Andy Lecomber

1
A Structured Approach to the KSF in a Large
Medical Physics Department

• Andy Lecomber Phil Harrison
• Regional Medical Physics Department
• Royal Victoria Infirmary Freeman Hospital
• Newcastle upon Tyne

2
KSF What is it?

• The Knowledge Skills Framework
• one of 3 key strands within Agenda for Change
• terms and conditions
• hours of working, overtime rates, annual leave
• job evaluation
• equal pay for work of equal value
• NHS KSF
• training requirements

3
KSF - Main Purpose

• defines and describes the knowledge and skills
  which NHS staff need to apply in their work in
  order to deliver quality services
• forms basis of pay progression mechanism

4
Pay Structure
5
Pay Structure
Incremental Pay Points within each Band
KSF FULL OUTLINE defines the SKILLS KNOWLEDGE
required to perform that job
GATEWAY
KSF FOUNDATION OUTLINE defines basic SKILLS
KNOWLEDGE expected of person recently in post
(6 - 12 months)
GATEWAY
6
Dimensions identify broad functions
30 Dimensions
6 Core
24 Specific
7
Communication
10 Health Wellbeing
Personal People Development
3 Information Knowledge
Service Improvement
Health, Safety Security
3 Estates Facilities
Quality
8 General
Equality Diversity
8
The broad function angle
9
Design, plan, implement and evaluate learning and
development programmes
Plan, deliver and review interventions to enable
people to develop
representing increasing complexity within that
skill area
Enable people to learn and develop
Assist with learning and development activities
10
Communication
HWB 1
HWB 2
HWB 3
HWB 4
HWB 5
HWB 6
HWB 7
HWB 8
HWB 9
HWB10
Personal People Development
Service Improvement
IK 1
IK 2
IK 3
Health, Safety Security
Quality
EF 1
EF 2
EF 3
Equality Diversity
G 1
G 2
G 3
G 4
G 5
G 6
G 7
G 8
Every level has a number of indicators
representing increasing complexity within that
skill area
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Developing a KSF Outline

• Decide which Dimensions are relevant to the post
• Decide what is an appropriate Level for each
  Dimension
• Check that ALL the Indicators associated with
  each Dimension / Level can be met
• Determine the Areas of Application most relevant
  to the work of the post-holder
• Identify Examples of Evidence from the work of
  the post-holder that can be used to meet the
  requirements of the Indicators
• Identified for post by post-holder manager

12
Developing KSF Outlines for RMPD

• ARL tasked with helping implement KSF
  consistently in RMPD
• Developed a KSF Outline Matrix (Dimension Level
  only) for all RMPD staff based on
• National Occupation Standards data for Scientific
  Technical staff
• Approved NuTH Trust Outlines for Administrative
  Clerical staff

13
NOS HealthCare Science Competencies

• Available on DoH website
• http//www.skillsforhealth.org.uk/view_framework.p
  hp?id73
• List of 646 competencies covering all aspects of
  healthcare science practice
• Grouped into 57 sets applicable to activities in
  specific areas
• Each competency linked to a KSF Dimension and
  Level

