Andy Lecomber & Phil Harrison Regional Medical Physics Department Royal Victoria Infirmary & Freeman Hospital Newcastle upon Tyne A Structured Approach to the KSF in a Large Medical Physics Department

KSF – What is it? The Knowledge & Skills Framework one of 3 key strands within Agenda for Change: –terms and conditions hours of working, overtime rates, annual leave –job evaluation equal pay for work of equal value –NHS KSF training requirements

KSF - Main Purpose defines and describes the knowledge and skills which NHS staff need to apply in their work in order to deliver quality services forms basis of pay progression mechanism

Pay Structure Every job is evaluated & assigned to a pay band on national scale PAY BANDS

Pay Structure PAY BANDS Incremental Pay Points within each Band GATEWAY KSF FULL OUTLINE defines the SKILLS & KNOWLEDGE required to perform that job KSF FOUNDATION OUTLINE defines basic SKILLS & KNOWLEDGE expected of person recently in post ( months) GATEWAY

30 Dimensions 6 Core24 Specific Dimensions identify broad functions

30 Dimensions 6 Core 24 Specific Communication Personal & People Development Service Improvement Health, Safety & Security Quality Equality & Diversity 10 Health & Wellbeing 3 Information & Knowledge 3 Estates & Facilities 8 General

30 Dimensions 6 Core 24 Specific Communication Personal & People Development Service Improvement Health, Safety & Security Quality Equality & Diversity HWB 1HWB 2HWB 3HWB 4HWB 5HWB 6HWB 7HWB 8 HWB 9HWB10 IK 1IK 2IK 3 EF 1EF 2EF 3 G 1G 2G 3G 4G 5G 6G 7G 8 The ‘broad function’ angle HWB6: Assessment and treatment planning IK2: Information collection & analysis EF1: Systems, Vehicles and equipment G2: Development and innovation

30 Dimensions 6 Core 24 Specific Communication Personal & People Development Service Improvement Health, Safety & Security Quality Equality & Diversity HWB 1HWB 2HWB 3HWB 4HWB 5HWB 6HWB 7HWB 8 HWB 9HWB10 IK 1IK 2IK 3 EF 1EF 2EF 3 G 1G 2G 3G 4G 5G 6G 7G 8 L 4 L 3 L 2 L 1 Every dimension has four levels representing increasing complexity within that skill area Assist with learning and development activities Enable people to learn and develop Plan, deliver and review interventions to enable people to develop Design, plan, implement and evaluate learning and development programmes G1: Learning and development

30 Dimensions 6 Core 24 Specific Communication Personal & People Development Service Improvement Health, Safety & Security Quality Equality & Diversity HWB 1HWB 2HWB 3HWB 4HWB 5HWB 6HWB 7HWB 8 HWB 9HWB10 IK 1IK 2IK 3 EF 1EF 2EF 3 G 1G 2G 3G 4G 5G 6G 7G 8 L 4 L 3 L 2 L 1 Every dimension has four levels Every level has ‘a number’ of indicators representing increasing complexity within that skill area

Developing a KSF Outline Decide which Dimensions are relevant to the post Decide what is an appropriate Level for each Dimension Check that ALL the Indicators associated with each Dimension / Level can be met Determine the Areas of Application most relevant to the work of the post-holder Identify Examples of Evidence from the work of the post-holder that can be used to meet the requirements of the Indicators –Identified for post by post-holder & manager

Developing KSF Outlines for RMPD ARL tasked with helping implement KSF consistently in RMPD Developed a KSF Outline Matrix (Dimension & Level only) for all RMPD staff based on: –National Occupation Standards data for Scientific & Technical staff –‘Approved’ NuTH Trust Outlines for Administrative & Clerical staff

NOS HealthCare Science Competencies Available on DoH website – List of 646 competencies covering all aspects of healthcare science practice Grouped into 57 sets applicable to activities in specific areas Each competency linked to a KSF Dimension and Level

CORE HWBEFIKG A1A2A3A4A5A6 Level 1 Level 2 Level 3 Level 4 NOS Competencies – KSF Links

