AAA Screening A Competence Approach

1. AAA ScreeningA Competence Approach Lorna Hunter Skills for Health Scotland

2. How it all fits together Functions / Competences Level of Skill Context x x = Competence based roles Role specific education Existing Skills & Knowledge Content & Level Qualification

3. AAA Screening

4. AAA Screening: The workforce problem • The introduction of a Scottish abdominal aortic screening (AAA) programme in 2012 utilising diagnostic ultrasound as the tool, is expected to increase the workload of the existing ultrasound workforce beyond that that can be safely undertaken.

5. AAA Screening: The workforce solution • “An innovative scheme to bolster capacity has to be established and may mean that AAA Screening will have to be undertaken by individuals who may not have had previous ultrasound training or expertise.”

6. AAA Screening: The competence approach • In order to ensure that those recruited to carry out the screening test are trained to a required standard and safe to practise, the need for a competency framework was identified.

7. How it all fits together Functions / Competences Level of Skill Context x x = Competence based roles Role specific education Existing Skills & Knowledge Content & Level Qualification

8. Functional Analysis Functions / Competences Level of Skill Context x x =

9. The AAA Pathway

10. The AAA Pathway:

11. What are Competences/National Occupational Standards? • Descriptors of the performance criteria, knowledge and understanding that are required to perform work activities • Outcome based • Activity based i.e. about the function being performed – not the person performing it e.g. obtain a venous blood sample • Patient Centred • Nationally (UK) agreed

12. Framework applications • Competences can be grouped by a related function or context e.g. • Mental Health Services • Public Health • Coronary Heart Disease • Other Applications • Competences can be assembled into structures for specific purposes e.g. • Team Development • Career Development • Qualifications • Building Blocks • National Occupational Standards Competences/ NOS – Building blocks & applications

13. Core Competences: Example Safeguard & Protect Individuals Health, Safety & Security Equality and Diversity Communication GEN 22 - Communicate effectively HSC 22- Support health & safety ENTO WRV1 Contribute to safe working culture HSC 234 – Ensure action support E&D IPC2 - Perform hand hygiene CfA 106 – Use IT Assessment & Investigation of health Management and administration of health care Address Health Requirements Education & Learning Around Health Provision of Health Care GEN 5 : Support individuals undergoing healthcare activities CfA 105 – Store and retrieve information PSL 5: Undertake an assessment or re-assessment of a patient HSC 23 – Develop your knowledge and practice AG2 – Contribute to care planning & review GEN 25: Administer appointments GEN 13 – Synthesis of new knowledge into practice GEN 4: Prepare individuals for healthcare activities CHS142: Test individuals abilities before planning exercise and physical activities

14. Functional Analysis Functions / Competences Level of Skill Context x x =

16. Role of the Assistant Practitioner in AAA Screening (SCoR 2008) • The Society and College of Radiographers believes that, similar to the NHS Breast Screening Programme, assistant practitioners who have been suitably trained could undertake this single organ imaging within a supervisory framework. • The screening unit will be overseen by a lead clinician and fully trained sonographers who will have special responsibility for quality assurance of staff and screening equipment, staff accreditation, and monitoring of clinical performance. They will also be available to give advice when required, especially in the event of complicated examinations and incidental findings. • The assistant would scan the abdominal aorta and collect data in the form of measurements which would then be referenced to normal ranges to see if repeat surveillance scans or onward referral were required. • There would be protocols, schemes of work and referral paths documented and regularly updated. The initial data analysis would consist of comparison of the acquired data to a norm referenced data set. Inconsistencies would be reportable. • The assistant practitioner would be expected to work under supervision of a qualified sonographer.

17. Functional Analysis Functions / Competences Level of Skill Context x x =

18. AAA Competences • Generic or ‘Core’ Areas • 1. Common Core Skills • 2. Specific Core Skills • Specific or ‘Defined’ areas • 1. Pre-Examination Checks (Pre Scan) • 2. Examination Management (Scan) • 3. Post-Examination Evaluation (Post Scan)

19. CI.C5 Acquire, interpret and report on ultrasound examinations of the vascular system • Overview • This standard is concerned with the imaging and interpretation of the vascular system using ultrasound. This will be undertaken as part of a diagnostic process and the outcomes will be of sufficient quality to assist diagnosis. • Knowledge and Understanding • Performance Criteria • Additional Information

25. AAA Screening Competency Framework • Endorsed by

27. Invited to speak at: • Society of Radiographers Scottish AGM • Society of Vascular Technologists AGM • Working with: • English, Welsh and N Ireland AAA Screening Boards Poster presentation at: NHS Scotland Conference

28. AAA Screening – Questions? • Lorna Hunter • lorna.hunter@skillsforhealth.org.uk • Tel: 01896 848546 Mob: 07826 950614