REVIEW ARTICLE Clinical practice at an advanced level: an introduction J. Nightingale, Msc, DCR, Lecturer and P. Hogg, Bsc (Hons), MPhil, PgCert, Professor Directorate of Radiography, University of Salford, Salford M6 6PU, UK INTRODUCTION The way that healthcare is developing in Great Britain is unique because of the way the advanced clinical practice of the so-called ‘non-medical’ profes- sions (e.g. nursing, radiography, physiotherapy etc.) has advanced at a phenomenal rate. At a local (hos- pital) level, radiographers are being encouraged to take on new roles; although in some sub-specialties of radiography, the rate of change has been more se- date. For example Holmes and Hogg [1] and also Huggett and McClellan [2] nicely illustrate this on the subject of image interpretation by non-medical staff or personnel in nuclear medicine. Nonetheless, it is well recognised that local variations exist, but the overall ambition (both politically and profession- ally) is for a greater engagement in advanced practice to improve patient care and management. One must accept that, for a variety of reasons, there will always be resistance to change; and perhaps in a future ar- ticle, this topic could be the subject of a debate. On examination of the literature, one will find many articles and comments in journals, professional maga- zines and conference abstracts books on the various aspects of advanced practice. However, there is a lack of systematic documentary evidence that takes into account the current and future states of practice. Many of the publications and presentations on the ad- vanced practice are often specific in nature—address- ing a focused aspect, and often such valuable work adds to the general body of knowledge. In this series of articles, an attempt will be made to summarise and document generic (e.g. legal issues) and specific (e.g. the role of the gastro-intestinal (GI) specialist) themes on the advanced clinical practice. There is a dual pur- pose to this exercise: to formally record summary in- formation for historical record; and to address more contemporary issues—such as the sharing of experi- ence and knowledge in a bid to help meet common educational needs. Although most articles on the advanced practice are specific in nature, it is important to note that some review and debate articles do exist. In par- ticular, we draw the attention to Hay’s [3] article. This article gives an excellent overview of skill mix and advanced practice in 1998. Then there is the more specific work of Price [4], a seminal piece, docu- menting how reporting for radiographers evolved throughout the ages. The work of Paterson [5] helps us to understand the need for publications ad- dressing not only the current situation, but also the future development of the profession. This article commences with a review of the cur- rent position of advanced radiographic practice, which is followed by an examination of some catalysts that (Received 6 January 2003; accepted 17 January 2003) Correspondence should be addressed to: Professor Peter Hogg. E-mail address: p.hogg@salford.ac.uk E-mail address: J.Nightingale@salford.ac.uk 1078–8174/03/010077+07 $30.00/0 Ó 2003 The College of Radiographers. Published by Elsevier Science Ltd. All rights reserved. Radiography (2003) 9, 77–83 doi:10.1016/S1078-8174(03)00005-1