Introduction Therapeutic radiographers play a vital and changing role in the delivery of radiotherapy services treating patients with cancer. Advanced Practitioners (AP) and Consultant Practitioners (CP) in radiotherapy have developed advanced clinical skills and specialisms, enhancing the ability of the profession to offer a greater depth of cancer services and ease pressure elsewhere in the system. The aim of this study was to define the opportunity and potential for Advanced Clinical Practice (ACP) roles in oncology services. Specific objectives were to explore local profiles, role development and opportunities for standardisation of ACPs in therapeutic radiography and to determine resource requirements to roll out and ensure continuation of the existing and new roles. Material and methods The research was addressed through a qualitative study design using focus groups. Convenience sampling was used to recruit therapeutic radiography advanced and consultant practitioners (N = 36) from the respective radiotherapy departments in England to participate in regional focus groups. Four regional areas were identified for inclusion. Data generated was analysed thematically. Results The findings are presented in four themes: ownership of professional identity, desire for standardisation and guidance, drivers of role development and self-directed educational routes. Conclusion Key findings from the focus groups indicated the need for standardisation in job descriptions, roles and responsibilities and a key understanding of career progression. The professional identity of the AP is acknowledged by independent, autonomous working; however, this can only be facilitated if the correct training is undertaken and the necessary support structures are in place to enable career progression. Challenges associated with role development are 1) lack of career and pathway guidance, 2) lack of clear educational routes, 3) lack of standardised roles.

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Objective: To investigate the profiles of advanced clinical practitioners (ACPs) in the allied health professions (AHPs) and their skills, attributes, experiences and involvement in new models of care. Methods: A 2 phase, cross sectional, mixed method survey of AHP ACPs across London was conducted in 2018-2019. Online questionnaires were completed by 127 AHP ACPs and then semi-structured interviews were conducted with 15 AHP ACPs. Results: The survey results gave a comprehensive overview of the attributes of AHPs in ACP roles across London. There was considerable variability between role titles, types and levels of qualification, and evolution of the roles. The respondents predominately worked in clinical practice, and less frequently in other ACP domains (research, leadership and management, education). The interview findings provided in-depth insights into the AHP ACP roles within four themes: being advanced, career pathways, outcomes of the advanced practitioner role and influencing and transforming. The "Being advanced" theme highlighted that expert practice comprised confident and autonomous practice, leadership, and applying specialist and expert decision-making skills. "Career pathways" highlighted the diversity within the participants' roles, titles, career opportunities and development. In the "Outcomes of the advanced clinical practitioner role" theme, the ACPs described their services as prompter, more accessible and providing an improved patient journey. The "Influencing and transforming" theme highlighted networking and dissemination and ideas for innovation, influencing and transforming services. Conclusion: This is the first comprehensive profile of ACP roles across AHPs and indicates that these roles are already having a positive impact on healthcare services and supporting new models of care. However, establishing the necessary infrastructure, standardization and governance for ACP roles across sectors, along with the career pathways, funding, sustainability and education, could increase impact in the future.

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IntroductionStudies have investigated the prevalence of compassion satisfaction and compassion fatigue in various healthcare professions. However, the majority of evidence is linked to the nursing profession and little is known about paramedical professions such as radiography and even less is known about its prevalence in students. The purpose of this study was to describe the levels of compassion satisfaction and compassion fatigue in the student population and how they varied in time.MethodsStudents undertaking radiotherapy training at the researcher’s host sites were surveyed using the Professional Quality of Life questionnaire at the end of each final clinical block in each year of their training.Results and conclusionDuring the 3 years of training compassion satisfaction falls and burnout increases in the student population, although the change is not significant. Secondary traumatic stress increases significantly during the 3 years of training, F=5·725, p=0·005. Considerable variation also exists in the three scores dependent on the student’s clinical training site. Relationships are also observed between some personality traits, particularly conscientiousness and neuroticism and compassion scores.