ST HELENA GOVERNMENT
TERMS OF REFERENCE FOR RADIOGRAPHER
RESPONSIBLE TO: Health and Social Welfare Directorate of the Government of St Helena.
CONTACT WITH: Patients, carers, visitors, multidisciplinary team, other healthcare
professionals, non-clinical staff.
The postholder is expected to provide specialist radiography/ultrasonography services to the
population of St Helena, as well as advice and support to the Senior Medical Officer/Clinical
Director (SMO/CD) and other Medical Officers (MOs) and clinical staff as required.
BACKGROUND
The island of St Helena, an Overseas Territory of the United Kingdom (UK) is of volcanic origin
and covers 47 square miles in the South Atlantic Ocean. St Helena is over 4,000 miles from
the UK, 700 miles southeast of Ascension Island, and 1,700 miles from South Africa. The
Island’s total population is around 4,000 persons, about 25% of whom live in the capital,
Jamestown. The climate is kept mild and equable by the southeast trade winds and
temperatures range from 14-32 degrees centigrade in the summer and 14-26 degrees
centigrade in winter. The economy is small and is mainly based on offshore employment,
agriculture, fishing and more recently a small but growing volume of tourism. Most
commodities are imported and St Helena relies heavily on UK Aid to support essential services
and livelihoods.
St Helena currently has no airfield and therefore the only regular mode of access to the Island
is via the Royal Mail Ship (RMS) St Helena, which calls roughly 25 times a year, shuttling
between St Helena, Ascension, and Cape Town. On 22 July 2010 the Secretary of State for
International Development, Andrew Mitchell, announced the UK Government’s intention to
finance a project to build an airport on St Helena subject to four conditions being met. On 3
November 2011 it was announced that the Secretary of State’s conditions had been met, and a
contract had been entered into with Basil Read (Pty) Ltd in the amount of £201.5 million for the
design and construction of the airport, an additional up to £10 million in shared risk
contingency, and £35.1 million for ten years of operation. The airport will greatly improve travel
to and from the Island, open up opportunities for sustainable economic regeneration and
ultimate financial self-sufficiency for St Helena.
The Governor is the most senior official in the St Helena Government (SHG) and he is
supported by the three next ranking officials ie the Chief Secretary, the Financial Secretary and
the Attorney General. Strategic decisions are in the main taken by the Executive Council which
is chaired by the Governor and comprises 5 elected Members of the Legislative Council and
the 3 senior SHG officials as ex officio members. The Public Service comprises a number of
directorates each headed by a Director reporting either to the Chief Secretary, Financial
Secretary or directly to the Governor. Most of the directorates are also required to work with
one or more of the 8 Council Committees that comprise elected Members of the Legislative
Council. The Directorates are required to provide advice to, and take policy direction from, the
relevant Committees.
The Directorate of Health and Social Welfare is one of the largest within the St Helena
Government. It employs 260 full and part-time staff and there is only one hospital on the
Island. The Directorate has no trained Radiographer and relies on 2 nurses who have had
some training in Radiography from visiting consultants to undertake the radiographic services,
although there has been locum radiographer support for a few months this year. The
radiography section has one mobile x-ray machine which the directorate depends upon for its
radiography service. The Directorate has recently invested in a Digitiliser to complement the xray service and allows email transmission of x-ray images. There are 2 ultrasound scanners,
which are operated in the main by medical staff and one nurse. They can undertake Doppler
small tissue abdominal, obstetric and cardiology (one can undertake continuous wave and
oesophageal scans).
Due to the Island’s isolation, it is essential that x-ray images are of a high quality to enable as
accurate a diagnosis as possible, hence the need for a fully trained and experienced
Radiographer with experience in ultrasonography to join the hospital team.
Equipment and Current Arrangements
The equipment available within the Hospital for X-Ray and Ultrasound is as follows:
X-Ray:
 Portable GE Medical AMX4 Plus. Currently approx 100 X-R images taken per month

Arcomec 140R N Mobile C Arm Unit. Currently not in working order

Pamarex OPT dental machine Plus intraoral dental in use in Dental department
Ultrasound:
 Siemens Sonoline G40 – which provides digital images and is connected to the EMIS
Medical Records system. Currently approx 45 – 50 U/S images taken per month (these
are for: cardiac, obstetrics, abdominal etc) but this is likely to increase
 Toshiba Xario
For second opinions, e-mails are currently sent to Drs Van Dyk and Partners Inc in South
Africa
Processor:
 Agfa Curix benchtop
Currently, there are plans for hospital re-development. These include the installation of a
general x-ray unit with digital capability.
