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Covid-19: Surviving the long road ahead

BMJ 2020; 369 doi: https://doi.org/10.1136/bmj.m1840 (Published 07 May 2020) Cite this as: BMJ 2020;369:m1840

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COVID-19: Trainee healthcare scientists are vital to surviving the long road ahead

Dear Editor

We read this article with interest and commend the advice of “good pacing, refreshment, and support” to help the NHS and its workforce survive the long road ahead. In light of this recommendation, we feel it is important to highlight the role and skills of trainee healthcare scientists, an often-overlooked group, in achieving this goal.

As the global pandemic, COVID-19, has taken its toll on workforces in all sectors of healthcare provision, trainees and students have been integral to bolstering the national response. Consequently, the structure of the NHS workforce has rapidly evolved. (1) Temporary/ emergency registers have been created and extended clinical placements have been made available for those wishing to join the fight against COVID-19. Valiant efforts from students, apprentices, and trainees across healthcare professional disciplines has contributed time and skills to this surge emergency response. Notably, trainee healthcare scientists in their final year are being temporarily registered with the Health and Care Professions Council enabling them to practise as registered professionals. (2)

The role of the healthcare scientist has proven to be particularly vital to efforts against COVID-19 in the UK. These scientists are involved in services across all frontline areas: contributing to the processing of tests for COVID-19, decontaminating and managing ventilators, imaging patients and, so much more. (3)

It is imperative that the role of trainee healthcare scientists, as well as those already in post, is recognised and their services in supporting the COVID-19 response is acknowledged and further utilised. Those on healthcare science training programmes (in a similar fashion to nursing and medical students) have much to offer in their basic and transferable skills, thereby allowing specialists and consultants in their field to focus on the more complex duties of their discipline. In some instances, trainees have already been actively contributing to the COVID-19 response. Many have been upskilled and redeployed to critical care or COVID-19 wards, or to the Nightingale hospitals. In other cases, trainees have reported working across hospitals acting in roles, such as family liaison officers.

Health Education England (HEE) has accredited training programmes which ensure that healthcare science trainees can be flexible in their application of knowledge and skills across specialties to ensure that the highest level of patient care is achieved through successful teamwork. (4)

Training programmes are available for healthcare scientists who are employed by NHS Trusts as apprentices; post-graduate scientific specialist trainees as well as doctoral level scientists (who are eligible for consultant posts in their area of specialty). These programmes are designed to ensure healthcare scientists are equipped with an all-rounded scientific training, in addition to acquiring specialism-specific knowledge and skills. The trainees’ evidence of proficiency across a range of basic scientific modules enables them to offer invaluable general transferable skills in this pandemic response. Furthermore, trainees’ movement through rotations during their programme enhances their flexibility and knowledge transferability across different settings.

All trainees enrolled with HEE’s National School of Healthcare Science have essential skills, (5) as outlined in the list below.

List of general and transferable skills of healthcare scientist trainees:

1. Data handling
- Data entry
- Record keeping
- Accessing, registering and inputting patient data into digital systems
- Audit, research and development
- Data analysis

2. Communication
- Colleague support and debrief
- Excellent communication with patients and their families
- Supporting informed consent
- Communication of information to authorised personnel

3. Patient care and management
- Gathering a patient history
- Competent in basic life support
- Prepare and support individuals for healthcare activities
- Patient liaison and support
- Administering appointments
- Observations (blood pressure, temperature, respiratory rate, pulse oximetry)
- Patient pathway management
- Phlebotomy
- Healthcare support worker tasks

4. Equipment management
- Donning and doffing of personal protective equipment
- Cleaning and disinfection of medical devices
- Basic mask ventilation skills
- Technical support for computerised medical devices
- Maintain stocks of resources, equipment and consumables
- Inspection, assessment and unpacking of medical devices
- IT tasks
- Creating testing pack kits

5. Safe practice
- Adheres to and supports infection control practices
- Self-assesses and practices within own scope of competence and refers to seniors as appropriate
- Sterile technique
- Health and safety trained
- Manual handling trained
- Waste management and sharps awareness
- COSHH awareness
- Removal and disposal of PPE
- Cleaning and disinfecting
- Second check of drugs and patient identification
- Risk management
- Laboratory quality assurance

6. Sample handling
- Handling of (high-risk) samples
- Booking in samples
- Preparing sample for pre-analytical testing
- Storing (high-risk) samples appropriately
- Preparing culture media and solutions
- Swabbing to provide point-of-care testing
- Documentation for transport of samples

7. Laboratory Testing
- Development of new tests
- Evaluation
- Verification
- Validation of new tests
- Rapid translation of new technologies and platforms

As noted in the editorial, General Practitioners will need support as they work through the post-lockdown long haul where they are supporting patients and families through a “new wave of problems”. Indeed, there is likely to a considerable workload for services and departments across the whole healthcare sector, particularly where routine activities were paused creating a backlog leading to extended waiting lists.

If the staffing and provision of care on the “long road ahead” of us is to be achieved to the best standard possible, it is essential that the role of trainee healthcare scientists is recognised and their skills are utilised appropriately. As outlined in this article, trainee healthcare scientists have a broad scientific skillset which can be applied to many of the tasks that are and will continue to be in demand. Not only this, this transferable skillset can extend to a variety of clinical settings supporting the NHS survival post-COVID-19.

References
1. Willan J, King A, Jeffery K, Bienz N. Challenges for NHS hospitals during covid-19 epidemic. BMJ. 2020:m1117. doi:10.1136/bmj.m1117
2. National School of Healthcare Science. HCPC COVID-19 temporary register for 3rd year STP trainees — Coronavirus (COVID-19) Information. NSHCS. https://nshcs.hee.nhs.uk/coronavirus-covid-19-information/hcpc-covid-19-.... Published 2020. Accessed April 28, 2020.
3. Deploying the healthcare science workforce to support the NHS clinical delivery plan for COVID-19. England.nhs.uk. https://www.england.nhs.uk/coronavirus/publication/deploying-the-healthc.... Published 2020. Accessed April 28, 2020.
4. Health Education England. Health Education England. https://www.hee.nhs.uk/. Published 2020. Accessed April 28, 2020.
5. National School of Healthcare Science. Your curriculum — Scientist Training Programme. NSHCS. https://nshcs.hee.nhs.uk/programmes/stp/trainees/your-curriculum/. Published 2020. Accessed May 7, 2020.

Competing interests: All authors are employees of the National School of Healthcare Science at Health Education England.

07 May 2020
Jaidev K Chandan
Research and Data Associate
Jane Lynch, Graham Wilson, Christal Fisher, Boota Singh, Lisa Ayers, Sandie Gay, Berne Ferry
National School of Healthcare Science, Health Education England, St Chads Court, 213 Hagley Road, Birmingham, B16 9RG