Andy Lecomber & Phil Harrison

Regional Medical Physics Department

Royal Victoria Infirmary & Freeman Hospital

Newcastle upon Tyne

A Structured Approach to the KSF in a Large Medical

Physics Department

KSF – What is it?

• The Knowledge & Skills Framework

• one of 3 key strands within Agenda for Change:– terms and conditions

• hours of working, overtime rates, annual leave

– job evaluation• equal pay for work of equal value

– NHS KSF• training requirements

KSF - Main Purpose

• defines and describes the knowledge and skills which NHS staff need to apply in their work in order to deliver quality services

• forms basis of pay progression mechanism

Pay Structure

Every job is evaluated & assigned to a pay band on national scale

PAY BANDS

9

8

7

6

5

4

3

2

1

Pay StructurePAY BANDS

9

8

7

6

5

4

3

2

1

Incremental Pay Points within each Band

GATEWAY

KSF FULL OUTLINE defines the SKILLS &

KNOWLEDGE required to perform

that job

KSF FOUNDATION

OUTLINE defines basic SKILLS & KNOWLEDGE

expected of person recently in post (6 - 12 months)

GATEWAY

30 Dimensions

6 Core 24 Specific

Dimensions identify broad functions

30 Dimensions

6 Core 24 Specific

Communication

Personal & People Development

Service Improvement

Health, Safety & Security

Quality

Equality & Diversity

10 Health & Wellbeing

3 Information & Knowledge

3 Estates & Facilities

8 General

30 Dimensions

6 Core 24 Specific

Communication

Personal & People Development

Service Improvement

Health, Safety & Security

Quality

Equality & Diversity

HWB 1 HWB 2 HWB 3 HWB 4 HWB 5 HWB 6 HWB 7 HWB 8 HWB 9 HWB10

IK 1 IK 2 IK 3

EF 1 EF 2 EF 3

G 1 G 2 G 3 G 4 G 5 G 6 G 7 G 8

The ‘broad function’ angle

HWB6: Assessmentand treatment planning

IK2: Informationcollection & analysis

EF1: Systems,Vehicles and equipment

G2: Developmentand innovation

30 Dimensions

6 Core 24 Specific

Communication

Personal & People Development

Service Improvement

Health, Safety & Security

Quality

Equality & Diversity

HWB 1 HWB 2 HWB 3 HWB 4 HWB 5 HWB 6 HWB 7 HWB 8 HWB 9 HWB10

IK 1 IK 2 IK 3

EF 1 EF 2 EF 3

G 1 G 2 G 3 G 4 G 5 G 6 G 7 G 8

L 4

L 3

L 2

L 1

Every dimensionhas four levelsrepresentingincreasing complexitywithin that skill area

Assist with learning and developmentactivities

Enable people to learn and develop

Plan, deliver and review interventionsto enable people to develop

Design, plan, implement and evaluatelearning and development programmes

G1: Learning anddevelopment

30 Dimensions

6 Core 24 Specific

Communication

Personal & People Development

Service Improvement

Health, Safety & Security

Quality

Equality & Diversity

HWB 1 HWB 2 HWB 3 HWB 4 HWB 5 HWB 6 HWB 7 HWB 8 HWB 9 HWB10

IK 1 IK 2 IK 3

EF 1 EF 2 EF 3

G 1 G 2 G 3 G 4 G 5 G 6 G 7 G 8

L 4

L 3

L 2

L 1

Every dimensionhas four levels

Every level has‘a number’ ofindicatorsrepresenting

increasing complexitywithin that skill area

Developing a KSF Outline

• Decide which Dimensions are relevant to the post

• Decide what is an appropriate Level for each Dimension

• Check that ALL the Indicators associated with each Dimension / Level can be met

• Determine the Areas of Application most relevant to the work of the post-holder

• Identify Examples of Evidence from the work of the post-holder that can be used to meet the requirements of the Indicators– Identified for post by post-holder & manager

Developing KSF Outlines for RMPD

• ARL tasked with helping implement KSF consistently in RMPD

• Developed a KSF Outline Matrix (Dimension & Level only) for all RMPD staff based on:– National Occupation Standards data for

Scientific & Technical staff– ‘Approved’ NuTH Trust Outlines for

Administrative & Clerical staff

NOS HealthCare Science Competencies

• Available on DoH website– http://www.skillsforhealth.org.uk/view_framework.php?id=73

• List of 646 competencies covering all aspects of healthcare science practice

• Grouped into 57 sets applicable to activities in specific areas

• Each competency linked to a KSF Dimension and Level

CORE HWB EF IK G

A1 A2 A3 A4 A5 A6

Level 1Level 2Level 3Level 4

NOS Competencies – KSF Links

HCS_A 6 general competences on equipment evaluation, commissioning, calibration, routine QA, PPM