HCS_A6 general competences on equipment evaluation, commissioning, calibration, routine QA, PPM HCS_AN8 competences on investigations of the autonomic nervous system HCS_AUD15 competences on Audiology examinations HCS_B4 general competences on developing and planning clinical procedures, investigation strategies and long term, multidisciplinary care pathways HCS_BM2 competences on the conduct of a multi component clinical movement analysis test, and the interpretation and reporting on biomechanical data for detailed patient evaluation HCS_CARD9 competences on the performance of both diagnostic and therapeutic cardiac procedures on inpatient or outpatient adults or children HCS_CCT4 competences on critical care equipment selection, set-up, operation and performance monitoring HCS_CM4 competences on the development of new clinical measurements, scientific support to existing techniques, or provision of a highly specialised clinical measurement service HCS_D5 competences on presentation and reporting of clinical investigation results, including confidentiality issues HCS_DX10 competences on X-ray equipment QA services HCS_E4 competences on risk assessment, MHSW & incident reporting HCS_EMD20 competences on medical equipment evaluation, procurement, maintenance and management HCS_F23 competences on management and direction of Medical Physics organisations HCS_G12 competences on provision and management of HCS learning programmes HCS_H15 competences on identification of areas for, and management of, R&D activities, including presentation of findings and translation into service HCS_I18 competences on dealing with patients, including receipt and management during clinical procedures and subsequent aftercare and reporting NOS HealthCare Science Competencies

HCS_J7 competences on what is expected of an expert in a Medical Physics discipline HCS_MPHYS14 general competences covering a number of key areas in a Medical Physics department HCS_MR8 competences on installation, operation and safety of MRI scanners, including interpretation of images and reporting HCS_N9 competences on investigation or monitoring of neurophysiological function HCS_NC14 competences on the provision of a nuclear medicine service, including both non- and imaging tests HCS_NIR13 competences on the provision of diagnostic and therapeutic NIR services, including both protocol development and safety considerations HCS_OVS16 competences on ophthalmic assessment, including some on assessment of electrophysiological function HCS_R15 competences on radiopharmacy procedures HCS_REHAB5 competences on the prescription, manufacture and subsequent management of assitive technology for individual use HCS_RP30 competences on the provision of radiation protection advice, including equipment and source calibration and management, personnel monitoring and waste management HCS_RTP37 competences on the provision of a radiotherapy service, including the development and implementation of treatment planning processes, equipment maintenance and manufacture of assistive devices, measurement of dose delivered and advice on patient management HCS_SS11 competences on the provision of a sleep study service HCS_UD9 competences on the conduct of urodynamic investigations HCS_UPT10 competences on the provision of a medical ultrasound equipment QA and safety service for both diagnostic and therapeutic applications HCS_VT3 competences on vascular ultrasound measurement NOS HealthCare Science Competencies

Linking NOS Data to RMPD Competencies applied uniformly across RMPD: NOS Competency Set Number of Competences in Set Area of Application HCS_MPHYS14 key areas in a Medical Physics department HCS_E4risk assessment HCS_H15R&D activities

Linking NOS Data to RMPD Competency sets used for specific subject areas: NOS Competency Set Number of Competences in Set Subject Area(s) to which Applied HCS_AUD15Audiology HCS_BM HCS_REHAB 2525 Bio-/Rehabilitation Engineering HCS_DX HCS_MR 10 8 Diagnostic Radiology HCS_EMD20 Equipment Evaluation, Electronics HCS_G12Training Schemes HCS_NC HCS_R Nuclear Medicine

Linking NOS Data to RMPD Competency sets used for specific areas of application: NOS Competency Set Number of Competences in Set Subject Area(s) to which Applied HCS_NIR13Non-Ionising Radiations HCS_RP30 Radiation Protection Diagnostic Radiology Nuclear Medicine Radiotherapy HCS_RTP37 Radiotherapy Physics Radiotherapy Technology Mould Room Dosimetry HCS_UPT HCS_VT 10 3 Ultrasound

Linking NOS Data to RMPD Competency sets used for physiological measurement / clinical instrumentation: NOS Competency Set Number of Competences in Set Area of Application HCS_AN8autonomic nervous system tests HCS_CARD9cardiac procedures HCS_CCT4critical care equipment HCS_CM4clinical measurements HCS_N9neurophysiological assessment HCS_OVS16ophthalmic electrophysiology HCS_SS11sleep studies HCS_UD9urodynamics

