Public Accounts Committee Inquiry submission
Update 20th December - the Public Accounts Committee now has all evidence submitted by all parties available to read
As part of our commitment to supporting the profession from the ground up and having an impact on government policy that benefits excellence in the profession and patient care, we have submitted evidence to the Public Accounts Committee's inquiry into managing NHS backlogs and waiting times.
As the Committee reported in March, the NHS in England was already running at close to maximum capacity before COVID-19. Pandemic disruption caused a sharp increase in waiting times and backlogs. Addressing these backlogs is a multi-faceted challenge for the NHS.
In this follow up inquiry, the Committee will question senior officials at the Department for Health & Social Care and NHS England on the start they have made on tackling the elective care and cancer backlogs, focusing on:
- the design of national recovery plans;
- implementation of the recovery plans, including the use of independent sector providers; and
- early progress made in recovering services.
Upon the submission of our evidence, IBMS Chief Executive David Wells commented:
Workforce is one of the biggest solutions to tackling the cancer and elective care backlogs. The IBMS will continue to speak with one voice on this matter - encouraging more funding to support the biomedical workforce, to see more advance roles adopted and to recognise the vital role that Biomedical Scientists play in modern healthcare.
The evidence the IBMS has submitted is pasted in full below:
PUBLIC ACCOUNTS COMMITTEE – MANAGING NHS BACKLOGS & WAITING TIMES WRITTEN EVIDENCE SUBMITTED BY THE INSTITUTE OF BIOMEDICAL SCIENCE
INTRODUCTION TO THE INSTITUTE OF BIOMEDICAL SCIENCE
1. The Institute of Biomedical Science (IBMS) is a professional body, established in 1912, that represents the interests of biomedical science professionals in the UK and internationally. Our mission is to support, progress and promote our members’ careers and their profession, and to ensure recognition for the important role that biomedical science plays in society.
2. The IBMS was initially launched to support the first practitioners in the evolving field of biomedical science - developing the first guidelines for good professional practice and delivering education and training in the ever-broadening array of specialist biomedical methods. Since its inception, the IBMS has become the world-leading professional body in biomedical science; dedicated to excellence in all aspects of biomedical science, in order to provide the highest level of service to patients and the wider public.
3. The IBMS now has more than 21,000 members, ranging from students studying IBMS accredited degrees, laboratory trainees completing the IBMS registration portfolio, biomedical scientists with IBMS specialist diplomas, and advanced laboratory practitioners with higher and expert IBMS qualifications.
4. IBMS Company Members include multi-national diagnostics companies and national institutions. The majority of IBMS members work in UK healthcare laboratories but they also work in government agencies, the commercial and industrial biomedical science sectors, research and development, academia, veterinary health, and biomedical science laboratories worldwide.
5. The IBMS oversees the route to registration as a biomedical scientist in the UK. To work with the title “biomedical scientist” in the UK, it is a legal requirement to be registered with the Health and Care Professions Council (HCPC).
6. Biomedical scientists contribute extensively to health and care in the UK, working to identify, research, monitor and treat diseases across the broadest areas of modern science, focusing on the complexity of the human body. From before conception right through to after death Biomedical Scientists are involved in delivering expert services.
7. Biomedical scientists operate largely, but not exclusively, in laboratory settings. They are experts in analysing, blood, fluid and tissue samples from patients, identifying diseases and preparing reports that highlight the best possible options for treatment. Without biomedical scientists, other key aspects of the healthcare system, such as GPs, Cancer Care and A&E, would not be able to function.
8. The important role of biomedical scientists was made clear during the COVID-19 pandemic, as the nation’s health planning and response largely relied upon laboratory testing undertaken by biomedical scientists and their skills testing innovation and technology deployment in hospitals and the home.
9. NHS waiting lists for diagnostics and elective care are at an all-time high following the devastating impact of COVID-19 which caused almost all other types of treatment to be placed on hold whilst the health and care workforce tackled the pandemic.
10. As of September 2022, over 7 million people in the UK are on a waiting list for NHS treatment1, with an average waiting time of approximately 14 weeks. This figure is likely to be higher as new patients are identified and the so-called ‘hidden backlog’ of patients who need care but whose referrals have been cancelled becomes apparent.2
11. Diagnostic testing is an increasing priority in the NHS as hundreds of thousands of patients are currently undiagnosed as a result of reduced capacity. Biomedical science will be crucial to ramping up diagnostic testing across the UK, allowing for patients to be triaged according to their results for entry into pathways. For example, the use of FIT testing to prioritise patients for colonoscopies (as per Sir Mike Richards’ 2020 review of diagnostics capacity) will require further training for colonoscopists.3
12. Workforce recruitment, training and retention are some of the biggest challenges facing the NHS today. Long-term issues including excessive workloads, fatigue and the chronic problem of unfilled vacancies have been aggravated by the Covid-19 pandemic, putting increasing pressure on existing personnel.4
13. The closure of the majority of the Covid-19 mass testing centres, also known as “Lighthouse Laboratories”, raised concerns over the future of HCPC-registered biomedical and clinical scientists, whose skills and expertise were crucial to the successful delivery of high-quality Covid-19 testing. As they look for new roles in the health sector, it is not clear how the Government will retain their expertise in the event of any future pandemic or help manage the elective care backlog.5
14. Recent data has revealed that there is a significant and rising number of vacancies in the medical workforce, leading to issues in the recruitment and retention of staff in some areas of biomedical science.6
15. Greater investment in the workforce and targeted skills training will be critical to meet the demand for biomedical science in the NHS. Having the right number of staff in the right places with the right skills will be key to the delivery of the Government’s ambitious vision to build an agile and resilient NHS with patients at its heart.