HCS_AN 8 competences on investigations of the autonomic nervous system

HCS_AUD 15 competences on Audiology examinations

HCS_B 4 general competences on developing and planning clinical procedures, investigation strategies and long term, multidisciplinary care pathways

HCS_BM 2 competences on the conduct of a multi component clinical movement analysis test, and the interpretation and reporting on biomechanical data for detailed patient evaluation

HCS_CARD 9 competences on the performance of both diagnostic and therapeutic cardiac procedures on inpatient or outpatient adults or children

HCS_CCT 4 competences on critical care equipment selection, set-up, operation and performance monitoring

HCS_CM 4 competences on the development of new clinical measurements, scientific support to existing techniques, or provision of a highly specialised clinical measurement service

HCS_D 5 competences on presentation and reporting of clinical investigation results, including confidentiality issues

HCS_DX 10 competences on X-ray equipment QA services

HCS_E 4 competences on risk assessment, MHSW & incident reporting

HCS_EMD 20 competences on medical equipment evaluation, procurement, maintenance and management

HCS_F 23 competences on management and direction of Medical Physics organisations

HCS_G 12 competences on provision and management of HCS learning programmes

HCS_H 15 competences on identification of areas for, and management of, R&D activities, including presentation of findings and translation into service

HCS_I 18 competences on dealing with patients, including receipt and management during clinical procedures and subsequent aftercare and reporting

NOS HealthCare Science Competencies

HCS_J 7 competences on what is expected of an expert in a Medical Physics discipline

HCS_MPHYS 14 general competences covering a number of key areas in a Medical Physics department

HCS_MR 8 competences on installation, operation and safety of MRI scanners, including interpretation of images and reporting

HCS_N 9 competences on investigation or monitoring of neurophysiological function

HCS_NC 14 competences on the provision of a nuclear medicine service, including both non- and imaging tests

HCS_NIR 13 competences on the provision of diagnostic and therapeutic NIR services, including both protocol development and safety considerations

HCS_OVS 16 competences on ophthalmic assessment, including some on assessment of electrophysiological function

HCS_R 15 competences on radiopharmacy procedures

HCS_REHAB 5 competences on the prescription, manufacture and subsequent management of assitive technology for individual use

HCS_RP 30 competences on the provision of radiation protection advice, including equipment and source calibration and management, personnel monitoring and waste management

HCS_RTP 37 competences on the provision of a radiotherapy service, including the development and implementation of treatment planning processes, equipment maintenance and manufacture of assistive devices, measurement of dose delivered and advice on patient management

HCS_SS 11 competences on the provision of a sleep study service

HCS_UD 9 competences on the conduct of urodynamic investigations

HCS_UPT 10 competences on the provision of a medical ultrasound equipment QA and safety service for both diagnostic and therapeutic applications

HCS_VT 3 competences on vascular ultrasound measurement

NOS HealthCare Science Competencies

Linking NOS Data to RMPDCompetencies applied uniformly across RMPD:

NOS Competency

Set

Number of Competences

in SetArea of Application

HCS_MPHYS 14key areas in a Medical Physics department

HCS_E 4 risk assessment

HCS_H 15 R&D activities

Linking NOS Data to RMPDCompetency sets used for specific subject areas:

NOS Competency Set

Number of Competences in

Set

Subject Area(s) to which Applied

HCS_AUD 15 Audiology

HCS_BM

HCS_REHAB

2

5Bio-/Rehabilitation

Engineering

HCS_DX

HCS_MR

10

8Diagnostic Radiology

HCS_EMD 20Equipment Evaluation,

Electronics

HCS_G 12 Training Schemes

HCS_NC

HCS_R

14

15Nuclear Medicine

Linking NOS Data to RMPDCompetency sets used for specific areas of application:

NOS Competency Set

Number of Competences in

Set

Subject Area(s) to which Applied

HCS_NIR 13 Non-Ionising Radiations

HCS_RP 30

Radiation Protection

Diagnostic Radiology

Nuclear Medicine

Radiotherapy

HCS_RTP 37

Radiotherapy Physics

Radiotherapy Technology

Mould Room

Dosimetry

HCS_UPT

HCS_VT

10

3Ultrasound

Linking NOS Data to RMPDCompetency sets used for physiological measurement / clinical instrumentation:

