S.I. No. 392/2013 - Radiographers Registration Board Code of Professional Conduct and Ethics Bye-law 2013.

Notice of the making of this Statutory Instrument was published in

“Iris Oifigiúil” of 15th October, 2013.

The Radiographers Registration Board, in exercise of the powers conferred in it by section 31 of the Health and Social Care Professionals Act 2005 (as amended), with the approval of the Health and Social Care Professionals Council, hereby makes the following bye-law:

1. This bye-law may be cited as the Radiographers Registration Board Code of Professional Conduct and Ethics Bye-law 2013.

2. The Radiographers Registration Board hereby adopts the Code of Professional Conduct and Ethics (the “Code”) contained in the schedule to this bye-law.

3. The Code is hereby incorporated by reference into, and forms part of, this bye-law.

4. This bye-law comes into operation on 11 October 2013.

SCHEDULE

Radiographers Registration Board

Code of Professional Conduct and Ethics

Contents

Foreword .............. 5

About the Code .............. 6

Conduct .............. 8

Performance .............. 11

Ethics .............. 15

Appendix A - Suggested procedure for ethical decision-making .............. 18

Bibliography .............. 19

Foreword

I am pleased to present the Radiographers Registration Board (RRB) Code of Professional Conduct and Ethics. The code specifies the standards of conduct, performance and ethics expected of registrants in either the radiographer or radiation therapist division of the Board’s Register.

The Radiographers Registration Board was appointed on 24 January 2012 by the Minister for Health, Dr James Reilly. The Board is one of twelve Registration Boards to be established under the Health and Social Care Professionals Act 2005 . The twelve Boards and the Health and Social Care Professionals Council operate under the umbrella of CORU. The purpose of CORU is to protect the public by promoting high standards of professional conduct, professional education, training and competence among registrants.

In 2010, the Health and Social Care Professionals Council at CORU developed a framework code detailing common standards across its twelve constituent boards. The Radiographers Registration Board, made up of both lay members and representatives of the profession, have carefully adapted the framework with additional assistance from experts external to the Board, a public consultation and international best practice. A scheduled review of the Framework Code conducted by the Health and Social Care Professionals Council early in 2013 has also been considered by the Board and is also reflected in this document.

The Code reflects the needs of patients and the standards they can expect when dealing with the practice of radiography and radiation therapy in this State. Each year registrants will be asked to pledge that they comply with the Code of Professional Conduct and Ethics. It is essential that all registrants read, understand and meet the standards set out in this Code. Failure to meet the standards could result in a complaint of professional misconduct being made about the registrant.

Under the Health and Social Care Professionals Act 2005 , professional misconduct is defined as “a breach of the code of professional conduct and ethics adopted by the registration board of that profession.”

As the goal of the RRB is to protect the public by fostering high standards of professional conduct, education, training and competence among registrants, adopting this Code is a major milestone in this process. As the professions develop, the RRB is committed to continually reviewing these standards and will ensure that they remain both relevant and comprehensive.

Jason Last

Chairperson

October 2013

About the Code

As a registrant you must comply with this Code of Professional Conduct and Ethics. It is recognised that ethical decision making presents challenges and it is suggested that the paradigm in Appendix A should be consulted.

Registrants must be aware that a breach or breaches of this Code could be held to be professional misconduct and could result in a disciplinary sanction being imposed following a fitness to practise inquiry.

In this document:

• ‘you must’ is used as an overriding principle or duty;

• ‘you should’ is used where the principle or duty may not apply in all cases or where there are factors outside your control affecting your ability to comply.

Below is a summary of your responsibilities as a registrant grouped into three categories: conduct, performance and ethics.

Conduct

1. Act in the best interests of patients.

2. Ensure the health, welfare, protection and safety of patients, carers, colleagues and the public with regard to radiation safety.

