Tamsin Arnold

What is your current role?

I’m an Advanced Practitioner Radiographer based at St Richard’s Hospital in Chichester, which is part of the University Hospitals Sussex NHS Foundation Trust that covers a large section of the south coast.

My specific position is as a computed tomography (CT) head reporting radiographer with an integrated role in radiology governance. My reporting role focuses on providing a dementia imaging service. In the past CT was used to rule out differential pathologies. With the advent of isotropic detectors and the ability to perform multiplanar reconstructions, CT can now be used to assist in the diagnosis of dementia. This is achieved by providing a severity scoring of specific dementia features and identifying patterns that may indicate which type of dementia is present. This is a developing area, and I am constantly learning and improving my knowledge.
CT head reporting radiographers provide an excellent service in all areas of brain reporting, with some even looking at CT angiographic studies. The majority of the work is based in an acute setting and is time critical. The work I undertake is chronic and more suited to my part-time working hours. This provides me with an excellent
work‒life balance.

Working in governance requires a certain amount of patience and determination. I’m sure my colleagues sometimes wonder what I am about to say… but as we are all committed to providing excellent standards of care, we work together to make progress. I am interested in medicines management, but I will try to make
improvements in any area where change is needed. I think it is particularly important to ensure that patients are represented and I try to support any changes they suggest if it is practical.

In addition to my job, I support the radiography profession in two ways. I am the co-chairperson of the CT Head Reporting Special Interest Group. We are an independent group of national and international practitioners who are supported by the Society and College of Radiographers (SCoR). Since the group was founded, it has been a forum to support colleagues with educational opportunities and professional issues. CT head reporting radiographers are often lone workers within their trusts and the group is essential in facilitating a relatively small professional group to connect with each other.  I have also been appointed to the SCoR CT Advisory Group (CTAG). I hope to use this opportunity to influence best practice and develop opportunities for CT radiographers within our profession.

How did you progress to this role?

When I was a student working in the East Midlands I really enjoyed my time in CT and was inspired by the cross-sectional team. I qualified in 2001 after gaining my undergraduate degree from the Royal Military College of Science (Cranfield University). After qualifying as a radiographer, I spent time in X-ray consolidating
my knowledge. I was able to rotate through CT quite quickly and became part of the on-call rota. This gave me some experience of lone working and taking responsibility for my own decisions.

I had to move to a different trust to gain a full-time cross-sectional imaging role. As I was relatively newly qualified, I am grateful to the operational manager for taking a chance on me. I loved working in MRI and found the work mentally challenging yet rewarding, but discovered I was more suited to the faster pace of CT. I gain quite a lot of satisfaction from knowing that a CT list is efficient and that we are maximising the number of patients we see while providing excellent standards of patient care and image quality. I completed my master’s degree in medical imaging (CT) at the University of Portsmouth over three years. It was difficult working full-time and participating in the on-call rota, but my employer gave me some study days. By completing this course, I gained a lot of practical knowledge in a short space of time that bolstered my relative inexperience. This gave me the confidence to suggest positive changes to the services we provided and to be able to deputise for the CT superintendent. The underpinning knowledge benefits me to this day as I am able to apply the principles of radiological physics to amend protocols and teach others. I am able to use the techniques I learnt to critically appraise professional publications, draw out the relevant details and apply this to the papers I am starting to write.

My dissertation explored the use of CT in cardiac imaging, which at the time was limited by the slice thickness that could be acquired. As scanner technology advanced, we were able to perform new techniques and I was able to use the knowledge gained in my dissertation to support the introduction of our CT cardiac angiography service. This has been successful, and we have been sharing our experiences through the Goodwood Cardiac CTA Course.

I have faced some personal challenges as a parent carer, and this has led me to be enthusiastic about governance. I uncovered some significant issues with our local education system and won a tribunal. Rather than place blame I wanted them to improve their services. I feel the same way about radiology governance and if we identify an area of improvement I feel it is important to take action.

What support has proved helpful or you’d like to see?

Without a doubt I receive a huge amount of support from my colleagues both in my own trust and on a national level through the groups I am involved in. The pandemic has really highlighted how much we rely on each other for advice, information and emotional assistance. I have met some amazing radiographers who have been dedicated to CT and have learnt a great deal from them. I was incredibly lucky to receive funding for formal postgraduate education. I feel I have used this academic knowledge to influence my work and improve the services we provide. It would be great to see more formal academic opportunities provided for CT radiographers and the funding for attendance to be given the same priority as other modalities.

The biggest disappointment I have experienced is not being able to report scans, despite being qualified earlier in my career. Sadly, I was not alone in this situation and radiographers faced barriers such as lack of resources, radiologist mentors and managerial support during the early stages. The early pioneers of radiographer CT head reporting worked to overcome these hurdles by promoting this area of career progression while striving to meet and exceed the high standards required.

Radiographer reporters are now commonplace and the number of CT head reporters is on the increase. In retrospect, the additional experience I have gained working clinically has been beneficial to my current job. While it took some time to become recognised and established in my role, I have benefited from a supportive radiologist mentor and line manager. I maintain key relationships with the CT superintendents and the CT team by working clinically as required.

What do you find most rewarding?

The most rewarding part of my role is knowing that our patients have access to high-quality services. This is true in both aspects of my job. The dementia reporting service has a direct impact on patient care by improving diagnosis and treatment pathways. The governance work is more general, but it is a great feeling to give your colleagues positive feedback, especially when this comes directly from patients.

I really enjoy providing educational opportunities and feel that this is the key to developing an enthusiastic and knowledgeable team. I organise clinical governance sessions, provide workshops to other professional groups and talk on courses and external study days. I have benefited greatly from the knowledge of others and I feel that we all have a responsibility to participate in the education of others.

Do you have any advice for people looking at similar progression?

CT head reporting is becoming much more commonplace. I would urge anyone who is interested to consolidate their general CT knowledge and research the postgraduate opportunities available. I would encourage colleagues to get involved with their local neurological multidisciplinary team and spend time with other reporters. In my opinion it is essential to find a supportive mentor, usually a radiologist or experienced reporting
radiographer, and ensure the management team agree with the plan.

Anyone interested in reporting can join the CT Head Reporting Special Interest Group. There are many introductory videos covering basic pathology and we hold a monthly educational meeting online. We have published examples of written schemes of work and job descriptions to support our members in creating their own role. We would assist any member who is not recognised for the role they undertake. We are a supportive group and welcome anyone with an interest in neurology.

The radiography profession is changing and there are many opportunities for extended roles. Anything is possible!