NOS Competency Set

Number of Competences in

SetArea of Application

HCS_AN 8 autonomic nervous system tests

HCS_CARD 9 cardiac procedures

HCS_CCT 4 critical care equipment

HCS_CM 4 clinical measurements

HCS_N 9 neurophysiological assessment

HCS_OVS 16 ophthalmic electrophysiology

HCS_SS 11 sleep studies

HCS_UD 9 urodynamics

Linking NOS Data to RMPD

NOS Competency Set

Number of Competences in

SetArea of Application

HCS_J 7what is expected of a Medical

Physics Expert

applied to radiation subjects where there is a legislative requirement for a Medical Physics Expert (Radiotherapy, Nuclear Medicine, Diagnostic

Radiology/Radiation Protection)

HCS_B 4care pathway planning and

investigation strategies

HCS_F 23 Medical Physics management

applied to categories of staff (Head of Unit, Head of Department) rather than subject areas

Linking NOS Data to RMPD

NOS Competency Set

Number of Competences in

SetArea of Application

HCS_A 6equipment assessment and

maintenance

applied to services for which assessing equipment performance is a major aspect of the work

HCS_D 5 clinical investigation reporting

applied to services in which clinical reporting is a regular task

HCS_I 18 dealing with patients

applied to services having significant direct patient contact

AAN

AUD

BBM

CARD

CCT

CM

DDX

EEMD

F G H I J

MPHYS

MR

NNC

NIR

OVS

R

REHAB

RP

RTP

SS

UD

UPT

VT

Audiological Science

Bioengineering

Bone Mineral Assessment

Clinical Instrumentation

Computing

Critical Care Physics

Diag. Rad. / Rad. Prot.

Dosimetrists

Electronics

Equipment Evaluation

Head of Department / Unit

AAN

AUD

BBM

CARD

CCT

CM

DDX

EEMD

F G H I J

MPHYS

MR

NNC

NIR

OVS

R

REHAB

RP

RTP

SS

UD

UPT

VT

Mechanical Workshop

Mould Room

Nuclear Medicine

Non-Ionising Radiations

Physiological Measurement

Radiotherapy Physics

Radiotherapy Technology

Rehabilitation Engineering

Training Management

Ultrasound

HCS_E

HCS_H

HCS_MPHYS

+

+

+

=

CORE HWB EF IK G

OVERALL‘ENVELOPE’

HCS_RTP

HCS_A

+

Combining Competency Sets

CORE HWB EF IK G

Results of Analysis

Audiological ScienceBioengineeringBone Mineral Assess.Clinical Instr.

ComputingCritical Care PhysicsDiag. Rad. / Rad. Prot.Dosimetry

ElectronicsEquipment Evaluation

Head of Dept. / UnitMech. WorkshopMould RoomNuclear MedicineNon-Ionising RadiationPhys. MeasurementRadiotherapy PhysicsRadiotherapy Tech.

Rehab. EngineeringTraining ManagementUltrasound

Number of Level 1sNumber of Level 2s 9

Number of Level 3sNumber of Level 4s

443

72

9050

0111

772

012517

00

2769

0

31035

0001

043

106

25

8514730

281272

0011

1

0

54974

286028

001

3

0100

7123

936

3042

004912

0222

0

14295984

7310

0010

0

5441113

39959470

5959784488137

65111

126

76

544560

Frequency of occurrence within subject area: <10% 10-20% >20%

• Identify skills required to undertake the role described in the Job Description

• Identify the appropriate Core Dimension Levels required to represent the skills work of the post

• Identify the Specific Dimensions (how many?) and Levels required to represent the skills not covered by Core Dimensions

Developing a KSF Outline

Bands & Specific Dimensions

• Distribution of RMPD staff bands following assimilation

0

20

40

60

80

100

120

2 3 4 5 6 7 8a 8b 8c 8d 9

AfC Band

Nu

mb

er

Technical Staff Scientific Staff

Setting Levels for Core Dimensions

• Core 1 (Communications) ranges between levels 2 and 4 across all specialities, so propose:– Level 2 for posts in bands 1, 2, 3 & 4– Level 3 for posts in bands 5, 6 & 7– Level 4 for posts in bands 8a, 8b, 8c, 8d & 9

• Core 2 (Personal and People Development) levels have been set using the assumption that Principal and Consultant grades will have more responsibility for developing their staff than will Senior and Junior grades, so propose:– Level 2 for posts in bands 1, 2, 3 & 4– Level 3 for posts in bands 5, 6 & 7– Level 4 for posts in bands 8a, 8b, 8c, 8d & 9

Setting Levels for Core Dimensions

• Core 3 (Health, Safety and Security) ranges between levels 2 and 4 across all specialities, so propose:– Level 2 for posts in bands 1, 2, 3 & 4– Level 3 for posts in bands 5, 6 & 7– Level 4 for posts in bands 8a, 8b, 8c, 8d & 9

