The standards of proficiency for radiographers
You must meet all the standards of proficiency to register with us and meet the standards relevant to your scope of practice to stay registered with us. It is important that you read and understand this document.
If your practice is called into question we will consider these standards (and our standards of conduct, performance and ethics) in deciding what action, if any, we need to take.
The standards set out in this document complement information and guidance issued by other organisations, such as your professional body or your employer.
We recognise the valuable role played by professional bodies in providing guidance and advice about good practice which can help you to meet the standards in this document
Your scope of practice is the area or areas of your profession in which you have the knowledge, skills and experience to practise lawfully, safely and effectively, in a way that meets our standards and does not pose any danger to the public or to yourself.
We recognise that a registrant’s scope of practice will change over time and that the practice of experienced registrants often becomes more focused and specialised than that of newly registered colleagues. This might be because of specialisation in a certain area or with a particular client group, or a movement into roles in management, education or research.
Every time you renew your registration, you will be asked to sign a declaration that you continue to meet the standards of proficiency that apply to your scope of practice.
Your particular scope of practice may mean that you are unable to continue to demonstrate that you meet all of the standards that apply for the whole of your profession.
As long as you make sure that you are practising safely and effectively within your given scope of practice and do not practise in the areas where you are not proficient to do so, this will not be a problem. If you want to move outside of your scope of practice, you should be certain that you are capable of working lawfully, safely and effectively. This means that you need to exercise personal judgement by undertaking any necessary training or gaining experience, before moving into a new area of practice.
It is important that you meet our standards and are able to practise lawfully, safely and effectively. However, we do not dictate how you should meet our standards. There is normally more than one way in which each standard can be met and the way in which you meet our standards might change over time because of improvements in technology or changes in your practice.
We often receive questions from registrants who are concerned that something they have been asked to do, a policy, or the way in which they work might mean they cannot meet our standards. They are often worried that this might have an effect on their registration.
As an autonomous professional, you need to make informed, reasoned decisions about your practice to ensure that you meet the standards that apply to you. This includes seeking advice and support from education providers, employers, colleagues, professional bodies, unions and others to ensure that the wellbeing of service users is safeguarded at all times. So long as you do this and can justify your decisions if asked to, it is very unlikely that you will not meet our standards.
We recognise that our registrants work in a range of different settings, which include direct practice, management, education, research and roles in industry. We also recognise that the use of terminology can be an emotive issue.
Our registrants work with very different people and use different terms to describe the groups that use, or are affected by, their services. Some of our registrants work with patients, others with clients and others with service users. The terms that you use will depend on how and where you work. We have used terms in these standards which we believe best reflect the groups that you work with.
In the standards of proficiency, we use phrases such as ‘understand’, ‘know’, and ‘be able to’. This is so the standards remain applicable to current registrants in maintaining their fitness
to practise, as well as prospective registrants who have not yet started practising and are applying for registration for the first time.
These standards may change in the future We have produced these standards after speaking to our stakeholders and holding a formal public consultation. We will continue to listen to our stakeholders and will keep our standards under continual review. Therefore, we may make further changes in the future to take into account changes in practice.
We will always publicise any changes to the standards that we make by, for instance, publishing notices on our website and informing professional bodies.
We also expect you to keep to our standards of conduct, performance and ethics and standards for continuing professional development. We publish these in separate documents, which you can find on our website.
