Patient information

Important things to know about X-rays and radiotherapy

In this section

In This Section

Information for patients 

When you visit a diagnostic imaging department for a diagnostic procedure such as an X-ray or scan, or a radiotherapy department for radiotherapy treatment, you will come across a range of staff who are there to help you and provide you with a safe and high quality service. 

Who will be looking after me and undertaking my test or treatment?

Many different people are likely to be involved in your care when you visit a diagnostic imaging or radiotherapy department. These include administrative staff, porters, support workers such as healthcare assistants, assistant practitioners, radiographers, sonographers, radiologists, cardiologists and other specialist doctors.

We will explain more about some of these roles.

Different types of radiographer

Diagnostic radiographer

Diagnostic radiographers employ a range of techniques to produce high quality images to diagnose an injury or disease. They are responsible for providing safe and accurate imaging examinations and often will also be the person who makes the diagnosis and writes the report.

There are also doctors who do this in diagnostic imaging and they are called radiologists. Whether your examination is reported by a radiographer or a radiologist you can be sure they have been appropriately trained to do so. Reporting radiographers and radiologists often work in teams and more complex cases are  discussed in multi disciplinary team meetings where other doctors may provide additional information about your case that will help everyone to agree on the right diagnosis.

The identification and monitoring of diseases, skeletal and soft tissue abnormalities and trauma are the major focus of diagnostic radiography. 

Significantly, radiographers provide this service throughout the 24-hour day, often working alone or in interprofessional care teams. 

They use a range of techniques including: 

  • X-rays – used to look through tissue to examine bones, cavities and foreign objects. May be used with contrast agents to provide a live motion image, eg, fluoroscopy to image the digestive system, or angiography to investigate blood vessels;
  • CT (computed tomography) – provides cross-sectional views (slices) of the body; 
  • Nuclear medicine – uses radioactive tracers which can be administered to examine how the body and organs function, for example, the kidneys or heart. Certain radioisotopes can also be administered to treat particular cancers, eg, thyroid cancer.

Why am I not offered any wearable protection from the X-Rays any more?

It is widely accpeted that the doses of ionising radiation (X-rays) needed to get a diagnosis are much lower than ever before. Using lead rubber or other types of shielding can obscure important parts of the body which your doctor may need to see. This may cause you to need another X-ray which can raise the total dose you receive. Many professional bodies across the world have examined the evidence and are publishing new guidance that says it is better not to use this shielding. There are far more effective ways of reducing your radiation dose such as high quality training for staff and the use of new technology.

For more information about why we no longer recommend the use of shielding you may like to read these publications:

Guidance on using contact shielding on patients for diagnostic radiology applications and public information flyer 

International guidance:

National Council on Radiation Protection and Measurements

Implementation Guidance for Ending Routine Gonadal Shielding During Abdominal and Pelvic Radiography and public information flyer 

 

Techniques that do not use x-radiation are:

  • Ultrasound – uses high frequency sound. This technique is increasingly used in obstetrics, including monitoring throughout pregnancy, gynaecology, abdominal, paediatrics, cardiac, vascular and musculo-skeletal; 
  • MRI (magnetic resonance imaging) – builds a 2-D or 3-D map of different tissues within the body. 

Click here to view a short patient information video, produced and edited by Stephen Lomax, which shows the diagnostic imaging modalities.  

Can you explain about sonographers?

Some sonographers are also radiographers who are regulated by the Health and Care Professions Council(HCPC) but they may also be a doctor (regulated by the General Medical Council(GMC)), nurse or midwife (regulated by the Nursing and Midwifery Council (NMC)). All of these regulators hold a list of people adequately trained and entitled to use their professional title.

There are other sonographers who are not registered healthcare professionals but have undertaken a focussed course of study accredited by the Consortium for the Accreditation of Sonographic Education (CASE) to BSc or Masters (MSc) level. You should know who your sonographer is and they should be able to provide you with reassurance that they are adequatley trained and assessed as competent to undertake your examination.

However, until Sonographeris recognised and regulated as a profession, anyone can call themselves a sonographer even if they have had little or no training. If you are seeking an ultrasound or baby scan outside the NHS make sure you know who your sonographer is. 

The Society and College of Radiographers have been working together to campaign for the regulation of sonographers in the public interest for safe and high quality care.

Therapeutic radiographer

Therapeutic radiographers play a vital role in the delivery of radiotherapy services. They are the only health professionals qualified to plan and deliver radiotherapy. They constitute over 50% of the radiotherapy workforce working with clinical oncologists, medical physicists and engineers.

Therapeutic radiographers are responsible for the planning and delivery of accurate radiotherapy treatments using a wide range of technical equipment. The accuracy of these are critical to treat the tumour and destroy the diseased tissue, while minimising the amount of exposure to surrounding healthy tissue. Their degree qualified training solely in oncology and the care of cancer patients makes them uniquely qualified to undertake this role. The newer treatment techniques such as Intensity Modulated radiotherapy, Image Guided radiotherapy and adaptive radiotherapy require decision making at the point of treatment delivery at each treatment to ensure the optimum personalised treatment plan is delivered accurately at every treatment.

