The EPA, the Ministry of Health and the Australian Institute of Radiography developed a user licence for remote operator's to allow limited radiography services to be provided in rural and remote areas of New South Wales.
What has changed and why
The remote operator user licence conditions have been amended to make the intent clearer. There have been occasions when remote operators have been requested to take x-rays outside the original intent of the user licence conditions. The amendments are intended to increase the accountability of referrers of x-ray examinations regarding the use of remote operators in place of radiographers and to ensure that the conditions of use are consistent across Local Health Districts (formerly Area Health Services). It is the responsibility of the employer to ensure that employees carry out these procedures.
Radiographer 'not available to attend'
In addition to the existing condition that the x-ray examination may only be performed by a remote operator when a radiographer is not in attendance, a clause has been added to specify what 'not available to attend' means for radiographers. A radiographer is taken to be unable to attend because they
have declared that they are unavailable
are not rostered on-call or are on leave
are required by OH&S not to attend to normal duties, e.g. workers compensation
are not contactable
are unable to attend in a timely manner due to restrictions in distance/time in emergency situations.
Local Health Districts must have clear documentation in relation to the above that demonstrates that
a comprehensive assessment has been undertaken of the need for on-call arrangements which has verified that an on-call roster is not required
all attempts to recruit radiographers have been undertaken prior to utilisation of a remote radiography operator to cover radiographer leave for a period of 5 working days - this includes documentation that labour market testing has been undertaken and at least one locum agency has been approached
all attempts to contact the radiographer are documented and follow a clear protocol based upon the Local District policies and/or individual hospital policies, with clear delegation of authority
an assessment was undertaken of the distance/time issue.
This documentation must be available for review as required.
Certifying the need for x-rays when a radiographer is unavailable
If a radiographer is not in attendance, or not available to attend, the remote operator may use x-ray apparatus to take plain radiographs. The remote operator's user licence conditions have been altered to require the medical practitioner to certify on the request form that the x-ray examination is required before the services of a radiographer can be obtained. The remote operators must obtain certification or authorisation by the referring medical practitioner on the request form prior to the examination. The remote operator must also see and countersign the request form before the radiographic examination can be carried out. This process will promote consistency with the NSW Health Patient Identification - Correct Patient, Correct Procedure and Correct Site policy.
The new certification requirements extend to situations where the medical practitioner considers that the life or wellbeing of the patient could be seriously threatened if the examination is not undertaken immediately. However, in these situations the remote operator may use any apparatus at any time to carry out the radiological examination.