Published: 22/07/2004, Volume II4, No. 5915 Page 7

It is better for patients and offers enhanced job satisfaction for staff.They are the two overall main benefits of the Skills for Health competence framework and the new roles it has underpinned, according to Derby breast screening service unit manager Barbara Young.

The service has created the roles of assistant practitioner (training people with no experience in radiography) and advanced practitioner (enabling existing radiographers to learn new techniques and practice more sophisticated procedures).

The outcome is that clinics run to time and patients are spared a second appointment for certain procedures and an early morning arrival for a different pre-surgery procedure, says Ms Young, a former superintendent radiographer.

'Radiologists are freed up for the increasing workload of more complex procedures, ' she says.'It also offers radiographers the chance to enhance their roles, which in turn improves recruitment and retention of staff.'

The competence framework was used alongside an established NVQ level 3 to create a new unit or module to assess the skills required of the assistant practitioners.

'We had never been involved in training before, ' says Ms Young.'We needed solid guidelines to help us.'

Two fully qualified assistant practitioners now take mammograms in the permanent and mobile breast screening units.Two other members of staff, currently employed as x-ray helpers, are undergoing vocational training.

The service includes four advanced practitioners who between them can read screening images, undertake stereo-guided core biopsies (using x-rays for guidance to a point in the breast from which tissue needs to be removed) and inserting needle markers under x-ray guidance prior to surgery.

'Some of the pilot sites chose to train one radiographer in all the advanced skills, 'explains Ms Young.'But we decided against the 'all our eggs in one basket'approach. Instead we identified the skills that were needed and asked radiographers to apply to be trained in one of them.'