The Institute of Biomedical Science

Independent Provision of Pathology Services

Statement released: 4 July 2007

Introduction

The Institute of Biomedical Science is the professional body for biomedical scientists in all fields of work, including the National Health Service. The aims of the Institute are to promote and develop biomedical science, its practitioners and to establish, improve and maintain professional standards. The Institute has published a code of professional conduct that details minimum standards of practice for the provision of pathology services.

Primary Care Trusts, NHS hospital trusts and other organisations planning to commission a pathology service from a new provider have a duty of care to ensure that the quality of service is no less than that currently provided and that all nationally recognised quality standards are met. Within their duty of care, commissioners of pathology services should be satisfied that providers will have the necessary attitudes to ensure that the pool of professional expertise will be maintained appropriately and updated during the life of all service level agreements. The following standards are a minimum requirement irrespective of whether the service is provided by the NHS or by an independent provider.

Staffing and Skill Mix

The quality of a pathology service is dependent upon the staff who perform the tests and manage the laboratory. Irrespective of the organisation providing a pathology service, there must be sufficient numbers of appropriately graded and qualified staff to ensure the delivery of a service which meets the standards set by the Institute and required for accreditation by Clinical Pathology Accreditation (UK) Ltd, the principal accrediting body for pathology laboratories in the United Kingdom

Pathology Support Grades

The role of non-registered staff in a pathology laboratory is acknowledged, as their presence allows the qualified and registered staff to undertake or manage more complex tasks. The Healthcare Scientists Career Pathway affords the opportunity to describe roles appropriate for support staff and the assessment process for these staff. However, the requirement to maintain quality of service would necessarily place limits on the numbers of support staff and the Institute recommends a ratio of no greater than three support staff to one registered biomedical scientist in any area.

Biomedical Scientists

It is statutory requirement that all biomedical scientists working in the NHS or providing a pathology service to the NHS must be registered. All laboratories employing biomedical scientists should have an audit system in place to ensure that all staff carrying out biomedical scientist duties are registered with the Health Professions Council and that their registration is maintained on a biennial basis. It is Institute policy that progression through employment grades must be linked to post-graduate qualifications, the demonstration of competence and continuing professional development.

Training

In the Healthcare Scientists Career Pathway, the Government has made clear the importance it places on training and staff development for Healthcare Scientists. The Institute welcomes this recognition of the standards that it has advocated and developed for healthcare scientists.

Training for Registration with Health Professionals Council

The minimum requirement for registration as a biomedical scientist is an Institute accredited honours degree in biomedical science or an HPC approved degree with integrated or post-graduate clinical placement training. Laboratories that employ pre-registration biomedical scientists in trainee posts must be approved for training by the Institute and must have a designated training officer or co-ordinator to facilitate this training. The IBMS registration portfolio defines the requirements for pre-registration training, but must also be accompanied by a comprehensive training programme specific to the laboratory in which training is being provided. Adequate provision of resources for both trainee and training officer is essential to support laboratory training.

Competence to Practise and Continuing Professional Development

The Institute was one of the first professional bodies to promote and develop a continuing professional development (CPD) scheme for its members. The importance of education and training to develop the level of expertise required to practise at a more advanced or specialist level must be taken into account by all providers of a pathology service. The Institute position is supported by the Health Professions Council requirement to undertake CPD as an integral part of the re registration process and the Healthcare Scientists Career Pathway that recognises the need to acquire post-graduate qualifications and high level practical skills in order to progress through this pathway. The Institute’s view of that is adequately resourced CPD is recognised by the Government as necessary for the development of a trained and competent workforce.

Multidiscipline Working

Within the independent pathology sector the concept of biomedical scientists working in more than one pathology discipline has long been accepted. The Institute supports the concept of a highly trained and flexible workforce in order to deliver a timely and quality pathology service. Central to any decision to introduce multi discipline working must be the provision of appropriate training based on the Institute’s Specialist Portfolio for that particular discipline. Commissioners should satisfy themselves that adequate training programmes have been identified by providers offering innovative methods of service provision. Registration itself is not discipline specific. However, as part of risk management it is the duty of a commissioner to ensure that the provider of a service can demonstrate fitness for purpose as evidenced by training and competency assessments. The Institute can provide guidance on suitable training and competency assessment prior to a biomedical scientist undertaking work in a second pathology discipline.

Quality Control and External Quality Assessment

As a professional body and a shareholder in Clinical Pathology Accreditation (UK) Ltd the recognition and setting of quality and professional standards is central to the Institute’s purpose. It is essential that laboratory processes adhere to recognised standards of practice. Full and appropriate internal quality control measures within documented standard operating procedures must be in place and available for scrutiny by potential commissioners of a pathology service. Potential providers of pathology services should have satisfactory evidence of regular participation in relevant, accredited external quality assessment schemes and current accreditation with Clinical Pathology Accreditation (UK) Ltd or an appropriate external body in all the disciplines provided.