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Setting up a STEMI PCI Programme in the UK: Implications for the cath lab workforce. Rob Henderson Trent Cardiac Centre Nottingham Chair, BCS Working Group on Non-Medical Cath Lab Staffing. NO CONFLICT OF INTEREST TO DECLARE . 2004 data: Ludman .

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setting up a stemi pci programme in the uk implications for the cath lab workforce

Setting up a STEMI PCI Programme in the UK: Implications for the cath lab workforce

Rob Henderson

Trent Cardiac Centre

Nottingham

Chair, BCS Working Group on

Non-Medical Cath Lab Staffing

NO CONFLICT OF INTEREST TO DECLARE

slide2

2004 data: Ludman

Estimating the need for Primary PCI Europe and UK

UK population 60 million, at 500 pmp = 30,000 PPCI per annum

slide3

2004 data: Ludman

UK Growth needed for primary PCI (assuming no increase in other types of PCI)

1050 pmp

1546 pmp

32 %

2.3 %

consultant cardiac workforce requirements in the uk
Consultant Cardiac Workforce requirements in the UK

*Assumes consultants dedicated to PCI; assumes UK population 60 million

424 consultants did PCI in 2004 (BCIS) – but majority not dedicated to PCI

710 cardiologists (663 wte) in 2004 (DOH)

630 cardiologists in 2003 (RCP)

David Hackett, BCS Working Group 2005

non medical cardiac workforce requirements in the uk
Non-Medical Cardiac Workforce requirements in the UK

*Assumes Nurses, Physiologists, Radiographers dedicated to PCI work

Assumes UK population 60 million

Information about available staff very limited

David Hackett, BCS Working Group 2005

available non medical clinical staff
Available non-medical clinical staff?

*Nursing & Midwifery Council website – includes staff working overseas

**Jackie Howard, Catriona MacGregor – excludes cardiographers

*** Audrey Patterson – 1563 SOR members work outside NHS

estimated uk catheter laboratory vacancies
Estimated UK catheter laboratory vacancies

Preliminary data – includes diagnostic and PCI labs

BCS Non-medical Cath Lab Staffing Working Group survey 2005

*BCIS 2004

catheter laboratory work traditional roles in the uk
Catheter laboratory workTraditional roles in the UK

Cardiologist and trainee

Do procedure

Radiographer (1)

Turns on machine and controls C arm

5-7 staff

Nurses (1-2)

Puts patient on table

Draws up drugs

Opens equipment

Physiologist (1-2)

Sets up & monitors pressure line & ECG

(Perfusionist – IABP)

catheter laboratory staffing for pci in the uk
Catheter laboratory staffing for PCI in the UK

6.6

6.0

5.8

BCS Non-medical Cath Lab staffing Working Group survey 2005

Preliminary data from 6 PCI centres

catheter laboratory staffing for pci
Catheter laboratory staffing for PCI

*and a cleaner

**and a porter

catheter laboratory staffing for pci11

UK

UK

Number PCI

1200

600

4000

430

2900

900

Cardiologist

1

1

1

1

1

1

Trainee/SpR

1

0

1

0

1

1

Nursing

1

2

2

2

2

2

Physiology

1

2

1

0

1

2

Radiography

0

0

0

0

1

1

Total

4*

5

5

3**

6

7

Catheter laboratory staffing for PCI

*and a cleaner

**and a porter

catheter laboratory multi skilling
Catheter Laboratory Multi-skilling
  • Cardiac Cath Lab practitioner project
    • London South Bank University
  • Middlesbrough generic worker training
    • In house programme
  • Nottingham nurse radiography training
    • In house programme
  • Need national coordination and funding
conclusions
Conclusions
  • A national primary PCI service will need additional medical and non-medical staff capacity - but there are currently significant staff shortages
  • More trainees and multi-skilling will help but may not solve the problem entirely
  • If primary PCI is to be rolled out across the UK we need multidisciplinary, flexible, and innovative solutions to medical & non-medical workforce problems
  • There is an urgent need for robust information about non-medical catheter laboratory staffing to facilitate future planning
bcs non medical catheter laboratory staffing survey 2006
BCS non-medical catheter laboratory staffing survey 2006

All cath lab managers

….please, Please, PLEASE……

complete the survey form

and return to BCS

physiology staff vacancies scst survey november 2003
Physiology staff vacanciesSCST survey November 2003

15%

8%

60% response

Extrapolated to 100%

2005 London survey estimated physiology vacancy rate at 23% (79 wte)

catheter laboratory multi skilling16
Catheter Laboratory Multi-skilling
  • Multiple projects across UK
  • Often driven by local need
  • Cost of training and release from work
  • Need transferable qualification
national guidelines and staffing
National guidelines and staffing
  • BCIS/BCS recommendations 2005
    • ‘….dedicated multidisciplinary team…’
    • ‘….multi-skilling should be encouraged…’
    • No statement on appropriate staffing levels
  • ESC PCI guideline 2005
    • No statement on staffing
  • ACC/AHA PCI guideline 2005 & STEMI guideline 2004
    • No statement on staffing
estimating the need for primary pci
Estimating the need for Primary PCI

Modified from David Hackett, BCS Working Group 2003

slide19

2004 data: Ludman

Primary PCI in the UK 2004-2005

Number of centres doing routine primary PCI

In 2004 51 centres did 3447 PCI for STEMI (1438 PPCI)

Data from 55 of 58 NHS centres

catheter laboratory staff training
Catheter laboratory staff training

HPC - Health Professions council

NMC - Nursing & Midwifery Council