Lead Colposcopist job description
The role of the lead colposcopist is considered crucial to a quality assured colposcopy service by both the RCOG and the NHSCSP QA group. In hospitals providing colposcopy services where there is more than one Colposcopy Unit there should be one lead colposcopist to lead the service and where appropriate (England) to co-ordinate the KC65 statutory return. There may be lead clinicians in separate colposcopy clinics within a single hospital but only a single lead colposcopist for each trust.
The National Quality Assurance Group of the NHSCSP working closely with the BSCCP has developed a job description for lead colposcopists. Both the RCOG and the NHSCSP Quality Assurance Group believe that the roles and responsibilities of the lead colposcopists should be recognised by a sessional commitment of at least one notional half-day per week. The lead colposcopist should be supported by at least one session of designated administrative/secretarial time for the tasks associated with the position.
Lead Clinicians should adopt the responsibility of devising appropriate written protocols for local use that will enable the service to work towards achieving quality as defined in NHSCSP Publications. It is advised that such protocols should incorporate the views of all working within the service and there should be a feeling of common ownership. After such protocols have been agreed and implemented, all those within the service under the direct management of the Lead Clinicians should work within them.
The lead colposcopist is responsible for:
- Ensuring that written protocols are in place for the service and that these include recommended national guidelines.
- Ensuring that the protocols are regularly reviewed so that the needs of the users of the service and the commissioners of the service are met. The Lead Colposcopists will be required to ensure that the defined quality assurance standards are being met.
- Ensuring that the BSCCP National Minimum Data Set is collected.
- Ensuring that regular audit of the service takes place to compare practice with local protocols and national targets.
- Liaising with those within the trust responsible for providing the facilities to ensure that the service is adequately staffed by appropriately trained individuals (medical and non-medical) such that the service needs can be met in a timely and consumer sensitive fashion
- Co-ordinating training and liaising with the BSCCP Certification and Training Committee as appropriate.
- Facilitating the maintenance of continued accreditation of practising colposcopists within the unit.
- Informing those in the hospital management about the need to ensure that procedures are in place to facilitate care and rapid communication with patients, other hospital departments, primary care agencies, cytopathology and histopathology services.
- Convening regular multi-disciplinary meetings for case discussion and protocol review, including cytology and histology services and involving the hospital based programme co-ordinator.
- Working with the hospital based programme co-ordinator to alert the PCT screening commissioner of shortcomings of any aspect of the ability of the colposcopy services to respond to issues in primary care.
- Conducting regular dialogue with users, providers and purchasers of care to ensure that service and development are both appropriate and meet the needs of the local population.
- BSCCP/RCOG certification
- Commitment to the colposcopy service and readiness to take responsibility for it
- Organisational skills
- Team management skills
- Training skills
- Information technology
- Data analysis
- Conducting research
- Clinical Governance - personal performance
- Where concerns arise about colposcopic practice there must be a means of open discussion between colleagues. The best way of ensuring this is a culture of audit within the unit. This should comprise regular multi-disciplinary meetings. Quality assurance is a means of ensuring that standards are improved, where necessary, using a constructive approach, rather than a critical one.
- When concerns arise about an individual's clinical performance in colposcopy, these require to be handled sensitively and should be the responsibility of the Lead colposcopist. There must be a speedy resolution and if this fails or if the Lead Colposcopist is under scrutiny, then the Medical Director (or equivalent) should take responsibility. The Regional QA Colposcopy Representative should also be involved at this stage.
- Often, individual practice cannot be judged on the basis of a small sample of cases with poor outcomes, unless these are extreme. Large truly representative samples may be required using valid outcomes, in order to reach reliable conclusions. Only when matters cannot be satisfactorily resolved "in house" should consideration be given to the need for external review. The external reviewer should assist in determining the extent and nature of the review. Under these circumstances the Regional QA Director will be informed.
Assessment of administrative support
It is the responsibility of managers to provide adequate space and facilities whereby colposcopy may be practised at the highest level. It is the responsibility of the Lead Colposcopist and the Quality Assurance visit assessors to identify where infra-structural support is deficient and to make aware the relevant administrative staff.
Assessment of systems management
The Lead Colposcopist will endeavour to ensure that the defined standards are being met, and to maintain data collection which will allow audit to be conducted against these standards. The agreed National Minimum Dataset and quarterly returns if required should be collected. An annual return will be the responsibility of the Lead Colposcopist.
The data collected will serve as a means of comparing performance between colposcopy units. All colposcopic practice, whether in Trusts or in the Community is required to be measured against uniform national standards. Regional arrangements should be in place to ensure that colposcopy clinics are running effectively. A scheme of regular visits every three years may provide an effective process for identifying deficiencies before problems arise and encouraging good practice.