3. Respect the confidentiality and privacy of patients and their families.

4. Maintain high standards of personal conduct and behaviour.

5. Provide information about conduct and competence.

Performance

6. Address health issues related to your fitness to practise.

7. Obey laws and regulations.

8. Act within the limits of your knowledge, skills, competence and experience.

9. Keep your professional knowledge and skills up-to-date.

10. Seek informed consent from patients.

11. Communicate with patients, carers and other professionals.

12. Assist and advise colleagues and recently qualified registrants and students.

13. Teach, supervise and assess students and other professionals.

14. Supervise tasks that you give to others.

15. Enhance the patient experience.

16. Keep accurate records including images.

17. Address health and safety risks.

18. Be an advocate for patients.

Ethics

19. Demonstrate ethical awareness.

20. Respect the rights, needs, values, culture, dignity and vulnerability of patients.

21. Carry out your duties in a professional and ethical way.

22. Undertake research in an ethical manner.

23. Make sure that advertising is truthful, accurate and lawful.

Conduct

You must always maintain a high standard of conduct. Your duties are to:

1. Act in the best interests of patients

You are personally responsible for acting in the best interests of the patient.

You must:

a. treat patients as individuals;

b. respect diversity, different cultures and values and not condone, facilitate or take part in any form of discrimination;

c. respect and, where appropriate, speak out on behalf of patients and carers;

d. support the patient’s right to take part in all aspects of the service provided and to make informed choices about the service they receive;

e. do nothing and allow nothing to be done that might put the health or safety of a patient at risk;

f. when working in a team, be responsible for:

• your own professional conduct,

• any service or professional advice you give,

• your own failure to act, and

• appropriate delegation of tasks and any tasks delegated to you;

g. protect patients if you believe they are threatened by a colleague’s conduct, performance or health. Patient safety must always come before personal and professional loyalties;

h. talk to a suitable professional colleague if you become aware of any situation that puts a patient at risk.

You must not:

for reasons of personal or commercial benefit, direct public patients to private practice.

2. Ensure the health, welfare, protection and safety of patients, carers, colleagues and the public with regard to radiation safety

You must:

a. be responsible for the optimisation of any ionising or non-ionising radiation dose to patients consistent with the ALARA principle (As Low As Reasonably Achievable). This applies to all imaging modalities and radiation therapy;

b. make sure that carers, colleagues and the public are not unnecessarily exposed to radiation;

c. only accept properly authorised requests or referrals in line with current legislation and where these requests or referrals are for examination or treatment that will be of benefit to the patient;

d. take responsibility for justifying any medical exposure involving ionising radiation;

e. report any near misses or errors in procedures or treatments through your department’s reporting channels.

You should:

communicate medically significant findings to the appropriate clinical team who made the treatment request or imaging referral.

3. Respect the confidentiality and privacy of patients and their families

You must:

a. treat information about patients as confidential and use it only for the purpose for which it was given;

b. check that people who ask for information are entitled to it, in particular in relation to child protection;

c. be aware of your obligations to vulnerable adults and children under child protection and other laws;

d. always follow ‘best practice’, employer guidelines and data protection laws when handling confidential patient information. Stay up to date with best practice developments.

You must not:

give personal or confidential patient information to anyone, except if the law or your professional practice obligations requires you to do so.

Registrants must be conscious of their need to use social media and social networking in a responsible way, in particular, to avoid any breach of their obligations in this Code such as confidentiality under clause 3 and use of records and information under clause 16.

Disclosure of information to colleagues:

If you need to share patient information with a relevant colleague to give safe and effective care, you must make sure that they know that the information must be kept confidential.

4. Maintain high standards of personal conduct and behaviour

You must:

a. behave with dignity and integrity to keep public trust and confidence in the profession;

b. work co-operatively with colleagues;

c. respect the roles and expertise of other health professionals and work in partnership with them.

You must not:

a. harm, abuse or neglect patients, carers or colleagues;

b. exploit or discriminate against patients, carers or colleagues in any way;

c. form inappropriate personal relationships with patients;

d. condone discrimination by patients, carers or colleagues;

e. put yourself or others at unnecessary risk;

f. behave in a way that would call into question your suitability to work in health and social care professional services.

