Evaluation of supplementary prescribing by dietitians and independent prescribing by radiographers

This study will be conducted in four phases:

Phase 1:

Will be a literature review, to understand the roles of advanced practice dietitians and therapeutic radiographers in medicines management and to assess the impact of their prescribing activities on patients and organisations.

Phase 2:

Will be a survey of the current therapeutic radiography and dietetic services provided in England and surveys of dietitian/therapeutic radiographer prescribers. The surveys will explore how and where dietitian and therapeutic radiographer prescribing is being put into action.  

Phase 3:

Will consist of a comparative case study of four sites where dietitians or therapeutic radiographers are prescribing. At these sites we will compare the impact of these prescribers versus non-prescribing colleagues.   

In addition, we will identify two sites where dietitians or therapeutic radiographers are about to begin prescribing training. In these cases, we will collect data before and after the training to look at the changes resulting from the qualification.

We will be collecting a range of information using prescriber self-reporting tools, patient questionnaires and phone interviews, and data collected for us by hospital staff on-site.This will include:

• Staff reports on their prescribing and patient-facing activities   
• Patient satisfaction and views
• Economic data
• Patient safety data

Case studies will be from different hospital or community-based clinics around England. This data will be used to assess the impact of dietitian/therapeutic radiographer prescribing on patients, staff and services.

Phase 4:

Will be the development of a model of implementation and an online tool-kit.

Progress

Phase 1:

• We’ve completed the literature review and this is being prepared for publication.

Phase 2:

• We’ve completed data collection for this phase and are now analysing the data.
• We carried out 55 interviews with radiotherapy and dietetic service managers in England in our first round of interviews.
• We then spoke to 12 managers 12-18 months after their first interview, to see if anything had changed in their service. 
• We received 103 completed surveys from dietitian and therapeutic radiographer prescribers in our first survey, and 34 of these completed our follow-up survey 12-18 months later.

Phase 3:

• We have completed data collection at all our case sites, 3 dietetics services and 4 radiotherapy services across England took part.
• We interviewed 32 staff members and 27 patients, and received 180 patient questionnaires.
• We also gathered information about prescriber and non-prescriber working practices, by collecting 513 self-reports from practitioners, and are assessing the safety of prescribing decisions.

Phase 4:

• Our prescribing toolkits are now hosted on the NHS Learning Hub (https://learninghub.nhs.uk/catalogue/prescribingtoolkit).  The catalogue is accessible to researchers and healthcare workers and includes the preparing to prescribe toolkit. More resources will be added as they are developed.

We always welcome input from patients or carers using dietetic or therapeutic radiographer services. If you’d like to help with our work, please contact us on TRADIP@surrey.ac.uk.