stone for MLAs • A proving ground for a multitude of Qualification • A recruiting ground for the future • Paid enough to stay!

16. Changing Cultures • 2005 – MYHT had Job Freezes, loss of support roles, frozen training budgets, central control of staff levels • New Hospital – Workforce redesign • Opportunities to existing MLA staff • Recruiting to new roles of support staff • Reduction in tedium. Increased help • 2009 – New evening work, BMS demand Associate practitioner support. • 2010 - Business Units – We can do what we want within budget, no longer told who we can employ.

17. The New Generation of BMS • High Expectations. • Less happy working through the low end jobs • Less likely to sacrifice social life for unsocial working hours • High levels of debt • Do not feel that the NHS owes them anything • Some degree of “waiting out the recession”

18. What do AP’s do? • Generic APs • Working across Blood Sciences • Loading samples, consumables and reagents • Basic QA • Basic Maintenance • Generate technically correct results • Immunology AP • Near Patient Testing AP.

19. Qualification Current and Projected • Biomedical Sciences Degree (accredited) • Biomedical Sciences Degree (non-accredited) • Variety of Science degrees • A Non-EU “lab technician” • We have 3 MLAs doing their Science HNC • We are looking forward to Bradford’s Foundation Degree

20. Fitting the Future • My vision is that an experienced AP with 2 years practice could join year 3 of the part time BMS BSc. • As Science graduates become a scarcer commodity, we will have a pool of suitable staff • The best will be put forward as trainee BMS • A significant number will happily sit at this grade for their career (The eternal Junior A)

21. What’s the real benefit • Staff able to work to grade • Staff able to get on with their own jobs • Progression possible for any grade to move up • Slower progression through the wider laboratory gives a broader understanding. • Mimics the ONC / HNC which produce a very stable and loyal workforce • Motivation – it’s worth aiming higher

22. £-s-d • Over the next 5 years I expect my budget to be cut by 20% in real terms • 80% my budget are Staff costs • PBR will go and straight competitive tendering will replace it • I need to be able to drive down costs whilst upholding the Quality Standards • Improved utilisation of all grades in conjunction with process modelling will drive down costs • Skill mix is key to us surviving the future.