5. Provide information about conduct and competence

You must:

a. inform the Radiographers Registration Board if you have been convicted of a criminal offence (other than a ‘fixed charge’ driving offence under the Road Traffic Acts). You must also inform the Board if you have been given an ‘adult caution’ by An Garda Síochána or a caution from the police in another country;

b. inform the Radiographers Registration Board if your employer or another body has suspended you or placed restrictions on your practice because of concerns about your conduct or competence. You must co-operate with any investigations or formal inquiry into your professional conduct;

c. report any serious breaches of behaviour or malpractice by yourself or others. Malpractice includes negligence, incompetence, breach of contract, unprofessional behaviour, causing danger to health, safety or the environment, and covering up any of these issues.

You should:

inform your employer if, in your professional opinion, the practice of colleagues may be unsafe or have a negative effect on patient care.

Performance

You must always keep a high standard of performance. Your duties are to:

6. Address health issues related to your fitness to practise

You must:

a. look after your physical, emotional and psychological health and avoid contact with patients if you are ill, emotionally distressed or on medication which may affect your judgment or performance;

b. follow your employer’s guidelines regarding personal health issues which could place patients or others at risk;

c. limit your practice or stop practising if your health is affecting your performance and could have a negative effect on patients.

7. Obey laws and regulations

You must:

a. know and work within the laws and regulations governing your practice and keep up-to-date with any changes in legislation or regulation;

b. obey the laws of the country in which you live and work in all your professional and personal practice.

8. Act within the limits of your knowledge, skills, competence and experience

You must:

a. act within the limits of your knowledge, skills, competence and experience;

b. practise only in areas in which you have relevant competence, education, training and experience. If a task is beyond your knowledge, skills or experience, you must refer the patient to a colleague who has the skills to examine or treat the patient;

c. accept that a patient has the right to ask for an examination or treatment by another registrant of the profession;

d. monitor your practice and any protocols you work within using evidence from audits and research to develop best practice;

e. make sure you understand any request from a prescriber. You must only examine or treat a patient if it is in the patient’s best interest. If this is not the case, you must discuss the issue with the patient and the prescriber and/or practitioner who made the referral before providing any service;

f. be able to justify any decisions you make within your scope of practice. You are always accountable for what you do, what you fail to do, and your behaviour;

g. meet professional standards of practice and work in a lawful, safe and effective manner.

9. Keep your professional knowledge and skills up-to-date

You must:

a. make sure your knowledge, skills and performance are of a high quality, up to date and relevant to your practice;

b. participate in continuing professional development (CPD) on an ongoing basis by identifying your learning needs, making a personal learning plan, implementing the plan and reflecting on the learning you gained from the CPD activities;

c. maintain clear and accurate records of your CPD and submit your records for audits of compliance when requested by your Registration Board;

d. comply with your Registration Board’s continuing professional development requirements.

10. Seek informed consent from patients

You must:

a. explain the treatment or procedure along with any risks to the patient in a way the patient can understand and give informed consent;

b. obtain consent or ensure consent has been obtained, as appropriate. If or where a patient cannot give informed consent, ensure consent has been given by an appropriate alternate and in any case make sure that any actions taken are in the patient’s best interests;

c. make reasonable efforts to encourage the patient to go ahead with treatment or examination that is justified and in their best interest. However, you must respect the patient’s right to refuse treatment or examination;

d. follow your employer’s procedures on consent and any guidance issued by appropriate authorities.

11. Communicate with patients, carers and other professionals

You must:

a. communicate sensitively and effectively with patients, carers and their families, taking into account any special needs when communicating with children and vulnerable adults;

b. co-operate and share your knowledge and expertise with colleagues and students for the benefit of patients.

12. Assist and advise colleagues and recently qualified registrants and students

You should:

help and advise colleagues, recently qualified registrants and students in your profession to develop the professional skills, values, courtesies, attitudes and behaviour they will need when dealing with patients, carers and staff.

13. Teach, supervise and assess students and other professionals

You should:

a. be willing to be involved in supervising, teaching, training, appraising and assessing students in your profession and do so fairly and respectfully using agreed criteria;

b. meet your professional obligation to teach, train and mentor other healthcare professionals in specified practice areas.

