Radiographers are currently in a similar position to those nurses 30 years ago. Even advanced and consultant radiographers are restricted by the lack of autonomy to prescribe medicines and must approach radiologist colleagues to prescribe so that they can continue their current work; what could they achieve if they could prescribe independently? With resources stretched, a leaner patient journey involving fewer health professionals, but with the skills to provide everything the patient needs must be more cost effective. Diagnostic radiographers are working with specialised clinical teams and individual radiographers
The patient will see the therapeutic radiographer daily, but might not necessarily see their own medical practitioner or any other doctor until treatment is completed
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are being drawn into tighter multidisciplinary networks; local angiographic radiographers work alongside nurses and share their scrub duties as well as direct patient handling skills. Their skills and responsibilities are changing and becoming merged, and should also include the ability to prescribe for post-procedural pain. Often nuclear medicine radiographers work in an isolated environment with, in some places, poor access to general medical staff. There are many drugs used for this speciality which require prescribing to enhance these studies. The commonly used procedure of CT colonography utilises bowel preparation, anti-spasmodics such as hyoscine butylbromide, contrast agents and occasional analgesia – a minefield of prescription types. Radiographer independent prescribing for both diagnostic and therapeutic radiography, is an essential component in advanced and consultant practice. Clinical decision making and prescribing decision making are inextricably linked; both are fundamental at this level of practice and, if enabled, can complete or enhance the patient’s experience. An unpublished audit undertaken by supplementary prescribing therapeutic radiographers in the North West4 considered 186 patient contacts. Of these, 54 patients needed a medicine to be prescribed during
the consultation, and in 41 instances the therapeutic radiographer could prescribe. However, the lack of a clinical management plan for the patients in the remaining 13 instances, meant that the patients had a poor experience, delays in their treatment and, for some, prolonged symptoms. The therapeutic radiographers commented that independent prescribing would have enabled them to have quicker access to medicines and provide complete episodes of care to more of their patients. This, in turn, would have resulted in patients needing fewer appointments and having a shorter consultation time.
Examples of scenarios where independent prescribing for radiographers
could have positive impact Radiographer-led discharge of patients in urgent care centres is gaining popularity within the UK. Here the radiographer would interpret the image and if no abnormality is present, they would discharge the patient. In some cases, the patient might complain of discomfort or pain and the radiographer could prescribe analgesia. Small remote x-ray units within community hospitals are excellent examples of where this could happen. In this context a prescribing radiographer could facilitate the following:
• Patient discharge by one health professional would be quicker for the patient; importantly the patient would interact with only one professional who would see to all their needs;
• Radiographer-led discharge with prescribing would minimise or even negate the need for re-involving
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