Since 2000, IMPACT/ Fórsa Voluntary group representatives, IICMS representatives and Fórsa  officials have been attending ongoing talks between the HSE and DOHC re the need for a formal programme of learning  to be established to ensure uniformity of qualification across all disciplines and in particular to eliminate unsafe work practices. Traditionally, we were known as Technicians, but the debt of our knowledge and working practices did not reflect this title. In 2005, the HSE agreed the BSc in Clinical Measurement Science as a minimum entry requirement for Clinical Physiologists.

Initially the implementation talks had been very positive with a definite willingness on behalf of the HSE and DOHC to engage with the working party.  The working group was established to bring our profession up to date akin to that of our other allied health professionals. It was tasked to review our career structure, to include such areas as professional title, workplace title, quality awareness and standards and training and development.  In 2014, the McHugh Report for Clinical Measurement Science was published.

The HSE had agreed to review a detailed report submitted by our professional body, the IICMS, on suggested possible acceptable outcomes in keeping with professional academic development and to reply with a definitive response. Development.

In August 2014 , we finally saw our  professional title changed to reflect our responsibilities and  level of expertise. We are now known as Clinical Measurement Physiologist in our specific disciplines.

Another key issue was HSE recognition of the IICMS as the professional body representative for Clinical Measurement Science, responsible for such areas as professional academic development and providing a pathway for those candidates who do not have the BSc in Clinical Measurement Science to apply to the IICMS for equivalence and recognition to practice. The practice of employing nursing staff and/or personnel who are not fully trained and proficient in the discipline to which they are employed should no longer exist.The IICMS has to approve any applicant for a suitable appropriate qualification prior to any appointment. This provides safeguarding to our profession to keep its high standards of educational and professional expertise

We are aware that some hospitals are not seeking potential candidate letters of Equivalence prior to shortlisting, and that situations have arisen that positions have been offered to candidates that do not comply with HSE regulations qualifications. Can we appeal to Head of Departments to ensure that prospective candidates are not short listed for interview if they have not yet sought equivalence.  Likewise, if you are aware of any staff carrying out our job descriptions without suitable qualifications, FORSA needs to be aware and you can contact your local representative with the details, and your anonymity will be protected. Similarly, if you spot any job advertisements that do not comply with HSE regulations, please don’t assume that someone else has seen it, please bring it to the attention of the vocational group or your local FORSA representative. We need to protect our job titles and disciplines in order to maintain our professionalism, and avoid inappropriately trained staff performing investigations.

These review negotiations are still ongoing. There are still some issues of concern that hasn’t been concluded, such as management structure, long service increments, advances in academic and technological areas and possibility of specialist grades, pay scales, professional registration with CORU,etc.

The union has tried to advance these negations however between Covid and HSE/ IBEC being slow to reenter negations, Catherine Keogh , FORSA General Secretary has confirmed  that the Clinical Measurement Professional Group has been being registered under the Sectoral Agreement piece in the Public Sector Agreement. This means that we are now listed as “being on the list of outstanding agreements that needs to be implemented”.

We await the outcome under this agreement.

Clinical Measurement Science (CMS) Physiologists are set to take a much greater role in community focused diagnostics. The driver behind this has been the shift in national health policy towards integrated community based care, the Slaintecare approach. It too has been advanced by the hard work of colleagues in the CMS family specifically aligning with this policy and taking the first steps towards diagnostic procedures preformed out in the community and closer to the patient. The successful application of trials of CMS services in the community has been achieved by colleagues including Geraldine Nolan and Orla Farrelly (Respiratory Physiologists) and Paul Nolan and Donal O Dea (Cardiac Physiologists). They identified services that could be provided out of the hospital such as pacing, ECHOs and lung function assessments. With the support of their hospital leadership and the HSE, they have demonstrated that these new pathways are safe, effective and convenient for patients. 

The National Clinical Programs are described as “a reference point for providing cross-service and cross programme solutions in relation to new models and pathways of care based on population need”. They have been established for many diseases including Respiratory and Cardiac diseases. According to the HSE, the objective of the Integrated Care Programmes is to “design an integrated model of care that treats patients at the lowest level of complexity that is safe, timely, efficient and as close to home as possible”. The Integrated Care Programme for the Prevention and Management of Chronic Disease (ICPCD) focuses on a number of chronic diseases that impact a large number of health service users. Fundamental to the integrated care approach is early disease detection, therefore the role of the CMS Physiologist is central to the success of these programs. 

