This page was last updated: March 14th, 2022
The Department of Clinical Technology provides specialist wide-ranging technical services across the healthcare community in Cornwall; this includes (but is not limited to) The Royal Cornwall Hospitals Trust and Cornwall Partnership Foundation Trust. The service provides whole-life management of medical equipment from pre-purchase assessment through safety and maintenance issues to end-of-life disposal. Fully integrated into DCT, a Medical Equipment Library provides a comprehensive and efficient loan equipment service for the RCHT.
Our staff work hand-in-hand with the clinical services every step of the way with regards to the application and exploitation of available technologies, including the identification of equipment to meet need, trials and evaluation, equipment roll-out, planned and reactive servicing, upgrades and future replacement. Where equipment is supported by a 3rd party, DCT will monitor the compliance of such contracted support.
DCT has 24 technical staff of varying backgrounds, qualifications and specialisms, with enormous collective experience and expertise. DCT has embraced a greater diversity of backgrounds than would be the case in many typical Trusts, and is a firm believer of casting the net as widely as possible into the talent pool of technical expertise.
We have numerous staff who developed their engineering skills on technologies as wide-ranging as military aircraft, yacht building, radar systems and food production lines, all of whom have been able to successfully re-apply their skills through re-training and mentorship – into healthcare technology. We strongly encourage professional development and are currently running numerous technical apprenticeship programmes at Levels 3, 4 and 5.
DCT also has a team of dedicated support staff for business and contract administration, equipment pick-up and delivery, front-of-house operations and technical stores and logistics.
The array of equipment types that we deal with is so large that our workshops are broken down into functionally-based teams, who each look after associated technologies:
The pandemic has been a major challenge to the entire healthcare sector, and DCT has proactively adjusted and reprioritised in order to meet the ever-changing clinical need as the Trust has responded to Covid. It has played a pivotal role in the procurement and commissioning of over 5,000 additional medical devices, and has worked closely with Critical Care consultants and staff to ensure Cornwall was leading the way in preparing for potential challenges of ventilation and other aspects of care for seriously ill patients.
DCT will continue to adapt to new priorities and new ways of working as the requirements of Covid change. The huge increase in equipment held will continue to drive the need to look for potential ways to improve the efficiency of our services. It is an exciting time at the Trust when it comes to medical equipment, with huge new investment projects both planned and underway.
Current programmes include the replacement of the majority of volumetric pumps, anaesthetic machines, and the Trust’s entire holding of patient monitoring systems – all with state-of-the-art technology. Many other projects are planned. DCT will continue to play a pivotal role in this, developing its staff’s skillsets to diversify its abilities and grow its specialisations, so as to offer excellent support to clinicians and thus the best care to the people of Cornwall.
When patient samples are tested on the analysers, any results that fall outside set ranges are held by laboratory software for authorisation; this involves a qualified biomedical scientist reviewing the results to determine whether they are valid and able reported. This is the point where issues such as sample contamination from IV fluids are identified. Results outside set reference ranges are telephoned to wards and GP surgeries to alert clinicians to results that may require urgent attention. We also perform a range of tests which require more manual techniques, requiring a high level of skill and training to perform.
A duty biochemist reviews and authorises results falling outside set ranges and they may add further investigations and comments to requests. The laboratory receives, prepares, and sends samples to external laboratories when a requested test is not currently performed in-house. The clinical chemistry team is very dedicated and hard-working one, and always aims to offer the best service it can provide.
You may have heard the terms “Doppler” or “Duplex” used when referring to our scans. In many of our investigations we measure the speed of the blood in the body, and this is possible due to a phenomenon called the Doppler effect. An example of this is when the siren of an ambulance or fire engine changes pitch as it travels away from you. The name “Doppler” can also be used for when the pulses are listened to, usually in the feet, as well as when blood pressure cuffs are placed around the arms and ankles of a patient to detect possible arterial narrowings or blockages.
