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The changing role of the Anatomical Pathology Technician Technologist

The changing role of the Anatomical Pathology Technician Technologist. James Lowell Manager, Directorate of Cellular Pathology Guy’s & St Thomas’ NHS Foundation Trust Chair Association Anatomical Pathology Technology. What's in a name?. APT Mortician Mortuary / Morgue Attendant

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The changing role of the Anatomical Pathology Technician Technologist

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  1. The changing role of the Anatomical Pathology Technician Technologist James Lowell Manager, Directorate of Cellular Pathology Guy’s & St Thomas’ NHS Foundation Trust Chair Association Anatomical Pathology Technology

  2. What's in a name? APT • Mortician • Mortuary / Morgue Attendant • Mortuary / Morgue Superintendent • Medical Technical Officer • Morgue Master • Pathologists Assistant • Mortuary Technician • Anatomical PathologyTechnician • Anatomical Pathology Technologist

  3. Anatomical Pathology Technologist • Approximately 750 UK • NHS, Local Authority & Medical School • Hospital & Public mortuary

  4. Anatomical Pathology Technologist • Royal Society of Public Health - since 1950 • Three to five years to qualify • Certificate & Diploma of Anatomical Pathology Technology • Healthcare Scientists • Over 50 disciplines • 3 divisions: • Physiological sciences • Clinical engineering and physical sciences • Life sciences

  5. The role of the APT • Wide scope of practice – Variable depending on where you are! • Technical / Clinical • Management • Health & safety • Educational • Unusual duties • Deceased patient care

  6. What's driving change ?

  7. Specific Standards • Regulatory framework Published 2006

  8. The HTA was somewhat surprised and concerned to find that as a professional group, APTs do not appear to have benefited from regular appraisal or training opportunities • In addition, we understand that the Association of Anatomical Pathology • Technologists (AAPT) is working with Skills for Health in consultation with the Royal College of Pathologists (RCPath) to develop a modern professional educational programme for APTs, which, if implemented, will help bring about positive change in this area. Published 2008

  9. Principles: • Respect for the individual and Equality of provision. • Core Elements: • Bereavement Support: 3 major components. • Policy: Bereavement care pathways. • Partnership: Coordination and Consistency of services. • Before Death: Patient’s wishes, Honest prognosis and Organ donation. • Immediate needs: Sensitively inform people of a death.

  10. Mortuaries provide a vital part of the service the NHS gives to patients and their families, but it is a part which most people - happily - do not encounter. As a result, they are sometimes overlooked. • Mortuary staff have an important and challenging role, balancing the very different needs of bereaved families and clinical staff. They must deliver an efficient, safe, secure service, following stringent procedures, while treating grieving relatives and friends with respect and sensitivity. • People come into contact with mortuary staff at a very difficult time, and they may have to face painful issues. The quality of their experience can have a great impact, for good or ill. Mortuary staff often work closely with a hospital's bereavement service to meet needs beyond their own remit. • There is much good practice in NHS mortuaries, and many dedicated and caring staff work in them. Their role is an integral part of NHS care, and deserves to be recognised as such. Published August 2006

  11. The Medical Certificate of Cause of Death (MCCD) should be completed by the medical practitioner responsible for the deceased person’s care, as now. After completion, the MCCD should be passed to a Medical Examiner

  12. The Programme will: • Improve the quality and accuracy of medical cause of death certificates (MCCDs) • Introduce a single system of effective medical scrutiny applicable to all deaths that do not require a Coroner’s post mortem or inquest • Provide improved information on cause of death to strengthen local clinical governance and public health surveillance. Published July 2009

  13. High Quality of Care Safe care Effective care Patient experience Published June 2008

  14. A clinical vision for the NHS Staying healthy Mental health Maternity and newborn Children’s health Planned care Long term conditions Acute care Acute care Acute care Acute care Acute care Acute care End of life care

  15. ‘58% of deaths occur in NHS hospitals’ ‘When asked over 50% of people express a wish to die at home’. • Holistic and care pathway approach recommended • Recognises • - numbers dying in England set to rise (from 500,000 to 530,000 by 2030) • only one third of general public discuss death and dying • Key areas addressed include: • High quality services in all locations. • Care planning. • Last days of life and care after death. • Involving and Supporting carers.

  16. The End of Life Care Pathway

  17. Need for Registration • From DH (The regulation of the non-medical healthcare professions): • “we have defined regulation as the set of systems and activities intended to ensure that healthcare practitioners have the necessary knowledge, skills, attitudes and behaviours to provide healthcare safely. The goal of professional regulation is patient safety. • This means professional regulation needs to: • set and promote those standards which, for reasons of safety, everyone in a profession (or branch of a profession) has to meet; • publish a register of those who meet these standards, and ensure that everyone on the register continue to meet the standards, both by periodic checks for all and by procedures for resolving concerns which a complaint or incident might create.”

