Transcript Careers in Healthcare Science

Healthcare Scientistsa call to action
Fiona Carragher
Deputy Chief Scientific Officer
East Midlands HCS
Summit
9th October 2013
1 NHS | Presentation to [XXXX Company] | [Type Date]
Ageing
Population
Challenges for
the NHS
Health
Inequalities
Scientific
Discoveries/
Technology
Advances
Chronic
Diseases
Challenges
to the NHS
Many
Comorbidities
Mobility &
Greater
expectations
of Public
Late
diagnoses
The NHS- Reflecting on 65yrs
• If the NHS is to survive
another 65yr it must change
• www.england.nhs.uk
• Have your say
Addressing the Challenges
Creating CCGs with a
‘new DNA’ with added
clinical value
Developing new integrated
pathways of care with quality
outcomes at its core
Taking a
patient AND
a population
focus
Shifting care outside of
hospital and closer to
home, providing more
choice
Innovative models of provision –
at the centre of new NHS thinking
From Everyone Counts
– 2013/14 planning guidance from the NHS
Commissioning Board
“Our National Medical Director will establish a forum that includes
national and local commissioners, providers and regulators to
identify how there might be better access to routine services
seven days a week and report in the autumn of 2013.
“As a first stage, the review will focus on improving diagnostics and
urgent and emergency care. It will include the consequences of the
non-availability of clinical services across the seven day week and
provide proposals for improvements to any shortcomings.”
NHS Outcomes Framework
Duty of quality
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NHS OUTCOMES FRAMEWORK
Domain 1
Domain 2
Domain 3
Domain 4
Domain 5
Preventing
people from
dying
prematurely
Enhancing
the quality
of life for
people with
LTCs
Recovery
from
episodes of
ill health /
injury
Ensuring a
positive
patient
experience
Safe
environment
free from
avoidable
harm
2
Duty of quality
Duty of quality
1
NICE Quality Standards
(Building a library of approx 150 over 5 years)
3
Commissioning
Outcomes
Framework
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4
Commissioning
Guidance
5
Provider payment mechanisms
tariff
standard
contract
CQUIN
Commissioning / Contracting
NHS Commissioning Board - Specialist services and primary care
GP Consortia – all other services
Duty of quality
QOF
Premature mortalitythe challenge for HCS
• Britain has worse record for premature
death than comparable countries
– and the gap is rising 1
• A key issue is the late diagnosis of disease
• Government has identified the need for
more and earlier diagnostic activity,
particularly in primary care
1
The Lancet, 5 March 2013
doi:10.1016/S0140-6736(13)60355-4
Long term conditionsthe challenge for HCS
• Around 15 million (28%) people in the UK have a long term condition,
and the number is increasing
• People with LTCs account for
• 50% of all GP appointments
• 70% of all bed days
• 70% of budgets
• Co-existing conditions can produce confounding diagnostic results and
complicate interpretation
• Remote and other forms of monitoring needs to be developed to support
self and directed management approaches
Acute and episodic carethe challenge for HCS
• Preventing admission and readmission – diagnostics
supporting risk modelling
• Reducing length of stay and supporting early discharge
• Responsive emergency care with embedded diagnostics
• 24/7 provision of diagnostics with the intervention – eg
interventional radiology and cardiology
• 7 day service provision especially linked to areas of higher
mortality at weekends
Improving the patient experience –
The challenge for HCS
• Providing services at accessible locations
• Further reducing waiting times
• Effective measures that relate to the
experience of HCS services ( eg friends and
family test)
• Patient Information on which to base choice
and quality of provider
• Open and accessible test results and support
to understand them
Ensuring safe care –
The challenge for HCS
• Global Antibiotic resistance
– Highlighted in the CMO report (pub.
