Code of Conduct and Ethics

Published on Society of Radiographers (https://www.sor.org)

Code of Conduct and Ethics

Responsible person: Rachel Harris
Published: Friday, February 1, 2008
ISBN: 9781 871101 45 X
Edition: 1st

Summary
This code replaces the Statements for Professional Conduct published in 2004. It outlines the
principles required of a professional working in imaging or radiotherapy. It provides advice and
guidance and requires staff to use their professional judgement to apply the principles to the various
situations in which they practice and in their personal lives in order to maintain the widest public
trust and confidence in the profession.

Introduction
About this code
This document and the principles inherent within, outlines the principles and precepts required of a
professional working in the wide field of what is encompassed within the generic term ‘radiography’.

It is issued by the Society and College of Radiographers (SCoR) to give advice and guidance to
radiographers. Radiographers should use their judgement to apply these principles to the various
situations in which they practice and in their personal lives in order to maintain the widest public
trust and confidence in the profession.

Radiographers are advised that this document is not an alternative but is an adjunct to the current
Health Professions Council (HPC) Standards of Conduct, Performance and Ethics1 and must be used
in conjunction with it and all other relevant HPC publications. The HPC is the regulatory body for a
number of named health professions.

Whilst this document addresses the profession of radiography and radiographers, most aspects
contained within it are pertinent to members of the wider radiography workforce (eg, student
radiographers, assistant practitioners, trainee assistant practitioners and support workers). It is
incumbent on this wider workforce to ensure that they apply these same principles and precepts
within their own scope of practice to ensure the public’s trust in radiography service provision and
thus also in the profession of radiography.

Legal framework in which radiographers practice

Under the Health Professions Order (2001) the terms ‘radiographer’, ‘diagnostic radiographer’ and
‘therapeutic radiographer’ are protected titles and can only be used by persons who have
successfully completed an approved course leading to a diploma or degree in radiography and who

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are registered with the HPC. Title protection is one way of assisting the public in the identification of
those individuals who are not only registered with the regulatory body and subsequently accountable
for the delivery of a wide range of radiographic services, but also meet the established standards of
the profession. It is permissible for the term ‘student radiographer’ to be used as long as it refers to
an individual who is at the time following a recognised degree course which leads to eligibility for full
HPC registration as a radiographer.

Individuals using any of the protected titles relevant to radiography in all clinical specialities;
(educational, research, managerial or industrial employment) must comply at all times with the
current legislation and laws in their country of practice, with current best practice and with their
employer’s reasonable policies and procedures.

Complaints, professional conduct and fitness to practice

The HPC, as the professional regulatory body, handles complaints concerning the professional
conduct or fitness to practice of registrants. The Society of Radiographers is the body that handles
complaints or considers matters of fitness to practice concerning members of the Society who are
not regulated by the HPC.

The HPC and the Society of Radiographers will take into account adherence or otherwise to this code,
by radiographers and the wider radiography workforce, in the event of any complaint received.

Expectations
The Society and College of Radiographers expect members of the profession to, at all times, conduct
themselves in a manner that will maintain public trust and confidence in the profession as a whole.
The reputation of the profession must never be put into jeopardy through the actions or behaviours
of either its members or the wider radiography workforce. In addition, individual members of the
whole of the radiography workforce have a right to expect to be treated with respect and to be free
from threats, violence or verbal abuse.

Whilst this document addresses the ethical requirements of radiographers and, by implication, the
radiography workforce, it is also intended to enable the public to know what to expect from the
provision of radiography services and, as such, this document should be widely available.

Best practice
At the heart of best practice is a commitment to the health and safety of all service users: to
integrity and honesty; to professional competence; to continuing self-development and to the
development and maintenance of high standards of ethics and behaviour.

This document consists of four major areas of standards of ethical behaviour which underpin and
sustain professional and personal conduct:

1. Scope of Professional Practice

2. Relationships with Service Users
3. Relationships with Professional Staff
4. Personal and Professional Standards

and which are further informed by the following five philosophical precepts of:

Autonomy (respect for persons)

Beneficence (doing good)
Non-maleficence (not doing/preventing harm)
Justice (fair treatment of persons/environment)

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Trustworthiness

Note
The HPC uses the term ‘service users’ to refer to anyone who uses or is affected by the services of
registrants and will thus be applicable to all radiography registrants in whichever field they practice.
The term ‘service users’ has therefore been adopted for this present publication.

