Radiography in Europe

The European Federation of Radiographer Societies (EFRS) celebrates its 15th anniversary this year, having been founded on 17 November 2008 by 29 professional societies that represent radiographers across the geographic continent of Europe¹. The key mission of the EFRS is to represent, promote and develop the profession of radiography in Europe¹.

Through its member organisations, the EFRS represents more than 100,000 radiographers and 8,000 radiography students across Europe². Today, the EFRS has grown in strength to represent 41 national societies and 62 affiliate members (radiography educators).

In the UK, the Society and College of Radiographers (SoR | CoR) is a founder national society member of the EFRS. In its work, the EFRS is proud to represent radiographers working in all radiography sub-specialties, including medical imaging, nuclear medicine and radiotherapy.

The role of the EFRS, as with any professional body, is vast and dynamic. The spectrum of activities is growing and needs to be responsive to the demands of the day, for example, the Covid-19 pandemic. Within its work, led by an Executive Board, the EFRS frequently undertakes actions to influence European policies and negotiate with relevant European bodies, for example, the International Atomic Energy Association. Within its wider work, the EFRS has long argued for an internationally accepted definition of a radiographer (Table 1) and that the term “radiographer” should be universally applied across the continent of Europe³.

Table 1

The EFRS has also sought to stimulate inter-state professional cooperation in scientific, technical, ethical, organisational and labour areas throughout Europe. The EFRS continues to achieve this in several ways, for example, being a shareholder in the European Institute for Biomedical Imaging Research (EIBIR)⁴.

The EIBIR provides research support (project management, grant writing and dissemination and communication) and the EFRS has partnered or suggested radiography collaborators for several large multicentre/multinational research projects⁵ (Table 2).

Table 2

For many years, the EFRS has been key in benchmarking radiographic practices and identifying changes. Since the formation of the EFRS, the federation has conducted many surveys across pertinent topics. One of the most recent surveys was an evaluation of ultrasound practice across Europe⁶.

Patient safety has always remained of prime importance to the EFRS. Patient safety, including radiation protection, is a core activity and examples of the federation’s work in this area include an evaluation of patient safety content within pre-registration training curricula⁷. The EFRS, in conjunction with the European Society of Radiology (ESR), has also published a joint statement on patient safety in medicine⁸.

Developing and defining standards of professional practice is a function of both national and international societies. Like the SoR | CoR, the EFRS has developed, based on work groups established from its Expert Network, documents to promote standards of professional practice. One of the first such documents was the Radiographer Code of Ethics⁹ , published by the EFRS in 2010.

The EFRS seeks to continually develop and promote evidence-based-practice for radiographers across Europe. This aim is met using several methods, such as including European radiographers in the planning of the European Congress of Radiology (ECR). The ECR is the official annual meeting of the EFRS and takes place every March in Vienna, Austria. 

UK radiographers frequently contribute to sessions, based on their expertise in clinical practice (Figure 1) or radiographic research. The theme for the next (2024) ECR is Next Generation Radiology (Figure 2). Further EFRS initiatives around the development of evidence-based practice for radiographers include promoting the international peer-reviewed journal Radiography, which is owned by the SoR | CoR.

Figure 1

Figure 1. Helen Bucknall, advanced practice radiographer from St George’s Hospital, London, presents on her scope of practice in interventional radiology as part of the Cube Programme at ECR 2023.

Figure 2

Figure 2. A poster advertising ECR 2024, Next Generation Radiology.

In education, the EFRS continues to promote the harmonisation of pre-registration and postgraduate education across Europe. The harmonisation of curricula, at a European level, has many advantages and has been actively promoted nationally and internationally. In supporting the concept of harmonisation, the EFRS, together with its Expert Network, has developed benchmark documents for European Qualifications Framework (EQF) levels 6 (bachelor’s), 7 (master’s) and 8 (doctoral studies – to be published in October). In the search for curricular harmonisation and the development of similar standards of practice for radiographers across Europe, the EFRS continues to conduct periodic surveys of its membership. 

