Workforce
Workforce considerations for screening programmes.
Individuals who make a personal informed choice to accept the offer of screening must be supported by trained and competent staff along the whole end-to-end screening pathway.
There must be an understanding of the workforce capacity and capability required to implement an accessible, high quality screening service for the entire screening pathway, including any subsequent diagnostic testing, treatment, or other interventions.
The screening pathway must have the right number of appropriately trained and competent staff, in the right place and at the right time to provide an accessible, high quality screening service.
Capacity covers all resources required to implement screening, including:
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accessible screening locations and appointment times
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acceptable time periods to give the person a test result (sometimes known as turnaround times)
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enough trained staff to deliver and quality assure the service across all locations
A screening programme should not operate in isolation from diagnostic testing, treatment or intervention services. Therefore workforce capacity across the follow-on diagnostic and treatment service must also be addressed.
It is good practice to undertake an assessment of feasibility study to understand, plan and design the workforce requirements when establishing a new screening programme or considering major modifications to an existing programme. Support from organisations with oversight for workforce and relevant professional bodies is essential to obtaining this data. The study should assess:
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what resources and capacity already exist
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what additional resource and capacity is required, including number and type of staff across various locations and organisations, for example, hospitals, community settings, bespoke clinics, laboratories and administrative offices
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if there is scope for embedding screening into existing services
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what workforce constraints, pressures and opportunities exist across the system, and in individual locations and staff groups
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what mitigations exist to alleviate any identified constraints
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resilience and succession planning in the service to cope with periods of absences, staff movement and retirements
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flexibility in the workforce to allow for potential modifications to the screening programme, for example new tests
The findings of the feasibility study should inform and shape a sustainable and supported screening workforce that meets the needs of the individuals eligible for screening.
Workforce plans are also required for programme level staffing. They should include consideration of programme management, quality assurance, data management, education and training and IT staffing.
Some screening roles must be carried out by healthcare professionals who belong to a professional group which is subject to statutory regulation. Statutory regulation refers to professions that must be registered with a professional regulatory body. It exists to make sure healthcare professionals are safe and fit to practise on an ongoing basis.
Screening providers must assure themselves that statutorily regulated healthcare professionals undertaking screening are registered with the appropriate regulator, and that they maintain registration and fitness to practise in line with their registration throughout their employment with the provider.
It is important to engage with any statutory or other bodies that can provide support or advice on accreditation, workforce training and numbers.
The skills, knowledge and training requirements for staff are specific to a screening programme and their role within that programme.
Some screening roles will require staff to have existing knowledge and skills and belong to a registered healthcare profession. Staff may also be required to undertake additional training and development specific to their screening role.
In other screening roles, staff may undertake a standalone specific screening qualification, or train ‘on the job’ by following a specific training programme to gain the necessary competencies.
Workforce competencies should be set at the outset of the development of a screening programme, or when modifications are made to an existing programme, and kept up to date. Setting competencies is a multi-organisational task and requires expertise in teaching, learning and qualification development. Important stakeholders include:
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student representatives
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patient user groups
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professional member organisations
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professional regulatory bodies
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clinical experts
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screening programme experts
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organisations with oversight for workforce
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screening commissioners
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education providers
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quality assurance
Competencies must be evidence based, fit for purpose, proportional to the role, achievable and capable of being monitored and continuously developed and improved. To achieve this, there must be a flexible and accessible training programme to support learners to gain the competencies, whatever their existing level of knowledge and skills.
Develop training programmes in collaboration with the stakeholders involved in setting the staff competencies. This ensures training is fit for purpose, accessible, of high quality and can be evaluated and quality assured.
Screening-specific training programmes vary with each role and each staff group and may include:
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higher education courses
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a bespoke national qualification, for example the health screener diploma in the UK
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approved training centres, for example laboratory-based cervical cytology training
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apprenticeships
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workplace-based training
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e-learning
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masterclasses
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induction programmes
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professional network training programmes, for example from the Joint Advisory Group on GI Endoscopy in the UK and the Gastroenterological Society of Australia
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a combination of the above
Workforce competencies and recommended training programmes should be specified in a screening programme’s national education and training standards and guidance.
It is vital to be clear which organisation/s are responsible for having the required workforce in place to deliver the screening programme and the recommended training of staff.
An individual’s competency should be assessed at recommended intervals, and they should be able to access fit for purpose continuing professional development (CPD) and take part in supervision as per any relevant professional code of practice, national or local guidelines.
CPD and re-registration (where appropriate) arrangements should be clear.
Screening staff should maintain competence for their screening role. Each screening programme should specify how often staff must access resources such as e-learning modules, and complete knowledge and skill assessments where included. Where possible, professionally registered staff should be able to use completion of screening e-learning resources and/or knowledge assessments towards CPD professional revalidation requirements.
It is essential that staff learn from screening safety incidents. This learning should be incorporated into staff CPD programmes at either a national or local level.
Quality assurance (QA) of screening services is an integral part of screening provision. QA processes should review staffing, competency assessment and training compliance.
Reviews should check that:
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the provider has enough staff to effectively offer screening to the eligible population across the whole end to end pathway
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lead management and supervisory roles are filled and meet national guidance
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staff are appropriately trained in line with national standards and guidance
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staff are maintaining their skills and able to access the required CPD in line with national standards and guidance
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staff competence to use equipment in the clinical setting is assessed in line with national standards and guidance
Refer to the programme specific chapters for the relevant education, training and workforce requirements in each case.