Linking NOS Data to RMPD NOS Competency Set Number of Competences in Set Area of Application HCS_J7 what is expected of a Medical Physics Expert applied to radiation subjects where there is a legislative requirement for a Medical Physics Expert (Radiotherapy, Nuclear Medicine, Diagnostic Radiology/Radiation Protection) HCS_B4 care pathway planning and investigation strategies HCS_F23Medical Physics management applied to categories of staff (Head of Unit, Head of Department) rather than subject areas

Linking NOS Data to RMPD NOS Competency Set Number of Competences in Set Area of Application HCS_A6 equipment assessment and maintenance applied to services for which assessing equipment performance is a major aspect of the work HCS_D5clinical investigation reporting applied to services in which clinical reporting is a regular task HCS_I18dealing with patients applied to services having significant direct patient contact

A ANAN AUDAUD B BMBM CARDCARD CCTCCT CMCM D DXDX E EMDEMD FGHIJ MPHYSMPHYS MRMR N NCNC NIRNIR OVSOVS R REHABREHAB RPRP RTPRTP SSSS UDUD UPTUPT VTVT Audiological Science  Bioengineering  Bone Mineral Assessment  Clinical Instrumentation  Computing  Critical Care Physics  Diag. Rad. / Rad. Prot.  Dosimetrists  Electronics  Equipment Evaluation  Head of Department / Unit 

A ANAN AUDAUD B BMBM CARDCARD CCTCCT CMCM D DXDX E EMDEMD FGHIJ MPHYSMPHYS MRMR N NCNC NIRNIR OVSOVS R REHABREHAB RPRP RTPRTP SSSS UDUD UPTUPT VTVT Mechanical Workshop  Mould Room  Nuclear Medicine  Non-Ionising Radiations  Physiological Measurement  Radiotherapy Physics  Radiotherapy Technology  Rehabilitation Engineering  Training Management  Ultrasound 

+ + + = + Combining Competency Sets

CORE HWBEFIKG Results of Analysis Audiological Science Bioengineering Bone Mineral Assess. Clinical Instr. Computing Critical Care Physics Diag. Rad. / Rad. Prot. Dosimetry Electronics Equipment Evaluation Head of Dept. / Unit Mech. Workshop Mould Room Nuclear Medicine Non-Ionising Radiation Phys. Measurement Radiotherapy Physics Radiotherapy Tech. Rehab. Engineering Training Management Ultrasound Number of Level 1s Number of Level 2s 9 Number of Level 3s Number of Level 4s Frequency of occurrence within subject area: <10%10-20% >20%

Identify skills required to undertake the role described in the Job Description Identify the appropriate Core Dimension Levels required to represent the skills work of the post Identify the Specific Dimensions (how many?) and Levels required to represent the skills not covered by Core Dimensions Developing a KSF Outline

Bands & Specific Dimensions Distribution of RMPD staff bands following assimilation

Setting Levels for Core Dimensions Core 1 (Communications) ranges between levels 2 and 4 across all specialities, so propose: –Level 2 for posts in bands 1, 2, 3 & 4 –Level 3 for posts in bands 5, 6 & 7 –Level 4 for posts in bands 8a, 8b, 8c, 8d & 9 Core 2 (Personal and People Development) levels have been set using the assumption that Principal and Consultant grades will have more responsibility for developing their staff than will Senior and Junior grades, so propose: –Level 2 for posts in bands 1, 2, 3 & 4 –Level 3 for posts in bands 5, 6 & 7 –Level 4 for posts in bands 8a, 8b, 8c, 8d & 9

Setting Levels for Core Dimensions Core 3 (Health, Safety and Security) ranges between levels 2 and 4 across all specialities, so propose: –Level 2 for posts in bands 1, 2, 3 & 4 –Level 3 for posts in bands 5, 6 & 7 –Level 4 for posts in bands 8a, 8b, 8c, 8d & 9 Core 4 (Service Improvement) ranges between levels 2 and 4 across all specialities, so propose: –Level 2 for posts in bands 1, 2, 3 & 4 –Level 3 for posts in bands 5, 6 & 7 –Level 4 for posts in bands 8a, 8b, 8c, 8d & 9

