13.50 p.m. competency and development techs vr

CST and Screening Technician Workshop – 10 November 2016- How can the CST & US Lead contribute to the competency and development of Screening Technicians?Ved Ramnani, Ultrasound Lead, North Central London AAA Screening Programme

Public Health England leads the NHS Screening Programmes

National service specificationService Model Summary• Lead Ultrasound Clinician (0.1 wte/800,000

population) (part of programme clinical staff)

• Clinical Skills Trainer (Senior Sonographer/Vascular Scientist – 0.1 wte per 800,000) (part of programme screening staff)

2 CST/Ultrasound lead Roles and Responsibilities

The Provider shall ensure that all roles and responsibilities are carried out in accordance with the Guidance (section 3.30 pg.16)


Where is CST input required along the screening pathway?

AAA Pathway Themes• Identification • Invitation • Inform • Test • Surveillance • Diagnose • Treatment/ intervention • Monitor outcomes


Spot the CST


Implications for the programme

National service specification no.23 (NHS Public Health

functions agreement 2016-2017)

provides a consistent and equitable approach across England and this common

national service specification must be used to govern the provision and

monitoring of abdominal aortic aneurysm screening

services

Screening has important ethical differences from clinical practice as the

health service is targeting apparently healthy people, offering to help individuals to make better informed

choices about their health. However, there are risks

involved.

The benefits should outweigh the harm to the

target population


National service specification describes provider responsibilities for clinical and corporate governance across the following areas;

– Accountability and oversight– Risk management– Programme board– Quality assurance– Governance policies

Implications for the programme

Roles and responsibilities - CST


• Training– cascade practical training to other staff and screening

technicians, guiding and supporting their professional development and on-going quality assurance

• QA Image– provide QA through the monitoring of the quality of the

images and measurements taken by the Screening Technicians• Incidental findings (observed anatomy that may appear unusual or

different from technician's scope of practice)– review any additional images taken and decide the

appropriate course of action– technicians should report these as incidental findings within

SMaRT• Equipment maintenance

– monthly performance tests to be carried out by ultrasound quality assurance lead or appropriately trained clinical skills trainers

– Maintain and retain log of findings, faults and actions

Roles and responsibilities – US Lead


• Monitor NAAASP Accreditation of Staff– Ensure continued NAAASP accreditation status of

screening technicians & CSTs• QA Images

– provide QA through the monitoring of the quality of the images and measurements taken by the Screening Technicians

• Incidental or atypical findings– review any additional images taken and decide the

appropriate course of action– technicians should report these as incidental findings

within SMaRT• Equipment maintenance

– monthly performance tests to be carried out by ultrasound quality assurance lead or appropriately trained clinical skills trainers

– Maintain and retain log of findings, faults and actions

Assessing Trends


Assessing Trends


• Potential to use SMaRT

• Identify trends associated with– Clinic– Machine– Screener

• Programme board data template– Anonymised, can provide external assurance to commissioners and QA

• Quarterly feedback to screeners

• Incorporate into annual review / appraisal

• Inform clinic visits (needs linkage between CST & US Lead)

Supplying Feedback


• Quarterly statistics to each screener

• Compare with average for service– Understand there likely should be variation

• Discussion during clinic visits

• Annual review / appraisal

• Reflective feedback in portfolio

Discussion Points:


• What would be helpful to submit to programme boards?

• How can SMaRT be adapted to support?

• What specific support do newly qualified screeners need?

• How can learning for one screener be shared for all?

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