Therapeutic radiographers are extensively involved at all stages of the patients' radiotherapy journey: 

  • Pre-diagnosis – giving health promotion advice and raising awareness of cancer.
  • Patient consent – working with patients to enable them to make informed decisions about their treatment options. 
  • Pre-treatment preparation and planning – the use of sophisticated equipment to scan patients and plan treatments. As well as the preparation of any required devices to ensure the accurate delivery of treatment.
  • Treatment delivery – the use of a range of radiotherapy equipment to deliver external beam radiotherapy and brachytherapy (internal radiotherapy treatments). 
  • Patient management during treatment – the regular assessment of patients whilst undergoing treatment. Many radiographers qualify to prescribe drugs for patients to counteract the side effects of treatment. They are also responsible for the psychosocial well being of their patients whilst they are attending for treatments.
  • Patient follow up, management and care after treatment has finished. 

As Allied Healthcare Professionals, therapeutic radiographers undertake clinical practice at all levels;

  • Assistant
  • Practitioner
  • Advanced
  • Consultant practitioner
  • Radiotherapy service manager

A growing number of radiographers undertake tumour site specific roles or specialist treatment roles (at both advanced and consultant level practice), where they are responsible for their own patient load from treatment referral, through treatment to post treatment follow up. They are part of the multi-disciplinary approach to patient management by attending and participating in MDT meetings. These post holders provide continuity of care for their patients across their cancer journey with improved levels of care for their patients as well as efficiency benefits for the service.

Therapeutic radiographers are also involved in clinical research at all levels; ranging from recruitment to trials through to radiographer led research studies to evaluate the newer technologies and techniques as part of providing evidence based practice.

They can also specialise as community liaison practitioners. These post holders provide continuity of care between all health care providers. They also support and educate staff in the primary care services to understand and manage the side effects experienced by radiotherapy patients after they have finished their course of treatment.

Radiotherapy Service Managers are professional qualified managers responsible for the strategic delivery and planning of the service along with the day to day operational management of radiotherapy services. Their professional training and expertise is critical to the provision of safe and efficient radiotherapy services.

Other healthcare staff you may meet in imaging

Assistant practitioners

Assistant practitioners are pivotal to the delivery of high quality, patient-centred care in radiography. Although they are not registered healthcare practitioners they have a high level of skill through their experience and training and will work to a specific scope of practice. They will be assessed as competent before they are entitled by their employer to undertake your X-ray.

Areas where you may commonly meet an assistant practitioner are in the NHS Breast Screening Service, in some hospitals undertaking X-rays of your body if you are an adult (but not usually doing scans),or in the independent sector working alongside radiographers.

Radiographic support workers

The support workforce provides valuable additional care, support and capacity to enable diagnostic imaging services and radiotherapy departments to work safely and effectively. They may be involved in meeting you, helping you to undress, looking after your mobility needs or transporting you around the department. They may care for you while you wait for your test or treatment. 

#Hellomynameis

Anyone you meet in a healthcare environment should introduce themselves and tell you their name, it's a kind and respectful thing to do. They may also tell you their job title. It may not be important for you to know if they are a radiographer, nurse or doctor but if it is and they haven't told you, please don't be afraid to ask. Sometimes these things are just forgotten because the person has said it so many times during the day or they may be trying to catch up some time if the previous patient needed more time than was scheduled for them. They won't mind you asking and in many cases will be pleased you are interested.  The Society and College of Radiographers supports the #hellomynameis campaign. Please read more about this here.

What do I need to know before I attend?

Diagnostic tests

For any examination or treatment using ionising radiations ( X-rays, CT scans, Nuclear Medicine, Bone densitometry (DXA), breast screening etc it is a legal requirement that you are provided with information relating to the benefits and risks of the radiation dose you will receive. This includes what to do if you are or think you may be pregnant and if you are breast feeding.

Patient information leaflets, specific to your test may have been sent to you with your appointment letter or may be available from the hospital you are going to for your diagnostic procedure. If you have any questions it is important to discuss these with the radiographer BEFORE your test.

Cancer treatments

All cancer centres provide their patients with information about their radiotherapy before and as they start treatment, so do find out what they can provide before you start your treatment. Many cancer centres have their own cancer information and support centres which are staffed by specially trained health care professionals and volunteers to provide information and support about all aspects of cancer, the treatment options, side effects of treatment and other services available. Many of these centres produce their own information resources about local treatment treatments and services.

How can I find out more about my condition?

We are compling a list of reputable charities, networks and support services for patients. Please read more here.

Please read our article an overview of radiotherapy. This gives more details about the role of radiotherapy and links to other organisations’ websites which provide information about radiotherapy.

Access to your health records

You have a legal right to be able to access your health records. For more information about the types of healthcare records and how to access them click here.

How to raise concerns or make a complaint

If you have concerns or wish to make a complaint about the quality of care you receive from the NHS, or would like to provide feedback about any other issues or experiences whilst using the NHS you should contact your local PALS (Patient Advice and Liaison Service).

Visit your local hospital website for details of your local PALS service or search using your postcode here. All NHS Trusts must provide this service.

It is always better to speak directly to those responsible for the care you received and PALS offers confidential advice, support and information on health-related matters. They provide a point of contact between patients, their families and carers and your service provider. Because they listen, PALS can also help to improve future services as a result of your comments and experiences.

The Francis Report

The Society and College of Radiographers has implemented a number of actions and published a response to the final report of the Mid Staffordshire NHS Foundation Trust Public Inquiry, chaired by Robert Francis QC.

Our response includes revising the profession’s Code of Professional Conduct, building on and enhancing the library of e-learning resources, and upgrading the online CPD portfolio tool.

The joint response of the Society of Radiographers and the College of Radiographers to the Final Report of the Independent Inquiry into care provided by Mid Staffordshire NHS Foundation Trust

Click here to find out how healthcare staff use your personal information.

Fact sheets