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6.0 Implementing preliminary clinical evaluation and clinical reporting

6.1 Education and training 

All radiographers who are engaged in preliminary clinical evaluation and clinical reporting must have undergone education and training that will enable them to function effectively in these roles (see section 5.1).

Clinical imaging service managers seeking to implement or extend preliminary clinical evaluation and/or clinical reporting systems are advised to carry out a detailed training needs analysis and to establish a strategic framework for their radiographer and associated workforce development, to include an overview of projected human and financial resource requirements. 

6.2 Clinical governance 

Clinical imaging service managers and clinical directors are jointly responsible18 for establishing and maintaining robust mechanisms for the safety and protection of patients and delivering effective service and clinical outcomes. Both preliminary clinical evaluation and clinical reporting must be included in the scope of the governance arrangements for the clinical imaging service. 

Scenario-based protocols and schemes of work should be drawn up. This should normally include radiological involvement and should comply with professional body and regulatory guidance. Lines of accountability and a mentoring/supervisory framework should be established. Radiographers must practice within an agreed and defined scope of practice which should be set out clearly within the protocols and radiographers should understand the limits of their practice.29  Processes for consultation, discussion, agreement, and review of protocols and schemes of work should be defined. 

Radiographers must be enabled (through allocated time and the provision of appropriate learning resources) to undertake CPD to develop, maintain and enhance their skills. These must be agreed at the planning stage of these services. Self-directed CPD has a role to play in supporting the introduction of these services but is insufficient on its own. There needs to be full ownership of the process by all relevant stakeholders to ensure success and highly motivated staff. Stakeholders will, at least, include radiographers and radiologists and should also include referrers and patients.

A process of periodic audit of preliminary clinical evaluation and clinical reporting should be established which enables ongoing scrutiny of these services and action planning and follow up of issues that emerge. Multi-disciplinary team meetings and establishment of discrepancy review meetings should be established, with learning rather than blame being the underlying principle.

6.3 Professional accountability and indemnity

Radiographers are independently regulated, autonomous healthcare practitioners, individually and fully accountable for all of their actions and practice,30-32 including all opinions expressed and all judgements and decisions made. Radiographers must, therefore, ensure that they are properly trained for all roles and responsibilities they agree to undertake and they must maintain their skills through continuing professional development. This applies to the whole of their practice including when that practice encompasses preliminary clinical evaluation or clinical reporting.  

Radiographers in membership of the Society of Radiographers benefit from personal professional indemnity cover33 subject to them working in accordance with the Scope of Practice28 and the Code of Conduct and Ethics34 of the Society and College of Radiographers.

Employers’ vicarious liability  expects employees to work in accordance with their authority and within their policies. Radiographers undertaking new or enhanced roles should ensure that their employer is aware of significant changes to their personal scope of practice, for example, clinical reporting.

6.4 Employment

Clinical reporting is an advanced practice skill.27 Radiographers undertaking clinical reporting may well have clearly defined roles and responsibilities with regard to the training, development and supervision of staff undertaking preliminary clinical evaluation. These posts will normally be at NHS pay bands 7 or 8a or their equivalents.

In the case of preliminary clinical evaluation, the associated knowledge, skills and responsibilities are consistent with NHS pay band 6 or its equivalent.

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