The role, scope and utilisation of the imaging support workforce in England: a qualitative framework analysis

Introduction

Effective utilisation of the unregistered support workforce is essential to counter a well-documented imaging workforce crisis, yet it is unclear how imaging departments deploy their support staff. As part of a wider explanatory mixed methods study, this research explored models of support workforce deployment across England, identifying the factors which may encourage or inhibit implementation of these models.

Methods

Imaging support workforce deployment at regional and place (NHS Trust) level was investigated using Framework Analysis to combine interviews with Imaging Network representatives and Radiology Service Managers (RSMs) alongside workforce establishment data. Purposefully selected imaging services represented varying regions, sizes and support workforce proportions.

Results

Forty-two interviews represented 18 (81.8%) Imaging Networks, and 24 imaging services (17.5% eligible NHS Trusts). Additional workforce data was supplied by 18 RSMs. Three themes (Deployment Rationale and Decision-Making, Innovations in Support Workforce Activities, Stability and Sustainability of the Support Workforce) demonstrated the pivotal role enacted by the imaging support workforce. Extensive variations in role utilisation, deployment, scope of practice and pay rates were recognised, alongside inconsistently implemented Assistant Practitioner roles with a limited scope of deployment.

Conclusion

This is the first research to explore support workforce deployment at regional and place levels. The imaging support workforce in England is operationally managed rather than strategically planned, exposing services to local variation with deployment models developing in isolation. This pivotal workforce can support greater service capacity development but requires a more consistent approach to utilisation and deployment.

Implications for practice

National alignment of roles and competencies is urgently required. At regional and place levels, deployment models should be interrogated as a first step towards longer term workforce planning for this essential, yet under-utilised, workforce.