Radiography skill mix to increase imaging capacity and capability

Mid Yorkshire Hospitals is a large multicentre acute NHS trust.

It provides a full range of secondary care services, and tertiary burns and spinal injuries rehabilitation services.

The driver for change was increased imaging referrals, particularly in CT and MRI. This, combined with a drive to decrease waiting times, placed pressure on the radiology department. To develop new pathways and utilise roles effectively the trust needed a different way of staffing the department.

The trust had a history of role development. Alongside the introduction of assistant practitioners and expansion of advanced practice they developed a trainee consultant radiographer programme. The programme supported five aspiring AHP consultants. All have now become consultant radiographers. They work within a multidisciplinary team structure alongside radiologist colleagues.

The leadership of the consultant radiographers and the new workforce model has enabled pathway improvement. A key example is for emergency department (ED) referrals.

Consultant radiographer Lisa Field said:

“If a patient comes for an x-ray, they want the answer as quickly as possible. Advanced practice within reporting helps that.”

With agreement of the referring clinician if the x-ray is normal, patients receive information on the diagnosis and management of their soft tissue injuries. Patients are discharged home without re-attending the ED. This has released ED capacity by reducing patient interactions. It improves patient experience and reduces waiting times while maintaining continuity of care. Engagement of ED staff is key to maintaining confidence in service quality.

Bev Snaith, Clinical Professor of Radiology, University of Bradford and Mid Yorkshire Hospitals Trust, says:

“We can make a big difference in terms of patient pathways by putting a radiographer with advanced skills early in the patient journey and working with the multidisciplinary team”.

The radiographers can provide an immediate report to the clinicians and to patients.

To make this possible, the trust looked at the whole team. By embedding the assistant practitioner role, the team increased its capacity to take images. This released time for advanced and consultant practice.