Many of the programs are designed to be deployed within a large MDT in community-based hubs. When initially the Cardiac and Respiratory programs were announced Cardiac or Respiratory Physiologists were not listed as the core MDT (https://www.hse.ie/eng/about/who/cspd/icp/chronic-disease/documents/chronic-disease-service-model-implementation-resource-pack.pdf). This caused great consternation among CMS Physiologists in the FORSA professional group. Efforts were made to clarify the situation and to identify the reasons for this decision. Under the fog of the COVID crisis several offices in the HSE were experiencing reduced staffing due to redeployment. It was not easy to get good visibility of the responsible office or leadership team within the HSE making these decisions. Around Autumn 2020 a tender was announced for diagnostic services including Cardiology and Pulmonary function services without having consultation with the union. The worry was that such a tender could derail any significant uplift in publicly funded posts for these new centres. This tender was not completed. Instead, we have approval for in the region of 100 new senior posts (Respiratory and Cardiology) to support the hubs and community testing. This is most welcome.

These new posts have been approved under the enhanced community care (ECC) programme and the posts will be recruited by the acute hospitals. The service activity will be managed via a Service Level Agreement (SLA) with the chosen hospital. Existing labs will recruit these new appointees and they will fall under existing line management arrangements. The HSE is funding hospitals to employ senior physiologists and utilize them to provide 80% community capacity and 20% hospital capacity. The tests provided will be decided locally but the capacity commitment must be met to ensure the community hubs and local GPs have access to diagnostics. Locally, each hospital will have a consultant split between community and hospital equally and so these will be the leaders of the service and will decide the diagnostic assessment that each patients needs.

This raises significant concerns for labs that don’t have a chief in place and could see perhaps an increase of 2 or even more senior physiologists. In Respiratory for instance, it is unfortunately not uncommon for Labs to be led by a Senior and no Chief. It is also evident based on announcements to date that new senior posts will be allocated to some hospitals that don’t have a lab. The HSE through the HSCP office have been compiling a report into the supply of Physiologists and we hope it will clarify issues such as these anomalies and address career progression and specialist’s posts. We have not yet seen the report but it needs to cover these issues of organisational structure and professional development. We want to get the best return on this investment and do so in a way that is safe and effective for patients and ensures the future training, progression and development of staff.

With such a fast pace of change there will be unforeseen issues. Please get in touch with the local hospital rep or the FORSA CMS group if you have any concerns or ideas to achieve the best possible outcome for members. FORSA will be looking into these issues arising in the coming weeks and we will report back on progress.

The profession is growing faster than at any other time in its history. We are seeing new community-based posts and the largest uplift in WTE in the history of Clinical Measurement Science.

We also welcome a new education provider in Sligo, the Atlantic Technological University (ATU). Formally Sligo IT, the ATU is the latest Technological University in the Republic that will host a brand-new training course in Clinical Measurement Science. This will be to the benefit of students in the West of Ireland and ultimately the people of Ireland as we have more professionals to take up jobs. A choice of education provider will hopefully deliver more graduates and hence more skilled Physiologists that will improve patients access to vital diagnostics. 

We need to support each other where we can by sharing experiences and solutions and to keep a watchful eye on how the new community services are implemented and managed. We need to make sure that for instance there are clear management structures in place and not accept peer-to-peer as a legitimate line management structure. It is a time for optimism but with any rapid expansion we need to be cautious of  unintended consequences. It is an opportunity too for FORSA to show us the benefit of union membership in action and demonstrate how they can support us during a time of rapid change.

Over the coming months I would encourage you all to promote the union and the benefits of membership to new and existing colleagues. There is strength in numbers and we can achieve more as a tight-knit block that stays connected and communicates across the disciplines. We are seeing a large increase in Respiratory and Cardiac posts and I do believe that in time the other disciplines will also benefit from the Integrated Care Programs as they evolve. In fact, we must insist that CMS Physiologists are at the forefront of all disease management programs such is the unique role we fulfil and the quality and impact of the work we do. We might be a small cohort in the wider HSCP family, but we are highly skilled and adaptable professionals that impact directly on the health and wellbeing of our patients.

There are challenging recruitment issues across all the disciplines. There is worrying reports of candidates being selected without equivalences or not even having sought equivalence.  The hospitals need to make sure that equivalents are sought (IICMS) and no shortcuts are taken that will undermine the profession and place patients at risk. We have a new graduate entry group in TU Dublin. They have spent their hard-earned money to enrol on the course (after already completing a degree) so that they can become CMS Physiologists. It is an honour that they have chosen our career. It is deeply unfair to them and all the other graduates that put four years of blood, sweat and tears into become a fully qualified Physiologist. No hospital should consider employing anyone without certainty that they are equivalently trained. Its unfair to all workers and unsafe for patients. We demand better.

