100% questionnaire return rate.

Results, for RRs reporting PFI in NWE.

• 2/24 2 hospitals did not have RRs.
• 91% (20/22) hospitals had RRs, 333 by headcount/178 by WTE.
• 156 WTE RRs reporting PFI for 7.1m population (only 7.8 WTE hospital).
• 92% reported PFI only; 8% PFI + other modality/ies.
• Figure 2 shows variation of % RRs in AfC bandings. Expectedly, majority (89%) were Band 7 as been 'adopted' by hospitals as reasonable banding for scope of practice.
• Table 1, figure 3 show number by headcount reporting PFI in Musculo-skeletal (MSK), chest X-ray (CXR) and abdominal X-ray (AXR) examinations and % combinations of examination types reported. As expected, majority, 56% (99/178) were reporting PFI MSK since it was the original area RRs developed. 10% (18/178) were reporting CXR; 1% (1/178) reporting AXR only.
• Increase of 278% in numbers reporting PFI CXR between 1997>2017; linked to substantive radiologist support in specific areas of NW England for CXR RRs.
• Only 76% (mean, range 63-100%) had a job plan, 24% = no job plan (figure 4).
• 63% (mean, range 50%-75%) specified an expected number of reports/reporting session. Table 2 shows variation in minimum and maximum number of reports expected/session.  

  - 110 exceeds the RCR 2022 guidance for PFI reporting at 80 reports/session [2], which is concerning if RRs are expected to report more reports/session than radiologist colleagues.

• 81% of the total images reported by RRs were PFI in census period. No double reporting undertaken.
• 1,168,333 PFI examinations reported by RRs (01/04/2022>31/03/2023); only 23% total reports (all workforce/modalities).

• No standard minimum qualification required for independent reporting in UK. Anecdotally, a postgraduate certificate adopted. Table 3 shows the range/costs of qualifications achieved.

• In UK, training programmes for RRs are offered by universities requiring rigorous approval. Initial assessment of competence is essential, with emphasis on reflective practice focused on roles/boundaries and patient safety. Learners are required to have mentorship by a consultant radiologist(s) [5,6]. 

• Limited number of universities offering such courses in UK; RRs have travel long distances to train with additional costs/absence from work.

• Figure 5 shows the trend in training for PFI in NW England. There has been a general uptick since 2018-2023, with an erratic/inconsistent pattern of training. This does not allow effective workforce planning and the possible contribution that RRs could make to report output productivity in departments.

• Figure 6 shows key themes from qualitative thematic analysis.