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NOS Competencies KSF Links
Level 1
Level 2
Level 3
Level 4
HWB
EF
IK
G
CORE
17
NOS HealthCare Science Competencies
HCS_A 6 general competences on equipment evaluation, commissioning, calibration, routine QA, PPM
HCS_AN 8 competences on investigations of the autonomic nervous system
HCS_AUD 15 competences on Audiology examinations
HCS_B 4 general competences on developing and planning clinical procedures, investigation strategies and long term, multidisciplinary care pathways
HCS_BM 2 competences on the conduct of a multi component clinical movement analysis test, and the interpretation and reporting on biomechanical data for detailed patient evaluation
HCS_CARD 9 competences on the performance of both diagnostic and therapeutic cardiac procedures on inpatient or outpatient adults or children
HCS_CCT 4 competences on critical care equipment selection, set-up, operation and performance monitoring
HCS_CM 4 competences on the development of new clinical measurements, scientific support to existing techniques, or provision of a highly specialised clinical measurement service
HCS_D 5 competences on presentation and reporting of clinical investigation results, including confidentiality issues
HCS_DX 10 competences on X-ray equipment QA services
HCS_E 4 competences on risk assessment, MHSW incident reporting
HCS_EMD 20 competences on medical equipment evaluation, procurement, maintenance and management
HCS_F 23 competences on management and direction of Medical Physics organisations
HCS_G 12 competences on provision and management of HCS learning programmes
HCS_H 15 competences on identification of areas for, and management of, RD activities, including presentation of findings and translation into service
HCS_I 18 competences on dealing with patients, including receipt and management during clinical procedures and subsequent aftercare and reporting
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NOS HealthCare Science Competencies
HCS_J 7 competences on what is expected of an expert in a Medical Physics discipline
HCS_MPHYS 14 general competences covering a number of key areas in a Medical Physics department
HCS_MR 8 competences on installation, operation and safety of MRI scanners, including interpretation of images and reporting
HCS_N 9 competences on investigation or monitoring of neurophysiological function
HCS_NC 14 competences on the provision of a nuclear medicine service, including both non- and imaging tests
HCS_NIR 13 competences on the provision of diagnostic and therapeutic NIR services, including both protocol development and safety considerations
HCS_OVS 16 competences on ophthalmic assessment, including some on assessment of electrophysiological function
HCS_R 15 competences on radiopharmacy procedures
HCS_REHAB 5 competences on the prescription, manufacture and subsequent management of assitive technology for individual use
HCS_RP 30 competences on the provision of radiation protection advice, including equipment and source calibration and management, personnel monitoring and waste management
HCS_RTP 37 competences on the provision of a radiotherapy service, including the development and implementation of treatment planning processes, equipment maintenance and manufacture of assistive devices, measurement of dose delivered and advice on patient management
HCS_SS 11 competences on the provision of a sleep study service
HCS_UD 9 competences on the conduct of urodynamic investigations
HCS_UPT 10 competences on the provision of a medical ultrasound equipment QA and safety service for both diagnostic and therapeutic applications
HCS_VT 3 competences on vascular ultrasound measurement
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Linking NOS Data to RMPD

• Competencies applied uniformly across RMPD

NOS Competency Set Number of Competences in Set Area of Application
HCS_MPHYS 14 key areas in a Medical Physics department
HCS_E 4 risk assessment
HCS_H 15 RD activities
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Linking NOS Data to RMPD

• Competency sets used for specific subject areas

NOS Competency Set Number of Competences in Set Subject Area(s) to which Applied
HCS_AUD 15 Audiology
HCS_BM HCS_REHAB 2 5 Bio-/Rehabilitation Engineering
HCS_DX HCS_MR 10 8 Diagnostic Radiology
HCS_EMD 20 Equipment Evaluation, Electronics
HCS_G 12 Training Schemes
HCS_NC HCS_R 14 15 Nuclear Medicine
21
Linking NOS Data to RMPD

• Competency sets used for specific areas of
  application

NOS Competency Set Number of Competences in Set Subject Area(s) to which Applied
HCS_NIR 13 Non-Ionising Radiations
HCS_RP 30 Radiation Protection Diagnostic Radiology Nuclear Medicine Radiotherapy
HCS_RTP 37 Radiotherapy Physics Radiotherapy Technology Mould Room Dosimetry
HCS_UPT HCS_VT 10 3 Ultrasound
22
Linking NOS Data to RMPD

• Competency sets used for physiological
  measurement / clinical instrumentation

