Developing and Supporting Associate Practitioners (Band 4)

Ian LeggBlood Sciences Manager

Mid Yorkshire Hospitals Trust

Where Mid Yorks was in 20052005 – Mid Yorks most overspent Trust in

EnglandYears of Attrition via job freezesChief / Senior and BMS staff labelling samplesNo-one had time to address CPA/MHRAManagement consultants appointed – need more

staffCPA / MHRA inspections – need more staffWe needed “Pairs of hands”Our solution must be found within budget.

MLA to BMS gapHuge gap between MLA and BMSHigher turnover of MLAs and “freezes”

created top heavy structure.BMS staff spending significant time doing

less complex tasksMLAs did not have scientific education for

more complex tasksLimited scope for progression within

Pathology

Analysing Job Roles Fundamental review of what is requiredYounger BMS staff particularly unhappy

doing lower tasksMLA JD only required “good secondary

education”Intermediate “technical” role became obviousFitted in with DH philosophy at the time.We want to deepen the Specialist BMS role to

expand our test range.

What’s in a Job?Core Job – what the job was designed to do

what you’re paid forLower Tasks – Tasks you need to do because

there are insufficient support staff BMS labelling samples / data input

“Aspirational Tasks” – when aiming for a higher roleTasks that stretch / what one’s training for.

Skills GapWe all have great MLA’s We also have Scientifically challenged MLA’sWhen 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!

Associate PractitionerTechnical support for BMS staffGood Science education HNC, Foundation

Degree or BSc.A stepping stone for MLAsA proving ground for a multitude of

QualificationA recruiting ground for the futurePaid enough to stay!

Changing Cultures2005 – MYHT had Job Freezes, loss of support roles,

frozen training budgets, central control of staff levels

New Hospital – Workforce redesignOpportunities to existing MLA staffRecruiting to new roles of support staffReduction in tedium. Increased help2009 – 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.

The New Generation of BMSHigh Expectations.Less happy working through the low end jobsLess likely to sacrifice social life for unsocial

working hoursHigh levels of debtDo not feel that the NHS owes them anythingSome degree of “waiting out the recession”

What do AP’s do?Generic APs

Working across Blood SciencesLoading samples, consumables and reagentsBasic QABasic MaintenanceGenerate technically correct results

Immunology AP Near Patient Testing AP.

Qualification Current and ProjectedBiomedical Sciences Degree (accredited)Biomedical Sciences Degree (non-accredited)Variety of Science degreesA Non-EU “lab technician”We have 3 MLAs doing their Science HNCWe are looking forward to Bradford’s

Foundation Degree

Fitting the FutureMy 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)

What’s the real benefitStaff able to work to gradeStaff able to get on with their own jobsProgression possible for any grade to move

upSlower progression through the wider

laboratory gives a broader understanding.Mimics the ONC / HNC which produce a very

stable and loyal workforceMotivation – it’s worth aiming higher

£-s-dOver the next 5 years I expect my budget to be

cut by 20% in real terms80% my budget are Staff costsPBR will go and straight competitive tendering

will replace itI need to be able to drive down costs whilst

upholding the Quality StandardsImproved utilisation of all grades in conjunction

with process modelling will drive down costsSkill mix is key to us surviving the future.