May 2013)
• Continued focus on HAI and VTE
prevention
• Safety and side effect monitoring of
drug therapy
• Safety of blood products and tissues
Science will be crucial
research informing new ways of working
• Genetic profiling
• Personalised medicine
• Enhanced Point of Care Testing
• Portable and home monitoring
• Smart homes
• Data fusion & bioinformatics
• Virtual physiological human
• Multi-modality imaging
Think about the changes in your career
Healthcare Science Specialisms
Laboratory (life) Sciences
• Analytical Toxicology
• Anatomical pathology
• Blood transfusion
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science/transplantation
Clinical biochemistry including
paediatric metabolic
biochemistry
Clinical genetics/Genetic
Science
Clinical embryology &
Reproductive Science
Clinical immunology
Cytopathology including cervical
cytology
Electron microscopy
External quality assurance
Haematology
Haemostasis and thrombosis
Clinical Immunology
Histocompatibility &
immunogenetics
Histopathology
Microbiology
Molecular pathology of
acquired disease
Phlebotomy
Tissue banking
Physiological Sciences
• Audiology
• Autonomic neurovascular function
• Cardiac physiology
• Clinical perfusion science
• Critical care science
• Gastrointestinal physiology
• Neurophysiology
• Ophthalmic and vision science
• Respiratory physiology
• Urodynamic science
• Vascular science
Bioinformatics
• Genomics and Clinical Bioinformatics
• Health Informatics
• Pathology
Physical Sciences and
Biomedical Engineering
• Biomechanical engineering
• Clinical measurement &
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Development
Clinical Pharmaceutical Science
Diagnostic radiology & MR physics
Equipment management & clinical
engineering
Medical electronics &
instrumentation
Medical engineering design
Clinical photography
Nuclear medicine
Radiation protection & monitoring
Radiotherapy physics
Reconstructive Science
Rehabilitation engineering
Renal dialysis technology
Ultrasound & non-ionising radiation
50+ scientific professions delivering over 150 different services that cost
the NHS approximately £8bn.
The workforce of 55,000 informs 80% of all diagnoses and is involved in
the delivery of over 1 billion tests and investigations per annum.
They have multiple impacts on all patient pathways through the specialist
diagnostic, therapeutic and equipment services they provide.
Transition from paediatric to adult
with long term hearing loss
Engineers supporting Augmentative
and Alternative Communication
Respiratory scientists
leading high quality
spirometry within the
community for COPD
Monitoring anticoagulation therapy in the
primary care
Implementing telehealth to
support patients with LTC
Biochemical screening for
diabetes in Sikh community
Neurophysiology monitoring
of treatment in X-ALD
Rehabilitation engineers
support for wheelchairs and
prosthetics
Challenges for HCS here and now
• Patient and public engagement
• Commissioning and improvement
• Limited engagement with patients and
public
• Commissioning models not well
described or understood with services
often ‘hidden’ in block contracts
• Lack of quality information for patients
particularly to understand test results
and support self-care
• Areas for improvement not well
recognised and best practise not
adopted
• Quality and Safety
• Lack of integration across sectors and
limited offer in primary care
• Significant variability in quality and
access/waits for some services
• Advice and expertise
• Patient safety issues uncovered
• Lack of robust assurance frameworks for
all services
• Knowledge and advice provided by HCS
is a resource that the NHS still isn't using
to the full
CSO team: Key aims
• We aim to drive a whole health system approach
to providing high quality, innovative patient
centred scientific services integrated across all
delivery sectors with influential scientific leaders,
aspirational providers and informed
commissioners.
High quality care for all, now and for future generations
Healthcare Scientistscall to action
• Break the stereotype
• Always remind yourself why
you became a HCS
• Don’t loose your passion
and commitment
• Think about how you can
play your part in this
challenge
‘enthusiasm is contagious…..’
…Be Innovative
• Unleash your
entrepreneurial spirit
• Think creatively
• Collaborate and build
relationships with;
• Clinical colleagues
• Industry
• Academia
• Other Scientists
….Be a champion of quality
• Understand what quality
means in your area
• Be proactive not reactive
• Don’t be complacent,
always look to improve
• Use data to target problems
and then show
improvement
• Think end to end
…Always put the patient first
• How do your actions impact
on patient care
• Not just a test result
• Think about patient
experience and safety
• Work with patient groups
• Include them in your user
survey
…Communicate your science
• Patients, public and
professionals
understand the value
you add
• Think about languagemake it accessible
• Opportunities as STEM
ambassadors
• www.stemnet.org.uk
• We need to engage the
workforce of the future
…Take your place in the team
• Multi-professional networks essential
• Part of clinical decision making
• Bringing expertise and scientific thinking
• Making a real difference to patient care
And be fearless !
• Think about how you can
make a difference
• Challenge when things are
not right
• Be a leader whatever grade
you are
• Others may come with you!