Federation for Healthcare Science response to Department of Health Consultation Document: "A Framework for the Development of Positron Emission Tomography (PET) Services in England" October 2004

Introduction

The Federation for Healthcare Science consists of 46 member professional
bodies, associations and societies that represent the 50,000 workforce that
covers healthcare science in the health service.

Its current membership covers medical physicists and clinical technologists across all healthcare science disciplines, groups which are significantly affected by the proposals in this consultation.

The major role of the Federation in responding to consultations is to articulate the collective views of its member organisations on matters that are significant for the practice of healthcare science.

Development of a strategic approach

The Federation for Healthcare Science welcomes the development of strategic approaches to the introduction and dissemination of new science and technology into clinical practice.

PET already offers significant clinical benefits to patients. It is important that these benefits are realised, while at the same time supporting research and development into the underlying technique and its clinical applications. Healthcare scientists are presently involved in all these areas in existing PET facilities.

Siting

Careful consideration should be given to the siting of these facilities, with regard to providing sufficient basic and clinical research and development capacity, and to make best use of existing resources. The provision of PET CT in Wales, Scotland and Northern Ireland also needs to be taken account of in this regard, and the effects on the viability of existing centres and their workforce. Healthcare scientists working in Nuclear Medicine Departments have already commented on the desirability of linking PET CT to existing nuclear medicine facilities.

Workforce issues

Healthcare scientists working directly in PET include medical physicists and clinical technologists. It is important to note that medical physicists and other healthcare scientists are needed not only for cyclotron operation but also to support the routine delivery of PET CT.

A range of healthcare scientists are needed to support PET. As well as nuclear medicine specialists, radiation protection physicists need to acquire and exercise specialist knowledge to ensure the safe generation, processing, transport, clinical use and disposal of PET radioisotopes. Diagnostic radiology physicists apply expertise to the make sure CT systems operate effectively and safely. Clinical technologists who are involved include nuclear medicine technicians, who help to deliver services, and medical physics technicians with radiation protection and electronic, computing and mechanical expertise, who provide specialised backup to both research and clinical activities.

Scientific, technical and radiopharmaceutical staff working in PET are employed currently by universities, industry and the NHS. Integrating the work and movement of staff between different employers to support technological development, translational research and clinical application remains a significant challenge, and underlines the importance of the work being done by StLaR in developing an HR strategy to support this movement between the NHS and academia.

Another area on which PET CT may impact is radiotherapy (as a tool to assist in radiotherapy treatment planning). Medical physics staff involved in radiotherapy will need to work closely with colleagues involved in PET CT, and there will be clinical impacts on radiotherapy departments. The development of links between PET CT and radiotherapy systems will require healthcare scientists with suitable software and computer network skills.

The recruitment and training of healthcare scientist staff to work in and support PET CT is likely to come initially from Nuclear Medicine and/or Medical Physics departments. There are already pressures on the recruitment and training of these staff, and some shortages, and the co-location of such facilities should be considered as a way to maximise the use of these skills and encourage recruitment and retention. There are particular shortages of the scientific and technical skills to support cyclotron operation and the recruitment and training of suitable staff needs to be carefully considered to avoid staff moving from existing centres to new facilities.

A concerted approach should be taken to considering training for healthcare science professions involved in PET. The number of facilities which are likely to be put in place, and their geographical dispersion, will make it difficult for individual SHA/WDC’s to organise training requirements for healthcare scientists. A national overview should be provided, ideally by a lead SHA/WDC working together with the relevant professional bodies, to set up and commission appropriate training.

The linking of CT to PET introduces additional facilities but also extra risks, and will require suitable cross-training for involved staff and the development of national guidance.

The development of mobile scanning will impact on the pool of trained staff and any significant expansion in these facilities should be considered when taking a national overview of training requirements.

20 October 2004

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