In this document the following terms are used:

'You must' is used as an overriding principle or duty'You should' is used where the principle or duty
may not apply in all circumstances or where there are factors outside your control affecting your
ability to comply.

This document replaces Statements for Professional Conduct2 which was issued by The College of
Radiographers in March 2002 and re-issued with minor amendments in September 2004.

1. Scope of Professional Practice

As a member of the radiography workforce you must practice in a safe and competent manner within
your own scope of practice based on education, competency, knowledge, extent of experience and
registration.

Professional indemnity insurance is available through membership of The Society of Radiographers.

There may be circumstances when public liability insurance is required, this would only be applicable
for unusual conditions, for example, radiographers working as independent practitioners. You must
seek to further the profession of radiography and to maintain public confidence in the profession.

1.1 Scope of practice of radiography

All radiographers have a responsibility towards users of your services and a unique individual
responsibility for the optimisation of any ionising or non-ionising radiation dose to individuals and to
the genetic inheritance of the public at large. You are required to abide by current legislation and
healthcare policy.

1.2 Individual scope of practice

You must consider the requirements of your individual scope of practice and seek to develop and
maintain your abilities, to recognise the limits of your competence and to practice within them. You
must monitor your practice and any protocols you work within using evidence from audit findings
and from the relevant research in order to develop best practice.

You will always be accountable for your actions, your omissions and your behaviours and need to be
able to justify any decisions you take within your scope of practice. You should recognise any
deficiencies you may have and take appropriate action to rectify them.

1.3 Development of the profession

You should endeavour to ensure that the profession of radiography continues to develop in all fields
and specialities and look for opportunities where development is possible. With this in mind you
should seek out and work with others in pursuit of this goal, bearing in mind that your main
responsibilities are always to service users.

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1.4 Individual role development

Opportunities for individual role development lie within the career progression framework. You must
engage in educational planning relevant to your needs and the needs of the service arising from
clinical practice. You should seek to become a reflective, self-directed learner; able to appraise
recent relevant research and to discuss and review the evidence base with colleagues in a variety of
situations. You should encourage colleagues and other members of the radiography workforce in
their role development.

1.5 Competence and continuing professional development

You must develop and maintain high standards of competency in skills, knowledge, acquired
attitudes and behaviour and must work within current legislative and employers’ frameworks.

You should actively engage in learning in a constant process of development through the integration
of Continuing Professional Development (CPD) in your day to day practice. CPD is a requirement for
registrants and therefore must be a planned activity which is evidenced.

Registrants must follow the HPC guidelines in Your guide to our standards for continuing professional
development3.

1.6 Clinical supervision/teaching

You should be willing to be involved in the supervision, teaching, training, appraising and assessing
of student radiographers, assistant practitioners and trainees. You also have a professional
obligation towards the teaching and training of other healthcare professionals (HCPs) in some
practice areas eg, radiographers may be involved in mentoring nurses or midwives in ultrasound
training. When involved in any such activities, you need to develop the skills, attitudes and practices
of a caring and competent teacher/trainer. You should be objective and honest when supervising,
appraising, evaluating or assessing the performance of others as service users will be at risk if you
describe as competent someone who has not yet met or maintained a satisfactory standard of
practice.

1.7 Professional liability insurance

There are inherent risks arising from the wide practice of radiography so it is important that you
have adequate insurance to cover these risks. Usually insurance coverage is vicariously undertaken
by your employer as long as you practice within your own scope otherwise the vicarious liability of
the employer may be negated. The SCoR, through its annual subscription, covers personal liability
insurance for those members working in the UK or who are travelling and temporarily working
abroad in all countries with the exception of the USA and Canada.

Radiographers undertaking imaging outside any recognised care management framework eg, social
ultrasound scans arising from self-referrals are advised to obtain additional professional indemnity
provision.

Radiographers who practice as independent practitioners must ensure that they have adequate
vicarious, personal and third party liability insurance.

