SVT IQIPS Survey 2022

(Sept/October 2022)

A survey was recently sent out to Heads of Service (56 services) using the list held by the SVT. The aim was to find out how many services are engaging with IQIPS, whether there are any significant barriers and what further help that services require from the SVT. We received 13 responses, and are very grateful to the Service Leads for taking the time to answer our questions.

Survey questions:

These were divided into 2 sections, dependent on whether the service is currently IQIPS accredited.

The majority of services do not currently hold IQIPs accreditation, and their questions covered:

• Whether they aspire to or are in the process of achievement of IQIPS accreditation
• How they are working towards this
• Whether they have accessed any of the UKAS training resources and guidance documentation and any SVT resources
• What the SVT could do to help.

We had responses from 12 services, some of whom are in the process of accreditation (2), previously started but now halted (2) and the majority of services (8) for whom IQIPS accreditation is seen as unachievable and they are therefore not working towards this, although they do aspire for their service to engage with quality improvement.

The main barriers to engagement with IQIPS accreditation were stated as:

• Not seen as mandatory, a legal requirement or necessary for the continuation of service provision
• Lack of staffing resource time to meet the requirements, particularly relating to documentation and continuous audit
• Lack of funding for the costs and time required
• No incentive – financial or reputational
• Lack of engagement/support from the hosting organisation with difficulty in engaging the frequently changing senior managers
• Conflicting priorities within an organisation with larger departments (e.g. Cardiology/Radiology) favoured
• Lack of a Quality Lead within the organisation who can help with generic aspects
• Lack of engagement of other physiology services who may have their own professional body accreditations, so no prospect of a joint application
• The workload is seen as disproportionate to the benefit
• There is a perception that it is unachievable

Some services had accessed the UKAS training resources but the majority had not. There were comments that the costs could be more transparent (e.g. £250 for 1 course which then suggested a second course costing another £250) and the documentation could be more user friendly. Some services had used these resources to inform their own service improvements and development of workplace standards outside of engagement with formal accreditation.

Some services have released staff to train as IQIPs assessors with the benefit of this knowledge driving their own service improvement.

The majority of services have accessed SVT resources which were found to be helpful with service improvement, and would value more help with generic documents. There was a suggestion that the SVT could adapt its focus to encourage services to implement basic aspects, such as regularly reviewed protocols, regular team meetings and good patient information. Once the basics are in place, more labs may feel that IQIPS is more achievable. There was a suggestion that the SVT could provide an IQIPS lead who could visit labs to provide help and advice.

One service reported that their initial application for IQIPs accreditation had been turned down and this was largely to do with inadequate resources. The service saw this as a positive benefit of engagement because they were then able to use the accreditation outcome as a driver for change within their Trust. They were being helped by their Trust Lead Healthcare Scientist who was seen as vital in their journey towards achievement of accreditation.

Overall, service leads did not think that the SVT, as a professional body, could do much more to help services achieve IQIPS accreditation as this needed local Trust/organisation support which was the main barrier.

For services who are currently accredited, we asked:

• why they sought accreditation
• whether there were any significant barriers
• whether UKAS training resources/tools were used
• whether they planned to maintain their accreditation
• how they had found the transition to the latest version of the accreditation standard
• And how the SVT could help with maintenance of accreditation.

With 1 response from an accredited service (out of the 3 currently accredited providers) the data is limited, but there were some useful insights into how and why this service achieved accreditation. They saw IQIPS as a useful framework to drive quality improvement and because they believed it would become mandatory and more services would engage. Another reason was to confirm that what they considered to be a good service was indeed valid and to demonstrate to the profession that it could be achieved in a department with limited resources.

Time was one of their initial perceived barriers but this did not put them off as they had not set a deadline and decided to tackle the requirements slowly and steadily. They reported that it felt like valuable progress towards quality improvement and was work that needed to be done anyway in terms of protocol/policy development and audit to ensure that processes were embedded. Since gaining accreditation they have found the barriers to maintenance are time and staff enthusiasm to maintain the considerable documentation and evidencing, and feel that a lot of this process is becoming increasingly laborious and “box ticky” They also say that justifying the service disruption each year for the arduous assessment process is difficult with the impact on clinical capacity on those days. It is also difficult to justify the cost to management when it is an expense for something that is not considered mandatory, and is not very visible or transparent to patients.

This service has recognised that they will be required to undertake significant additional work to maintain their accreditation next year under the revised standard which will involve addressing the uncertainty of measurements issue and the creation of a quality manual. They are considering whether it is sensible to continue with IQIPs accreditation as it becomes less meaningful if other labs aren’t going to engage with the process. This lab felt that the SVT could continue to encourage an increasing pool of Vascular technical assessors to ensure consistency and objectivity in assessments.

Conclusion.

There is still very slow take up of the IQIPS accreditation scheme within Vascular Labs. There are considerable barriers to achievement of an accreditation which isn’t being mandated or consistently supported within local Trusts/organisations despite its endorsement from national NHS leadership.

Partial engagement with the scheme and elements of the accreditation standard have been used by some services to drive local service improvement.

It is evidently possible for Vascular Diagnostics providers to achieve and maintain IQIPS accreditation, but this requires continuous allocation of resources and this constant drive for improvement is itself becoming a barrier as the gulf between accredited and non-accredited services widens. The slow take-up within Vascular is also a barrier to maintenance of accreditation for those currently accredited services.

The SVT resources which were developed to drive and encourage service improvement are useful aids to help with achievement and maintenance of accreditation.

We would be very grateful for comments from SVT members who were not part of this survey and may have further insights into how we as a professional body can inform the wider debate on accreditation of Physiology diagnostic providers.

SVT Professional Standards Committee