"In a lot of units the technician is not a part of the team. We need to promote the team cause."

There was, he continued, no standardised line-management structure, either.

"At the moment there are no real safeguards about what technicians can do and who they are responsible to," Mark Forrest said.

"Quite often they are responsible to the consultant or through a medical electronics department. It's a bit ad hoc.

"The way technicians work is very widespread, too. In some units if they work for the electronics department of the hospital, they go in and fix a machine and come out. They've no clinical hands on. They've no patient contact. And then you have the other extreme, where in units with home patients you're actually on a one to one with home patients, advising them how to set up the machine, sorting out problems, often over the phone while the patient's on the line. This is a much better use of our talents. And patients value the contact too."

Improved status for renal technicians was a government aim, too. Government sees their role as essential to the delivery of better care for patients.

"There's a lot of government initiatives coming out to enhance all scientists and technologists in the health service and to boost their status partly to get more recruitment because there is not enough staff. It's dire, virtually every unit has probably got staff shortages."

He told nephronline that his poster presentation at Nephrology in Practice 2001 was intended to increase awareness among medical colleagues of the role renal technicians could play.

"This is a PR exercise to promote our cause and show what we do. We don't just fix machines. We're involved. We need a lot of technical clinical skills.

"We need to know almost as much, if not more, than the nursing staff to know if the machine's telling you something's wrong with the patient or if the machine is simply being confused.

"Our overall maintenance role is probably going down as machines are being built better. They run better. The service intervals have increased and mean time between failures has improved. The days when we just soldered circuit boards have gone," he concluded.

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