Radiography Advanced Practice Accreditation, so what Radiotherapy NHS QIS Practice Development Netwo

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Radiography Advanced PracticeAccreditation, so
what?Radiotherapy NHS QIS Practice Development
Network Study Day, 21st March 2009
Maria Murray MPhil, FHEA, MSRP, CRadP,
DCR(T) Professional Officer (Scotland UK
Radiation Protection)
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The College of Radiographers (CoR)

• The College is a registered charity engaged in
  the promotion and
• development of the science and practice of
  radiography and radio-therapeutic and
• allied subjects
• promotes technical, professional and educational
  matters
• oversees administration of training
• is administered by an elected Council consisting
  of national members and regional representatives
• objectives concerned with
• education
• research
• Approval and accreditation of
• - Programmes
• - People
• - Places
• Promotion of profession - Nationally
• - Internationally

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Accreditation SCoR meaning

• A statement that
• an individual has been assessed as meeting
  stated criteria and judged as fit for practice
  and purpose, or
• an institution is recognised as delivering
  approved education programmes or courses, or
• a clinical department is an approved clinical
  placement provider, or
• a learning department or environment satisfies
  stated criteria that it supports individuals
  development and the professions career
  progression framework

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SCoR Accreditation mirrors SCoR Career
Progression Framework

• Defines radiographic teams by the skills and
  competencies that best deliver the patient or
  clients needs
• Maintains practice standards and develops the
  inherent potential of all staff involved in
  imaging and radiotherapy services
• Promotes new and extended roles, encourages
  lifelong learning, and offers challenging and
  rewarding careers
• Widens the routes of access to clinical careers
  and improves recruitment and retention of the
  radiographic workforce
• Accreditation for all 4 tiers
• NOTE SCoR do not give the title SCoR makes
  the statement about the level of professionalism
  and practice associated with advanced practice.

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The Advanced Practitioner in RadiographyCoR
definition

• those who have significantly developed their
  roles and who consequently have additional
  clinical expertise in a defined area of practice,
  accompanied by deep underpinning, evidence based
  knowledge related to that expertise.
• They make appropriate clinical decisions
  related to their enhanced level of practice,
  directly impacting on the patient care pathway
• Advanced Practitioners work in a specific area of
  expert clinical practice and are involved in
  delivering specialist care to patients.
• They also contribute to the evidence base and the
  development of other staff
• Act as an expert resource for their particular
  field of practice and demonstrate team leadership
• (Education and Professional Development (EPD),
  CoR, 2003
• EPD Moving Ahead, CoR, 2006)

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Another way of putting it..

• The advanced practitioner will have developed
  expertise to be able to function at the forefront
  of professional practice (clinical, research,
  service development / management, education).
• Detailed application of knowledge and
  understanding of how research informs practice is
  required. Advanced practitioners must be able to
  deal with complex issues and tackle and solve
  problems.
• They are required to demonstrate sound
  judgement, personal responsibility and initiative
  in complex and sometimes contentious situations.
  
• Advanced practitioners may also take the
  initiative in research and may lead research
  projects.
• (CoR, Learning Development Framework, 2007)

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Is accreditation necessary ?

• No, but.
• Yes, because
• Point of registration with HPC is the only
  national standard
• SCoR policy is that advanced practitioners are at
  M-level..
• Confusion between advanced practice extended
  role
• A range of qualifications held at M-level, some
  generic, some specialist, some outside of
  radiography ..
• Almost no effective succession planning an
  issue at advanced practice / consultant level
  where established posts may disappear if
  post-holder leaves
• No external reference / comparator for clinical
  governance purposes
• Long consultation within profession took place
  agreement about necessity but..complex issue

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Examples to ponder.

• A Therapeutic Radiographer undertakes IV
  injection course uses skill in department an
  Advanced Practitioner?
• Under AfC procedures - A LinAc Team Leader was
  entitled as an Advanced Practitioner to get as
  high a banding as possible an Advanced
  Practitioner?
• A Therapeutic Radiographer undertaking a scan
  reviewing the scan and deciding to treat by
  working to protocol an Advanced Practitioner?
• A Therapeutic Radiographer delivers on-treatment
  review with ability to prescribe supplementary
  medication an Advanced Practitioner?

