1. 1 BROOKLYN 2 RADIOTHERAPY Anne JESSOP Fri 30 th Aug 2013 Session 4 / Talk 1 15:15 – 15:35 ABSTRACT Over recent decades the roll of radiation therapists has developed with advanced practitioners and consultant practitioners taking on more diverse roles other than ln the preparation and delivery of Radiotherapy. This progression has allowed for the introduction of the Assistant Practitioner, a locally trained individual, who has gained academic knowledge through a structured work based learning programme. There has also been a Government drive in promoting skill mix throughout the NHS along with the implementation of the Four Tier Structure (CoR 2000). To provide training of the assistant practitioner to the required standard by both clinical practice and Professional Body, Sheffield Hallam University offer a programme of learning - Diploma in Higher Education Radiotherapy & Oncology Practice. As a profession Radiation Therapy programmes are renowned for high attrition even though every effort is made to attract and enrol the right individuals. The advantages of the Dip HE has been that students have been recruited from a different pool of applicants, they have been more local to the department where they have trained and worked and they have often been mature with more life experiences. The SHU Dip HE programme is designed so that the programme learning outcomes mirror the learning outcomes of the BSc programme exactly, allowing those APs, who are supported through appraisal and are academically capable, to progress onto the third year of the BSc programme and gain registration as a qualified radiation therapist. This presentation will give audit details of the Dip HE programme and those students who have subsequently undertaken further study and become registered practitioners.

2. Assistant Practitioners in Radiotherapy – An audit of provision and progression Anne Jessop Senior Lecturer Sheffield Hallam University UK

3. The Radiotherapy Experience Highly demanding job that’s not very glamorous! Is primarily delivered by Radiation Therapists who are registered with the HCPC or equivalent Work in teams of 3 or 4, never alone Difficult to recruit staff Increasing demand on the service New ways of working 3

4. Background In 2000 The College of Radiographers (UK) published "A strategy for the education and professional development of therapeutic radiographers" The Pilot Project - Spring 2001 – Complete NVQ 3 in Therapy and Diagnostics For Radiotherapy this didn’t suit the educational content necessary to fulfil the role 4

5. Growing Demands on the Registered Practitioner Role Extension Advanced Practice Specialist Roles 5

6. Band 4 & 5 Band 6 Band 7 Adv Pr 6

7. Sheffield Hallam University Provision MSc > 200 Home and International Students – Radiotherapy & Oncology – Supportive &Palliative Care – Prostate Cancer – RT Planning – Advanced Practice R&O Dip Cert Post Reg CPD PgD – 18 students per year BSc - 46 students per year Dip HE R & O Practice - variable intake per year 7

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10. The Role of an Assistant Practitioner Primarily their job description defines the role as being supportive of the Registered Practitioners Carrying out tasks following a protocol Usually under supervision 10

11. High Level Skills – in Reality.... Blurred boundaries Sharing of tasks Assistant Practitioners at all levels? Information and support - skilful - AP follow a protocol Image matching - technically skilful and precise task - AP follow protocol to do this? – this will be tomorrows normal practice 11

12. Entry Requirements for Dip HE At least 5 GCSE’s at C or above including Maths and English At least 1 “A” Level or equivalent in any subject To have been recruited as a Trainee Assistant Practitioner (TAP) in a Radiotherapy Department and to have gained funding for the course 12

13. Entry Requirements for BSc (Hons) Radiotherapy & Oncology At least 5 GCSE’s C or above including Maths, English and Science “A” level qualification amounting to 280 UCAS points including 1 science subject – 120 – A – 100 – B – 80 – C – 60 – D – NCEA or the NQF – 42 or more credits at Level 3 in specified subjects 13 A,B&D (120 + 100 + 60 = 280) B,B&C (100 + 100 + 80 = 280) A,C,C (120 + 80 + 80 = 280)

14. Examples of TAPs previous education level Medical Secretary Drama Student Dry Cleaning Manager 1 has been a speech and language therapist 1 has been an audiology technician 1 has a degree in sociology Others have experience in IT, admin other caring professions 14

15. TAPs intake by year 15 Have had 2 intakes per year

16. APs Progressing onto BSc 16

17. Degree Classifications 17

18. Sheffield Hallam Training to date 78 APs trained / training to date 23 have progressed, 9 are progressing to become qualified Radiographers Attrition – 8 students have left the programme since 2004 - 6.24% – Compare this to annual attrition from BSc of 11% at SHU and ~ 40% Nationally 18

19. Some Comments From Qualified Staff "AP’s are valuable members of the team/workforce who develop their clinical skills quickly, they become embedded within the department/teams and provide good patient care and are effective professionals in terms of clinical competence. AP’s see this as a route to Band 5 without the high cost implications of the BSc route." "Excellent addition, but scope of practice needs to reflect the differences between them and Band 5 rads. If numbers are small then there is a danger that they are treated as just cheap radiographer substitutes. In small departments where the workload is mixed then it is potentially more difficult to separate routine from unusual treatments." "in our department they work and perform at a similar level to Band 5 radiographers" 19

20. Aspirations of Assistant Practitioners Role Extension Advanced Practice Specialist Roles 20

21. Growing Demands on the Registered Practitioner Role Extension Advanced Practice Specialist Roles 21

22. Why is it Successful? Local recruitment and a loyalty to the department where they have been employed and trained – Only a few APs have moved away from their original place of training after qualifying Work Based Learning – Clinical skills develop quickly – gain staff confidence 22

23. Case Study In August 2005 3 Trainee Assistant Practitioners (TAPs) appointed in a RT department Qualified as APs in Sept 2007, had to apply and compete for jobs They worked along side band 5 Radiographers 23

24. Career Progression During 2007 / 08 2 APs enquired about progression to become Radiographers Completed a bridging module in research methods Sept 2008 joined year 3 of BSc (Hons) Radiotherapy & Oncology June 2009 graduated with 2:1 Band 5 Radiographers 24

25. Career Progression (cont) By June 2010 both had become Band 6 Radiographers with responsibility to now manage a team of Radiographers and a treatment machine The tasks that were once outside of their remit are now everyday routine tasks 25

26. Aspirations of Assistant Practitioners Role Extension Advanced Practice Specialist Roles 26

27. Recent Up date ! We now have a previous AP who progressed, completed the BSc year 3 and is now working here in New Zealand! - Wellington 27

28. How is the course delivered 28

29. Course Structure 6 modules in total – 3 per year RT Physics Oncology & Technique Clinical Skills All assessed through a portfolio of evidence – Greatest emphasis is on clinical skills 29

30. Study Days Each module is supported by a study day at SHU – Students have an opportunity to meet other TAPs – An opportunity to meet SHU staff – Access resources at SHU Specialist study events – Service User – Anatomy and image recognition 30

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32. Support & Delivery Each department having TAPs has a clinical tutor who is responsible for facilitating their learning and development We have bi annual meetings with clinical tutors Tutors are invited to study days 32

33. E-Learning 33

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37. Live Chat Options 37

38. Mobile Phone APP 38

39. Not Without Challenges! Funding ? Is it better to employ a Band 5 Registered Practitioner? Maybe even Band 2 or 3 39

40. Summary A locally delivered programme Quality and equity maintained through SHU produced learning material and study days Cross department marking of all work submitted Allowing progression Challenges are acknowledged 40

41. Thank You! a.j.jessop@shu.ac.uk Acknowledgements – Dave Green SHU (Course Tutor) 41