Below is an image taken from one of our scans. The red area demonstrates blood flow in a superficial femoral artery, and the waveform below this tells us more information about the blood flow throughout the whole leg.
There are 19 different specialities under the umbrella of Pathology, including:
Did you know…
Our staff are amazing, all the time, across many staff groups:
Pathology has also been involved in looking after the environment. Historically, Pathology has employed a single containment system for submitted bloods from primary care by use of plastic bags. Over the course of a year almost 780,000 specimen bags are sent to the Blood Sciences laboratories which is more than enough to fill an Olympic sized swimming pool!
The radiotherapy department in the Sunrise Centre is modern, containing various pieces of state-of-the-art equipment for treatment delivery, planning, and patient management. As mentioned above, the radiotherapy physics team are responsible for these:
I am a Biomedical Scientist who works in the Clinical Chemistry laboratory of the Royal Cornwall Hospital. Covid-19 has had a large impact on the way we work across the whole of Pathology. In Chemistry it led to us implementing a new blood test to look for Covid-19 antibodies in patients to determine whether they had been exposed to the virus in the last 14 days and whether they may have built up some kind of immunity. We were also involved in a large scale research study called the Siren project where volunteers had regular blood samples taken and their antibody levels were tested – this is still ongoing at the moment and should help us to understand the virus much better.
As for my day to day work – we offer a 24/7 service where there is always a Biomedical Scientist in the department to allow for a rapid turnaround of blood sample results. The main focus of our working is testing blood samples for various body chemistry functions which allow us to determine a patients kidney or liver function, whether a patient has had a heart attack, various hormone levels, drug levels that a patient has taken (either prescribed or other types of drugs such as paracetamol overdoses) and tumour markers for different kinds of cancers.
Whilst the main bulk of our work is blood samples we also process urine samples (both as a single collection, or sometimes over a 24 hour period), faecal samples, sweat testing, cerebral spinal fluid and even on the rare occasion eyeball fluid! All of these have important functions – for instance, when we test spinal fluid we can help to rule out whether a subarachnoid haemorrhage has occurred -bleeding on the brain from a head injury.
It is a very busy working environment which has a variety of different challenges on a daily basis. For me, one of the most difficult and yet rewarding times is when I work on-call and am the only person in the laboratory overnight or at the weekends. This means that I am responsible for all of the samples that come through the laboratory and for providing a rapid turnaround of results in order to support the A+E department and other critical wards across the hospital.
The NHS scientist training program (STP) is a program that aims to produce graduates who will possess the essential knowledge, skills, experience, and attributes required of a newly qualified and registered clinical scientist. By the end of the training the trainee should be competent to undertake complex scientific and clinical roles, defining and choosing investigative options, making key judgements about complex facts and clinical situations within a quality assurance framework.
The program aims to achieve this by part academic study (for an MSc) and part work-based training learning and training. As a first year Medical Physics trainee I spent the first year rotating between the four key branches of Medical Physics in the UK:
Once the rotational year was completed, I chose a specialism which I will work and train in for two more years.
I am currently a second-year trainee who has chosen Radiotherapy as his specialism, much of my day as a trainee involves observing competent clinical scientists perform their duties, aiding them and maintaining a journal of my experiences in a series of written documents.
The aim of Radiotherapy is to use high energy radiation to damage cancerous tissues and destroy their ability to divide and grow. It may be delivered using machines called linear accelerators or via radiation sources positioned on or in the patient on a temporary or permanent basis.
As radiation passes through a patient is deposits its energy to the patient, we call the deposition of the radiation’s energy per unit mass of the patient, a dose of radiation. A dose of radiation is called a Gray (Gy).
