Research finds consultant practitioners improve patient care at no additional cost

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 site reporting the number of examinations up from 125,304 to 147,886 over two years, an increase of 18%. For fluoroscopy examinations, there was a 24.8% increase in activity in the first year following implementation of the new structure. Lists were no longer cancelled because of holidays or sickness and, if required, the capacity was increased. As a result, patient waiting times were substantially reduced.

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, radiologists, and oncologists, and spiraling demand for clinical imaging services, the pressures on imaging departments are well recognized,” said Professor Audrey Paterson, director of professional policy at the Society and College of Radiographers, which commissioned the research.

“As demand for imaging services grows and budgets tighten, consultant practitioner appointments have supported service delivery and innovation and freed up radiologist’s time.”

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