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6. Conclusion

The Whitley Council framework adopted by the NHS at its outset had clearly ceased to be fit for purpose. The failure of the framework to recognise radiographers wishing to develop a clinical career pathway or align this with a fair system of pay was a real shortcoming. On reflection it is difficult to see how the Whitley Council arrangement survived for nearly 60 years in the NHS.

The concepts of AfC and the NHS KSF were sound and represented an admirable attempt to introduce transparency in determining levels of pay relative to the knowledge and skills of the workforce. The potential for aligning career progression with a pay structure that recognised clinical career pathways promised much, although a majority of members of the SoR, as evidenced by the ballots on AfC, were not impressed or considered other factors to be more important. Many would feel their misgivings had been justified by the findings of this research although it appears that opinions have in many cases been influenced by the way in which implementation of AfC was managed. 

The judgement of the majority of the respondents to the study is that poor implementation of AfC has hindered acceptance despite any promises it may have held. To expect that in an organisation the size of the NHS everyone would be satisfied with their individual outcome was unrealistic despite the appeals system to deal with any objections. Evidence from this work suggests AfC has been implemented selectively and variably, and inequity is rife both within organisations and between organisations. Many staff were disillusioned from the start and have found it impossible to recover from what they perceive as the insult of being wrongly banded initially. Many other senior staff report a feeling of loss of professional identity by being banded equally with individuals with often far less experience and qualifications. 

The overriding beliefs were that under funding, understaffing, feeling ‘stuck’ in their band and poor support from managers are the main factors hindering progression. Furthermore many believe that AfC was a money saving exercise, and that appraisals are not taken seriously by managers.

The SCoR had the foresight to introduce the CPF at the beginning of the decade. The introduction of AfC and the KSF was timely in that they could have been the vehicles and the opportunities of promoting the CPF. Indeed this was the case with those managers who had the foresight, the means and leadership skills to grasp the moment. However, it would also be fair to say that not all managers would appear to have been persuaded by the merits of the CPF and even if they were there is evidence to suggest that financial restrictions in a number of organisations constitute substantive barriers. Overall, there is little evidence of AfC positively influencing new ways of working and career progression for the radiographic workforce. This was certainly the view of the majority of respondents in this study although staff in centres where the CPF is recognised appear more satisfied with their career progression and claim to enjoy more development opportunities.  Since appraisals and the KSF lie at the heart of the career progression element of AfC, these findings may provide a fundamental insight into the actions that could be taken to improve career progression for the radiographic workforce.

Almost equal numbers in this study indicate that AfC has had little influence either way on their career development and believe that other unrelated factors have helped or hindered their progress. 

Not all of the views were negative. There was a small minority within the study who felt that AfC exerted a positive influence over their career. These tended to be staff on the higher bands, therapeutic staff and recently qualified radiographers as opposed to others on lower bands, diagnostic radiographers as a whole and those who have been qualified many years. Arguably, it could be said that the former groups are more pro-active in taking responsibility or had the means at their disposal to influence for their own career progression.

The SCoR is clearly concerned with the current situation of its membership and this is demonstrated by the commissioning of this investigation. Our findings will assist the SCoR in influencing changes within the working environment of the radiographic workforce to ensure more of the potential benefits of AfC are realised.

Finally, one participant sums up the feelings of the many who contributed to the study:

The philosophy of everyone being equal regardless of profession and location hasn't worked out. The same jobs in different trusts are different bands. Even in the same trusts, jobs are not banded equally. The suggestion of one on-call system for all is unworkable. The success of KSF depends more on the manager than anything else, and good managers don't need KSF to ensure training opportunities.

6.1 Summary

AfC promised much but inequitable implementation has thwarted full realisation of its potential.

The majority of the radiographic workforce is dissatisfied with AfC in relation to their career progression. A large proportion feels it has had no effect, and less than one in ten has a positive view of AfC.

The CPF is viewed positively and staff are more satisfied with their progression in sites where it has been adopted.

Staff are against being defined by their salary band, and feel that professional identity and status has been lost with the removal of the Whitley Council grades.

6.2 Recommendations

In view of the findings emerging from this investigation the following recommendations to the SCoR are made:

  • Encourage and facilitate greater standardisation and harmonisation of roles across trusts in line with the spirit of AfC

    (i) by pursuing high level discussions with the Departments of Health

    (ii) by working closely with the NHS Staff Council to guarantee as fair a system as possible in advance of new on call arrangements

  • Expedite the integration of the CPF in all departments, and encourage the use of the KSF at appraisals
  • Increase support and develop better training programmes to help managers value appraisals and conduct them more effectively
  • Promote the advantages and benefits of protected study time for the workforce, and promote radiographers’ active engagment with research
  • Develop a new contemporary system of professional titles, which may go some way to restoring professional identity, which many feel has been eclipsed by AfC banding
  • Through the use of the SCoR website, invite trust managers to provide information on whether they recognise the CPF and Annex T, whether they provide protected study time, and whether they appoint consultants.  This will enable the mobile workforce to be more discerning as to where they seek employment. 



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