01/11/20051 MLA / ATO Development: The Plymouth Experience Presented by Gill Jones BSc, CSci, FIBMS Department of Microbiology, Plymouth Hospitals NHS Trust.

2 Order of Events Reasons for change in working practices Development of training pathways for ATO staff LATA NVQ overview Current situation Take – home messages

3 Reasons for change in working practices 1998/9 PHLS South West initiated survey - “Recruitment and Retention of MLAs” Supporting Facts: turnover – % (mean 62%) sickness – increased rates (turnover associated) accident occurrence  turnover, shortages, sickness

4 Survey cont. Recruitment and Retention of MLAs Objectives: Revise pay structure Identify needs and expectations Introduce national qualification Recommendations: Regrade as ATOs Access to enhanced salary points (e.g. SATO, MTO1, MTO2) Introduction of NVQs e.g. LATA * (Level 3) * Laboratory and Technical Activities

5 Moving on……. 2000: - All Pathology MLAs regraded as ATOs 2001: - 5 ATOs commenced NVQ training 2003: - 2 Senior BMS staff became NVQ Assessors - First wave of ATOs completed LATA NVQ level 3 - First qualified ATOs appointed SATO status

6 One step further……. Jan. 2003: Team of 3 BMS appointed “To Review the Training of Pathology ATO Staff” Objectives To provide a clearly defined training pathway for developing and progressing ATO staff programmes and recordsTo provide common ATO training programmes and records

7 Outcomes: Pathways for Progression of ATO Staff I. Routes of progression to BMS level. Routes identified: 2 Science “A” Levels (one must be Chemistry / Biology) Chemistry “A” or “AS” Level Access to Higher Education (Science) - currently £361 (HNC in Laboratory Technology - Truro) LATA NVQ Level 3 - currently £320 Access to BMS BSc verified by University West of England Funding via NHS NVQ (< £550) or NHS ILA (£150)

8 Outcomes: Pathways for Progression of ATO Staff II. Routes of progression to MTO level. Some ATOs either do not want, or lack academic skills, to progress to BMS level. SATO, MTO1 and MTO2 grades redefined using Professional and Technical Staffs B Whitley Council (PTB) guidelines.  Alternative career structure provided for Pathology support staff.

9 Outcomes: Training Programmes & Records Common Training Programmes & Records for: Trust and Departmental Induction Competency Training Statutory Update Essential Training Staff appraisal Monthly Feedback Reports on Performance Common JDs

10 ATO Training Pathway

11 Preferred routes of progression Access to Higher Education (Science) Best suited for ATOs that demonstrate clear potential and commitment to become a BMS and lack science A Level(s) LATA NVQ Level 3 Best suited for ATOs that have developed and demonstrated real progress during competency training

12 Outcomes: ……..Summarised A clearly defined training pathway was developed for ATO staff: ATO  SATO  MTO (via LATA NVQ 3)    Trainee BMS (via Access Course) It provided the Plymouth Pathology Directorate with a stable ATO workforce. Electronic ATO programmes and records developed for all disciplines. Managers advised to consider laboratory needs at recruitment and selection stage.

13 Example of pathway in practice: In Microbiology: 9 ATOs  3 SATO  SATO  MTO 2  1 BMS (First Class BMS BSc)  Trainee BMS  BMS 1  BMS 2 Ongoing  1 studying Access to Higher Education (Science)  2 about to commence LATA NVQ 3

14 What are NVQs? National Vocational Qualifications Designed to assess competence in the workplace Individuals must demonstrate: technical competence underpinning knowledge

15 NVQs - assessment of technical competence and knowledge Performance evidence written answers to the unit’s performance-based questions direct observation by assessor witness report by someone else product evidence Knowledge evidence written answers to the unit’s knowledge-based questions answering assessor’s questions during a direct observation

16 What is LATA? Laboratory And Technical Activities Based on occupational standards for technicians working in science and technical laboratories Standard comprises 9 individual units Each unit based on a particular aspect of the job

17 LATA - structure 9 units of competence 5 Compulsory Units: Carry out testing operations Carry out investigations Assess data and produce reports Maintain safe working practices in the working environment Working as a team

18 LATA - structure 4 Optional Units - taken from 2 suites (selection of 20 units): Examples include: Provide technical support Identify and monitor calibration requirements for equipment Controlling stocks of laboratory materials and equipment Manage information for action Maintain and improve hygiene within the workplace Support efficient use of resources