(1) PRINCIPAL OBJECTIVES:
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To manage and develop the existing x-ray and ultrasound service
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To supervise and train trainees
3
To deliver the NVQ training programme (level 3) in Clinical Imaging to identified
nurses in order that they achieve assistant practitioner status
4
To maintain a good radiographic standard and professional technical knowledge
provide training to staff in a number of key areas to be agreed with SMO/ CD, possibly
as a result of a training needs analysis if required
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To seek distant telemedicine advice if/as requested by SMO/MO, including
transmission of digital images to overseas specialists
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To develop and undertake regular audits and participate in clinical governance
meetings when required
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To provide radiographic support to the dental section
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To liaise with other hospital staff
(2) EXPECTED OUTPUTS:
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Improved standard of x-ray images and reduction of repeat x-rays as revealed by audits
The capture and processing of images, as well as the Interpretation of images, where
appropriate
Reduction of referrals for CT scan/MRI
Up to 5 staff attaining NVQ level 3 in Clinical Imaging within 1 year of arrival of
Radiographer/Ultrasonographer on island; commencing professional training on island and
showing satisfactory progress
Development and undertaking of quarterly audits
Quarterly progress reports submitted showing achievements of workplan targets
(3) SCOPE & DELIVERABLES - Where, What, When
The post-holder will be required to undertake a full range of duties as part of the role and will
divide their time between providing radiographic duties; ultrasound duties; producing images;
teaching/professional development of nurses/students; producing protocols/guidelines; and
participating in clinical and staff meetings as follows:
Clinical Care and Service Provision
1.
Management and development of x-ray and ultrasound service delivery - it is
anticipated that the ultrasound service will be developed to include for example,
fine needle aspirations in conjunction with the resident surgeon together with
any other appropriate developments required to progress the service
2.
Update patient records on EMIS system. Be aware that diagnosis and treatment
plans are the realm of the doctor treating the patient
3.
It is envisaged that some elements of digital radiography will be introduced in
the near future and therefore some knowledge on the implementation of such a
system is a requirement of the job
4.
Assist wherever necessary in providing appropriate specialist advice as
required.
Training and Professional Development Duties
5.
Training of at least 5 staff and assisting them with studies towards attainment of
an NVQ Level 3 in Clinical Imaging
6.
Nurse education - involvement in the training of student nurses from the School
of Nursing in, for example, CPD; some anatomy; and reflective practice
(4) METHODOLOGY
The Radiographer will work closely with the SMO/CD in all stages of his/her work to ensure that
services planned, treatment given is acceptable and cost efficient, taking into consideration the
financial constraints within Directorate of Health and Social Welfare
(5) REPORTING
The Radiographer will work closely with all medical and nursing staff; the SMO/CD on St
Helena; and report directly to the Acute and Community Health Manager, Mrs Wendy Henry
who will act as Reporting Officer for the consultant’s Performance Assessment.
The Radiographer will be expected to submit the following reports to the SMO/CD and the
Director, Health and Social Welfare:
a)
Quarterly progress reports: a short summary of activities and contribution towards
achieving the objectives of the St Helena Public Health Strategy. These reports should be
submitted via email before the 10th day of the month following each quarter and should detail
activity during the preceding quarter.
b)
Annual Report: Review of activities undertaken during the preceding year, achievement
of personal objectives and targets as set through SHG performance review system, and
contribution towards achievement of the objectives of the St Helena Public Health Strategy.
The Radiographer will also be expected to prepare quarterly workplans and undertake quarterly
audits.
(6) TIMEFRAME
It is expected that the duration of the contract for provision of specialist
radiography/ultrasonography services to St Helena will last for a period of approximately one
year with the possibility of extension.
(7) COMPETENCY REQUIREMENTS
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Diploma College of Radiographers or BSc (Hons) Diagnostic Radiography
Must be a State Registered Radiographer
Possession of Diploma in Ultrasound
Must have previous experience in degree student assessment/training and must be
able to demonstrate evidence of this, as well as evidence of teaching experience
Must have at least 5 years post qualification experience in general radiography and
ultrasound
Must have knowledge of PACS
Must be able to work with automatic processing, stationary grids and manual exposure
factors
Possession of NVQ Assessor qualification is desirable
Must have good management skills
Must be a good team player
Must be confident and of a pleasant demeanour
Must be reliable and be able to work without supervision
Must have excellent communication skills, both verbal and written
Must be computer literate
Note This job description is intended only as a guide to the duties involved and may be
modified to meet changing needs. The post-holder will be expected to be flexible in his or
her role and responsibilities to enable the medical team to work most effectively.