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Challenges and opportunities

20 March, 2017
Jonathan McConnell
Jonathan McConnell, consultant reporting radiographer

Director of professional policy, Charlotte Beardmore, welcomed delegates to the College of Radiographer’s Heads of Education Meeting recently, where speakers discussed a variety of topics including the implications of the change in student funding and the introduction of apprenticeships, as well as challenges in mammography education and recruitment, advanced clinical practice and what working as a clinical academic actually means in practice.

Degree apprenticeships and beyond
Fleur Nielsen, head of policy, Council of Deans of Health gave the audience an overview of apprenticeships from the Council of Deans’ point of view and advised all delegates to make the most of the money offered by the annual £200million NHS levy, available from April, and which translates into around 28,000 apprenticeships across the NHS.

"People who want to become healthcare professionals have a clear choice," she said. "University and student loan, or ‘earn as you learn’.

"The apprenticeship agenda will be employer-led," she added, "So the profession must consider whether employers want to pay for what students want to do and whether the students themselves will want to do what employers are prepared to pay for.

"Every large employer is going to have to decide where they are going to spend the money they get" she added, "And that will vary greatly from trust to trust.

"In addition, Health Education England (HEE) has a list of ‘priority apprenticeships’ for development and the HEIs must work with employers, know the process, do the math and collaborate with each other, to make sure there is enough money for radiographer training both pre- and post-registration."

Advanced clinical practice and the relationship with education
Shelagh Morris, the deputy chief allied health professions officer explained how the College and NHS England have been working together to produce a working definition of advanced clinical practice, which has now been agreed.

She explained that the definition is essential, not only to help the development of the profession, but needed to further the ongoing battle to achieve independent prescribing for diagnostic radiographers.

"The definition is just a useful starting point," she said. "We need to find out how it relates to service delivery nationally.

"Plus," she asked, "Once you have defined advanced practice, what other definitions are needed, such as for extended or specialist roles?"

Shelagh also discussed the Five Year Forward View and how more responsive and accessible healthcare would be delivered nationally if successful, easing the pressure on hospitals and benefiting patients.

"There will be new ways of working and many opportunities to maximise the potential in the workforce we have already," she said.

Shelagh also explained how the College and NHS England have been working together through an HEE programme spanning across AHPs, nursing and other professions.

If there is interest from employers in developing an advanced clinical practice apprenticeship standard, please contact Charlotte Beardmore.

Clinical academics: 
The best of both worlds
Dr Jonathan McConnell, consultant reporting radiographer at NHS Greater Glasgow and Clyde, Queen Elizabeth University Hospital, began by showing the audience a slide which defined both an ‘academic’ and a ‘clinician’. He asked delegates if they thought a radiographer could be a good clinician and an academic at the same time, and if they agreed that the best clinician would also be an academic beyond professional development demands.

As a clinical academic, Jonathan described himself as a ‘big fat sandwich!' - the bread being clinical and the filling being academia, with all aspects of the sandwich complementing each other and academia sticking the whole thing together.

Jonathan also discussed the pathways that clinical academics take through the healthcare system and the crossover between clinical and academic roles. "International collaboration is essential," he said, "And multi-disciplinary partnerships are key. The cross-fertilisation of ideas across the professions is a must to create a breeding ground for new ideas.

"The advantages to being a clinical academic include making the most of every opportunity, while understanding that the job will never be complete and learning to delegate."

Symptomatic and screening breast imaging - service needs, challenges and opportunities
Kathryn Taylor, consultant radiographer, Cambridge University Hospitals NHS Foundation Trust began by emphasising the need to train radiographers who are ‘fit for practice’ in a service where cancer diagnoses are increasing at a high rate, along with growing GP referrals and pressure from the ‘worried well’.

All this while coping with a crisis in the workforce and difficulty in attracting people to mammography, due to poor perceptions of it by both students and practitioners.

To find out what was happening nationally, Kathryn worked with Dr Ruth Strudwick of Suffolk University to survey HEIs across the UK and find out how much time was spent teaching students about breast imaging. The results were extremely varied and training very often depended on whether HEIs themselves had people on staff with mammography experience.

Discussions with delegates included whether radiographers should be able to apply for a first post in mammography, whether students should be targeted specifically to work in this area, including male students, and how much time should be allocated within any given curriculum for study of this imaging modality.

Concluding, Kathryn said breast imaging has an evolving workforce and environment and that people must be given the message that mammography is valuable.

Julie Nightingale, professor of diagnostic imaging education and director of radiography and occupational therapy at the University of Salford, explained how her HEI delivers a range of PGT breast imaging and that a major research theme there is mammography.

Julie is also an HEI representative on a PHE breast imaging workforce and education taskforce.She warned that the workforce problem is real and significant in terms of the growing workload and the number of people who are due to retire, with a corresponding loss of many skills.

A focus on undergraduates is only part of it, she told delegates, there is a need to look at all areas of the profession. "Kathryn’s study," Julie said, "Has suggested minimal engagement with mammography in some areas and a flexible HEI curriculum will be needed. No other specialty concentrates on one anatomical area only so there may be an argument for direct entry, and there is potential in the apprenticeships route."

Julie left delegates with an interesting question to ponder: is there an argument for direct entry, or is the current model more beneficial?

A manager’s perspective of facilitating clinical research
Ben Roe, deputy chief operating officer at Taunton and Somerset NHS Foundation Trust was "trying to stand up for the humble manager!"

He talked about organisation and team culture and how that can impact on research both positively and negatively. "There are big issues in terms of budgets, resources, increased demands, activity growth, an ageing population and the lack of social care, which might preclude a health research culture," he said.

"But this does not have to be the case if it is thought out and planned properly.

"There’s no money, so where does research fit into that? Will it have to wait? Not necessarily, if we use research to drive us where we want to be. We must understand the challenges out there and use research to drive change."

Ben continued: "To be successful in retaining a health research culture we must capture the full value of research in a business case and emphasise that research is at the heart of positive NHS changes. Research needs to be considerate of operational challenges, but if we use it to align to NHS aims then it becomes an enabler."

The need for radiographer engagement in public health research
Laura Pattinson, senior lecturer, Sheffield Hallam University, asked: "What is the answer to fixing the health service? Changing our way of thinking when we fix people?

"Prevention rather than fixing is going to take a long time and increasingly public health leaders are recognising the potential of AHPs.

"Recognising the impact of ‘making every contact count’, understanding the radiographer role in public health research and where we fit in will be crucial," Laura said.

"Ensuring that we are giving radiographers the tools and skills to have public health conversations with patients will be key. Many radiographers are already having these conversations and lots of us want to do more," she added.

"Research has proved that the majority of radiographers both therapeutic and diagnostic, agree that PH is at the core component of their professional role - we need to get out there and show what we are doing," Laura said.

Research partnerships with industry: An effective strategy to establish a research programme
Luca Cozzi, Adj Professor at Humanitas University, Milan, explained to delegates how partnerships with industry have worked for him and his organisation, focusing primarily on the 25-plus years’ association with SCoR industry partner, Varian.

"We must find new ways of encouraging industry to spend money," he said, "By showing them not only the benefits for us and our patients, but the benefits to the company as well. It has to be tangible and milestones have to be well defined.

"If everything is clear from the beginning then the partnership will be successful; communication and transparency are key."

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