We do need new members and in particular the younger career members to come aboard. We can benefit from their fresh perspective, energy, and enthusiasm. We have seen the power of grassroots activism in recent years with the success of the marriage equality referendum and the Repeal the 8^th movement. The success of these movements was in large part down to the efforts of young people that wanted to see change and a better way forward. We need to capture this energy in the new entrants and graduates and encourage their activism in the union or within the professional bodies, they (you) are the future. The best way to predict the future is to invent it. They should get active and share their vision and not let other people decide for them how their future work life or career will be.

I am very pleased to announce Donal O Dea (Cardiac Physiologist) as the new Chair of the Clinical Measurement Professional Group of FORSA. Donal has more than 20 years’ experience as a Physiologist and has been vice chair since 2019. He works in Tallaght hospital and recently in the community as part of a Slaintecare initiative. I wish Donal the best of luck.

I also want to thank Deirdre Whelan our group secretary. Deirdre is the backbone of the committee. I am most grateful for her wisdom, support and energy over the past years and recently with the challenges presented by COVID and the HSE data hack. She keeps going, she cares deeply about workers and workers rights and is a really great person and trade unionist. Thank you, Deirdre. I would also like to send a big thanks to all the committee members. They give their time freely and most generously. The meetings are always well attended even though we are all under huge work pressure. Thank you, keep up the good work.

All the best in 2022, here’s to a happy and health new year.

In December 2016 the WRC gave a decision that affected the Voluntary hospitals. The hospitals accepted the principle that the Clinical Measurement Physiologists grades are in actual fact under the Therapy Grades umbrella.

We had initially been denied the standardisation of annual leave on the basis that we were stand-alone and not under Therapy Grades.

The committee recognised the importance of that decision and initiated the campaign to achieve the Standardisation of AL for our grade, however Fórsa (our union) gave us a strong voice at the table.

It took years of negotiating and consultation as the employers were dragging their heels on the concession.

However, with diligence and patience, the committee with extensive union support eventually won the battle.

The annual leave entitled to our members would be not only issued but also backdated. Finally in 2020 the employers released the annual leave that had been long over-due our members.

It just reiterates the importance and benefits of joining Fórsa and the more physiologists who join Fórsa the stronger our group will be, especially in the future where we will be looking for clinical specialist roles and state registration.

Workers who wish to join Fórsa can to do so using a new ‘join online’ function on the union’s website.

Going live with the new system follows several months of research, preparation and testing aimed at making it easier than ever to join the union. It also goes live as the union continues to process a large number of new membership applications, as interest in joining the union has surged since the onset of the Covid-19 crisis.

Fórsa’s general secretary Kevin Callinan commented: “The current crisis has created the necessity to be able to carry out our business in different ways. Work on this project had commenced before the Covid-19 crisis took hold, and its completion marks a vital step as we tackle the challenges of living in changed times.

“We can see that more people want to join a union in response to what’s happening in the wider economy. It’s vital that they can take those initial steps quickly and easily, and making the membership application process more accessible is part of that process.

“This is a crucial new venture to enable Fórsa to substantially increase our membership - and to strengthen the union’s hand - at a critical time in the union’s development,” he said.

The online facility is a streamlined and simplified membership application process, and will be the quickest and easiest way to join the union. All incoming applications will continue to be subject to check-off and approval by Fórsa branches and the national executive committee, while the new online system is designed to ease the administrative burden on branches.

You can join Fórsa online at https://join.forsa.ie/

Fórsa is here to protect you if you have problems arising from the coronavirus or other workplace issues. The best way to contact the union at this time is HERE.

We will deal with queries as quickly as we can but, needless to say, the union will prioritise cases where members’ jobs and incomes are at immediate risk – as well as any serious health and safety issues that may arise.

Fórsa has cancelled all face-to-face meetings for the time being. The union is redeploying its staff to prioritise engagement with management on proposals arising from the Covid-19 public health crisis, and to provide rapid and efficient responses to members’ queries and concerns.

Fórsa's main phone line (01 817 1500) is now open from 9am to 5pm Monday to Friday. Alternatively members can use the Contact Us page on the Fórsa website to submit queries directly to the relevant division within Fórsa and this remains the most efficient way to access advice directly.

Wherever possible, Fórsa staff have been equipped to work remotely. Therefore, members should not attend Fórsa offices at this time. If you have a query or concern, the best way to raise it is to contact the union HERE.