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In 2008 the Society and College of Radiographers commissioned research examining the scope of radiographic practice. The aims of that study were to:

  1. Identify and quantify the different healthcare environments in which the radiography workforce function
  2. Quantify the current radiography workforce within the career progression framework
  3. Quantify the different roles undertaken by the radiography workforce within clinical practice, management, education and research
  4. Identify role developments which have occurred within the profession over the past five years and to describe current trends and future prediction.

The subsequent report to the SCoR1 made a series of recommendations; three of these related directly to Aim 3 around the CPF.  The recommendations were as follows:

  • the SCoR is urged to commission an independent evaluation of the impact of implementation of consultant, advanced practitioner and assistant practitioner grades in line with that recently commissioned by Skills for Health for the roles of anaesthesia practitioner, endoscopy practitioner, surgical care practitioner, peri-operative specialist practitioner and physician assistant, in order to assess the cost benefits of introduction of the new radiography grades.
  • further research is recommended. It would be beneficial for consultants and advanced practitioners to clarify the content of their current roles and the direction in which they should be developed.
  • the development of further guidance on implementing consultant and advanced practitioner posts was viewed as potentially helpful; this could include clarification of the various requirements such as whether audit counts towards the ‘research’ strand of the post and the need for an individual caseload.

The recommendations were prompted by the fact that, while the concept of the CPF (formerly the 4-tier structure) had been in existence for nearly a decade, its adoption and diffusion had been variable1. In particular, the rate of adoption of radiographer consultant posts has been slow compared to the adoption of advanced practitioner and assistant practitioner grades.  This is despite the announcement of consultant posts from allied health professions (AHP) in the NHS Plan of 20002 and a Department of Health Advanced Letter3.

Therefore, following the submission of the Scope of Practice report the SCoR commissioned the University of Hertfordshire and the Institute for Employment Studies (IES) to undertake exploratory work on the adoption and diffusion of the career progression frame work and to investigate the evidence for impact of introduction of these roles.

The outcome of this work is reported here. The research captured data on issues relating to consultant appointment, impact on service operations and service improvement and hence their immediate impact on clinical imaging services at two National Health Service (NHS) trusts in England.  Based on the outcomes of the study, recommendations are made for a larger study embracing clinical imaging and radiotherapy within the UK as a whole.

The work was classified as a Phase 1 pilot study, leaving the option open for the SCoR to commission an in-depth study at a later stage if required.

This report sets out:

  1. the methodology by which the materials and tools were designed
  2. an account of the procedure through which the evaluation research was conducted
  3. an account of the quantitative information obtained
  4. an account of the contextualising information obtained through the qualitative work, on the perceived value and local implementation facilitators and barriers
  5. a description of the performance impact/cost-benefits of changes to skill-mix and suggestions for the data required to model cost-benefits
  6. a concluding section making further recommendations based on the findings of the work undertaken to date.


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