NOS Competency Set Number of Competences in Set Area of Application
HCS_AN 8 autonomic nervous system tests
HCS_CARD 9 cardiac procedures
HCS_CCT 4 critical care equipment
HCS_CM 4 clinical measurements
HCS_N 9 neurophysiological assessment
HCS_OVS 16 ophthalmic electrophysiology
HCS_SS 11 sleep studies
HCS_UD 9 urodynamics
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Linking NOS Data to RMPD
NOS Competency Set Number of Competences in Set Area of Application
HCS_J 7 what is expected of a Medical Physics Expert
applied to radiation subjects where there is a legislative requirement for a Medical Physics Expert (Radiotherapy, Nuclear Medicine, Diagnostic Radiology/Radiation Protection) applied to radiation subjects where there is a legislative requirement for a Medical Physics Expert (Radiotherapy, Nuclear Medicine, Diagnostic Radiology/Radiation Protection) applied to radiation subjects where there is a legislative requirement for a Medical Physics Expert (Radiotherapy, Nuclear Medicine, Diagnostic Radiology/Radiation Protection)
HCS_B 4 care pathway planning and investigation strategies
HCS_F 23 Medical Physics management
applied to categories of staff (Head of Unit, Head of Department) rather than subject areas applied to categories of staff (Head of Unit, Head of Department) rather than subject areas applied to categories of staff (Head of Unit, Head of Department) rather than subject areas
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Linking NOS Data to RMPD
NOS Competency Set Number of Competences in Set Area of Application
HCS_A 6 equipment assessment and maintenance
applied to services for which assessing equipment performance is a major aspect of the work applied to services for which assessing equipment performance is a major aspect of the work applied to services for which assessing equipment performance is a major aspect of the work
HCS_D 5 clinical investigation reporting
applied to services in which clinical reporting is a regular task applied to services in which clinical reporting is a regular task applied to services in which clinical reporting is a regular task
HCS_I 18 dealing with patients
applied to services having significant direct patient contact applied to services having significant direct patient contact applied to services having significant direct patient contact
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A A N A U D B B M C A R D C C T C M D D X E E M D F G H I J M P H Y S M R N N C N I R O V S R R E H A B R P R T P S S U D U P T V T
Audiological Science P P P P P P P
Bioengineering P P P P P P P P
Bone Mineral Assessment P P P P P
Clinical Instrumentation P P P P P P P P P P P P
Computing P P P P
Critical Care Physics P P P P P P P P P P P P
Diag. Rad. / Rad. Prot. P P P P P P P P
Dosimetrists P P P P
Electronics P P P P P
Equipment Evaluation P P P P P
Head of Department / Unit P P P P P
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A A N A U D B B M C A R D C C T C M D D X E E M D F G H I J M P H Y S M R N N C N I R O V S R R E H A B R P R T P S S U D U P T V T
Mechanical Workshop P P P P P
Mould Room P P P P P
Nuclear Medicine P P P P P P P P P P P
Non-Ionising Radiations P P P P P P
Physiological Measurement P P P P P P P P P P P P P
Radiotherapy Physics P P P P P P P P
Radiotherapy Technology P P P P P
Rehabilitation Engineering P P P P P P P P
Training Management P P P P
Ultrasound P P P P P P P P
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Combining Competency Sets





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Results of Analysis
Frequency of occurrence within subject area
lt10
10-20
gt20
HWB
EF
IK
G
CORE
72
Audiological Science
Bioengineering
54
Bone Mineral Assess.
41
Clinical Instr.
113
39
Computing
95
Critical Care Physics
94
Diag. Rad. / Rad. Prot.
Dosimetry
70
Electronics
59
Equipment Evaluation
59
Head of Dept. / Unit
78
Mech. Workshop
44
Mould Room
88
137
Nuclear Medicine
Non-Ionising Radiation
65
Phys. Measurement
111
Radiotherapy Physics
126
76
Radiotherapy Tech.
54
Rehab. Engineering
Training Management
45
Ultrasound
60
0
0
14
Number of Level 1s
9
0
0
0
0
0
8
28
0
28
0
7
3
0
0
7
0
0
0
Number of Level 2s
0
9
0
111
12
43
51
12
0
6
0
1
123
0
0
2
29
3
0
3
0
54
44
5
77
51
27
106
47
7
11
97
0
1
0
93
4
49
22
59
1
1
Number of Level 3s
10
0
Number of Level 4s
69
3
0
2
7
35
1
25
30
2
1
4
28
3
0
6
2
12
0
84
0
0
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Developing a KSF Outline

• Identify skills required to undertake the role
  described in the Job Description
• Identify the appropriate Core Dimension Levels
  required to represent the skills work of the post
• Identify the Specific Dimensions (how many?) and
  Levels required to represent the skills not
  covered by Core Dimensions

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Bands Specific Dimensions

• Distribution of RMPD staff bands following
  assimilation

31
Setting Levels for Core Dimensions

• Core 1 (Communications) ranges between levels 2
  and 4 across all specialities, so propose
• Level 2 for posts in bands 1, 2, 3 4
• Level 3 for posts in bands 5, 6 7
• Level 4 for posts in bands 8a, 8b, 8c, 8d 9
• Core 2 (Personal and People Development) levels
  have been set using the assumption that Principal
  and Consultant grades will have more
  responsibility for developing their staff than
  will Senior and Junior grades, so propose
• Level 2 for posts in bands 1, 2, 3 4
• Level 3 for posts in bands 5, 6 7
• Level 4 for posts in bands 8a, 8b, 8c, 8d 9