Registrant radiographers must:
1.1 know the limits of their practice and when to seek advice or refer to another professional
1.2 be able to manage their own workload and resources effectively and be able to practise accordingly
2.1 understand the need to act in the best interests of service users at all times
2.2 understand what is required of them by the Health and Care Professions Council
2.3 understand the need to respect and uphold the rights, dignity, values, and autonomy of service users including their role in the diagnostic and therapeutic process and in maintaining health and wellbeing
2.4 recognise that relationships with service users should be based on mutual respect and trust, and be able to maintain high standards of care even in situations of personal incompatibility
2.5 know about current legislation applicable to the work of their profession
2.6 be able to practise in accordance with current legislation governing the use of ionising and non-ionising radiation for medical and other purposes
2.7 understand the importance of and be able to obtain informed consent
2.8 be able to exercise a professional duty of care
2.9 understand the legislative, policy, ethical and research frameworks that underpin, inform and influence the practice of radiography
3.1 understand the need to maintain high standards of personal and professional conduct
3.2 understand the importance of maintaining their own health
3.3 understand both the need to keep skills and knowledge up to date and the importance of life-long learning
4.1 be able to assess a professional situation, determine the nature and severity of the problem and call upon the required knowledge and experience to deal with the problem
4.2 be able to make reasoned decisions to initiate, continue, modify or cease radiotherapy treatment or diagnostic imaging examinations and record the decisions and reasoning appropriately
4.3 be able to initiate resolution of problems and be able to exercise personal initiative
4.4 recognise that they are personally responsible for and must be able to justify their decisions
4.5 be able to make and receive appropriate referrals
4.6 understand the importance of participation in training, supervision and mentoring
5.1 understand the requirement to adapt practice to meet the needs of different groups and individuals
5.2 understand the emotions, behaviours and psychosocial needs of people undergoing radiotherapy or diagnostic imaging, as well as that of their families and carers
5.3 be able to provide appropriate information and support for service users throughout their radiotherapy treatment and care or diagnostic imaging examinations
7.1 be aware of the limits of the concept of confidentiality
7.2 understand the principles of information governance and be aware of the safe and effective use of health and social care information
7.3 be able to recognise and respond appropriately to situations where it is necessary to share information to safeguard service users or the wider public
8.1 be able to demonstrate effective and appropriate verbal and non-verbal skills in communicating information, advice, instruction and professional opinion to service users, colleagues and others
8.2 be able to communicate in English to the standard equivalent to level 7 of the International English Language Testing System, with no element below 6.5 *
8.3 understand how communication skills affect assessment and engagement of service users and how the means of communication should be modified to address and take account of factors such as age, capacity, learning ability and physical ability
8.4 be aware of the characteristics and consequences of verbal and non-verbal communication and how this can be affected by factors such as age, culture, ethnicity, gender, socio-economic status and spiritual or religious beliefs
8.5 understand the need to provide service users or people acting on their behalf with the information necessary to enable them to make informed decisions
8.6 understand the need to assist the communication needs of service users such as through the use of an appropriate interpreter, wherever possible
8.7 recognise the need to use interpersonal skills to encourage the active participation of service users
8.8 be able to advise other healthcare professionals about the relevance and application of radiotherapy or imaging modalities to the service user’s needs
8.9 be able to formulate and provide information to service users about the treatment or imaging process and procedures, with regular reappraisal of their information needs, as appropriate
* The International English Language Testing System (IELTS) tests competence in the English language. Applicants who have qualified outside of the UK, whose first language is not English and who are not nationals of Switzerland, must provide evidence that they have reached the necessary standard. Please visit our website for more information.
9.1 be able to work, where appropriate, in partnership with service users, other professionals, support staff and others
9.2 understand the need to build and sustain professional relationships as both an independent professional and collaboratively as a member of a team
9.3 understand the need to engage service users and carers in planning and evaluating their diagnostic imaging and interventional procedures or their radiotherapy pre-treatment planning, treatment and follow-up
9.4 be aware of the need to empower service users to participate in the decision-making processes related to their radiotherapy or diagnostic imaging examination
9.5 be able to contribute effectively to work undertaken as part of a multi-disciplinary team
9.6 be able to understand, interpret and act upon information from other healthcare professionals, in order to maximise health gain whilst minimising radiation dose to the service user
10.1 be able to keep accurate, comprehensive and comprehensible records in accordance with applicable legislation, protocols and guidelines
10.2 recognise the need to manage records and all other information in accordance with applicable legislation, protocols and guidelines
11.1 understand the value of reflection on practice and the need to record the outcome of such reflection
11.2 recognise the value of multidisciplinary team reviews and other methods of review
12.1 be able to engage in evidence-based practice, evaluate practice systematically, and participate in clinical and other audit procedures
12.2 be able to gather feedback and information that helps to evaluate the response of service users to their care