19 LATA Overview Laboratory & Technical Activities NVQ Level 3 (Course Code SH LOA) Course providerCourse provider Awarding bodyAwarding body Entry requirem’tsEntry requirem’ts CostCost FundingFunding Course lengthCourse length Plymouth Coll. of Further Education (CFE)Plymouth Coll. of Further Education (CFE) EdexcelEdexcel GCSEs (english, maths)GCSEs (english, maths) >1yr lab. experience £320£320 SHA via Hospital’s Training Dept. (£550 * )SHA via Hospital’s Training Dept. (£550 * ) * £250 in 2 instalments to Assessor’s lab <3 years (18 months realistic target)<3 years (18 months realistic target)

20 LATA Overview Laboratory & Technical Activities NVQ Level 3 (Course Code SH LOA) Laboratory TimeLaboratory Time Training/AssessingTraining/Assessing Access to BMS BScAccess to BMS BSc ½ day every 2 wks recomm; ½ day every 2 months more realistic. Competence work, paperwork in own time.½ day every 2 wks recomm; ½ day every 2 months more realistic. Competence work, paperwork in own time. Planning, overseeing,witnessing to be performed by assessor, trainer, supervisor or colleague.Planning, overseeing,witnessing to be performed by assessor, trainer, supervisor or colleague. UWE has agreed to accept students with this NVQ. Laboratory to decide whether appropriate.UWE has agreed to accept students with this NVQ. Laboratory to decide whether appropriate.

21 LATA – Advantages & Disadvantages Disadvantages: (All time related) Candidate Reluctance to sacrifice his/her own time.(1-2 hrs per week) 3-4 hours laboratory time per unit for meeting with Assessor and follow-up sessions with the Training Officer. Training Officer (T.O) 3-4 hours laboratory time per unit for meeting with Assessor and follow-up sessions with the Candidate. Laboratory Minimal – approx. ½ day every 2 months per Candidate + ½ day per T.O.

22 LATA – Advantages & Disadvantages Advantages: Encourages MLAs / ATOs to look beyond ‘just doing the job’.Encourages MLAs / ATOs to look beyond ‘just doing the job’. Increases awareness / knowledge - reflected in monthly feedback sheets on performance at bench level.Increases awareness / knowledge - reflected in monthly feedback sheets on performance at bench level. Feeling of self worth.Feeling of self worth. Other ATOs eager to start.Other ATOs eager to start. Backs up GLPBacks up GLP MLAs / ATOs gain nationally recognised qualification.MLAs / ATOs gain nationally recognised qualification. Plymouth need NVQ 3 or equiv. to become Plymouth need NVQ 3 or equiv. to become SATO. (NOTE that an NVQ 3 does not automatically entitle SATO status)

23 And still there’s more…. Recent developments Clinical Laboratory Support NVQ Level 2 Foundation degrees National Occupational Standards IBMS Gazette / Website keeps us informed

24 The way forward? …..it’s your choice

25 We were quite happy with ours !

26 And then there was….. Agenda for Change ATOs at Plymouth have been placed onto Band 2. Other Healthcare staff on Band 2 include porters and cleaners. MLAs / ATOs in neighbouring hospitals have either been banded, or are likely to be banded on 3. AfC has given staff more annual leave but has not funded for the extra staff needed to cover absentees. The laboratory is often short staffed leaving those left on duty to struggle through an increasing workload.

27 Agenda for Change Our ATOs are angry and disappointed; they have lost their feeling of self worth. They have started to look elsewhere for employment. 67% of ATO staff (equiv. to 40% support staff) have applied, or are about to apply for other jobs. Other staff also feel dejected. It has literally taken just a few months to undo 7 years of progress.

28 AfC AFC was viewed by healthcare workers as an opportunity for achieving parity of pay. Staff would be rewarded fairly for their knowledge, skills and responsibilties irrespective of profession. This has not happened Given time, the resultant disparity in pay for many staff will no doubt be resolved. For the time being, AfC appears to stand for…..

29 “Agenda for Conflict!”

30 Take home messages Be proactive! Be prepared to change – but only if it’s a real improvement. Staff seem to respond well rather than vote with their feet – well, at least they used to! …. and even when you think that you have got it sorted, be prepared to start again.

31 Thank you for listening! Any Questions?