14. Supervise tasks that you give to others

You must:

a. acknowledge that patients have the right to assume that the person providing treatment or imaging services to them has the knowledge, skills and competence to do so;

b. always continue to give adequate and appropriate supervision, if you delegate a task;

c. understand that you are accountable for any task you delegate to a student;

d. understand that if a student or another practitioner is unwilling to carry out a task because they do not think they are capable of doing so safely and effectively, you must not force them to do so. If their refusal raises a disciplinary or training issue, you must deal with this separately. The patient must never be put at unnecessary risk.

You must not:

ask anyone to do anything which is outside their knowledge, skills and level of expertise unless they are supervised by a practitioner (Radiographer/Radiation Therapist) experienced in that area of practice.

15. Enhance the patient experience

You should:

a. contribute to the development of your profession in a way that improves the patient experience;

b. be willing to work as part of a multi-disciplinary approach to optimising patient care.

16. Keep accurate records including images

You must:

a. keep clear and accurate records including images in line with the policies and procedures set out in your workplace;

b. make sure that all records are:

• complete,

• legible (if handwritten),

• identifiable as being made by you,

• dated and timed,

• prepared as soon as practicable following examination or treatment, and

• clear and factual;

c. if you supervise students, review each student’s entries in the records and record that you have done so;

d. protect information in records against loss, damage or access by anyone who is not allowed to access them;

e. make sure that if records are updated, the information that was there before is not erased or made difficult to read;

f. hold and use records according to relevant legislation.

Records are all information collected, processed and held in manual, electronic or any format pertaining to the patient and patient care. Records include data (within the meaning of the Data Protection Acts 1988 and 2003), demographics, clinical data, images, unique identification, investigation, samples, correspondence and communications relating to the patient and their care.

17. Address health and safety risks

You must:

a. follow risk assessment policies and procedures to assess potential risks in the workplace and your areas of practice;

b. take any steps needed to minimise, reduce or eliminate the risks you identify;

c. inform colleagues and the authorities about the outcomes and implications of risk assessments;

d. read and understand your institution’s or department’s safety statement.

18. Be an advocate for patients

You should:

a. speak out on behalf of patients about safety and quality of care;

b. report any concerns you have about patient safety and quality of care to the proper authorities.

Ethics

You must always keep a high standard of ethics. Your duties are to:

19. Demonstrate ethical awareness

You must:

make sure you read and understand this Code of Professional Conduct and Ethics.

You must not:

enter into any agreement or contract or accept any gift that might cause you to breach this Code.

You should:

be aware of the wider need to use limited resources as efficiently and responsibly as is practicable. Whilst acknowledging your primary duty of care to the patient, you have a duty to assist in the efficient and effective use of resources and to give advice on their appropriate allocation. Take particular care when ethical issues arise. (Please see Appendix A for a suggested procedure for ethical decision-making.)

20. Respect the rights, needs, values, culture, dignity and vulnerability of patients

You must:

a. always show, through your practice and conduct, respect for the rights and dignity of all individuals as identified under the Equal Status Act as updated from time to time, regardless of their:

• gender,

• family status,

• civil status,

• age,

• disability,

• sexual orientation,

• religion,

• ethnicity, or

• membership of the Traveller Community;

b. respect patients’ rights, needs, values, culture, dignity and vulnerability. Be especially respectful when you are carrying out an intimate or sensitive investigation or procedure and make sure that another suitable member of staff is present, even if you are the same gender as the patient.

21. Carry out your duties in a professional and ethical way

You must:

a. carry out your duties and responsibilities in a professional and ethical way to protect the public;

b. uphold the reputation of the profession and always behave with integrity and honesty;

c. make sure your practice benefits and does not cause harm to the patient or others;

d. if there is a conflict of interest between the patient and the safeguarding of children or other vulnerable people, safeguarding should take precedence. Remember that you have responsibilities under child protection and other laws.

