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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)
3 CST/Ultrasound lead Roles and Responsibilities
Where is CST input required along the screening pathway?
AAA Pathway Themes• Identification • Invitation • Inform • Test • Surveillance • Diagnose • Treatment/ intervention • Monitor outcomes
4 CST/Ultrasound lead Roles and Responsibilities
Spot the CST
5 CST/Ultrasound lead Roles and Responsibilities
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
6 CST/Ultrasound lead Roles and Responsibilities
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
7 CST/Ultrasound lead Roles and Responsibilities
• 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
8 CST/Ultrasound lead Roles and Responsibilities
• 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
9 CST/Ultrasound lead Roles and Responsibilities
Assessing Trends
10 CST/Ultrasound lead Roles and Responsibilities
Assessing Trends
11 CST/Ultrasound lead Roles and Responsibilities
• 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
12 CST/Ultrasound lead Roles and Responsibilities
• 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:
13 CST/Ultrasound lead Roles and Responsibilities
• 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?