Specialist echocardiography services across the NHS are experiencing unprecedented challenges as they struggle to recruit, retain and train staff, an independent report commissioned by British Society of Echocardiography (BSE) has warned.
An echocardiogram is the most requested inpatient and outpatient cardiological imaging investigation and plays a vital role in diagnosing and monitoring heart disease, as well as enabling patient discharge from hospital. However, there is currently a large backlog, with March 2023 data from NHS England showing that over 160,000 patients were waiting for an outpatient echocardiogram. 38% of these patients were waiting for more than six weeks.
This backlog comes at a time of increasing pressure on the workforce. A survey prior to the report found that half of the workforce were doing unpaid work with a further third reporting they don’t have the time or capacity to do all their scans.
This is leading to a problem with both retaining and training staff. Commenting on the report, Dr Claire Colebourn, President of the BSE, said: “Pressure on echocardiography services has created a perfect storm for the workforce, with clinicians lacking time to train new staff and the workload leading to staff burnout and retention issues with more experienced members. Echocardiography is highly complex work which is both physically and cognitively demanding.
“Comments from our workforce survey paint a worrying picture whereby staff are unable to complete their duties, are doing unpaid work, and in some instances are suffering from burnout, physical injury, and fatigue. Not only is this a serious threat for the NHS’s diagnostic capacity when it comes to the burden of heart disease, it may be putting patient safety at risk.
“We are urging NHS England, the National School for Healthcare Science, policymakers at the Department for Health & Social Care, and other key stakeholders to respond to our report recommendations if we are to avert a serious problem with this vital NHS service.”
The report highlights retention strategies, pointing to the importance of experienced clinicians in training new staff. It also focuses on the lack of career structure for echocardiographers, with a workforce focused on direct clinical work while lacking the capacity to do important quality assurance and safety work, service development work, or train the next generation.
The report recommends:
- Implementing a formal national career pathway in echocardiography to make services sustainable and promote retention.
- Recognising the advanced level role of an echo educator.
- Enabling diagnostics by increasing training capacity and utilising new models such as a slow lane to promote the growth of skilled novice workers, and attracting returners.
- Developing new roles which help distribute work such as administrators, data managers and support workers.
In March, the National School for Healthcare Science published its Educator Workforce Strategy. It also recommended recognising echo educators with a view to improving retention, encouraging staff to return, as well as addressing burn out and insufficient time due to increasing service pressures.
The full ‘UK Echocardiography Workforce’ report commissioned by the BSE can be accessed from 7 June at: www.bsecho.org/Public/Resources/Workforce/Report-2.aspx