  18. Need for Registration • Voluntary Registration (Professional Regulation) • First step towards Statutory Regulation • Allows Technologists more control over Regulation process • Input from Professional Bodies • Statutory Regulation • HPC Registration • Protected Title First registrants 2006

  19. Need for Registration • The DH continues: • “Professional regulation becomes statutory regulation at the point where the State regards it as so important for public safety that it legislates for a ban on either using the professional title or doing certain things unless your name appears in the register. • This protects patients from the harm caused by people practising a profession which they are not fit to. It engenders public confidence by allowing members of the public and the employers of professionals to check on a person’s registration status, knowing that the information they find will be correct and up to date.”

  20. VRC • Membership Groups • NAC - Cytoscreeners • BARS - Retinal Screeners • AOSP - Ophthalmic Science Practitioners • BATB - Tissue Bankers • SCCT - Critical Care Technologists • AAPT - Anatomical Pathology Technology • ACC/CMGS, represented jointly by the AGTC - Genetic Technologists

  21. Modernising Scientific Careers • Consultation Process • 4 country wide consultation closed 6th March • Outlined a new training and career pathway Key themes • Recognition of the need to change • Support to modernise education and training • Need for further detail to be developed in certain areas • Where we are and what happens next • Deliberative events over summer to help develop further details • Final policy proposals in Autumn Published November 2008

  22. Underlying principles of the Modernising Scientific Careers Programme • Protection of the public and delivery of safe and effective services • Standards and quality underpinned by assessment • Explicit training and career pathways • Planning the workforce • Funding which is secure and sustainable • Raising the profile of healthcare science workforce and scientific careers • Adding Value to healthcare

  23. Role definition of the Modernising Scientific Careers Programme • Healthcare Science Assistants and Associates– supported to perform task and protocol based roles through range of vocational qualifications underpinned by a learning and development framework • Healthcare Science Practitioners – supported to perform applied scientific techniques through a work based training programme and relevant accompanying academic award leading to regulation • Healthcare Scientists – supported to undertake complex clinical scientific roles through a 3 year broad base clinical training programme, including themed rotations and a vocational Masters level qualification leading to regulation

  24. Service review APTs • Role evolving tissue retrieval and storage in some cases/locations in line with HTA, involvement in more advanced techniques and possible future use of imaging, move into bereavement services/care • Coroner and NHS Post Mortems implications for training e.g. consent, tissue retrieval for education and research, forensic evidence • Training more breadth and depth, modernised involving all stakeholders ( MSC, RSPH and RCPath), role of regulation

  25. The professional body The Association of Anatomical Pathology Technology

  26. AIMS AND OBJECTIVES • “COMMITTED TO WORKING WITH THE APPROPRIATE AUTHORITIES AND ORGANISATIONS TO HELP ENSURE AND IMPROVE THE PROFESSIONAL, EDUCATIONAL AND PRACTICAL STANDARDS FOR TECHNOLOGISTS”

  27. STRONG LINKS • HUMAN TISSUE AUTHORITY • ROYAL COLLEGE OF PATHOLOGISTS • INSTITUTE OF BIOMEDICAL SCIENCE • SKILLS FOR HEALTH • MSC • ROYAL SOCIETY FOR PUBLIC HEALTH • GOVERMENTAL DEPARTMENTS

  28. CONTINUING PROFESSIONAL DEVELOPMENT (CPD) • AAPT PROVIDES A CPD PORTFOLIO AS A BENEFIT OF MEMBERSHIP TO RECORD CPD ACTIVITY • ON-LINE LEARNING IS AVAILABLE THROUGH www.aaptuk.org in the LEARNING ZONE • CPD AWARD CERTIFICATE

  29. CONTINUING PROFESSIONAL DEVELOPMENT (CPD) • 15 multiple-choice questions on a relevant article to APT staff • Score of 12 = 5 CPD credits

  30. Next steps RCPath approval • Learning Pack for APTs Continue to: • promote VRC -Leading to submission for inclusion under the Health Professions order and regulation with HPC • Work with all stakeholders to positively improve the profession Introduction of TEC programme • Training, Education and Competency

  31. Next steps National and International Emergency Response • Continue to work with all relevant stakeholders to ensure that the profession can respond. Training at different levels for APTs • Trainee • Team member • Senior

  32. Final Thought “The care with which our dead are treated is a mark of how civilised a society we are. Much goes on, for understandable reasons, behind closed doors. For this reason there is a special responsibility placed on those entrusted with this work and the authorities who supervise it, to ensure that the bodies of the dead are treated with the utmost care and respect. That is what bereaved and loved ones are entitled to expect and what society at large demands” Charles Haddon-Cave QC representing the Marchioness Action Group

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