In Radiotherapy, we are typically interested in how this deposited dose interacts with human tissue. The absorbed dose or energy deposited by radiation via to a patient can cause the initiation of a chain of events which can result in tissue damage.
|Physics Stage||10-18 sec||Energy absorption|
|10-16 sec||Physical Events
|Chemical Stage||10-12 sec||Physio-chemical Events
|10-12 sec – 10-16 sec||Chemical Events
|Biological Stage||Minutes to hrs||Biochemical/Cellular Processes
|Days to months||Tissue Damage
|Years||Late Somatic Effects
Tissue damage can result from damage caused to the DNA of the cells which make up the tissue. Damage to DNA can occur as the result of two effect direct action and indirect action.
Direct action is when an electron resulting from the absorption of a high energy photon directly damages the DNA. For indirect action, the electron generated by the high energy photon instead interacts with a water molecule in the body to produce a free radical. Free radicals are highly chemically reactive, and so it goes on to damage the DNA.
The damage caused to DNA can be in the form of single strand break (SSB) or a double strand break (DSB). SSBs are typically of little biological consequence as they are repaired readily using the opposing strand as a template. It can however be repaired incorrectly and lead to mutation. DSBs are less readily repaired and considered the most important lesions produced in chromosomes and may result in cell necrosis, carcinogenesis or mutation.
To summarise so far, ionising radiation can deposit energy to a patient. This energy deposition causes the freeing of electrons, which can cause damage to cells and subsequently tissues via direct or indirect action. The natural question is, why do we expose the patient to radiation in radiotherapy if it causes damage to normal healthy tissue?
To oversimplify, the answer is that tumour cells are, typically, more radiosensitive than normal tissue cells. This means that is can be more easily damaged than normal tissue for a given dose of radiation. The principle of radiotherapy is to deliver sufficient radiation to the tumour to damage its DNA cells and destroy it, without irradiating normal tissue to a dose that will cause serious complications (morbidity) to its healthy cells.
I am currently on my 3rd year of the Scientific Training Programme (STP) to become a clinical scientist, working within the Cardiac Outpatient Department. Within our department we have three main areas to work:
I am very lucky to have been able to gain experience in all areas. Currently my favourite role is completing exercise treadmill testing and working with the labs, as patients can deteriorate without warning I need to recognise the signs are be proactive in keeping the patient safe. My course has also taken me around the hospital including respiratory and vascular departments. Experiencing the roles of others gives a vital understand to the areas around me and what a patient may go through during their individual diagnostic and treatment pathway.
I am a cardiac scientist apprentice working in the cardiac outpatient department. The apprenticeship scheme is a brilliant programme where I learn on the job gaining skills and completing competencies as well as carrying out academic studies to a degree level.
I want to be a qualified healthcare scientist because I have a passion for both people and science. As a cardiac scientist, you are in a privileged position where you can form excellent patient relationships, especially with those who require ongoing care, as well as performing interesting diagnostic procedures. The role is varied and I can honestly say no two days are ever the same whether it’s the excitement of an emergency procedure or the analysis of patient data; it’s never a boring day! However, the factor that makes it a special field of work is the incredible team of people that you have the opportunity to work with. I’m so proud to work alongside such inspirational, innovative people who all combine to provide the best patient care possible.
My name is Sam and I work for the Cardiac Department in Treliske Hospital. I am a Trainee Cardiac Scientist, completing a degree apprenticeship in partnership with UWE Bristol. The course is a NHS Practitioner Training Programme (PTP) which entails full-time study and integrated workplace-based training for three years.
So far, the course has incorporated the other healthcare science specialisms into our academic studies. This has provided me with a broader understanding of the healthcare science sector and how they link together. Having the workplace-based learning has been invaluable and where most of the development and learning is noticeable.
Working in the healthcare science sector is very rewarding as you are a part of the diagnostic and treatment pathway for a patient. You get to work in a variety of settings, with different equipment and encounter diverse experiences. Working to better the lives of patients is the core purpose of the job. The sector is advancing rapidly with new evolving technology and scientific approaches to improve the outcomes of patient treatment.