For further advice see SCoR documents Statements on Ultrasound Referrals and Professional
Insurance Arrangements4 and Professional Indemnity Insurance Statement5.

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2. Relationships with Service Users

You have moral and legal obligations to service users and a duty of care to all.

You should demonstrate respect for individual dignity, belief, culture and autonomy through a
commitment to the principles of consent and confidentiality. You must neither engage in, nor
condone, behaviour that causes physical, emotional or psychological distress or damage to anyone.

2.1 Provision of good care to service users

You must ensure equality of care to all with no discrimination (gender, age, disability, ethnic origin,
race, religion, beliefs, marital status, economic status, lifestyle, sexual orientation). You should strive
for a consistency of care at all times and in all situations.

You must not be judgemental of any service users and ensure that children and other vulnerable
groups are protected.

You must recognise the limits of your competence, consider the provision of appropriate health
educational advice and, when deemed appropriate, consult with and take advice from colleagues.

You should make good use of resources available to you and at all times optimise exposure to
radiation.

2.2 Professional boundaries

You should, if practicable, avoid providing imaging or radiotherapy services to anyone with whom
you have a close personal relationship.

In order to maintain professional boundaries, you must not use your position to enter into
relationships that may exploit service users sexually, emotionally, socially, financially or in any other
manner.

You must use your professional judgement as to whether it may be prudent to involve a chaperone
for a particular situation involving a service user. Wherever possible, it is good practice to offer the
patient the presence of a chaperone during certain intimate procedures (eg, transrectal or
transvaginal examinations) whether or not you are the same gender as the patient.

Considerations of chaperoning should be annexed to patient consent for examinations and it is

advisable to ensure that the patient agrees with, and understands the role of, staff that might be
present during intimate examinations.

Conversations with service users which include references to sex, politics or religion should be
avoided.

2.3 Communication
You should introduce yourself by full name and job title to any user of your service and ask
individuals how they wish to be addressed (eg, you must not use first or given names without initially
gaining permission).

You must listen and respect service users’ views, communicate clearly, openly and effectively and be
conscious of their ability to make decisions for themselves.

You should identify individuals with communication difficulties and make adjustments to
accommodate their particular problems (eg, if there are language difficulties you should use
interpreters not family members wherever possible).

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In addition, you should develop sensitivity to the different cultural needs of patients.

Good communication with vulnerable people such as the elderly or special needs patients is
imperative; you must always listen carefully to them and respect their views.

2.4 Children
You have a professional and personal duty to safeguard and protect children and therefore should
follow the SCoR guidelines in The Child and The Law: the roles and responsibilities of the
radiographer6.

2.5 Consent
You must satisfy yourself that the appropriate informed consent has been gained prior to
undertaking any examination or procedure and follow the SCoR guidelines in Consent to imaging and
radiotherapy treatment examinations: an ethical perspective and good practice guide for the
radiography workforce7.

2.6 Confidentiality
You must not share the medical or personal details of a patient/client with anyone except those
healthcare professionals who are integral to the well being of the patient. Consent of the patient
should be gained before sharing information with relatives, carers or whoever may accompany the
patient.

You must neither misuse electronic mail nor discuss patients or their illnesses in a public place. Local
policies and procedures should be followed with regard to the leaving of messages on telephone
answering systems.

Service user confidence is imperative and you need to follow the SCoR guidelines in Consent to
imaging and radiotherapy treatment examinations: an ethical perspective and good practice guide
for the radiography workforce7 and the HPC guidelines in Confidentiality: guidance for registrants8.

2.7 Infection control

You must ensure that you understand and follow the principles and practice of infection control and
that you minimise the risks of cross infection. You should seek to advise service users and students
on how to avoid cross infection and report instances where cross infection may arise from activities
you have witnessed.

You should follow the SCoR guidelines in Healthcare Associated Infections: practical guidance and
advice9.

3. Relationships with Professional Staff

You are obliged to co-operate with carers, other healthcare professionals, hospital staff and social
care professionals. You should seek to understand and respect their responsibilities, needs, skills and
working practices to ensure the best interests of all service users and avoid inappropriate criticism of
them.

