Sample Taker Training Review Update

1
Sample Taker Training Review Update

• Caroline Burnley
• QA Co-ordinator (Cervical)
• Quality Assurance Reference Centre
• Caroline.burnley_at_nhs.net

2
The history of the review

• Between 2005 2008 there were three incidents
  relating to quality of sample taking where
  training and governance were highlight as root
  causes or contributory factor
• In November 2008 the SHAs requested a review of
  the sample taker training
• The process included review of NHSCSP publication
  23, interviews with professionals, review of
  current processes and documentation.
• A number of recommendations were identified
• A project board, action plan and clinical lead
  were appointed
• A complete risk assessment of the project was
  undertaken and referenced within SHA, PCTs and
  collaborative commissioning risk registers

3
Is it still a problem?

• We are still having incidents
• Trainees who failed the training but continue to
  take samples
• Sample takers with TZ rates less than 30
• Sample takers trained moving into the NEYH and
  taking samples in the ThinPrep method
• Sample takers regularly not visualising the
  cervix for a variety of reasons
• Samples incorrectly labelled
• These all lead to women being recalled and
  happened in the last 12 months

4

• What progress has there been?

5
Training Guidance

• The Purpose of the Group and Why is it an issue?
• To develop the new training programme to
  implement from April 2011
• There is variation in how the training is
  provided across the NEYH
• Update progress
• There are two new guidance documents
• Learning outcomes for each aspect have been
  agreed
• A Grandfather clause training event has been
  developed
• E-learning package for updates developed
• Requirement of basic training courses to
  strengthen the accountability and governance
  aspects of their training
• Factsheets for training courses to use FOC
• Guidance for visits to care pathway

6
Assessing sample taker performance

• TZ pilot has progressed to Sample Taker
  performance pilot
• Uses the web-based system to calculate the TZ,
  inadequate and abnormal rates
• The percentages are then entered into the funnel
  plot spread sheets and the RAG (red-amber-green)
  analysis undertaken by laboratory
• Sample taker performance/feedback will be
  accessed via the database
• This identifies sample takers where there are
  concerns with their data
• The PCT/mentor would then visit the sample taker
  and discuss the data
• A supervised assessment form has been developed,
  trialled and in use which consists of two
  sections knowledge of the programme and
  equipment availability and the supervised
  assessment of 5 samples
• The next stage of the pilot is to assess when it
  is appropriate to only undertake the first
  section of the supervised assessment

7
Sample Taker Database

• The Purpose of the Group and Why is it an issue?
• To establish a database to allow all sample
  takers, practice managers and PCTs to access the
  data to evaluate their services.
• Many sample takers are not aware of their own
  performance
• There currently is no QA of primary care
  therefore the largest and most diverse part of
  the system is open to errors.
• Update on progress www.mezzobeta.co.uk/cstd

8
Commissioning of the NHSCSP work stream

• The Purpose of the Group and Why is it an issue?
• There is a lack of clarity and clear service
  specifications in the Region
• Departments are often not clearly contracted to
  undertake the NHSCSP to expected standards
• Lack of performance management across the
  majority of the NEYH
• To bring clarity to the commissioning of the
  NHSCSP
• To establish a number of best practice documents
  to be rolled out across the region
• Update on Progress
• Accountabilities grid has been developed
• Recommendations on the role of the Sample Taking
  Coordinator
• Template service specification
• Roles and responsibilities guidance

9
Commissioning of Training

• The Purpose of the Group and Why is it an issue?
• To ensure the improved training programme has
  clear governance and commissioning arrangements
• Currently there is a lack of clarity with regards
  to the roles of the training providers, GPs and
  the PCT
• Update
• The two SHAs will be progressing training in
  different ways.
• NE will continue with Newcastle PCT and the
  University of Northumbria
• YH will be delivering Basic through their
  Universities (or university accredited courses)
• YH update training will be part via e-learning
  package and part local events

10
Mentors Services

• The Purpose of the Group and Why is it an issue?
• To develop the role of the mentor and ensure the
  governance around these is clear.
• Mentors currently undertake different roles
  dependant on which PCT they work in.
• Update on progress
• The NE mentors will continue to be hosted by
  Newcastle PCT whilst a new host is currently
  being sort for the YH mentors.
• YH have three new mentor providers.
• Training days for mentors will be held in
  June/July
• The mentors and their hosts will work together to
  develop the role

11
What still needs to be done?

• Deliver the grandfather training
• Address basic training for medical staff
• Develop templates for visits to the care
  pathway (if the support is requested)
• Implement the database across NEYH
• Develop centralised evaluation process

12
Summary

• A lot of work has been undertaken in the last
  year
• There is a trend to more local arrangements
  whilst maintaining a regional approach to
  standard delivery
• In the future quality assurance of primary care
  and a sample taker Professional Advisory Group
  will be developed
• But there is still work to be done

13

• Any questions?