When you have highly qualified, expert staff in costly facilities, the last thing service managers need are bottlenecks that make it difficult for patients to access vital services quickly, writes Christina Pond

Skills for Health is working with healthcare employers across the UK, through six demonstrator sites, to help tackle bottlenecks in services and evaluate how workforce development and service redesign can be part of the solution.

One such project is taking place at Central Manchester and Manchester Children's University Hospitals trust, where managers set out to achieve an ambitious programme as part of their work as a demonstrator site testing Skills for Health competencies and tools.Their aim was to see how workforce analysis and process mapping could improve service delivery and patient experiences, reduce waiting times and support workforce development.

The trust discovered that by reshaping the workforce, in particular allied health professionals and healthcare scientists, the result would be a more flexible and responsive team configuration for improved service delivery.The work centred around three clinical areas:

  • computed tomographic colonography (virtual colonography);

  • magnetic resonance imaging of the internal auditory meatus;

  • radionuclide myocardial perfusion imaging.

Trust managers looked at patient pathways, blockages and competencies needed to unblock pathways. They found that new and enhanced roles could support the trust's existing good record around the 18-week target.Key aims for the work areas included reducing waiting times for scans, increasing capacity for stress testing, increasing reporting slots and investigating the viability of introducing radiographer reporting.

The trust reviewed the patient pathway, resources and roles involved across each area to scope the potential for service redesign, supported by development of new and/or different roles based on competencies.Managers mapped the entire process, beginning with referral through to testing, scans and reporting, which allowed them to see how services could be reconfigured. Skills gaps were identified and it became apparent that upskilling senior technicians to carry out certain procedures, such as stress and rest testing, could release medical staff to reduce delays in triaging referrals and reporting.

Skills for Health competencies were matched against skills gaps, and job profiles were created. To develop knowledge and skill acquisition across the three clinical areas, managers scoped suitable learning programme providers.The results were:

  • services have been redesigned and competencies mix changed;

  • waiting times in certain diagnostic areas have been reduced from 35 to 19 weeks;

  • new roles will lead to further reductions in waiting times;

  • increase in available appointments in the master patient index;

  • job roles based on competencies and designed around procedures and patient need;

  • training needs and skills gaps identified for future developments and recruitment;

  • future education commissioning will be based on competencies.

Although the project was ambitious, a close working partnership between the trust, allied health professional and healthcare scientist leads, members of the clinical radiology and nuclear medicine department and Skills for Health meant issues could be addressed and revisions made.The trust anticipates continued involvement in the development of Skills for Health allied health professional and healthcare scientist career frameworks and workforce competencies, and greater partnership with local higher education institutions to commission demand-led programmes based on service need.

Skills for Health sees work with demonstrator sites as vital for putting workforce solutions into the hands of employers, so they can develop a skilled and flexible workforce, using a competence-based approach to design and redesign of roles and services.

For more on demonstrator sites and our database of competences, visit www.skillsforhealth.org.uk