• Core 4 (Service Improvement) ranges between levels 2 and 4 across all specialities, so propose:– Level 2 for posts in bands 1, 2, 3 & 4– Level 3 for posts in bands 5, 6 & 7– Level 4 for posts in bands 8a, 8b, 8c, 8d & 9

Setting Levels for Core Dimensions

• Core 5 (Quality) ranges between levels 3 and 4 across all specialities, so propose:– Level 3 for posts in bands 1, 2, 3, 4, 5, 6 & 7– Level 4 for posts in bands 8a, 8b, 8c, 8d & 9

• Core 6 (Equality and Diversity) levels have been set to the lowest values appropriate for their observance:– Level 1 for posts in bands 1, 2, 3, 4, 5, 6 & 7– Level 2 for posts in bands 8a & 8b– Level 3 for posts in bands 8c, 8d & 9

Selecting Specific Dimensions

• General guidance recommends ≤ 7 Specific Dimensions

• NuTH AfC office advice is to have no more than 4–5

• Therefore assigned:– 5 specific dimensions for Band 9 posts– 4 specific dimensions for Band 8c & 8d posts– 3 specific dimensions for Band 8a & 8b posts– 2 specific dimensions for Band 5, 6 & 7 posts– 1 specific dimension for Band 2, 3, 4 & 5 posts

30 Dimensions

6 Core 24 Specific

Communication

Personal & People Development

Service Improvement

Health, Safety & Security

Quality

Equality & Diversity

HWB 1 HWB 2 HWB 3 HWB 4 HWB 5 HWB 6 HWB 7 HWB 8 HWB 9 HWB10

IK 1 IK 2 IK 3

EF 1 EF 2 EF 3

G 1 G 2 G 3 G 4 G 5 G 6 G 7 G 8

L 1

L 2

L 3

L 4

How to use the ‘KSF Tool’

• The ‘Workshop Method’…– Identify your speciality and band on the KSF

Tool

How to use the ‘KSF Tool’

• The ‘Workshop Method’…– Identify your speciality and band on the KSF

Tool– Identify the recommended Core Dimension

Levels

How to use the ‘KSF Tool’

• The ‘Workshop Method’…– Identify your speciality and band on the KSF

Tool– Identify the recommended Core Dimension

Levels– Identify the number of Specific Dimensions

suggested for post, and select appropriate Levels for each

Study each highlighted dimension to determine which 2 apply and at which level(using the Specific Dimensions Table in conjunction with the KSF Handbook)

Specific Dimensions Table

How to use the ‘KSF Tool’

• The ‘Workshop Method’ continued…– Use the KSF Handbook to check that

EVERY Indicator can be achieved for each chosen Level

How to use the ‘KSF Tool’

• The ‘Workshop Method’ continued…– Use the KSF Handbook to check that

EVERY Indicator can be achieved for each chosen Level

– For each Dimension• Complete the relevant ‘Outline Detail’ form

How to use the ‘KSF Tool’

• The ‘Workshop Method’ continued…– Use the KSF Handbook to check that

EVERY Indicator can be achieved for each chosen Level

– For each Dimension:-• Complete the relevant ‘Outline Detail’ form

How to use the ‘KSF Tool’

• The ‘Workshop Method’ continued…– Use the KSF Handbook to check that

EVERY Indicator can be achieved for each chosen Level

– For each Dimension:-• Complete the relevant ‘Outline Detail’ form• Identify the ‘Areas of Application’

Or your own suggestion…

ultranucmeonics

How to use the ‘KSF Tool’

• The ‘Workshop Method’ continued…– Use the KSF Handbook to check that

EVERY Indicator can be achieved for each chosen Level

– For each Dimension:-• Complete the relevant ‘Outline Detail’ form• Identify the ‘Areas of Application’

How to use the ‘KSF Tool’

• The ‘Workshop Method’ continued…– Use the KSF Handbook to check that

EVERY Indicator can be achieved for each chosen Level

– For each Dimension:-• Complete the relevant ‘Outline Detail’ form• Identify the ‘Areas of Application’• Suggest ‘Examples of Evidence’

Risk assessment

(a)(b)(c)(d)(e)

H&S audit

(b)(c)(e)

Attendance at

mandatory training

(b)(d)

ultranucmeonics 6

Full vs Foundation Outlines

• Full Outline specifies the skills required of a fully-trained individual performing the work

• Foundation Outline specifies the skills that must have been achieved after 1 year in post

• Foundation Outline levels set one level below the value specified for the Full Outline

RMPD website KSF Page

KSF Outline Library