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Research finds consultant practitioners improve patient care at no additional cost

22 September 2010

When radiographer consultant practitioners are introduced into clinical imaging departments, more patients are seen and a higher-quality service is provided at the same cost, a study has found.

Drs Richard Price and Linda Miller researched two NHS trusts where the four-tier career progression framework – assistant practitioner, practitioner, advanced practitioner, and consultant – has been implemented. Departmental performance was found to have markedly improved following the filling of the consultant radiographer post.

Both sites – one in the north of England and one in the south – demonstrated an increase in throughput of patients, with the first reporting the number of examinations up from 125,304 to 147,886 over two years, an increase of 18 per cent. For fluoroscopy examinations, there was a 24.8 per cent increase in activity in the first year following the new structure. Lists were no longer cancelled because of holidays or sickness and, when required, capacity was increased. As a result, patient waiting times reduced substantially.

The service ‘gold standard’ of the double reporting of barium enemas and breast screening was achieved, and appointments were being offered to patients at a wider and more convenient range of times. The study also shows radiologists’ time is being used to greater effect and there is improved teamworking within the imaging service and across departments.

The participants reported no negative impacts of the new staffing framework, although staff did acknowledge that the introduction of the consultant practitioner post takes ‘a lot of time and effort’.

The study observed that:

‘The introduction and design of consultant practitioner posts remains an ad hoc process, driven either opportunistically, through highly talented individuals being in post and driving the development and approval process; or through service need, where the consultant grade is introduced in an attempt to resolve a service difficulty.’

The cost of introducing the consultant post was restricted to the individual’s salary, plus development and training. In both trusts, there was no additional funding to resource the post and start-up costs were found from the existing budgets.

‘With the current world shortage of radiographers and radiologists, and spiraling demand for clinical imaging services, the pressures on imaging departments are well recognised,’

commented Professor Audrey Paterson, the Director of Professional Policy at the Society and College of Radiographers, which commissioned the research.

‘As demand for imaging services continues to grow and budgets tighten, consultant practitioner appointments make sense, supporting effective service delivery, innovation and good team working’.

The report concludes by recommending a larger study which would investigate clinical imaging and radiotherapy linked with a cost/benefit analysis.

Further information

Consultant practitioners

There are currently 50-plus qualified radiographer consultant practitioners and more are being trained.

The study

The evidence was gathered by carrying out detailed, structured interviews with imaging staff including service managers, radiologists and the consultant radiographers.

The authors

Richard Price is Head of the School of Health and Emergency Professions at the University of Hertfordshire.

Linda Miller is a Senior Research Fellow at the Institute for Employment Studies.

For further information or comment, contact Professor Audrey Paterson on 020 7740 7208, Dr Richard Price on 01707 284962, or Linda Miller or call +44(0)20 7104 2076, or the IES press office, or call 01273 763414.