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RADIOTHERAPY

Occupational Standards

The technical working groups are now refining the draft occupational standards. In parallel with this work the standards are being aligned to the draft role descriptors for each of the four tiers.

Assistant Practitioners

Many of the trainee assistants have now completed their NVQ 3 in Diagnostic & Therapeutic Support. A high level of agreement has been reached on the underpinning knowledge required for the specific radiotherapy elements. The trainees are continuing to collate portfolio evidence to demonstrate their knowledge and understanding for the specific radiotherapy standards. This will ensure that the process of assessment can be undertaken as soon as the standards are disseminated to each of the pilot sites.

State Registered Practitioners

State registered radiographers will be responsible for directly managing all treatments including those that are complex and non-routine, whilst the assistant practitioner will be limited to delivering treatments governed entirely by protocol. Grouping the occupational standards will provide further clarification of the differential between state registered and assistant practitioners.

The model for preceptorship, developed and tested last year, has been further revised and will be tested again following the changes within each of the pilot sites. This will take place in early 2003. Anecdotal evidence suggests the changes made in the light of last year's evaluation have been well received by the clinical staff.

Advanced Practice

Radiotherapy and Human Resources staff from each of the pilot sites attended a workshop on 10th December. The aims of the workshop were to agree factors that constitute advanced practice and to define an assessment and implementation process for advanced practice. This was successfully achieved and following endorsement by the strategic team on 9th January 2003 the assessment model is now being tested in each of the 9 pilot sites.

Consultant Roles

All the pilot sites are investigating the scope for consultant practice in their service and some are extremely close to agreement. Emphasis has importantly been placed upon ensuring that these non-medical Consultants fit the criteria defined by the Department of Health. The pilot sites have invested significant effort in pursuing this and progress at the moment is very encouraging.

Evaluation: Staff Attitude Survey

The second staff attitude survey has demonstrated that the majority of staff believe that implementing the 4 tier model will not change the safety of the service, the quality will improve and the status of radiographers will be enhanced. Issues such as role clarity, training demands on clinical staff and the need to ensure competence for new roles are being fed back to inform on-going work. There was also recognition of the value of preceptorship.

CLINICAL IMAGING

Occupational Standards Development

The first phase of the National Occupational Standards (NOS) development is focused in Barium Studies, Ultrasound, Computed Tomography and Plain Film. The Technical Working Groups (TWG,) formed from radiographers and radiologists from the development sites, have now met on several occasions. At the workshops the TWGs focussed on the NOS relating to acquiring images and interpreting images across plain film, fluoroscopy, Ultrasound, Computed Tomography and Magnetic Resonance Imaging.

The first National Reference Panel (NRP) met in December. This group is drawn from radiology departments across the UK and the key stakeholders in the project e.g. Society of Radiographers and Royal College of Radiologists etc. The remit of the group is to review the draft standards, in the light of their professional expertise and experience. Two NRPs are scheduled for early 2003.The NOS will be in draft form in April 2003.

Assistant Practitioners

There are forty six assistant practitioners undergoing training across the eight development sites. They have been recruited from a variety of backgrounds. Several were previously employed as radiographer helpers/aides. Others have been recruited from outside the NHS.

All sites see a role in departmental plain film radiography. Some will develop the Assistant Practitioners to work in chest clinics or dental departments; others will focus on developing staff in to a variety of plain film areas. These will be determined by the needs of the service.

Preceptorship

A preceptorship model has been developed following on from the model in the Radiotherapy project. This later model can be applied not only to newly qualified state registered radiographers but also to staff who have recently developed a new role such as plain film reporting. Within the Clinical Imaging Project, the development site leads have been asked to consider the preceptorship model in either or both of these areas.

Evaluation

A staff attitude survey, seeking the views of radiographers, student radiographers and radiologists was implemented within the development sites in November. The report on the survey is expected in February

Patient satisfaction surveys are underway within all sites to cover the service areas of the first phase of the project. All sites will seek the views of patients on the waiting times within the department and the patient's perception of those delivering the service. Other questions incorporated in the departmental surveys will be according to local needs.

Extended Role/Advanced Practice

Involvement in the project has seen an increase in the number of radiographers extending their roles and a notable increase in the number providing definitive reports in areas of Plain Film, Computed Tomography, Barium Enemas and Ultrasound

A workshop focussing on differentiating between extended and advanced practice is scheduled for the end of February. The workshop will be attended by radiographers, radiologists, service managers and HR representatives from the development sites.

Consultant Practice

Work continues in this area at each development site. Identifying a service need for a Consultant post within the Trust is core to progress in this tier. Mechanisms are being developed and refined by the Workforce Development Confederations and Strategic Health authorities to advise Trusts on job descriptions for Consultant posts in the Allied Health Professions, and provide guidance on applications. Progress continues and Consultant job descriptions should emerge from the ongoing discussions.

NATIONAL HEALTH SERVICE BREAST SCREENING PROGRAMME

Advanced Practice Standards

The advanced practice standards have now been field tested. A report has been prepared and forwarded to Skills for Health who will implement a UK wide consultation in May.

Further roll out

Staff continue to be developed into the new roles in many units within the NHSBSP

OVERARCHING PRINCIPLES

Much of the theoretical work to support this new model of clinical practice continues. Emphasis is being placed upon ensuring that there is a clear framework to align the occupational standards and the new roles, that each of the levels of practice are described and that the competence assessment mechanisms for all four tiers are designed. This will ensure that all outcomes required from the projects are reached in April 2003 to support new ways of working within radiotherapy, clinical imaging and breast screening.

Clinical Supervision

Clinical supervision is recognized as being essential for all clinical NHS staff throughout their careers. The projects teams have developed a model of clinical supervision which will be reviewed by key stakeholders and development sites.