Increasing capacity through new ways of working
8.32 These initiatives to increase the number of staff in training will ease the pressures on the cancer workforce and improve the service to patients. But further action is needed to tackle problems in specific areas, notably diagnostic and therapeutic radiography.
8.33 Increasingly the NHS is moving to new arrangements to make best use of the skills and abilities of its staff. New opportunities will empower staff who have previously only had supporting roles. They will promote autonomy and increase job satisfaction.
8.34 These new approaches are being applied to diagnostic radiography, for example, to increase the capacity of the breast screening programme.
Skill mix in diagnostic radiography
The NHS Breast Screening Programme (NHSBSP) has recently undertaken a review of its demand for both radiologists and radiographers. This work highlighted a growing shortage of both professions and has resulted in the piloting of a new and innovative model of service delivery. This model is based on a tiered structure that will introduce assistant practitioners in mammography who will be educated and trained to take mammograms as well as developing the mammography radiographer to an advanced level which will include the reading of mammograms. This inclusive team based approach will be piloted in four sites: Bolton, Bury and Rochdale; South Derbyshire; Norfolk and Norwich; and Warwickshire, Solihull and Coventry and will commence in October 2000. National occupational standards are being developed to support the education and training required to deliver this.
8.35 The difficulties faced by the NHSBSP in recruiting sufficient radiologists and radiographers are by no means unique to them. Cancer therapy centres are also experiencing similar difficulties. A skill mix pilot in therapeutic radiography based on the tiered structure identified above will commence in November 2000. This will look at the service from an inclusive team-based approach that places patients' needs firmly at its centre.
8.36 Similar opportunities will be developed in other areas of care. Discussions are taking place with the Royal College of Pathologists and the Institute of Biomedical Scientists to develop an advanced practioner grade in cervical cytopathology (see Chapter 3).
