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Key Findings

Stakeholder interviews

Key stakeholders were identified and interviewed because of their knowledge, expertise and experiences of AfC. They included SCoR past presidents, industrial relations officers, Society representatives at early implementer sites, managers and consultant radiographers. Their responses informed the structure of the survey tool. Whilst some agreed with the principles of AfC and recognised the potential benefits, many felt that discrepancies between the actions of different trusts meant that local circumstances may have continued to have more impact than AfC itself. Assimilating both Senior I and II staff to band six was identified as a major impediment to career progression among radiographers. In addition, where there were staff shortages, training posts had been banded higher, resulting in some staff being given an advantage. In spite of noting that there were ‘winners’ and ‘losers’ under AfC, stakeholders felt that it had led to a widespread loss of goodwill and decreased morale amongst the radiographic workforce.

"There has been a failure of some trusts to adhere to the whole package of AfC…they are leaving out the bits they don’t like, such as Annex T..."

"There is still a rash of local agreements which defeats the object of AfC..."

"Within the banding there are unclear lines of authority within departments..."

Results from the online survey

There were 2373 responses to the online survey, of which 2299 were radiographers. Fifty-two were assistant practitioners and twenty-two were healthcare assistants (HCAs). The majority of the radiographic workforce did not feel that AfC had lived up to their expectations or helped their career progression. Selective implementation of AfC terms and conditions by managers was frequently identified as a serious impediment to its success.

"It has been really demoralising and in some cases morally wrong..."

There was little evidence of the impact of recent NHS initiatives such as ‘Workforce Improvement’ and ‘New Ways of Working’ as a consequence of AfC. Results indicated that whilst the effect of AfC on radiographer morale was largely negative, the morale of many staff was unchanged. Negative effects appeared least amongst assistant practitioners and HCAs. A very few radiographers, mostly in the higher pay bands, felt that the introduction of AfC had increased their morale. Diagnostic radiographers who had worked under the previous Whitley conditions believed their morale was damaged by AfC, whilst more recently qualified staff did not express this view so strongly.

"AfC has improved my financial position but not my career progression..."

In band five, 59% of diagnostic radiographers and only 26% of therapeutic radiographers felt that AfC had reduced their morale.

But at band six, 70% of diagnostic radiographers and 71% of therapeutic radiographers felt this way.

Negative effects on morale were expressed by only 38% of band 3 staff together with 49% of those at band four.

 How as AfC affected your morale?

"I believe a golden opportunity to recognise and reward people has been missed... AfC is now a barrier that Trust boards can hide behind  to stop paying fairly for work..."

Most radiographers did not feel that AfC had fulfilled its promises and often complained about selective implementation of its terms and conditions by managers.

Inequity between and within trusts was commonly reported, but also there was no evidence for better career progression within foundation trusts. Staff disliked being grouped within the same salary band when they felt that their previous work had been at different levels of responsibility. Also many staff complained about being defined by their salary band and would have preferred a title which in their view better reflected their current role.

"The system means that senior I radiographers were put into band six, the same as senior II radiographers..."

Career development expectations

About a third of the radiographic workforce had chosen to appeal against their AfC pay band. Satisfaction with pay band amongst diagnostic staff increased sharply from those in band five to those in band eight. In radiotherapy this trend was less steep, with staff at the lower end of the banding range feeling relatively satisfied. The most common reasons for disagreement with banding in both disciplines were:

  • Higher levels of own perceived autonomy and responsibility relative to others in the same band
  • Job-matching inequities between trusts
  • Non-recognition of own experience or qualifications

Staff employed at band eight and above were the most likely to feel that their banding was fair and reflected their role responsibilities. In contrast, the majority of healthcare assistants felt that their pay band was too low.

"People were banded differently according to how clever their managers were at writing job descriptions..."

In both diagnostic imaging and radiotherapy most staff correctly anticipated their future AfC bands, with the exception of Senior I radiographers, some of whom expected to be on band seven but were placed on band six.

The majority of new graduate radiographers expected to progress into band six within two years but few were aware of whether their current employer recognised Annex T.

In diagnostic imaging, 58% of radiographers who were placed into band five expected to be on that band, while 28% had expected to be on band six.

Only 31% of diagnostic  radiographers who were placed on six had expected to be on that banding, whilst 45% had anticipated being on band five.

Key findings - Career progression opportunities

In some pay bands, particularly four, six and seven, staff felt “stuck” with no hope of progression. However, in departments where the Career Progression Framework (CPF) was implemented, appraisals occurred more regularly and were more likely to be aligned with the Knowledge and Skills Framework. Staff at these sites were more satisfied with their progression, as were therapeutic radiographers compared with diagnostic radiographers overall, and staff in higher pay bands compared with those in lower bandings.

"The implementation of the four tier structure, and support of colleagues... has helped my career progression..."

When was your last appraisal?

Those who qualified within the last five years appeared to have career development opportunities offered to them more frequently than longer serving staff.

Most staff felt that acquiring new skills was unlikely to speed their progression into the next pay band, even though it would boost their KSF levels. Promotions often appeared to be dependent on the existence of vacancies, rather than on professional development. No more than a tenth of diagnostic radiographers received protected study time, although many took part in activities such as in-house meetings and training. Protected study time was more widespread in radiotherapy.

"My progression to band seven will involve the retirement of the current post holder..."

Those who were the most optimistic about future career prospects included:

  • Band five staff generally
  • Mammographers
  • Therapeutic radiographers

The least optimistic were:

  • Band six staff generally
  • Ultrasonographers
  • MRI radiographers
  • RNI radiographers

Key findings - Barriers to and incentives for career progression

Many staff, and particularly those on bands two to four, reported barriers to career progression. Assistant practitioners most frequently acknowledged encouragement from peers, and many radiographers acknowledged the support of radiologists. A small minority of staff felt that AfC had helped their careers. Those in the higher pay bands were most likely to identify positive factors which had helped their career progression. Many staff commented that lack of funding or time off for training had damaged their morale.

"Trusts... have an ongoing lack of commitment to KSF..."

Just over 10% of diagnostic radiographers in bands five to seven received at least one hour of protected study time per month.

In radiotherapy this time was just over 20%.


  • Poor management support
  • Lack of funding
  • Under-staffing
  • Appraisals not done  


  • Good management support
  • Helpful colleagues
  • Organisational changes
  • Self-motivation

"The main barrier to my career progression has been lack of qualified and trained staff to cover my role..."

Do you feel there has been any barriers to your career progression?

"Inspirational line manager... who encouraged my development..."

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