12.3 understand the principles of quality control and quality assurance as they apply to the practice of diagnostic or therapeutic radiography
12.4 be aware of the role of audit and review in quality management, including quality control, quality assurance and the use of appropriate outcome measures
12.5 be able to maintain an effective audit trail and work towards continual improvement
12.6 be aware of, and be able to participate in, quality assurance programmes, where appropriate
12.7 recognise the need to monitor and evaluate the quality of practice and the value of contributing to the generation of data for quality assurance and improvement programmes
13.1 understand the philosophy underpinning the development of the profession of radiography
13.2 understand the concept of leadership and its application to practice
13.3 understand the role of the radiographer in the promotion of health and health education in relation to healthy living and health screening for disease detection
13.4 recognise the role of other professions and services in health and social care
13.5 understand the structure and function of the human body, together with knowledge of health, disease, disorder and dysfunction relevant to their profession
13.6 understand the radiobiological principles on which the practice of radiography is based
13.7 understand the risk-benefit philosophy and principles involved in the practice of diagnostic or therapeutic radiography
13.8 be aware of the principles and applications of scientific enquiry, including the evaluation of treatment efficacy and the research process
13.9 understand and be able to apply the physical principles of ionising radiation production, interaction with matter, beam modification and radiation protection for diagnostic imaging or radiotherapy treatment
13.10 know the physical and scientific principles on which image formation using ionising and non-ionising radiation is based
13.11 understand radiation dosimetry and the principles of dose calculation
13.12 understand the theoretical basis underpinning patient assessment prior to and during radiotherapy or diagnostic imaging examinations
13.13 understand the capability, applications and range of technological equipment used in diagnostic imaging or radiotherapy
13.14 be able to distinguish between normal and abnormal appearances evident on images
13.15 know the concepts and principles involved in the practice of diagnostic imaging or radiotherapy and how these inform and direct clinical judgement and decision making
13.16 know the pharmacology of drugs used in diagnostic imaging or during radiotherapy treatments
13.17 understand the methods of administration of drugs
13.18 be able to remove and re-apply dressings and supports appropriately and in a safe, effective and considerate manner
13.19 understand the quality assurance processes in place within diagnostic imaging or radiotherapy
13.20 be aware of the current developments and trends in the science and practice of radiography
Diagnostic radiographers only
13.21 understand the structure and function of the human body in health, disease and trauma, as well as common pathologies and mechanisms of disease and trauma, including the:
– musculoskeletal system
– soft tissue organs
– regional and cross-sectional anatomy of the head, neck, thorax, pelvis and abdomen
– the cardiovascular, respiratory, genito-urinary, gastro-intestinal and neuro-endocrine systems
13.22 understand the signs and symptoms of disease and trauma that
result in referral for diagnostic imaging procedures
Therapeutic radiographers only
13.23 understand the structure and function of the human body in health and disease, including:
– regional and cross-sectional anatomy of the head, neck, thorax, pelvis and abdomen
– common pathologies and mechanisms of disease with a concentration on cancer, histology, haematology and the lymphatic and immune systems
– oncology, the pathophysiology of solid and systemic malignancies
– the management and effect of cancer
13.25 know the physiological signs and symptoms, clinical investigations and diagnostic procedures that result in referral for radiotherapy
13.26 know the biochemical science of radiation pathophysiology
13.27 understand the influence of adjuvant treatment including surgery and chemotherapy on radiotherapy dose prescription, timing of radiotherapy and post radiotherapy complications
14.1 be able to conduct appropriate diagnostic or monitoring procedures, treatment, therapy or other actions safely and accurately
14.2 be able to formulate specific and appropriate management plans including the setting of timescales
14.3 be able to assess, monitor and care for the service user before, during and after diagnostic imaging procedures or radiotherapy treatments
14.4 be able to use independent methods to establish and confirm service user identity prior to undertaking diagnostic imaging procedures or delivering radiotherapy treatments
14.5 be able to undertake or arrange investigations as appropriate
14.6 be able to undertake and record a thorough, sensitive and detailed clinical assessment, selecting and using appropriate techniques and equipment
14.7 be able to gather appropriate information
14.8 be able to use physical, graphical, verbal and electronic methods to collect and analyse information from a range of sources including service user’s clinical history, diagnostic images and reports, pathological tests and results, dose recording and treatment verification systems
14.9 be able to interrogate and process data and information gathered accurately in order to conduct the imaging procedure or radiotherapy most appropriate to the service user’s needs
14.10 be able to appraise image information for clinical manifestations and technical accuracy, and take further action as required
14.11 be able to manage complex and unpredictable situations including the ability to adapt planned diagnostic imaging examinations, interventions or treatments
14.12 be able to demonstrate a logical and systematic approach to problem solving
14.13 be able to change their practice as needed to take account of new developments, technologies and changing contexts
14.14 be able to use research, reasoning and problem solving skills to determine appropriate actions
14.15 be aware of a range of research methodologies
14.16 recognise the value of research to the critical evaluation of practice
14.17 be able to evaluate research and other evidence to inform their own practice
14.18 be able to operate radiotherapy or diagnostic imaging equipment safely and accurately
