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2.0 The College of Radiographers’ position in 2012

The College of Radiographers’ position in 2012 is clear:

Clinical imaging examinations undertaken by radiographers should receive an immediate preliminary clinical evaluation as part of the examination to assist in on-going patient management. Preliminary clinical evaluations generated by the radiographer undertaking or supervising the examination should be followed by a definitive clinical report provided by a radiologist, an appropriately qualified clinical reporting radiographer, or another registered healthcare professional able to report to the same standard as radiologists and clinical reporting radiographers. 

The College confirms that both preliminary clinical evaluations and clinical reporting are core parts of the radiography profession’s scope of practice, subject to those undertaking these roles having appropriate and relevant post graduate education and training. 

Those undertaking clinical reporting must have attained a relevant postgraduate qualification approved by the College of Radiographers. They should also seek and maintain accreditation by the College at advanced practice level as a minimum.

The College acknowledges that there is a lack of consistency in the terms used by the profession to describe its contributions to reporting. It now defines the two distinct roles in reporting as follows:

Preliminary clinical evaluation: This term is used to describe the practice of radiographers whereby they assess imaging appearances, make informed clinical judgements and decisions and communicate these in unambiguous written forms to referrers. Importantly, where a radiographer is unable to provide a preliminary clinical evaluation, this fact must be communicated to the referrer in written form.

Clinical reporting: This term is used to describe the practice of radiographers who have successfully completed postgraduate education and training approved by the College of Radiographers to enable them to produce diagnostic reports in defined fields of practice. The quality of the reports produced by radiographers must at least be at the same standard as reports produced by other recognised reporting practitioners, medical or non-medical.

The College believes that implementation of integrated and properly supported and governed systems of preliminary clinical evaluation and clinical reporting, in the context of multi-disciplinary team working, will assist clinical imaging services to meet the needs of patients and referrers for rapid access to the right imaging examinations and the ensuing outcomes and reports.

The College expects those services operating abnormality signalling (‘red dot’) systems to phase them out in favour of preliminary clinical evaluation (PCE) systems. While abnormality signalling systems have enabled radiographers to make significant contributions to diagnosis in accident and emergency services for many years, such systems are ambiguous and no longer sit comfortably in current clinical governance processes. The relatively informal nature of such systems and the often optional approach are inconsistent with delivering reliable outcomes for patients and referrers and for attributing accountability for errors.

The College’s record on advocating and supporting the development of radiographers’ roles is consistent and long standing. With regard to radiographers’ roles in preliminary clinical evaluation (initial image interpretation) and in clinical reporting, it has been, and remains, unequivocal. The benefits of deploying radiographers in these ways are clear and supported by evidence.  Nonetheless, it remains important to ensure that changes to systems and practice are approached strategically and within an appropriate governance framework in line with the joint publication of the Royal College of Radiologists and the College of Radiographers.18

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