An investigation of the impact/potential impact of a four-tier profession on the practice of radiography – A literature review

Increased demands for radiology services and a shortage of radiologists and radiography staff have been factors driving skills mix and radiographer role development. The blurring of professional boundaries, greater workforce flexibility and a team approach contribute to the provision of high quality patient service. The government introduced the “four-tier” model (based on a College of Radiographers initiative) to help do this and to provide structured career pathways, improve life long learning and address recruitment/retention issues of radiography staff.This review examined the extent of radiographer role development, the effect on patient services, the attitudes of radiologists and other health care professionals, work quality and accountability and recruitment and retention issues. Many studies revealed improvements to patient services, good work quality but mixed results with recruitment issues. Radiologists were found to be supportive generally, although some studies disagreed on the effects of radiographer role development and junior radiologists' training. Areas were identified where more research was required.