Setting Levels for Core Dimensions Core 5 (Quality) ranges between levels 3 and 4 across all specialities, so propose: –Level 3 for posts in bands 1, 2, 3, 4, 5, 6 & 7 –Level 4 for posts in bands 8a, 8b, 8c, 8d & 9 Core 6 (Equality and Diversity) levels have been set to the lowest values appropriate for their observance: –Level 1 for posts in bands 1, 2, 3, 4, 5, 6 & 7 –Level 2 for posts in bands 8a & 8b –Level 3 for posts in bands 8c, 8d & 9

Selecting Specific Dimensions General guidance recommends ≤ 7 Specific Dimensions NuTH AfC office advice is to have no more than 4–5 Therefore assigned: –5 specific dimensions for Band 9 posts –4 specific dimensions for Band 8c & 8d posts –3 specific dimensions for Band 8a & 8b posts –2 specific dimensions for Band 5, 6 & 7 posts –1 specific dimension for Band 2, 3, 4 & 5 posts

30 Dimensions 6 Core 24 Specific Communication Personal & People Development Service Improvement Health, Safety & Security Quality Equality & Diversity HWB 1HWB 2HWB 3HWB 4HWB 5HWB 6HWB 7HWB 8 HWB 9HWB10 IK 1IK 2IK 3 EF 1EF 2EF 3 G 1G 2G 3G 4G 5G 6G 7G 8 L 1 L 2 L 3 L 4

How to use the ‘KSF Tool’ The ‘Workshop Method’… –Identify your speciality and band on the KSF Tool

How to use the ‘KSF Tool’ The ‘Workshop Method’… –Identify your speciality and band on the KSF Tool –Identify the recommended Core Dimension Levels

How to use the ‘KSF Tool’ The ‘Workshop Method’… –Identify your speciality and band on the KSF Tool –Identify the recommended Core Dimension Levels –Identify the number of Specific Dimensions suggested for post, and select appropriate Levels for each

Study each highlighted dimension to determine which 2 apply and at which level (using the Specific Dimensions Table in conjunction with the KSF Handbook)

Specific Dimensions Table

How to use the ‘KSF Tool’ The ‘Workshop Method’ continued… –Use the KSF Handbook to check that EVERY Indicator can be achieved for each chosen Level

How to use the ‘KSF Tool’ The ‘Workshop Method’ continued… –Use the KSF Handbook to check that EVERY Indicator can be achieved for each chosen Level –For each Dimension Complete the relevant ‘Outline Detail’ form

How to use the ‘KSF Tool’ The ‘Workshop Method’ continued… –Use the KSF Handbook to check that EVERY Indicator can be achieved for each chosen Level –For each Dimension:- Complete the relevant ‘Outline Detail’ form

How to use the ‘KSF Tool’ The ‘Workshop Method’ continued… –Use the KSF Handbook to check that EVERY Indicator can be achieved for each chosen Level –For each Dimension:- Complete the relevant ‘Outline Detail’ form Identify the ‘Areas of Application’

Or your own suggestion… ultranucmeonics

How to use the ‘KSF Tool’ The ‘Workshop Method’ continued… –Use the KSF Handbook to check that EVERY Indicator can be achieved for each chosen Level –For each Dimension:- Complete the relevant ‘Outline Detail’ form Identify the ‘Areas of Application’

How to use the ‘KSF Tool’ The ‘Workshop Method’ continued… –Use the KSF Handbook to check that EVERY Indicator can be achieved for each chosen Level –For each Dimension:- Complete the relevant ‘Outline Detail’ form Identify the ‘Areas of Application’ Suggest ‘Examples of Evidence’

Risk assessment (a)(b)(c)(d)(e) H&S audit (b)(c)(e) Attendance at mandatory training (b)(d) ultranucmeonics6

Full vs Foundation Outlines Full Outline specifies the skills required of a fully-trained individual performing the work Foundation Outline specifies the skills that must have been achieved after 1 year in post Foundation Outline levels set one level below the value specified for the Full Outline

RMPD website KSF Page

KSF Outline Library