The imaging support workforce: Stakeholder perceptions of role, impact and career progression

Demand for imaging continues to rise, placing significant challenges on an already-stretched radiography workforce. Enhancing the capability and capacity of the Support Worker and Assistant Practitioner (SWAP) workforce is a potential solution, yet little evidence exists about their deployment. This study explored imaging department stakeholder perceptions in NHS institutions across England regarding SWAP roles and responsibilities, their contribution to service provision, and potential for career progression.

This qualitative study is the final phase of a multi-stage explanatory mixed methods study investigating the utilisation of the imaging SWAP workforce. A case study approach included semi-structured interviews (service/modality leads) and focus groups (SWAPs) across nine NHS Trusts. Sampling was evidence-based and purposive, aiming for representative diversity in SWAP utilisation levels, geographical spread and department size. Thematic analysis was conducted within and across cases.

The SWAP workforce was consistently recognised as crucial for maintaining operational efficiency and enhancing patient care. Four overarching themes emerged: (1) operational efficiency and service impact, where SWAPs were critical in optimising workflows; (2) roles and responsibilities, recognising both role clarity and ambiguity leading to role strain; (3) career progression, support, and training, highlighting opportunities yet significant barriers to advancement; and (4) workforce dynamics and job satisfaction, where high job satisfaction contrasted with challenges in role stability and professional recognition.

SWAPs significantly enhance imaging service delivery. Despite their substantial contributions, SWAPs face challenges in role clarity and career progression that can impact on inherently high job satisfaction.

A high level of variation in SWAP deployment is confirmed; a structured framework is required to guide implementation of effective deployment models. Moving from SWAP rotational models to static modality deployment may enhance consistency, team dynamics and job satisfaction.