Paul O’Riordan

What is your current role?

I’m a Consultant Radiographer in musculoskeletal (MSK) practice at the University Hospitals of Leicester NHS Trust. This was both a new role for the trust and a new role for me when I joined the trust in 2019. Working across modalities in an area as broad as MSK allows my clinical practice to be informed in a manner that I could not have achieved in single modality practice.

How has it helped you develop?

This system-specific (MSK) focus lends itself to developing the expert clinical practice of a consultant practitioner. Over my years of practice, I have gained an understanding of the resources required to develop teams of skilled individuals through consistently providing postgraduate higher education while also providing structured local mentorship to both special trainees in radiology and reporting radiographers and sonographers. My leadership and management skills have developed as my knowledge and experience have developed. I have progressed from being solely involved with local service development to regional and now national involvement in organisations where I can be a voice for the potential contribution of imaging practice in multiprofessional and radiographer-specific role development.

Focusing in an area of practice has allowed me to lead on projects that capture the patient journey from primary care and follow the patient’s contact with imaging, ensuring that we reduce or eliminate unnecessary imaging while also making sure the right imaging test occurs at the right point in a patient’s journey. Engaging with audit and service evaluation early in my career and leading on the development of local projects prepared me for progressing to research. Immersing my clinical practice in a defined area of practice and regular engagement with stakeholders in multidisciplinary forums or involvement in patient pathways highlights the necessary areas of interrogation and potential research and provides the opportunity for collaborative work with translational outcomes.

How did you reach this position?

I completed MSK appendicular reporting training at a London higher education institute (HEI) in 2004, followed by axial and specialised imaging in MSK postgraduate modules. I built on this by publishing some e-learning modules related to radiographic reporting. In 2008, I completed a computed tomography (CT) postgraduate certificate (PgCert) and again followed this with publishing some e-learning modules related to CT, including CT imaging of spinal fractures as I had an interest in multimodality trauma imaging through my combined reporting and imaging role.

In 2011, I had the opportunity to manage a reporting service and this allowed me to focus on the area of reporting, where I gained valuable insight into and experience of the complexity of managing a reporting workload in an imaging department. I also gained experience in developing enhanced and advanced practice to respond to these complexities. Through engagement with stakeholders from both community and within the trust I then worked for, I started to look beyond the established model of modality-specific practice to address patients’ needs.

In 2013, I was granted the opportunity to undertake a PgCert in the reporting of selected magnetic resonance imaging (MRI); I discussed with the HEI my interest in focusing on the subject of MSK practice as opposed to a modality-based approach. In 2016, I negotiated the opportunity to complete a PgCert in MSK ultrasound and ultrasound-guided injections, and finally in 2019. I was able to bring my qualifications together in an MSc in reporting.

What are the next steps for you?

Pursuing doctoral study is the next academic target for me. Having focused on an area of practice this no longer seems as daunting but is instead a natural progression. I would hope that we will be able to work with our HEI colleagues to ensure the design and content of level 7 MSc pathways and doctoral-level study will support the development and evolution of advanced and consultant practice roles in the future. This may reduce the academic journey and burden on future advanced and consultant practitioners as more well-established and common roles emerge. I do not consider myself to be an academic as such and I would encourage people not to be put off by the postgraduate academic requirements when looking at a career in AP or CP as each step becomes a natural progression as your career progresses.

What sort of support have you found helpful?

People who supported my learning and development have provided me with great support throughout my career. I am grateful to those who set a high bar so that it ensured their trust in my development and safeguarded patient care but also facilitated development when it was at times contentious. On the few occasions that I have moved trust, it has always been for an opportunity that was not, at that time, available to me and I take this forward in discussing the expectations and opportunities of my colleagues.

As a newly qualified reporting radiographer, my reporting lead at the time provided me with a great understanding of how to develop change over time and to bring colleagues from different backgrounds with you on a journey that requires a transition of thought both among those who have concerns about the proposed change but also by those proposing and facilitating change. This ensures that change occurs in the correct and safe manner, with regular reflection and with patient care being at all times the motivation for decision-making. What I lacked at times in my career development was someone to point towards to demonstrate that my proposed development was being done elsewhere successfully. There is a responsibility on all of us who have benefited from opportunities to make others aware so that they can point towards successes when pushing boundaries locally.

What do you find most rewarding?

The depth of knowledge that my career choices have allowed me to develop brings me great satisfaction. I have experienced the transition from an inexperienced radiographer sitting in meetings or educational forums where I felt my role was more of a listener and observer to becoming a confident and informed professional who feels empowered to bring my voice to those environments in the knowledge that I can add value by presenting or in joining the discussion. It brings me great satisfaction to see others observing the benefits of cross-modality practice in MSK and beyond and pursuing a similar pathway in their own career.

I initially struggled with my choice of profession but for those in a imilar position I can assure you that through personal investment and application it is remarkable how interesting and rewarding our profession can become as we learn to understand its unique and powerful voice and its place in modern healthcare.

Is there any particular advice you can offer?

I have been fortunate to have met or worked with some of the pioneers of formal radiographer reporting and I thank them for their work that has helped facilitate my career. It is important for those who follow to demonstrate respect for their pioneering work in picking up the baton and looking towards the next boundary.

Just as we have all learned from their initial models of practice, I would ask that those coming into enhanced, advanced and consultant practice look at current roles and developments as the foundation for future roles and further development. I can see my own role pointing towards potential for further specialisation in areas such as rheumatology practice, adding value in a more focused manner to a patient pathway to add value to great patient care. Most of all I would say, maintain focus on the end goal and don’t let stumbling blocks along the way send you off course, as the end result is justly rewarding.