28Radiography: Lookingto the next decadeMaryann Hardy2010<strong>IMAGING</strong> &<strong>ONCOLOGY</strong>
That the future is unknown is an axiom. Butone thing is certain: The future <strong>of</strong> imagingwill demand the radiography pr<strong>of</strong>essionand its educators to think innovatively, andopen its mind to new ways <strong>of</strong> working. Thismay be a challenge, but the rewards willbe greater career advancement, higher jobsatisfaction and, <strong>of</strong> course, high quality careand imaging services for patients.A decade <strong>of</strong> change: 2000-2009In the 2005 issue <strong>of</strong> ‘Imaging & Oncology’, Adrian Thomas dared to take a look into thefuture and debate the ‘Role <strong>of</strong> the Radiologist in 2010’ 1 . He concluded that imaging willbe increasingly central to clinical medicine and argued that attachment to structures(and practices) <strong>of</strong> the past was unnecessarily limiting. He encouraged radiologiststo have open minds and support innovative solutions to ensure that the increasingdemands for medical imaging are met. But what about the role <strong>of</strong> the radiographer?This article discusses the challenges that could be waiting for the radiographypr<strong>of</strong>ession in the next decade and explores their implications for service delivery.The last decade has, without doubt, been a period <strong>of</strong> immense change for radiographersin the UK. Agenda for Change (AfC) 2 and the implementation <strong>of</strong> the four tier structure,now referred to as the Career Progression Framework 3 promised to recognise andappropriately reward radiographers for new and existing roles and responsibilities, takingaccount <strong>of</strong> additional knowledge and skills acquired to meet new role expectations.However, despite the publication <strong>of</strong> AfC banding criteria and sample job descriptions,the mapping <strong>of</strong> existing radiographer grades to new AfC bands was not consistentlyapplied across Trusts, particularly in relation to Bands 6 and 7, and created muchpr<strong>of</strong>essional anxiety nationally. In addition, while many Trusts have been happy toinvest in assistant practitioner roles to enhance the imaging workforce (1st tier), fewhave appointed radiographers to consultant positions (4th tier) 4 .Despite the grading inconsistencies, radiographer roles have continued to expandrapidly within all aspects <strong>of</strong> medical imaging and across modalities. Some authorshave argued that this rapid expansion in roles and responsibilities was a direct result <strong>of</strong>the shortage <strong>of</strong> radiologists experienced in the early 2000s.However, the Healthcare Commission Report An Improving Picture? (2007) 5 disagreeswith this, as radiographer role extension has been greatest in larger departmentswhere there are relatively more radiologists and fewer radiographers, and not indepartments where radiologist numbers are small in relation to radiographers.Consequently, while radiologist shortages may have been a contributory factor, itwould appear that increasing sub-specialisation within radiology 6 and changinggovernment and public expectations <strong>of</strong> high-quality health service provision were thereal driving force for change.Indeed, the government publication A health service for all talent: Developing theNHS workforce (2000) 7 encouraged the development <strong>of</strong> new skills and the acceptance<strong>of</strong> new roles that operated outside traditional boundaries thereby “maximising thecontribution <strong>of</strong> all staff to patient care and doing away with barriers which say onlydoctors or nurses can provide particular types <strong>of</strong> care”. As a result, the last decade hasseen radiographers embrace the opportunities available to them and adopt new ways<strong>of</strong> working, many <strong>of</strong> which have been evaluated, audited, researched and published inorder to provide a clear evidence base for practice developments 8-16 .Yet, despite all the external drivers for change and increasing research evidence basedemonstrating the success <strong>of</strong> new radiographer roles, tension still exists within someimaging departments, and across the radiology-radiography pr<strong>of</strong>essions as a whole, asto whether limits should now be placed on radiographer role development 17 . Nowhereis this more hotly debated than in relation to radiographer image reporting.Image reporting: A synergy <strong>of</strong> pr<strong>of</strong>essional talentsDiagnostic imaging services rely on the synergy <strong>of</strong> talents <strong>of</strong> two complementarypr<strong>of</strong>essions – radiology and radiography. While the boundaries between thesepr<strong>of</strong>essions are blurring in order to optimise service delivery and meet servicedemands, this has created some pr<strong>of</strong>essional anxiety as to who should undertake whatrole. Government documents would lead us to believe that pr<strong>of</strong>essional backgroundis <strong>of</strong> little consequence as long as the role is undertaken by a suitably competent andqualifi ed health pr<strong>of</strong>essional at an appropriate time in the patient pathway. However,while radiology colleagues generally remain supportive <strong>of</strong> radiographer role extension,there exists some disgruntlement with regard to the extent and range <strong>of</strong> radiographerreporting.The formal reporting <strong>of</strong> radiographs by radiographers in the UK began around 15years ago and on the whole is considered to be a huge success. While this time wassynonymous with a shortage <strong>of</strong> radiologists, we have already noted that this was not thesole driver for the onset <strong>of</strong> radiographer role expansion or introduction <strong>of</strong> radiographerreporting services. Consequently, the predicted increase in the number <strong>of</strong> radiologistsemployed within the NHS over the next decade should not restrict the continueddevelopment <strong>of</strong> radiographer reporting services, particularly when we consider that thepredicted demand for consultant radiologists may not reflect actual service demand dueto reasons <strong>of</strong> affordability, technology and impact <strong>of</strong> changes in skills mix 18 .292010<strong>IMAGING</strong> &<strong>ONCOLOGY</strong>
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