Improving service provision through education in a clinical setting
Matthew Southam is clinical imaging lead at AECC University College and a clinical specialist sonographer. Matthew oversees the clinical imaging services at AECC University College, a specialist health sciences Higher Education provider in Bournemouth.
Matthew joined the university college in 2016 as an associate lecturer and became a lecturer in radiography and ultrasound in 2019.
He played a key role in developing and leading the BSc (Hons) Radiography (Diagnostic Imaging) degree at the university college and continues to teach in the School of Radiology.
In his clinical practice, Matthew specialises in fine needle aspirations, head and neck, musculoskeletal, general, gynaecological, small parts, and early pregnancy.
I qualified as a diagnostic radiographer in 2013 and started working at Salisbury Hospital. As a newly-qualified radiographer, I was keen to expand my knowledge across various modalities to see where I wanted to progress.
As well as working within A&E, outpatients and theatre I worked in screening and also explored becoming a reporting radiographer. I quickly realised that I wanted to go into reporting practice and to be more involved in diagnosis, which led me to ultrasound and I undertook the MSc Medical Ultrasound at AECC University College.
Ultrasound allowed me take ownership of the imaging of the patient as well as completing the reporting of the examination, with lots of opportunities for advanced practice and ability to support students and other healthcare professionals.
I went on to establish advanced ultrasound practices at Salisbury Hospital. There was a clinical need for head and neck biopsies, and I was selected to learn the procedure. I went on to teach this internally and to establish and grow the provision.
At this point, I moved into project management at the hospital; I worked for the programme management team and gained valuable experience in making changes within the organisation.
The opportunity also came up to do some lecturing in radiography at AECC University College, alongside working in the NHS. This evolved into helping to set up the new BSc (Hons) Radiography degrees at the University College, and become course leader of the BSc (Hons) Radiography (Diagnostic Imaging) course.
A full-time position then became available to look after the clinical imaging provision at the University College, which appealed to me due to the mix of educational expertise and clinical management required that you don’t normally get in a health care setting.
Improving a radiography service
I became interested in service improvement quite early on. Rather than just accepting practice, I’m interested in exploring ways that we can make things better. That might be by optimising how our time is spent in providing a service, or optimising processes, patient diagnosis or care provision.
You’re always thinking: how do we improve the experience that our patients are getting? How do we improve the facilities that are available to them, the way that we communicate with them, and the way that we are delivering care?
It’s also looking at clinical quality: how do we make sure that we are following the best practice that we can? It’s making sure our practice is based on the latest research; on national guidance, NICE guidance, and lessons learned within our own clinic based on audit processes.
From a process point of view, I believe efficiency is really important. The more streamlined things are, the better they tend to be. I also find the more straightforward processes are, the more time clinicians have to focus on what’s really important: making good diagnoses, giving good patient care, and treating their colleagues properly.
From a technology point of view, it’s about ensuring that we are making use of what is currently available. Radiography is a technologically-advanced practice and we need to be utilising the latest technology. That’s something I feel really strongly about.
Education key to service improvement
My focus on service improvement led me to look at student training, which gives us an opportunity to improve our practice through getting education right.
The more we instil in people that we need to be constantly improving, the better clinicians our students make, and ultimately the better our department is. We’re then providing a better service and patient experience is better too. Nurturing that ‘always improving’ message is key for me.
The ultrasound services at AECC University College support the teaching provision of our MSc Ultrasound course. We have placements for around 30 students a year who are also enrolled on this course.
I’m a big champion of this because we’re increasing the amount of placements that are available locally. This means supporting the NHS by training healthcare professionals in ultrasound, which is an increasingly important specialism, as well as giving clinicians an opportunity to do ultrasound as adjunct to their clinical practice.
Collaboration with Health Education England
For the last 18 months, I’ve been working with Health Education England South East Allied Health Professions team and Cancer and Diagnostic team to look at radiography provision in the south-east, focusing in particular on students and student placements.
We’ve done a lot of work to engage with stakeholders to establish what the barriers are preventing the creation of more placements, and how many learners we need. At the moment, there’s a shortfall of supply to meet the increasing demand for medical imaging and current projections are well below where we need to be,
It became clear from these discussions that it’s really hard to quantify what the capacity of trusts and departments are for learners because they are all slightly different. They have different ways that they run lists and different numbers of associated learners.
Within the HEE SE Radiography programme delivery group, we decided to create a placement capacity tool that aimed to standardise the way that we capture that information.
We can take this one step further and use this information to adapt the placement element of courses to use available capacity, potentially increasing the number of students that we can accommodate for placements.
Addressing shortfall in radiographers
I think artificial intelligence is the next exciting area for radiography that will allow us to increase our diagnostic accuracy, reduce our doses of ionising radiation, and help with our workforce issue by making diagnoses. AI can also help with improving the efficiency of the test itself, reducing the time it takes.
There are some other opportunities that could help alleviate the shortfall in radiographers. We need to look at different routes into professions, for example; we’ve seen the creation of a number of postgraduate direct entry courses that are really popular.
We also need to be utilising tests more effectively and interrogating whether we need to do as much imaging as we are doing.
Finally, we need to make sure that we are using the staff that we do have more effectively; to ensure people are working to the top of their licence. We need to ensure that practitioners at every level are doing the most advanced procedures that they can to free up capacity.
Submitted by Matthew Southam, clinical imaging lead at AECC University College and clinical specialist sonographer.