3.1 Collaborative practice/collegiality

Frequently, you may work as part of a multi-professional team and you need to respect the skills,

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knowledge and contributions of colleagues from other professions and other team members. You
should communicate openly and effectively with team members, acknowledge their individual roles
and avoid inappropriate criticism of them.

3.2 Responsibility for peer behaviour

Radiographers and the wider radiography workforce have responsibilities within the work
environment to ensure the health and safety of service users and should seek to avert any
inappropriate activity of colleagues or others. If you have a patient-safety concern, you must ensure
you are aware of the procedures for ‘whistle blowing’ and must report serious breaches of behaviour
and malpractice.

The Public Interest Disclosure Act (PIDA) 1998 which came into force in July 1999 encourages people
to raise concerns about malpractice in the workplace and will help ensure that the organisation
responds by addressing the message rather than the messenger and resist the temptation to cover
up serious malpractice.

You are covered by the Act and employing authorities will have a written policy outlining the Act and
provide processes and stages for the reporting of suspected malpractice.

Malpractice includes, amongst other things, negligence, incompetence, breach of contract,

unprofessional behaviour, danger to health and safety or the environment and the cover up of any
such issues.

Should you have a reasonable belief that a malpractice has occurred, is occurring or is likely to
occur, you must approach a manager or senior professional with your concerns and follow the
employing authority’s procedures. Concerns you may have about staffing levels which may
compromise patient safety must also be reported.

You should not use ‘whistle blowing’ procedures to resolve a personal or business dispute.

You are encouraged to contact the SCoR and the Health Professions Council (HPC) for guidance
about any malpractice concerns.

3.3 Referrals
Radiographers may accept requests for clinical imaging from named, non-medically qualified,
registered healthcare professionals who are acting in the capacity of referrer under IR(ME)R,
provided that an up to date list of individuals entitled to act as a referrer is established, maintained
and made available to radiographers by the employer. The referrer is required to have an
understanding of IR(ME)R through appropriate training and experience. Further information is
available from Clinical imaging requests from non-medically qualified professionals (RCN, SCoR
2007)10. Where an individual undergoes an exposure following an invitation to attend an authorised
national screening programme, there is no requirement for a named referrer.

In the role of IR(ME)R practitioner, radiographers must take the responsibility for the justification of a
medical exposure and should refuse the referral if the procedure cannot be justified. Where and
when appropriate, the radiographer should propose the use of a procedure involving non-ionizing
radiation.

3.4 Delegation
If you delegate clinical procedures (eg, radiographers delegating to students or assistant
practitioners), you must satisfy yourself that that person is competent to carry out the procedure;
you will retain ultimate responsibility for the manner in which the delegated task is performed.

You must provide supervision commensurate with the level of competence of the person to whom

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the procedure is delegated.

4. Personal & Professional Standards

You must conduct yourself with honour and dignity and demonstrate trustworthiness and integrity in
both your personal and professional life in order to maintain the widest public trust and confidence in
the profession.

4.1 Personal conduct & deportment

You should support the health and well being of yourself, your colleagues and your service users.

You must carry out all activities conscientiously and treat all persons with whom you come into
contact with respect and dignity irrespective of their gender, age, disability, ethnic origin, race,
religion, beliefs, marital status, economic status, lifestyle, sexual orientation or political viewpoint.

4.2 Further employment

It is not appropriate to have any other employment outside radiography or in any other capacity
within your place of employment, if that employment conflicts and compromises your role in the
radiography workforce or brings the profession into disrepute.

4.3 Personal health

You must look after your own personal physical, emotional and psychological health and avoid any
contact or involvement with service users if you are ill, emotionally distressed or on medication
which may affect your performance or judgement. If you identify the need for help related to your
own personal health you should feel able to ask for it without fear of discrimination. You must follow
the requirements of the employing authority with regard to the need to disclose any illness and/or
disease which you develop which potentially places others, including service users, at risk (eg, if you
have an infection which could harm others).

You should be aware of any risks which may lead to work related disorders and ensure that these are
minimised. It is your responsibility to ensure that equipment and the working environment are
appropriate to minimise such risks and to inform management if these are considered to be
unsuitable.

4.4 Personal ethics

You shall not be required to become involved in any professional activity which you believe to be
unsafe, illegal, unethical or detrimental to any service user.

