'What is Your Job?': A Qualitative Analysis of the Deployment, Utilisation, and Contribution of Support Workers in Diagnostic Imaging Services in England.

Support workers (SWs) form the largest section of the NHS workforce, and the ongoing NHS workforce crisis underscores the need for their efficient utilisation. This study explored the deployment of imaging SWs within NHS radiology departments in England, forming part of a larger multiphase research project funded by the National Institute for Health Research (NIHR). It involved multi-centre case studies across nine radiology departments, employing a thematic analysis of focus groups and interviews with a range of radiology staff, including SWs themselves (n = 113). Results showed that recruitment of SWs was generally not challenging, however, retention was variable potentially due to limited opportunities for career progression and a lack of role understanding. Deployment strategies varied significantly across sites, which sometimes influenced SW effectiveness and were often selected for service need rather than SW development. Role scope was often unclear and training inconsistent which may exacerbate poor role understanding, and the lack of clear career pathways outside of professional registration conflicted with SWs' strong desire for progression. SWs are highly valued, crucial to operational efficiency and excellent patient care. Efficient deployment of SWs within NHS radiology services is crucial for alleviating workforce shortages and improving service delivery, however, this is impeded by the variability in role definition and deployment practices evidenced in this study. Standardising role titles, responsibilities, and training, and creating clear progression pathways could help to fully harness the capabilities of SWs in healthcare settings. National frameworks offer recommendations for standardisation, but this study suggests implementation remains inconsistent or delayed.