14.19 be able to demonstrate spatial awareness, visual precision and manual dexterity in the precise and safe manipulation of treatment units or imaging equipment and related accessory equipment
14.20 be able to check that equipment is functioning accurately and within the specifications, and to take appropriate action in the case of faulty functioning and operation
14.21 be able to use information and communication technologies appropriate to their practice
14.22 be able to apply the risk-benefit philosophy to radiation exposure to protect both individual service users and the population gene pool
14.23 be able to select and explain the rationale for examination and treatment techniques and immobilisation procedures appropriate to the service user’s physical and disease management requirements
14.24 be able to position and immobilise service users correctly for safe and accurate diagnostic imaging examinations or radiotherapy treatments
Diagnostic radiographers only
14.25 be able to plan appropriate diagnostic imaging examinations
14.26 be able to calculate radiation doses and exposures and record and understand the significance of radiation dose
14.27 be able to perform the full range of standard imaging techniques and contrast agent examinations, including those undertaken on service users suffering from acute trauma, and where the service user’s medical, physical or mental health needs require examinations to be carried out in non-standard imaging environments
14.28 be able to manipulate exposure and image recording parameters to optimal effect
14.29 be able to use to best effect the processing and related technology supporting imaging systems
14.30 be able to manage and assist with fluoroscopic diagnostic and interventional procedures, including those that are complex and involve the use of contrast agents
14.31 be able to perform a standard head computed tomographic (CT) examination, assist with CT examinations of the spine, chest and abdomen in acute trauma, and to contribute effectively to other CT studies
14.32 be able to assist with standard magnetic resonance imaging procedures
14.33 be able to assist with ultrasound imaging procedures
14.34 be able to assist with imaging procedures involving the use of radionuclides
14.35 be able to distinguish disease and trauma processes as they manifest on diagnostic images
Therapeutic radiographers only
14.36 be able to plan appropriate radiotherapy procedures
14.37 be able to generate a treatment plan and verify treatment parameters ensuring optimal radiotherapy prescription delivery
14.38 be able to use to best effect the image processing and related technology, including computer-based imaging systems for radiotherapy purposes
14.39 be able to perform the full range of radiotherapy processes and techniques accurately and safely
14.40 be able to calculate radiation doses and exposures
14.41 be able to scrutinise and interpret the radiation prescription in such a way that radiotherapy is delivered accurately and reproducibly
14.42 be able to manage and assist with fluoroscopic procedures, including those requiring the use of contrast agents
14.43 be able to assist in performing standard computed tomographic (CT) planning procedures
14.44 be able to assist in the construction of appropriate immobilisation devices, individualised to the specific needs of each patient and the treatment regime prescribed
14.45 be able to undertake complex radiation dose delivery calculations involving a range of radiation types and energies
14.46 be able to localise the target volume precisely in relation to external surface and anatomical reference markings using a range of techniques including computed tomography and magnetic resonance imaging
14.47 be able to manipulate exposure and image recording parameters to optimal effect and interpret and evaluate images obtained during radiotherapy planning and treatment
14.48 be able to interpret and evaluate images obtained during radiotherapy planning and treatment
14.49 be able to identify organs at risk on images to provide information for radiotherapy treatment planning
14.50 be able to recognise changing signs, symptoms and progression of disease, and make appropriate decisions not to treat or to review further before proceeding with treatment
15.1 understand the need to maintain the safety of both service users and those involved in their care
15.2 be aware of applicable health and safety legislation, and any relevant safety policies and procedures in force at the workplace, such as incident reporting and be able to act in accordance with these
15.3 understand the need to ensure the physical and radiation safety of all individuals in the immediate work environment at all times
15.4 be able to establish safe environments for practice, which minimise risks to service users, those treating them and others, including the use of hazard control and particularly infection control
15.5 be able to work safely, including being able to select appropriate hazard control and risk management, reduction or elimination techniques in a safe manner and in accordance with health and safety legislation
15.6 be able to select appropriate personal protective equipment and use it correctly
15.7 be able to use basic life support techniques and be able to deal safely with clinical emergencies
15.8 know and be able to apply appropriate moving and handling techniques
15.9 know the correct principles and applications of disinfectants, methods for sterilisation and decontamination, and for dealing with waste and spillages correctly
15.10 be aware of immunisation requirements and the role of occupational health
These standards are effective from Tuesday 28 May 2013.
Reviewing the standards of proficiency
We keep our standards under continual review, to look at how they are working and check whether they continue to reflect current practice. We also conduct a periodic review of the standards every five years.
In August 2022, we updated our standards of proficiency for the first time since 2015. The changes, which will come into effect on 1 September 2023, have been made following an extensive period of engagement with a wide range of stakeholders.
We will provide a host of resources and activities which will assist different stakeholder groups prepare ahead of the implementation date.
The revised standards set clear expectations of registrants’ knowledge and ability in a healthcare landscape which has changed and evolved in the wake of the COVID-19 pandemic. Updating them is a crucial component in fulfilling our purpose to promote excellence in the professions we regulate, and championing high quality care that the public can access safely and with confidence.