ArticleBMC health services research2025
An implementation facilitation intervention to improve the musculoskeletal X-ray reporting by radiographers across London.
Article in BMC health services research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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10 authors.
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Abstract
backgroundThe National Healthcare Service (NHS) radiology service delivery in London is representative of the current pressures and challenges faced in England of Musculoskeletal (MSK) X-ray reporting workforce shortages, and national turnaround time (TATs) targets. The implementation project evaluated facilitation as a strategy to achieve the NHS England 50% target for all MSK X-rays to be reported by radiographers.
methodsThe project was an eight-month multi-centre (n = 5 London NHS Trusts) study applying the Promoting Action on Research Implementation in Health Services (PARIHS) framework with embedded mixed-methods evaluation. Initial observational data using the Context Assessment Index (CAI) tool and the Workplace Culture Critical Analysis Tool (WCCAT) set the implementation interventions which comprised external facilitation, to support internal facilitators action learning activities. Evaluation data comprised monthly reporting performance, systems mapping, interviews.
resultsSystem mapping allowed a perspective beyond the characteristics of the NHS Trusts involved (small single site hospitals to large multi-sites hospitals) of mixed clinical duties, scope of practice, reporting session allocation, and equipment used. CAI scores for workplace culture demonstrated
conclusionThis study had an innovative approach using an implementation facilitation framework to improve service delivery. The clinical workplace context in which MSK X-ray reporting by radiographers occurs was key to implementing change. The complexities of sustaining and upscaling MSK X-ray reporting by radiographers to meet the NHS England target of 50% are varied and require local champions to facilitate and drive change at organisational levels. It is recommended that there are dedicated 'resources' to sustain implementations with a community of practice for support. Workplace leadership and stakeholder networks are needed to sustain improved working practices and embrace regular evaluation and monitoring of service delivery performance.
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