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NHS fast-track endoscopy programme 'too short for non-technical skills'

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A fast-track NHS programme for nurses and other practitioners to become non-medical endoscopists equips trainees with the required technical skills, but does not provide enough time for developing in other areas such as clinical decision-making, an evaluation of the scheme has indicated.

The programme, run by government arms-length body Health Education England, was launched in 2016 to help increase the number of endoscopy staff to cope with rising demand for these procedures.

“Trainees will require more time to fully develop the non-technical elements, such as clinical decision making”

HEE evaluation 

A total of 40 professionals took part – including 33 nurses – and 31 became certified as non-medical endoscopists within the accelerated timeframe.

It was designed as a six-month programme, but was extended part-way through the pilot by a further month due to delays with e-learning training and producing an academic assignment.

The Office for Public Management research organisation, which carried out the evaluation, said trainees and mentors both agreed that by the end of the course participants could perform endoscopy procedures “in a safe and timely manner”.

But it noted that participants would need more time after completing the course to “fully develop the non-technical elements, such as clinical decision making”.

Those who took part in the first wave of the pilot said the training programme had less of an impact on managing adverse incidents, interpreting histology results, and making decisions around patient follow-up, said the OPM in its report for HEE.

“Those with full release performed on average 251 procedures compared to 216 among those with partial release”

HEE evaluation 

Following completion of the course, the majority – 85% – of the first cohort of 14 trainees said they were “always” or “very often” working independently when carrying out endoscopies.

However, supervisors and mentors said further work was needed for them to develop capability and confidence. Around half said participants still needed support from colleagues when carrying out endoscopies after the programme had finished – and also needed more opportunities to develop the non-technical skills.

The OPM said it would monitor this as it continued to evaluate the programme in 2017.

Other overall findings from the evaluation were that trainees were helping to meet endoscopy service demands at their NHS trust and were freeing up medical staff.

Trainees who were fully released from their normal jobs to undertake the training were able to progress more easily, and were also able to perform more procedures.

“Overall, those with full release benefited primarily from having the time and flexibility to take on additional lists and ad hoc procedures, as those with full release performed on average 251 procedures during the programme compared to an average of 216 procedures among those with partial release,” said the report.

“More could be done to encourage applicants from non-nursing backgrounds to increase the skills mix”

HEE evaluation 

Meanwhile, it was noted that the pilot programme had largely attracted applicants with a nursing background.

“There is a view that more could be done to encourage applicants from non-nursing backgrounds to increase the skills mix and support the sustainability and further roll-out of the programme,” said the report.

As has been previously reported by Nursing Times, the accelerated training programme is now being rolled out across the NHS.

This is to try and ensure 200 non-medical endoscopists can be trained  by 2018, in line with an announcement made by the health secretary in 2015. 

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