Appleyard R, Etty S, Snaith B, Nightingale J
Sheffield Hallam University, United Kingdom.
Sheffield Hallam University, United Kingdom.
Radiography (Lond). 2025 Jul;31(4):102956. doi: 10.1016/j.radi.2025.102956. Epub 2025 May 5.
Demand for imaging continues to rise, placing significant challenges on an already-stretched radiography workforce. Enhancing the capability and capacity of the Support Worker and Assistant Practitioner (SWAP) workforce is a potential solution, yet little evidence exists about their deployment. This study explored imaging department stakeholder perceptions in NHS institutions across England regarding SWAP roles and responsibilities, their contribution to service provision, and potential for career progression.
This qualitative study is the final phase of a multi-stage explanatory mixed methods study investigating the utilisation of the imaging SWAP workforce. A case study approach included semi-structured interviews (service/modality leads) and focus groups (SWAPs) across nine NHS Trusts. Sampling was evidence-based and purposive, aiming for representative diversity in SWAP utilisation levels, geographical spread and department size. Thematic analysis was conducted within and across cases.
The SWAP workforce was consistently recognised as crucial for maintaining operational efficiency and enhancing patient care. Four overarching themes emerged: (1) operational efficiency and service impact, where SWAPs were critical in optimising workflows; (2) roles and responsibilities, recognising both role clarity and ambiguity leading to role strain; (3) career progression, support, and training, highlighting opportunities yet significant barriers to advancement; and (4) workforce dynamics and job satisfaction, where high job satisfaction contrasted with challenges in role stability and professional recognition.
SWAPs significantly enhance imaging service delivery. Despite their substantial contributions, SWAPs face challenges in role clarity and career progression that can impact on inherently high job satisfaction.
A high level of variation in SWAP deployment is confirmed; a structured framework is required to guide implementation of effective deployment models. Moving from SWAP rotational models to static modality deployment may enhance consistency, team dynamics and job satisfaction.
对影像检查的需求持续增长，给本就捉襟见肘的放射照相工作人员带来了巨大挑战。提高辅助人员和助理从业者（SWAP）队伍的能力和规模是一个潜在的解决方案，但关于他们的部署情况，几乎没有相关证据。本研究探讨了英格兰国民保健服务（NHS）机构中影像科利益相关者对SWAP角色和职责、他们对服务提供的贡献以及职业发展潜力的看法。
本定性研究是一项多阶段解释性混合方法研究的最后阶段，该研究调查了影像SWAP队伍的利用情况。采用案例研究方法，包括对九个NHS信托机构进行半结构化访谈（服务/模式负责人）和焦点小组讨论（SWAP人员）。抽样基于证据且具有目的性，旨在使SWAP利用水平、地理分布和部门规模具有代表性的多样性。在案例内部和案例之间进行主题分析。
SWAP队伍一直被认为对维持运营效率和改善患者护理至关重要。出现了四个总体主题：（1）运营效率和服务影响，其中SWAP在优化工作流程方面至关重要；（2）角色和职责，认识到角色明确和模糊都会导致角色压力；（3）职业发展、支持和培训，突出了机会但也存在重大晋升障碍；（4）劳动力动态和工作满意度，其中高工作满意度与角色稳定性和职业认可方面的挑战形成对比。
SWAP显著提高了影像服务的提供。尽管他们做出了巨大贡献，但SWAP在角色明确和职业发展方面面临挑战，这可能会影响本来就很高的工作满意度。
确认了SWAP部署存在高度差异；需要一个结构化框架来指导有效部署模式的实施。从SWAP轮岗模式转向固定模式部署可能会提高一致性、团队动态和工作满意度。
