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Practitioner

Scope of Practice

All radiographers at the point of registration are competent to practise autonomously in their discipline at the initial level. Clinical skills obtained during the pre-registration period need to be consolidated to provide the foundations for continuing development of this group of staff. Therefore, the infrastructure to nurture and develop practitioner radiographers must be in place. This should ensure exposure to both the breadth and depth of clinical skills organised around service needs and should include a formal period of induction followed by preceptorship.

Registered radiographers at the practitioner level undertake a broad portfolio of diagnostic examinations/radiotherapy procedures in the delivery of care for both clinical imaging and radiotherapy patients. The practitioner is an integral member of the clinical imaging or radiotherapy and oncology team delivering high quality clinical care.

Accreditation at this level of practice is achieved as the individual will have completed a recognised programme that entitles them to apply for membership of the Society of Radiographers and registration with the Health Professions Council  (HPC). At initial registration with the HPC, they will meet the Standards of Proficiency – Radiographers16 (2009) http://www.hpc-uk.org/publications/standards/index.asp?id=51

Thereafter, the individual is required to undertake CPD relevant to their practice in order to maintain and demonstrate continuing competence.

Education requirements

The minimum qualification for SoR accreditation and HPC registration at this level is currently a BSc (Hons) degree or its equivalent.

Pay and grading

On qualification and initial entry into the NHS, practitioner radiographers are placed on band 5 of the NHS pay spine. Building on many years of experience of the benefits to service of accelerated progression linked to competency frameworks, the SoR believes that established practitioner radiographers work at band 6 level of the NHS pay spine.

Radiographers' roles tend to evolve quickly following qualification, requiring them to operate in increasingly autonomous clinical situations beyond those normally associated with Band 5. Provision has been made in Annex T of the Agenda for Change: NHS Terms and Conditions Handbook17 (2005) http://webarchive.nationalarchives.gov.uk/20130107105354/http://www.dh.g... for a review of job size no later than two years from the date of qualification. Evaluations that demonstrate that the job weight is sufficient to put individuals into Band 6 should be effected immediately and without the need to apply for a post at the higher level or to wait for a vacancy at this level to occur.

SoR guidance on the implementation of Annex T is available: https://www.sor.org/trade-union-support/agenda-change/annex-t

Accountability, autonomy and responsibility

The minimum standards for safe practice at the practitioner level have been established in accordance with the proficiency and education criteria set out by the HPC in Standards of Proficiency - Radiographers and Standards of Education and Training18 (2009) http://www.hpc-uk.org/publications/standards/index.asp?id=183

It is expected that all practitioners will develop from this minimum level as their careers progress. The minimum standards are the building blocks upon which individuals develop supported by a preceptorship period, continuing professional development and clinical supervision.

As a registered practitioner, radiographers are autonomous and accountable for their practice. They must only undertake tasks for which they have been educated and trained, in accordance with agreed local policies and protocols and with the agreement of the employing organization.

The responsibilities held by all registered practitioners are set out in the HPC’s Standards of Competence, Conduct and Ethics19 (2008 http://www.hpc-uk.org/publications/standards/index.asp?id=38  and in the SCoR’s Code of Conduct and Ethics13 (2008).

Continuing Professional Development

From the point of initial registration with the HPC, the individual is required to engage in CPD relevant to their professional practice. The SCoR has developed a web based tool, ‘CPD Now’, to support members in identifying their development needs, recording their CPD activity and evaluating their learning outcomes.

SCoR publishes articles and self assessment tools within ‘Synergy: Imaging and Therapy Practice’ and provides access to web based learning through ‘CoRe-learning’. http://www.sor.org/learning/e-learning

Support and resources

Following entry to service and initial induction, a period of preceptorship should be provided to ensure the smooth transition from student to confident clinical practitioner. A formal framework for the introduction of clinical supervision needs to be implemented within all clinical imaging and radiotherapy and oncology departments.

Following the preceptorship period, practitioners continue to be engaged in clinical supervision and continuing professional development to maintain and develop new competencies in preparation for career advancement linked to service needs and personal aspirations. Practitioners should be enabled to explore and experience diverse fields of clinical practice to assist them to make career choices.

The SoR believes that all practitioners should be supported by protected study time. Protected Study Time - Guidance for Radiographers, Managers and Union Representatives20 (2009) and A Charter for Protected Study Time in Scotland21 (2008).

There is also guidance for managers on implementing career progression at Implementing Radiography Career Progression: Guidance for Managers22 (2005).

The role of the radiographer at practitioner level

Practitioner level posts will be structured around identified service needs. Their core function is the delivery of high quality clinical practice within diagnostic imaging or radiotherapy. At this stage of a radiographer’s career, it is expected that he or she will exhibit skills relating to the AHP Career Framework levels 5 to 6  https://tools.skillsforhealth.org.uk/careerframework

For those working within Nuclear Medicine or as dosimetrists, career progression pathways within the Modernising Scientific Careers framework may be more relevant. This time is very influential in career development and will cement the foundations of clinical practice initiated in the undergraduate process.

Guidance relevant to this stage of career development includes :

  • Continuing Professional Development; Professional and Regulatory requirements23 (2008)
  • A Strategy for Practice development in Radiography24 (2008)
  • Mentoring: Guidance and advice25 (2009)
  • Code of Conduct and Ethics13 (2008)
  • Accelerated Career Progression: A briefing26
  • Research and The Radiography Profession: A Strategy and Five Year Plan27 (2005)
  • Modernising Scientific Careers framework28 (2009)
    The knowledge, understanding and skills required at practitioner level are stated in the SCoR’s Learning and Development Framework for Clinical Imaging and Oncology3  (2008).

Development of the Practitioner

When practitioners have progressed beyond preceptorship and consolidated their roles, they will be looking to advance their careers. This may be through a variety of routes, developing specialist skills and knowledge related to:

  • care pathways, anatomical, physiological and pathological systems, imaging or treatment modalities and techniques
  • teaching and learning
  • research
  • management.

A number of professional guidance documents give information on some of these career aspirations:

  • The Scope of Practice29 (2009)   
  • Scope of Radiographic Practice302008; a report compiled by the University of Hertfordshire (2008) 
  • Positioning Therapeutic Radiographers within Cancer Services: Delivering Patient–Centred Care31 (2006)
  • Practice Standards for the Imaging of Children and Young People32 (2009)
  • The Child and the Law: The Roles and Responsibilities of the Radiographer33 (2005)
  • The Scope of Practice in Medical Ultrasound34 (2009)
  • Information Management & Technology: Implications for the Radiography Workforce35 (2006)
  • Nuclear Medicine Practice36 (2007)

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