Driving improvement, delivering results: healthcare science national delivery plan 2015–2020

4 Improvement programme for developing sustainable services

Why this matters

To address changing needs in NHSScotland, the healthcare science workforce needs to adapt, acquire new knowledge and skills, and develop leadership structures to facilitate opportunities to assume leadership and decision-making roles. Future leaders are likely to find themselves working in a more distributed model of professional leadership, with a strong focus on multi-disciplinary teams and better integration of patient pathways. NHS board healthcare science leads will work closely with medical, allied health professional (AHP) and nurse directors to support clinical change and service improvements associated with the 2020 Vision and national priorities.

The health and care professions need strong leadership to drive participative and collaborative development of multi-disciplinary teams and solutions. Increases in cross-professional and multi-disciplinary working will underpin an effective, safe and quality-driven service in which care can be provided in environments closer to patients' homes.

Sustainable multi-disciplinary teams of the future will rely on the talents of the whole team. It is well recognised that healthcare scientists have the potential to lead scientific teams and care pathways and work in advanced practice roles. Histopathology is a good example of where staff roles in some NHS boards have already changed, with healthcare scientists now undertaking tasks traditionally performed by medically qualified histopathologists. This initiative is supported by the Royal College of Pathologists, in collaboration with the Institute of Biomedical Scientists.

Healthcare scientists undertaking new roles previously performed by medical staff are helping to relieve service pressures and support the medical workforce through creating additional capacity. Areas in which healthcare scientists have taken on such roles have found that the quality of the service has tended to be enhanced.

Building on achievements to date, redesign, skill-mix and role extension appropriate to task should be applied across all diagnostic specialties, for example in neurology and audiology, while ensuring cost-effective, efficient, high-quality and safe service delivery.

Senior scientific staff lead on research, innovation and service development, working closely with medical consultant colleagues to provide leadership and scientific clinical expertise. Clinical opinion, as opposed to technical reporting, is a vital element of their skill-set. For this reason, higher-level specialist scientific training development in the life sciences has always been overseen by medical royal colleges, enabling healthcare scientists to undertake the same examinations as medical professionals to achieve full Fellowship of the Royal College of Pathologists.

Current situation

Skill-mix requirements for many diagnostic teams require team members to take on new and sometimes expanded roles: this has been embraced to varying extents across NHS boards. There is a need to develop a sustainable clinical team model that focuses on shifting role responsibilities in the healthcare science workforce, freeing-up medical capacity and relieving service pressures.

Our ambitions

We want to:

• create sustainable teams
• improve patient pathways and experience
• free-up medical capacity
• reduce diagnostic turnaround times.

Deliverable 4

To achieve our ambitions, NHS board healthcare science leads will work with stakeholders to explore new and developing healthcare science roles that support areas of service pressure and have the potential to free-up medical capacity, with the initial focus on histopathology services. The delivery target is the end of 2019.

Achieving Deliverable 4

NHS boards will:

• further develop and strengthen the use of extended interpretive roles and clinical reporting in laboratory medicine, with a focus on histopathology
• support the recommendation of the Diagnostic Workforce Short-life Working Group that "redesign, skill mix and role extension appropriate to task should be applied across all diagnostic specialties".

National healthcare science leads and NHS board healthcare science leads, managers and heads of services will:

• work with stakeholders to explore new and developing healthcare science roles.

Scottish Government and others will:

• build on achievements to date to further develop excellence in extending interpretive roles and support growth in clinical reporting
• develop work plans to ensure healthcare science workforce data are accurately reflected, providing good-quality data to support appropriate multi-disciplinary workforce planning.