Domain 6: staffing a clinical service

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Standard 6.1: The service undertakes a review of the workforce.


Evidence Requirements

  • Evidence of administrative and clinical workforce review annually, or earlier if there is a significant change in the service.
  • Summary of workforce and skillmix needs for the service (should include any planned appointments to support new work).
  • Evidence to show that the minimum staffing levels recommended in the national PR service guidance are adhered to:
    • a ratio of 1:8 for exercise sessions
    • a ratio of 1:16 for education sessions
    • a minimum of two staff members in attendance, one of whom must be a qualified respiratory specialist healthcare professional to supervise the exercise component (NB: greater staff:patient ratio is required if oxygen users/complex patients are in attendance).
  • Meeting minutes or action plans that show how deficits in service provision will be addressed, where applicable.

Guidance

  • The review should include any planned appointments to support new work and skillmix of the team.

Standard 6.2: There is a service-specific induction programme, which new staff members and those with a change in role are required to complete.


Evidence Requirements

  • An induction pack based on competencies and adapted to staff groups if required.
  • Completed competency assessments for different grades of staff.
  • Feedback from staff regarding the induction process and how this has been used to enhance future inductions.
  • Relevant staff members to attend the BTS Fundamentals in PR and Advanced practitioner courses.
  • Evidence of staff attending postgraduate training programmes relevant to PR.
  • A competencies framework for completion of exercise and strength testing.

Standard 6.3: The service has an appraisal process for staff members.


Evidence Requirements

  • A policy that describes appraisals and staff development processes and managing and supporting performance.
  • Log of appraisal dates for the team.

Standard 6.4: The service has training plans in place for staff members.


Evidence Requirements

  • Training needs analysis for substantive staff, including how training will be resourced.
  • Examples of training discussions in appraisal paperwork (anonymised).
  • Mandatory training schedule and compliance.
  • Log of training records of all educational and professional development activities for staff members.
  • A safeguarding policy and evidence of its implementation.
  • A health and safety policy and evidence of its implementation.

Guidance

  • Team members should receive mandatory training procedures to safeguard patients and to protect the health and safety of patients and staff members.

Standard 6.5: The service implements a process to assess staff members as competent before using techniques and specialist equipment.


Evidence Requirements

  • A template of competency framework used and completed examples (anonymised).
  • A description of how the service uses temporary staff and their competency checks.

Standard 6.6: The service has documented procedures in place for staff members who have responsibility for students, trainees and observers.


Evidence Requirements

  • Documented training of key staff for student placements.
  • Documentation from the end of the student/ trainee placement interview.
  • Evidence of student/trainee feedback data and evidence of review of data and actions to continually improve.

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