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Why is accreditation important?(SCoR view)

• Provides clarity on nature of advanced practice
• Recognition of an individuals level and scope of
  practice
• Practice and underpinning education and
  development at the advanced practitioner level is
  so diverse
• Secures national consistency of standards
• Secures transferability of those standards across
  NHS other healthcare sectors
• Assures equity and transparency
• Provides recognition of compliance with
  professional governance standards
• Supports emerging advanced practitioners to
  facilitate succession planning within services
• And
• Cancer Peer Review Standards in England now
  say it is necessary for any Radiotherapy Advanced
  Practitioner!!
• Scottish Government may go that way verbally
  mentioned

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How do I achieve SCoR accreditation?

• Already have Practitioner level accreditation
• Accreditation at advanced or consultant level
  practice will be a voluntary process and a
  benefit of membership (through CPD Now upgraded
  platform)
• Apply at any time in your career
• Do not need managers support in application
• Criteria qualifications
• - demonstrate knowledge, skills and
  achievement at
  advanced level
• - portfolio production via
  CPD Now

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How do I achieve SCoR accreditation?Contd

• Provide (probably)
• Current self-certification on CPD Now showing
  development of advanced practice - evidence of
  learning reflection
• Personal statement of current advanced practice
  role signed off by an appropriate individual
• Reference from a person who can comment on
  individuals advanced role
• Optional provide testimonies
• Optional provide evidence of meeting relevant
  KSF dimensions
• Accreditation lasts for 2 years then require
  re-accreditation (like HPC timeline)
• Individual is expected to maintain that
  accreditation through ongoing CPD
• Some development work still needed pilot with
  consultants first

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What does accreditation mean to the
accredited?

• Peer recognition
• Practice evidenced and referenced against a set
  of agreed, broad criteria
• Public record for use by patients, public,
  employers and colleagues voluntary register
• Accreditation status is nationally recognised and
  readily transferable
• Help to provide assurance to a new employer of an
  individuals fitness for that level
• Professional kite mark!!
• Some may feel exposed.
• SCoR support for an advanced practice network
• Better pay!

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Radiotherapy challenges

• Radiotherapy delivery in the future
• Ever more highly technological (IMRT IGRT)
• Not just in large cancer centres just NHS (in
  Scotland)
• whole person management during treatment
• Treatment prescription
• dose modification during treatment
• common adult cancers, evidence based /
  protocols
• Cancer journey management
• Post radiotherapy initially but, in time, from
  early in the diagnostic phase
• Palliation integrated with terminal care support

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Three models of therapeutic radiographer led
expert practice (SCoR)

• Consultant and/or advanced practitioner roles
• .show the extensive contribution that some
  therapeutic radiographers already make to cancer
  care, as well as the potential to grow
  significantly.
• Site-specific expert practice practitioner
• Technical specialist expert practitioner
• Community liaison expert practitioner
• (Positioning Therapeutic Radiographers
  within Cancer Services Delivering Patient
  Centred Care, CoR, 2006)

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Radiography advancing practice

• Advanced Practitioners
• Many examples throughout UK
• Plain film reporting AE hot reporting
• GI imaging
• Site specific radiotherapy
• Counselling patient support
• Ultrasound imaging reporting
• CT head reporting stroke services
• Breast screening - biopsy

• Consultant Radiographers
• Scotland (5)
• 26 in total in UK (growing)
• D T
• Breast screening
• Ultrasound
• Plain film services
• Palliative cancer services
• Site specific cancer consultants leading a
  service
• Must involve 4 domains of practice
• Expert clinical practice (50 of time)
• Research
• Service development Policy
• Teaching

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Summary

• Accreditation of all levels of clinical practice
  is a must for the future
• Policy is in place
• Needs the support of the profession (take-up
  peer judgement process)
• Work yet to be done - professional culture
• - accreditation systems and processes
  - assessors!
• - what about those radiographers who
  have been specialists for a while - ?
  Fast-track route
• Accreditation to become a normal expectation by
  2012.
• Will become a regulatory requirement eventually

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Contact details (Scotland)

• Maria Murray
• Professional Officer (Scotland UK
  Radiation Protection)
• Mariam_at_sor.org
• 01236-736839 look who I
  saw on Google?