The EFRS also has a function in identifying collaborative opportunities with other organisations that have similar objectives. In the UK, this could be partnerships with The Royal College of Radiologists or the Institute for Physics in Medicine. In doing so, the EFRS Executive Board has developed formal relationships at a European level with the ESR, the International Society of Radiographers and Radiologic Technologists and the European Society of Medical Imaging Informatics (EuSoMII) (Figure 3), among others. A work package has been completed on the Future of the Radiography Profession (Radiography Research, Education and Practice – RERP)¹⁰ and this was led by Dr Jonathan McNulty (EFRS Past-President). The RERP project was multidisciplinary and sought to provide direction on the future of the radiography profession, which would be useful to national societies, educators and all involved in radiography.

Figure 3

Figure 3. Meeting between the Executive Boards of the EFRS and EuSoMII at ECR 2023.

This year marks the 15th anniversary of the EFRS. During this time, the federation has grown considerably, both in physical size but also in the spectrum of activities it undertakes. Success is not automatic or guaranteed, and it has depended on the hard work and dedication of many individuals, too many to list in full. 

However, it is important to note the contributions of several key European radiographers: Dorien Pronk-Larive, Graciano Paulo, Jonathan McNulty and Charlotte Beardmore. These individuals have made enormous contributions to the development of our profession across Europe. In terms of sustained impact, the EFRS continues to lead on the advancement of the radiography profession across Europe. Some highlights to consider include the webinar series, which is free for all to access (available at https://efrs.eu/webinars), the White Paper on the Future of the Profession¹⁰ and the Radiographers’ Programme at ECR 2024. 

The EFRS will not stop in its mission to pursue the development of the radiographic profession at a European level, which will continue to provide opportunities for shaping UK practice. In finishing, I would like to leave you with a quote: “Together, anything is possible.”

Dr Andrew England is Senior Lecturer in Medical Imaging and Radiation Therapy at University College Cork, Ireland and President of the European Federation of Radiographer Societies.

References

1. European Federation of Radiographer Societies (EFRS). EFRS Constitution. 2008. Available at https://api.efrs.eu/api/assets/publications/46. Accessed 5 March 2023. 

2. EFRS. About us – who are we? Available at https://www.efrs.eu/about. Accessed 5 March 2023.

3. EFRS. Definition of a radiographer. 2021. Available at https://api.efrs.eu/api/assets/posts/93. Accessed 5 March 2023. 

4. European Institute of Biomedical Imaging Research (EIBIR). Shareholders. Available at https://www.eibir.org/shareholders/. Accessed 5 March 2023.

5. EIBIR. Our projects. Available at https://www.eibir.org/projects/. Accessed 5 March 2023.

6. Harrison G, Kraus B, Martins Dos Santos R, Noij-Rijkes S and Pedersen MRV. The role of radiographers in ultrasound: a survey of the national societies within the European Federation of Radiographer Societies. Radiography. 2021; 27(3): 761-767. 

7. England A, Azevedo KB, Bezzina P, Henner A and McNulty JP. Patient safety in undergraduate radiography curricula: a European perspective. Radiography. 2016. Special Issue: Patient Safety. 2016; 22: S12-S19. 

8. European Society of Radiology and EFRS. Patient safety in medical imaging: a joint paper of the European Society of Radiology and the European Federation of Radiographer Societies. Insights Imaging. Apr 05 2019; 10(1): 45. doi:10.1186/s13244-019-0721-y.

9. EFRS. Code of Ethics. 2010. Available at https://api.efrs.eu/api/assets/posts/209. Accessed 5 March 2023. 

10. EFRS. EFRS White Paper on the Future of the Profession Radiographer Education Research and Practice (RERP): 2021-2031. Available at https://api.efrs.eu/api/assets/posts/275. Accessed 5March 2023.