Death threats and Survival Skills Cytologists – an endangered species? Sarah May Deputy Chief Executive Institute of Biomedical Science

Cytologists - an endangered species? OR Cytology - an endangered science?

A Perfect Storm QIPP Pathology modernisation and transformation Any qualified provider Modernising Scientific Careers HPV vaccination Molecular testing and new technologies

What is a cytologist? A laboratory assistant preparing cytology samples? A cytology screener screening cervical smears? A biomedical scientist in cytology? A biomedical scientist consultant in cytology? A consultant pathologist in cytology? All of the above?

Pathology and the ‘bungee effect’

18/12/2015 Modernising Scientific Careers – the consequences HCPC Biomedical Scientist register to remain open Biomedical science and healthcare science degrees can BOTH lead to HPC registration No evidence that the BMS workforce is not suitable or necessary for future service needs Fewer biomedical scientists, more users of biomedical science Reduced career opportunities?

18/12/2015 Higher Specialist Scientific Training Higher Specialist Scientific Training – an exceptional opportunity for an elite few....except in cytology and histology Restricted to HCPC registered Clinical Scientists 5 year funded (MPET/employer hybrid) training course, competitive entry Relationship with Advanced Specialist Diploma? Reduced high level career opportunities?

Professional protectionism

Technicians and technologists in pathology Service reviews and down-skilling exercises result in an increase in number of support staff Efficiency drives and technological innovation require and fuel changing skill mix The rise of the professional (cytology) technician (within histology?)  Access to and use of biomedical science cytology knowledge base  Different from ‘traditional MLA’  Biomedical scientist mindset

18/12/2015 Beware the race for the bottom 20% cost savings Workforce reprofiling Post reviews and regrading Any qualified provider Reduced career opportunities

Workforce consequences Reduction of experienced qualified staff and replacement with lower qualified individuals Limitation of promotion prospects Loss of expertise and interest in cytology as a scientific diagnostic service Potential increase in pathology and clinical costs through greater reliance on histological diagnosis

The UK has some of the best cytologists, who are excellent at working out which cells show potential signs of cervical cancer and which don’t. This is why UK trials have found much better results for the smear test than those in many other countries. If we move from smear tests to HPV testing, we would lose that experience and it would be almost impossible to recover it. Ed Yong, NCRI conference 2010

Cytologists- an endangered species? Yes, unless all groups work together to promote the science of cytology and its diagnostic and cost benefit to patient care

INSTITUTE OF BIOMEDICAL SCIENCE