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The Occupational Standards for the three projects are being developed by Skills for Health together with teams from the clinical departments.

The three projects in Radiotherapy, Clinical Imaging and Breast Screening are all at differing stages of development.

RADIOTHERAPY

The Radiotherapy project was launched in July 2001.

Occupational Standards

Occupational Standards are being developed to address the key roles identified by the map of the Radiotherapy domain. These cover:-

The development of the Occupational Standards is being undertaken by three technical working groups (TWGs) drawn from the development sites. The work is progressing well and the Standards will be available by the end of March 2003.

Assistant Practitioners

Agreement has been reached on the work the Assistant Practitioners will undertake delivering radiation on a linear accelerator. As the underpinning knowledge required to support this becomes clearer, it is planned to organise another day when the trainee assistants can meet up to have some tutorial time together. This will be particularly for aspects of the knowledge base, which may be more diffucult to deliver in the workplace. It will also provide an opportunity to ensure comparability of understanding.

The trainee Assistants met up for a day hosted by the Society of Radiographers and had an opportunity to discuss the issues of interest to them. It also gave them a chance to compare notes and was a great success

State Registered Practitioners

State Registered Radiographers continue to successfully train the Assistants. This is particularly challenging due to the pressures of the clinical service. Two frameworks have been developed for Clinical Supervision and Preceptorship within Radiotherapy that will facilitate the long-term career development of newly qualified State Registered Radiographers. The preceptorship model was revised after the first year and the modified version seems to be working well. There is evidence that the model is enhancing the level of confidence of newly qualified staff, integrating them into the team more quickly and more effectively than induction programmes alone. Both the Preceptorship and Clinical Supervision models will be further developed to reflect all parts of the radiography service.

Advanced Practice

Data has been collected from the Development Sites, which demonstrates a wide range of advanced practice. Further information will shortly be available to the wider health care sector. For all aspects of the work and for all staff groups, the work will be done to the Standards defined by the Occupational Standard regardless of who is doing it.

Consultant Roles

Three of the Development Sites have identified possible Consultant practice. These are being evaluted against the criteria for Allied Health Professions Consultants.

CLINICAL IMAGING

The Clinical Imaging project commenced in April 2002

Scoping the field of Clinical Imaging

Seven sites were identified for the scoping/mapping of the Clinical Imaging Service. The sites were identified to reflect size of service, urban and rural communities, Community and Acute Trusts and the full range of clinical practice within imaging departments.

Skills for Health completed the visits to each site during July. The full range of procedures within Clinical Imaging were identified and the number of Standards suggested. It is estimated that there are at least 40 Occupational Standards to be developed for the Clinical Imaging service. It would not be possible to complete this work programme by March 2003 so the Clinical Imaging Project Board have decided to prioritise the first stage of the work. The priority areas will reflect service needs as well as the requirements of the four-tier workforce structure.

Occupational Standards Development

Four technical working groups (TWGs) drawn from the development sites commenced work at the beginning of September on the development of the Occupational Standards. It is expected that the Occupational Standards identified as priorities by the Project Board will be completed by the end of March 2003.

Assistant Practitioners

All sites have a service need for Assistant Practitioners and see this role principally related to plain film radiography. The majority are focussing on radiography of the chest and appendicular skeleton. Others consider that imaging of the spinal column is appropriate. Radiography of the skull is not perceived to be a role for Assistants.

Sites have been requested to develop at least 2 staff to become Assistant Practitioners. Many are intending to train more than this but are still in the recruitment phase. Data on numbers is therefore not yet complete but the final total is expected to be between 25 and 30.

State Registered Radiographers

Many staff have additional responsibilities including training student Radiographers. Some radiographers already have training and assessing qualifications to support the development of Assistant Practitioners.

Advanced Practice

There are a large numbers of Radiographers who have already extended their roles in a variety of other ways. Common areas of practice are

There are several other local initiatives reflecting innovative staff developments, which could be adopted at other centres when the Occupational Standards have been developed.

Consultant Practice

Development Sites have also been asked to identify at least one area in which Consultant Radiographer practice might be developed. Full details are not yet available for all sites.

NATIONAL HEALTH SERVICE BREAST SCREENING PROGRAMME

The Breast Screening Project commenced in July 2000. This was the first of the three projects and is now nearing completion. The Development sites worked with representatives of Skills for Health and the following Occupational Standards were created

Assistant Practitioners

The Mammography Standard has been subjected to UK wide consultation and together with 12 Units from the Diagnostic and Therapeutic Support National Vocational Qualification is defining the development of Assistant Practitioners in Mammography. The eight Assistants from the Development Sites have completed their training satisfactorily.

A recent survey undertaken within the NHSBSP established that there are now 25 Assistant Practitioners employed in the service. A further 35 units are considering training staff into this function in the future.

Advanced Practice Standards

The remaining four Standards defining Advanced practice in Breast Screening are being tested against clinical practice. Nine Breast Screening units have been identified to test the Advanced Practice Standards.

The majority of sites are testing all four Advanced Practice Standards. Staff involved in the field-testing are Radiographers, Specialist Registrars, breast Physicians and Consultant Radiologists.

The recent NHSBSP survey also identified 139 Radiographers who have developed their role into one or more areas of Advanced Clinical Practice.

Trusts and services involved in each of the three projects

Radiotherapy Development Sites

Clinical Imaging

Scoping Sites

Development Sites

National Health Service Breast Screening Programme

Development Sites

Field Test Sites