Supporting students

The number of radiographers in the NHS is dwindling. According to the latest figures gathered by the Society of Radiographers, 94 per cent of members said there was a vacant post for a diagnostic radiographer in their department, while the UK’s vacancy rate for radiographers sits at 12.7 per cent. 

The government has repeatedly vowed to tackle the ever-growing NHS waiting lists but it’s clear that this goal is impossible to meet without immediate action to address the workforce shortage in radiography and the wider health service.

But what is the most effective way to address staff shortages? One area that could offer immediate benefits is tackling student attrition. 

While there is certainly a shortage of people choosing to study radiography (with most universities reporting that there were not enough students to fill places on diagnostic radiography courses in 2021-22), the student dropout rates are a major cause for concern. 

According to SoR figures, more than one in five (21 per cent) of radiography students dropped out of their courses in 2021-22, flagging an area that requires urgent attention to help combat the staff shortages. 

Offering some background on the student attrition problem, the SoR’s students and new professionals officer Nichola Jamison said: “While a concerning gap remains in the radiography workforce, it is vital that we continue to maintain a flow of competent and confident newly qualified radiographers into the profession. 

“Attrition not only reduces these numbers and slows growth, but the factors and challenges faced by those who choose to remain in the profession can have a significant impact on progress as these early career staff work to build confidence and resilience in their formative professional years.” 

To find out the reasons behind student attrition rates, who better to ask than the students themselves?

The biggest factors

Bekki Pobgee is a third-year diagnostic radiography and medical imaging student at the University of Portsmouth. 

Bekki, a mature student, has worked in the NHS for a decade, and has been an imaging support worker for the past seven years. Finding her love for radiography, particularly the patient contact and variety of the profession, she decided to study to become a radiographer. 

But the financial pressures on a mature student make completing a radiography course an even more demanding challenge, and Bekki has almost been forced to give up on her dream multiple times. “I’m a mature student and do not receive any financial help from family”, she said. 

“So I’ve been putting myself through university financially. It’s extremely difficult, especially trying to work bank shifts around placement.”

Travel costs to placement and to the university campus are the biggest concern, as Bekki is not eligible to claim any reimbursement. Taking the train costs Bekki £248 for each placement, and she is not able to stay near placement sites because again she is not eligible to reimburse the cost. 

She added: “A few times now I’ve almost left the course as a direct result of this. There’s times it’s even been a struggle to afford to get to campus. First year I coped okay, but since the cost of living crisis, it’s become very obvious that maybe AHP courses and their costs are not for those of us from low-income backgrounds. 

I’ve even had to approach the SoR Benevolent Fund at one point of desperation. NHS staffing, recruitment, training and retention levels desperately need improving, but something really needs to be done to help students be able to cope financially. Honestly, if I’d known this was going to happen, I wouldn’t have applied to study.” 

To get a wider look at the issues facing students, Synergy recently joined a virtual meeting of the SoR’s Student Representative Forum, led by Nichola. During the meeting, which involved student representatives from a variety of backgrounds, including mature students and radiography degree apprentices, an hour-long discussion on student attrition revealed similar themes rang true for many. 

Issues included the university courses being more academically demanding than students may have expected, some students not being aware of what a role in radiography actually entails, and of course the finances.  A particular concern for the members of SoR’s student network was the cost of placements, which are a requirement of radiography courses. 

Some students were required to attend placement a considerable distance from home, and were faced with the choice between cost of travel or the cost of accommodation. While some are eligible for reimbursement through the NHS Learning Support Fund for travel or accommodation, they are still faced with the upfront costs before claiming the money back. Other students were simply not eligible for reimbursement.

The money problem 

Nina Darling is a teaching fellow at the University of Portsmouth, where Bekki studies on the BSc Diagnostic Radiography and Medical Imaging course. 

“I would say one of the most consistent factors influencing attrition is money,” she said. “Mature students with family responsibilities have always found it a struggle and this has been exacerbated now students are paying tuition fees because they have to justify the impact of the additional debt on their family finances. 

“I was fortunate enough to study as a mature student while tuition fees were still covered by the bursary, and I still had to work 20-plus hours a week to help support the family. For our younger students the financial strain is felt in different ways, particularly as the rising cost of living is not matched by the financial support available.”

On why students may be misunderstanding the requirements of radiography careers, Nina pointed to a lack of work experience opportunities or clinical visits, as a result of the Covid-19 pandemic. 

“The result is students who don’t fully understand the career they are pursuing until their first clinical placement”, she said. For some, that initial clinical experience is the deciding point and the catalyst for a change of direction.” 

Bring back the bursary? 

In 2016, the Conservative government under Prime Minister David Cameron and chancellor George Osbourne scrapped NHS bursaries in England, forcing nurses, midwives, and AHPs to take out traditional student loans to fund their studies. This move was unsurprisingly controversial, and has fuelled a shortage of essential frontline staff in recent years. 

Nina said: “I am staggered that the government was shortsighted enough to take the bursary away. Surely it would be more beneficial to cover the cost of training for all healthcare professions and tie graduates into working within the NHS for a minimum term upon qualification? 

“Current working conditions and pay are obviously a factor in retention within the NHS, as is clinical and compassion fatigue. This and the Covid legacy are sadly impacting students' clinical experiences as they are often working in departments where morale is low and staff are stretched.” 

The tricky part

It’s easy to focus on the root of a problem as serious as a workforce crisis, but solutions are harder to come by. So what would help students to finish their courses? 

“I feel like the government needs to evaluate finance for healthcare students, taking into consideration the cost of living crisis,” said Bekki. We’re well aware that the NHS desperately needs more people to train in AHP roles, but it’s near to impossible to be able to do this and be financially comfortable for many mature students, especially those like me who have nobody to help support them financially and come from low-economic backgrounds.

“I feel like the NHS Learning Support Fund needs an overhaul to help everyone, and tuition fees should be scrapped for AHP courses as they were previously.” 

To support radiography students at the University of Portsmouth, each cohort is timetabled to be on campus for only two days most weeks, which reduces the cost of travel. Nina Darling said the university is also piloting a loan scheme for costs and travel associated with placement.

“This has already had a very positive impact on the first cohort of our students heading out onto clinical placement this year,” she said. Students that have been requesting to work three long days to reduce travelling costs and make placement achievable are now more able to focus on the clinical experience over the cost.” 

The SoR is also working hard to support students, using feedback gathered from the student forum. Initiatives from Society include running regular webinars to support students and new professionals through the areas that prove most challenging, including the Confidence series which runs from October 2023 to May 2024, and focuses on building confidence in both the clinical and academic settings, with an emphasis on wellbeing, leadership and access to support.

Nichola added: “The most important thing we can do, no matter what our role, is to listen to our students and newly qualified staff. The point of attrition is too late. What we do in the moment can have a lasting impact on a developing professional, however small the gesture. Our students are here, they are speaking, they are telling us right now what is impacting their ability to thrive. We will relentlessly continue to amplify that voice and transform it into meaningful and tangible action.”