‘Are we going around in circles trying to raise awareness of the profession?’

It was 50 years ago this September I left home to begin my training as a ‘radiotherapy radiographer’, so having read a recent article by Universities UK, I started to reflect on my own journey from careers advice to all that I have achieved since that point. I feel privileged to have had two careers in radiotherapy since I gained my DCR(T) in 1977. From that point until 2006 I worked in a number of clinical departments in the UK and abroad. And having enjoyed the mix of being involved in clinical developments, leadership and practice education I took my first steps into a full-time academic role by applying for a senior lecturer position in 2005. Over the years both roles have provided me with many opportunities to travel the world, to speak at international conferences and in 2020 to be awarded my PhD, an aspiration that was never on my radar back in 1977.

During the compilation of this retrospective I took the opportunity to re-read, among other things, Michael Jordan’s own retrospective to mark the 75th anniversary of the Society of Radiographers in 1995. Many of the things he wrote about then are still extant today, but in a slightly different guise. So I was saddened to read recently in the Synergy News Weekly email bulletin of his death. In looking back over my own career I have taken three related themes to reflect on what has changed (or not) over the years.

1. Careers advice and recruitment

From my early teenage years I was fairly certain that I wanted a hospital career. But when I relayed this to my careers adviser at my first interview the response was rather surprising. It went something like: ‘I don’t know anything about that apart from physiotherapy and you’ll never get into that.’ So having been sent away with a health careers magazine I found an advert for radiography training and was fixated. But having been told that my local hospital didn’t train male students my dreams were temporarily thwarted. That was until a visit to the next nearest School of Radiography and my first sight of a radiotherapy department. Well and truly hooked this time.

So given my early experiences I shouldn’t have been that surprised to see the results of the Censuswide survey of 5,259 people aged 16-26, conducted for Universities UK in December 2023. While the headline message that 73 per cent were considering or had considered a career in healthcare was encouraging, other findings were less so. Given the wealth of information now available online it was disappointing to see that 12.5 per cent of respondents were unfamiliar with the variety of career options within the NHS beyond becoming a nurse or doctor, and just 10 per cent indicated an interest in radiography. But perhaps I shouldn’t have been that surprised given that the audience for one of my university presentations to local careers advisers a few years ago attracted an audience of just four! As I recall, one attended because she had a friend who had received radiotherapy previously, one came along because her friend and colleague had signed up and another because she couldn’t think of another presentation to go to. When I related this to our outreach liaison lead, the response was that, anecdotally, most advisers tended to go to presentations for the high-demand courses so that they could get advice on what the ideal personal statement should look like.

As the UK University’s article confirmed, there are still considerable problems around the perceptions of training pathways and roles. So why does this happen? Why is the awareness of radiography so low? And why does it appear to have remained relatively unchanged after all these years? Maybe it’s all about the profile.

2. So what’s in a name?

Is there something wrong with our profile that leads to poor perception? To explore this I would like to return to the emphasis on my training in radiotherapy mentioned in my opening observations. I have always seen myself as a radiographer who has specialised in radiotherapy and that is how I introduce myself to others. You might have realised from this that I am not a fan of the HCPC [Health and Care Professions Council] protected title of Therapeutic Radiographer. While I recognise that many might find this contentious, in my mind the title and its associated description that we plan and deliver treatment using radiation doesn’t really do justice to what we actually do day to day. The description of the Diagnostic Radiographer role in producing and interpreting high-quality images of the body to diagnose injuries and diseases is only marginally better.

As radiographers we are at the heart of diagnosis, treatment and follow-up of cancer and other conditions, so is it time to open up the conversation around how we view ourselves and promote the many positives of our professions to others so that we increase the awareness beyond that 10 per cent?

3. Redefining working models

Returning to the UK Universities survey, it was interesting to see that when asked ‘to what extent would long hours put you off embarking on a career in healthcare?’ the response was 75 per cent, while 90 per cent identified low pay as a factor. Other factors related to lack of flexibility and work-life balance (82 per cent) and pressure and stress (79 per cent). So I am left wondering why the language we use is still related to out of hours or non-core hours working and 12-hour extended days? We really don’t do ourselves any favours, do we?

The realm of workforce planning and modelling and a sustainable long-term plan, or the lack of it, is an area where we do appear to have gone around in circles and yet never found the answer! Michael Jordan referred to shortages of radiographers during the 1940s, 50s and 70s, a trend that has continued to this day. I hope that the aspirations of the NHS Long Term Workforce Plan will remedy that. But it won’t be a quick fix given the challenging funding demands and decisions that the government will need to balance. This leaves me wondering what the future might hold for the next generations of medical imaging and radiotherapy radiographers given the negative perceptions of a career in healthcare that were demonstrated in the results of the UK Universities survey.

But that future is in our hands and we must take this opportunity to seize it. It is clear to me that even though we have a new government, the neglect of the last decade or so will mean that there will be little additional funding in the short term. But we can still have a major influence in redefining and streamlining patient pathways and drive down waiting times by using the combined skills and talents of radiographers, radiologists and oncologists.

We need to accentuate the positives of being a radiographer and all the opportunities that enhanced, advanced and consultant-level practice will deliver for our patients. I believe that we can do this by redefining working models and reducing isolationism and protectionism by working more collaboratively and using our skills in collaboration with the RCR to streamline patient pathways.

More about Andrew Williams

Andrew Williams PhD retired as a senior lecturer in August 2023 and has recently been appointed as a patient safety partner volunteer with Portsmouth Hospitals University NHS Trust.

While there are challenges, there is fantastic work taking place to focus on raising the profile of the Therapeutic Radiographer, and the profession itself is doing excellent work in demonstrating this through significant numbers of radiographers now engaged in research, growing the evidence base for the profession and importantly influencing practice for patients. We’re also committed to raising the profile through all of the work of the organisation, from careers campaigns to ensuring radiographers have a voice at the table and are able to evidence the practice and impact radiographers do have and can have on future policies.

Although we know that more always needs to be done, our national collaborations as a profession have really grown since the national work associated with the government’s imaging and cancer strategies. For example, the work of the National Radiography Advisory and Implementation groups, and now our work with the UK Radiotherapy Board and the UK Imaging Board, are both good examples of collaboration between the three colleges – the Royal College of Radiologists, the Institute of Physics and Engineering in Medicine and the SoR | CoR. We agree that collaboration is essential to consider how we can transform care for patients to deliver improved outcomes in safe, effective ways and supported by an evidence base. This work leads to policy development helping to ensure that the work of the profession is visible and is recognised.

The title of Therapeutic Radiographer has been the subject of discussion over many years within the Society of Radiographers, and the choice of title is determined by the regulator and therefore outside the remit of the Society and College of Radiographers; however, there have been wider discussions with the profession and the regulator over the years. A change in registered title takes time, and may not be advantageous when we are now making such progress in ensuring that the distinct roles of Diagnostic Radiographer and Therapeutic Radiographers are now understood and reflected in policies published by government and within careers promotional material.

This is positive work but alongside this we need the profession to also play their part, as every day you are interacting with large numbers of patients across imaging and radiotherapy services. As good practice we continue to campaign that all professionals always introduce themselves using their name and job title – ‘Hello my name is X and I am a Therapeutic Radiographer’, for example – and we continue to encourage radiographers to embrace this within their daily practice with every patient and at every interaction. This one action has significant potential to raise the profile of our wonderful radiography profession.

Image credit: Getty Images

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