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Setting Levels for Core Dimensions

• Core 3 (Health, Safety and Security) ranges
  between levels 2 and 4 across all specialities,
  so propose
• Level 2 for posts in bands 1, 2, 3 4
• Level 3 for posts in bands 5, 6 7
• Level 4 for posts in bands 8a, 8b, 8c, 8d 9
• Core 4 (Service Improvement) ranges between
  levels 2 and 4 across all specialities, so
  propose
• Level 2 for posts in bands 1, 2, 3 4
• Level 3 for posts in bands 5, 6 7
• Level 4 for posts in bands 8a, 8b, 8c, 8d 9

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Setting Levels for Core Dimensions

• Core 5 (Quality) ranges between levels 3 and 4
  across all specialities, so propose
• Level 3 for posts in bands 1, 2, 3, 4, 5, 6 7
• Level 4 for posts in bands 8a, 8b, 8c, 8d 9
• Core 6 (Equality and Diversity) levels have been
  set to the lowest values appropriate for their
  observance
• Level 1 for posts in bands 1, 2, 3, 4, 5, 6 7
• Level 2 for posts in bands 8a 8b
• Level 3 for posts in bands 8c, 8d 9

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Selecting Specific Dimensions

• General guidance recommends 7 Specific
  Dimensions
• NuTH AfC office advice is to have no more than
  45
• Therefore assigned
• 5 specific dimensions for Band 9 posts
• 4 specific dimensions for Band 8c 8d posts
• 3 specific dimensions for Band 8a 8b posts
• 2 specific dimensions for Band 5, 6 7 posts
• 1 specific dimension for Band 2, 3, 4 5 posts

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How to use the KSF Tool

• The Workshop Method
• Identify your speciality and band on the KSF Tool

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How to use the KSF Tool

• The Workshop Method
• Identify your speciality and band on the KSF Tool
• Identify the recommended Core Dimension Levels

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How to use the KSF Tool

• The Workshop Method
• Identify your speciality and band on the KSF Tool
• Identify the recommended Core Dimension Levels
• Identify the number of Specific Dimensions
  suggested for post, and select appropriate Levels
  for each

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Study each highlighted dimension to determine
which 2 apply and at which level (using the
Specific Dimensions Table in conjunction with the
KSF Handbook)
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Specific Dimensions Table
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How to use the KSF Tool

• The Workshop Method continued
• Use the KSF Handbook to check that EVERY
  Indicator can be achieved for each chosen Level

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How to use the KSF Tool

• The Workshop Method continued
• Use the KSF Handbook to check that EVERY
  Indicator can be achieved for each chosen Level
• For each Dimension
• Complete the relevant Outline Detail form

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How to use the KSF Tool

• The Workshop Method continued
• Use the KSF Handbook to check that EVERY
  Indicator can be achieved for each chosen Level
• For each Dimension-
• Complete the relevant Outline Detail form

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How to use the KSF Tool

• The Workshop Method continued
• Use the KSF Handbook to check that EVERY
  Indicator can be achieved for each chosen Level
• For each Dimension-
• Complete the relevant Outline Detail form
• Identify the Areas of Application

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ultranucmeonics
Or your own suggestion
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How to use the KSF Tool

• The Workshop Method continued
• Use the KSF Handbook to check that EVERY
  Indicator can be achieved for each chosen Level
• For each Dimension-
• Complete the relevant Outline Detail form
• Identify the Areas of Application

53
How to use the KSF Tool

• The Workshop Method continued
• Use the KSF Handbook to check that EVERY
  Indicator can be achieved for each chosen Level
• For each Dimension-
• Complete the relevant Outline Detail form
• Identify the Areas of Application
• Suggest Examples of Evidence

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ultranucmeonics
6
Risk assessment (a)(b)(c)(d)(e) HS audit
(b)(c)(e) Attendance at mandatory training
(b)(d)
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Full vs Foundation Outlines

• Full Outline specifies the skills required of a
  fully-trained individual performing the work
• Foundation Outline specifies the skills that must
  have been achieved after 1 year in post
• Foundation Outline levels set one level below the
  value specified for the Full Outline

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RMPD website KSF Page
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KSF Outline Library
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