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Methodology

Two exploratory case studies were conducted to examine development, implementation and impact of consultant radiographer roles at two NHS trusts.  Each case study consisted of structured interviews with key staff members at the trust.  The two case studies are appended (Appendix 1).

Research Tool

Discussion guides were designed for use in the interviews with staff. Three versions of the templates were designed: one for use with either imaging service managers or clinical service managers; one for use with consultant radiographers; and one for use with radiologists. These are presented in Appendix 2.

Development of the discussion guides was informed by the themes and issues that had emerged during the scope of practice work. The major themes identified concerned workforce issues and patient pathways.  Sub-categories were identified which formed the basis of the specific questions. The two main themes and sub categories are presented below.

Workforce issues

  • Drivers for role implementation
  • Process of post development
  • Rationale and criteria for consultant appointment
  • Area of  specialist practice and proportion of core elements included
  • Accountability and line management arrangements
  • Numbers and grades of staff who directly support consultants
  • Implementation of the career progression framework
  • CPD for consultant staff
  • Impact on use of other staff’s time.

Service quality

  • Impact of introduction on service quality
  • Indicators of service improvement
  • Cost-benefits
  • Other indicators of service improvement
  • Benefits for referrers and multi-disciplinary teams

Patient pathways

  • Patient throughput numbers pre- and post-implementation
  • Proportion of patients meeting targets pre- and post-implementation
  • Patient waiting-list length pre- and post-implementation

Participants
It was important that the work was undertaken at sites that had fully implemented the career progression framework.  Initially, the SCoR made contact with trusts via their consultant network to seek volunteer trusts to participate in the research.  The contact was restricted to NHS trusts in England with radiographer consultants in diagnostic imaging and where the career progression framework was implemented fully. Ten trusts responded to the request; after considering the range of trusts that had volunteered, two were asked to participate, one in the north of England and the other in the south.  Interviews were conducted with staff identified as being critical to the development and introduction of the radiographer consultant posts: consultant radiographers, radiologists and service or clinical managers.

Procedure
Each researcher took responsibility for one trust and made arrangements to conduct the interviewees.  A briefing paper was sent to each interviewee (Appendix 3).  Interviews were conducted on-site at each of the trusts.

Prior to the interview, the interviewees were asked if they had any questions and agreement was sought to record the interview.  Confidentiality was guaranteed for each of the two sites and for the staff participating.  Consent forms were signed by the interviewees and the researchers in all cases (see Appendix 4).

Ethical Approval
Prior to the interviews ethical approval was sought and gained from the Ethics Committee of the School of Health & Emergency Professions at the University of Hertfordshire, Protocol Number: HEPEC/10/09/2.

Structure of the report
In the remainder of the report we present the results, a discussion and conclusion with recommendations for further work.  As indicated above, the two case studies are included as Appendix 1. 

 

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