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Advanced and consultant practice roles

Sarah May and Chris Ward from the IBMS look at advanced and consultant roles and discuss new developments and qualifications.


The concept of healthcare consultants in professions other than medicine is not new, and the IBMS has for many years championed advanced and consultant roles for biomedical scientists, who are among the most highly and intensely qualified professionals within healthcare. Frustratingly, whilst advanced and consultant practice for scientists, and indeed the whole regulated healthcare workforce, has the full support of all four UK health departments, and is emphasised within the NHS workforce plan as part of the future for sustained delivery healthcare, the reality for biomedical scientists has been slow, with numerous external obstacles and progress tending to be local.

A big investment

As the IBMS Long Term Biomedical Scientist Workforce Plan makes clear, due to the many pressures on the NHS to meet the demand for high-quality and timely patient care, coupled with a recognised (and growing) shortage of medical pathologists, advanced and consultant roles for biomedical scientists are widely being seen as part of the solution.

The development of expert and advanced professional qualifications is one of the biggest investments the Institute has made for its members. The Diploma of Expert Practice (DEP) qualifications are aimed at those working in highly specialised areas of practice, particularly members who want to take their careers in a more clinical rather than managerial direction. The Advanced Specialist Diploma (ASD) qualifications are an alternative to professional doctorates and are aimed at the most senior members of the profession, with the ability and opportunity to undertake roles that are commensurate with consultant-level practice.

As an indication of the number of people who hold an expert or advanced qualification, some 370 individuals have achieved the DEP in Histological Dissection since it was launched in the mid 2000s, with around 300 individuals who have achieved one (or more) of the three cytology qualifications. Since its launch in 2014, the ASD in Histopathology Reporting has seen 27 individuals qualify and awarded the Certificate of Completion and there are 62 individuals at various stages of the qualification. This is not a “quick fix” and represents a major commitment as this four-stage qualification requires a minimum of 48 months of training. However, the successful candidates have the potential to make a significant contribution to the histopathology reporting workforce and consequently to help meet the cancer targets of the Major Conditions Strategy.

Successful qualifications

In response to the challenges faced by the respective screening programmes, two limited-scope reporting qualifications covering bowel and cervical screening have been launched. By virtue of their limited sample repertoire, these can be completed within two years and also offer a stepping stone onto the full scope pathways. Work has also commenced on developing a limited-scope placental reporting qualification and other priority areas for further reporting qualifications are being considered.

The success of these qualifications means that there are significant numbers of histology and cytology biomedical scientists working at advanced/consultant level at Band 8c or, in some cases, 8d although the IBMS has only limited evidence of how and where these individuals are practising once qualified and it is unclear as to whether they represent a “one off” or part of a department/employer strategy to develop scientist roles to undertake some medical pathologist duties.

Advanced Clinical and Consultant Practice Group

For the other disciplines, advanced practice is very limited and is usually dependent upon local need and individual circumstances. Even within cytopathology and histopathology the Institute has a limited knowledge of the extent to which members who have taken and passed professional qualifications are employed. While some are used and recognised as consultant scientists, others are given only limited opportunities despite their qualification. In some instances, an advanced or consultant role is only maintained during the employment of a specific individual and is not regarded as a permanent role to be continued once an individual has moved on or retired. Therefore, to better understand the advanced and consultant biomedical scientist landscape the IBMS is forming an Advanced Clinical and Consultant Practice group with representation sought across the pathology specialisms and from all four UK countries.

The group will have a specific remit to gather and provide intelligence on advanced and consultant practice across the UK, across all disciplines, to establish the extent of practice and to help formulate a strategy to accelerate the speed and scope of consultant scientist roles. Failure to have knowledge of where advanced and consultant roles exist, and where there are problems, prevents the Institute supporting the initiative beyond its examinations and could lead to the roles being local and occasional rather than UK-wide and established.

The remit of the group will also be to champion and raise awareness of the value of advanced/consultant roles, through means such as written articles and presentations, by challenging misleading claims/disinformation and to provide advice on appropriate existing IBMS qualifications and training routes. In monitoring those who have already passed DEP and ASD qualifications, and the roles they subsequently have within their employing organisation, it is hoped that the IBMS may be able to help accelerate the establishment of these roles.

New qualifications

As part of the work to widen opportunities in other specialisms, the IBMS is launching two new DEP haematological qualifications in Haemostasis and Thrombosis, and Red Cell Disorders, which will complement the existing DEP in Routine Haematology. During 2024, work will also resume on the development of a DEP in Medical Microbiology, with the plan to have optional modules covering areas such as infection prevention and control, mycology, antimicrobial resistance and stewardship, and pathogen genomics.

The IBMS is committed to providing opportunities for those aspiring to high-level scientific and clinical roles and recognition of the often under-utilised knowledge and expertise biomedical scientists can bring to patient care. Now biomedical scientists have real choice while remaining on their own professional register.  

Chris Ward is the IBMS Head of Examinations and Sarah May is a Biomedical Science Consultant.

Image credit | iStock

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