4.5 Conscientious objection

You must report in writing to your employing authority, at the earliest date in your employment, any
conscientious objection that may be relevant to your professional practice. You should explore with
them ways in which you can avoid placing an unreasonable burden on colleagues because of this.
Your right to conscientious objection does not exempt you from providing service users with full,
unbiased information eg, prior to prenatal screening or testing.

You do not have the right to refuse to take part in any emergency treatment.

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4.6 Respect for the law

You must keep within the law of the country where you live in all your professional and personal
practices.

Radiographers are required to inform the HPC if they have received a police caution or have been
charged with, or found guilty of, a criminal offence; this applies even if outside the country where
they live or work.

If asked to act as a witness in a formal inquiry or litigation process related to an employment

situation, you must make clear the limits of your knowledge and competence.

4.7 Integrity in research

You should either conduct research or be involved in research or its dissemination in order to further
the evidence base of the profession. You must protect the interests and confidentiality of patients
and ensure that you do not distort or misuse clinical and research findings.

4.8 Providing/publishing information related to services

Radiographers who provide independent professional services can advertise but must ensure that
any advertising is factual, legal, decent, honest and truthful and does not misrepresent the services
on offer.

If you do provide independent professional services you must be honest in the financial
arrangements with individuals informing them of any fees/charges at the earliest time and informing
them if the NHS is able to provide the same service free of charge.

You must not accept commission from third parties for recommending, when practicing, the
purchase of goods or services related to your professional status.

4.9 Public accountability and respect for the environment (sustainability)

The radiography workforce has a responsibility to society, to tax payers, to the wider community and
to the environment. You should demonstrate due regard for the sustainable management of
resources at your disposal and should use resources as responsibly and efficiently as is practicable.

4.10 Record keeping

The radiography workforce is required to write reports and complete forms and other documents for
a variety of tasks (eg, curriculum vitae, radiological reports, student supervision, travel claims, locum
or out of hours work) in professional and personal circumstances. You must carry out these tasks
using integrity and honesty and ensure that records are protected from loss, damage, tampering or
inappropriate access. You must comply with the current Data Protection Act. You should adhere to
any pertinent standards related to record keeping as in Standards for the Reporting and
Interpretation of Imaging Investigations11.

4.11 Uniform/work-based clothing

You should wear appropriate uniform or work-based clothing which meets the need to inspire
confidence in your patients and to afford protection against cross infection risks and other health
and safety considerations. Your employing authority will determine the nature of your work-based
clothing which will also take into account the cultural and religious requirements of members of staff.
You should follow advice given in Guidance on protective clothing/uniforms worn in clinical imaging
and radiotherapy and oncology departments12.

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References
1. Health Professions Council (HPC) Standards of Conduct, Performance and Ethics. London:
HPC; April 2003
2. SCoR Statements for Professional Conduct London: SCoR; Sept 2004.
3. Health Professions Council (HPC) Your guide to our standards for continuing professional
development. London: HPC; May 2006
4. SCoR Statements on Ultrasound Referrals & Professional Insurance Arrangements London:
SCoR; Nov 2006
5. SCoR Summary of Professional Liability Insurance Policy London: SCoR;
http://www.sor.org/members/membershipcentre/profindemn.htm
6. SCoR The Child & The Law: the roles and responsibilities of the radiographer. London: SCoR;
Oct 2005
7. SCoR Consent to imaging and radiotherapy treatment examinations: an ethical perspective
and good practice guide for the radiography workforce. London: SCoR; August 2007
8. Health Professions Council (HPC) Confidentiality: guidance for registrants. Consultation
document London: HPC; June 2007
9. SCoR Healthcare Associated Infections: practical guidance and advice London: SCoR; 2006
10. Joint document (RCN, SCoR, GCC, GOC, CSP, NHS Alliance and RCR) Clinical imaging requests
from non-medically qualified professionals London: RCN; 2006
11. Royal College of Radiologists Standards for the Reporting and Interpretation of Imaging
Investigations London: RCR; Jan 2006
12. SCoR Guidance on protective clothing/uniforms worn in clinical imaging and radiotherapy and
oncology departments London: SCoR; July 2005

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