16. The central aim of the IBMS has always been around training, education and supporting the career progression of our members. We also play an important role in inspiring the next generation of biomedical scientists through our support hubs and mentoring schemes.
17. The importance of encouraging young people into biomedical science cannot be understated. Training numbers need to grow across all biomedicine disciplines and support for employers that invest heavily in IBMS accredited apprenticeships degrees and IBMS training programmes should increase to support the supply of high-skilled jobs that deliver vital diagnostics research.
18. The biomedical scientist workforce is highly flexible and in a unique position to support medical colleagues – particularly in histopathology reporting – to help meet the demands of the elective care backlog. More work must be done to maximise the potential of biomedical scientists to upskill in areas of advanced and consultant-level practice and take on certain functions that have previously been the sole responsibility of medically qualified staff. This will help to minimise issues in the recruitment and retention of medical staff.
19. The IBMS, in partnership with the Royal College of Pathologists, have established a UK-wide recognised training and examination framework giving biomedical scientists the capacity to perform such tasks.7 This has been used to great effect in Cervical Cancer screening, and is now having a similar impact in bowel and skin cancer diagnosis with Biomedical Scientists working as equivalents to their medical consultant colleagues.
20. The Government should work proactively with the IBMS and the wider biomedical science industry to better understand and identify critical skills gaps. Tackling skills gaps in biomedical science can be challenging, due to the breadth and depth of the education and training needed. However, developing a deeper understanding of labour market requirements will support short, medium and long-term planning.
21. It is crucial that the skills and expertise of HCPC registered scientists who administered the rollout of Covid-19 testing at so-called “Lighthouse Laboratories” are retained to help manage the current elective care backlog.
22. It is critical that the existing highly skilled scientific workforce is used to the best effect in each area of diagnostics to fill the skills gap in the medical workforce, across the entire diagnostic pathway.
23. The IBMS therefore makes the following recommendations:
24. The Government should work closely with the IBMS to identify employment gaps in the biomedical science sector and understand how to generate the pipeline of talent needed through education and skills training and upskilling to secure medium- and long-term market needs.
25. The Government should commit to continued funding for the biomedical science sector to further diagnostic research that keeps pace with rapidly increasing demand.
26. The Government should recognise the need to increase training numbers across all biomedical science disciplines. Better intelligence on the workforce, including the number of existing posts, vacancies, training posts and workload trends will help identify shortfalls. The IBMS is well placed and keen to work with the Government to address this data gap to support short, medium and long-term planning.
27. The Government should invest more money and resources into the workforce and use the expertise of IBMS members to develop more enhanced diagnostic capacity.
28. The Government should commend and support the work of NHS England so far in developing the Biomedical Science workforce post pandemic through the provision of training grants and the Practice Educator model and ensure that this is supported and enabled across the UK.
29. The Government should encourage adoption of the Advance practice, consultant equivalent, biomedical scientists in every NHS Hospital to further reduce diagnostic backlogs and to further improve cancer outcomes through earlier diagnosis.
1 Institute for Fiscal Studies (2022), The NHS needs to ramp up treatment volumes if waiting lists are to start falling anytime soon. https://ifs.org.uk/articles/nhs-needs-ramp-treatment-volumes-if-waiting-lists-are-start-falling-any-time-soon#note1
2 The British Medical Association (2022), NHS backlog data analysis. https://www.bma.org.uk/advice-and-support/nhs-delivery-and-workforce/pressures/nhs-backlog-data-analysis
3 NHS England (2020), Diagnostics: recovery and renewal. Report of the Independent Review of Diagnostic Services for NHS England. https://www.england.nhs.uk/wp-content/uploads/2020/11/diagnostics-recovery-and-renewal-independent-review-of-diagnostic-services-for-nhs-england-2.pdf
4 The King’s Fund (2022), NHS workforce: our position. https://www.kingsfund.org.uk/projects/positions/nhs-workforce
5 The Institute of Biomedical Science (2022), The IBMS Monthly Statement. https://www.ibms.org/resources/news/the-ibms-monthly-statement-may-2022/
6 The Royal College of Pathologists (2021), GIRFT Programme National Specialty Report. https://www.rcpath.org/uploads/assets/171f0ed0-ec20-4c93-b399d8518ee55641/Pathology-GIRFT-Programme-National-Specialty-Report-Sept-2021.pdf
7 The Institute of Biomedical Science (2021), Position statement on role requirements and banding for scientists undertaking reporting within cellular pathology departments. https://www.ibms.org/resources/documents/position-statement-reporting-within-cellular-pathology/