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Case Study – Hull and East Yorkshire Hospital NHS Trust

Angiography practitioner role profile, job specification, and training plan implemented to help with increased demand and flexible working

Hull and East Yorkshire Hospital, part of the Hull and East Yorkshire Hospital NHS Trust, were aiming to develop a new role of angiography practitioner in response to the increasing number of angiograms being carried out, and to provide more flexible staffing for the cath labs. The CHD competence framework was used to develop a new role profile, job specification, training plan and assessment record.

Cardiology at Hull and East Yorkshire Hospital is divided between two hospital sites – Castle Hill and Hull Royal Infirmary. There are two cath labs at the Castle Hill site carrying out elective procedures. Both cath labs are staffed with multidisciplinary teams including medics, nurses, radiographers, and ECG technicians. Nurses and radiographers tend to be permanently based in a cath lab, while other staff (e.g. ECG technicians and registrars) rotate between sites.

The number of procedures conducted in the cath lab is increasing significantly. At the time of this project, in a single year, approximately 1,500 angiograms and 650 angioplasties are carried out, anticipated to increase to approximately 2,000 angiograms and 1000 angioplasties in the following year.

The aim was to use the CHD Competence Framework to develop a new role of coronary angiography practitioner to enable experienced multidisciplinary cath lab workers to perform coronary angiography.

The reason for developing this new role was to help in the reduction of waiting times, in line with NSF targets. This was to be achieved by making better use of the cath labs, which had often been under-utilised owing to staffing issues (e.g. staff split between two sites, the need to comply with the Working Time Directive and new consultant contracts).

The new coronary angiography practitioners would be permanently based in the cath labs, providing a more flexible role, and minimising the number of empty sessions. It was also anticipated that this new role would have a positive impact on staff retention, job satisfaction, and career progression for cath lab workers.

A process map was initially reviewed to clarify the competences required in the cath lab. Next, the relevant competences from phase 1and phase 2 of the CHD competence framework were identified using the Framework Guide and CD. Those that seemed to be relevant were printed out and looked at in more detail to develop an agreed coronary angiography practitioner role profile.

The role profile was used as the basis for a job specification for an angiography practitioner. The job specification was, in turn, used to clarify the training requirements for the role. This led to the development of a training plan and assessment record for the angiography practitioner role.

The key results are a comprehensive job specification and training plan for the new role of coronary angiography practitioner. The training plan also provides an assessment record, i.e. a record of when the required competences have been achieved in the workplace.

“It felt that the training package had greater credibility as it is based on a national framework, and it is now possible to look at a greater level of detail than previously existed.”

Maria Whitehead, Cath Lab Sister, Hull and East Yorkshire Hospital NHS Trust

Maria Whitehead, the cath lab sister who took the lead in developing these resources describes how using the Competence Framework as the basis of the training package gave it more substance, and meant that much of the work had already been done in providing a detailed definition of the competences required for each activity.

There is now funding for a new cardio-thoracic department which requires the development of several new job roles. It is planned to use the competence framework to support the development of these new job roles. It is also envisaged that the job descriptions and training plans developed using the competence framework will be used to support a more effective recruitment and selection process.

Finally, there are plans further to develop the angiography practitioner training package to provide a more detailed record of evidence and assessment against the required competences.