22. Undertake research in an ethical manner

You must:

a. collect, protect and destroy data in line with relevant legislation;

b. submit research proposals to the relevant research ethics committees and get ethical approval before starting the research;

c. obtain informed consent from patients in line with the procedures laid down by the ethics committee;

d. treat all information gathered during the research confidentially and make sure that participants cannot be identified through their data;

e. make sure you do not distort or misuse clinical or research findings;

f. make sure that a patient’s refusal to take part in research does not influence the delivery of service to that patient in any way;

g. follow accepted guidelines in scientific journals concerning intellectual property, copyright and acknowledging the work of others.

You should:

a. take part in research or support the research of others where possible;

b. disseminate or circulate the research findings widely to further the evidence base of the profession and to improve patient examination and treatment.

23. Make sure that advertising is truthful, accurate and lawful

You should:

make sure that any advertising is truthful, accurate and lawful.

Appendix A — Suggested procedure for ethical decision-making

1. Identify the problem and gather as much information as you can.

Ask yourself if it is an ethical, professional, clinical or legal problem.

2. Review the Code of Professional Conduct and Ethics and identify the relevant parts. Check other professional guidelines too such as those of the Health Service Executive or government departments as well as any relevant legislation.

3. Discuss the issue with professional colleagues.

4. Consider asking your professional body for advice.

5. Evaluate the rights, responsibilities and welfare of everyone affected. Remember that your first obligation is to the patient.

6. Keep notes at each stage of the process.

7. Consider different solutions and decisions.

8. Evaluate and document the potential consequences of each option.

9. Choose the best solution or decision based on your professional judgement.

10. Put the solution or decision into practice, informing all the people affected.

11. Remember that you are responsible, as an autonomous practitioner, for the consequences of the solution or decision that you choose.

Bibliography

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Council for the Professions Complementary to Medicine, 2006. Code of Practice-Radiography. [online] G’Mangia Malta: CPCM. Available at: https://ehealth.gov.mt/HealthPortal/others/regulatory_ councils/professions_ compl._ to_ medicine/professions_ compl_ to_ medicine.aspx [Accessed 2 July 2012].

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Health and Social Care Professionals Council, 2010. Framework Code of Professional Conduct and Ethics. [pdf] Dublin: HSCPC. Available at: http://www.coru.ie/uploads/Framework%20Code%20of%20Professional%20Conduct%20and%20Ethics.pdf [Accessed 11 September 2012]

Health and Social Care Professionals Council, 2013. Framework for a Code of Professional Conduct and Ethics.

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Nursing & Midwifery Council, 2008. Standards of Conduct, Performance and Ethics for Nurses and Midwives. [pdf] London: NMC. Available at: http://www.nmc-uk.org/Documents/Standards/nmcTheCodeStandardsofConductPerformanceAndEthicsForNursesAndMidwives_ TextVersion.pdf [Accessed 2 July 2012].

New Zealand Institute of Medical Radiation Technology, 2004. Code of Ethics for Medical Technologists. [online] New Plymouth: NZIMRT in conjunction with the Medical Radiation Technology Board. Available at: http://nzimrt.co.nz/default.aspx-g=42f9096a-1cd6-4f8b-be9d-6da76817a997[Accessed 2 July 2012].

Royal College of Radiologists, 2004. Individual responsibilities: a guide to good medical practice for clinical radiologists. London: RCR.

Royal College of Radiologists, 2006. Standards for the reporting and interpretation of imaging investigations. [pdf] London: RCR. Available at: http://www.rcr.ac.uk/docs/radiology/pdf/StandardsforReportingandInetrpwebvers.pdf [Accessed 2 July 2012].

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Social Workers Registration Board, 2011. Code of professional Conduct and Ethics for Social Workers. [pdf] Dublin: SWRB. Available at: http://www.irishstatutebook.ie/pdf/2011/en.si.2011.0143.pdf [Accessed 2 July 2012]

GIVEN under the seal of the Radiographers Registration Board,

11 October 2013.

JASON LAST,

Chairperson, Radiographers Registration Board.

LOUISE RAINFORD,

Member, Radiographers Registration Board.

EXPLANATORY NOTE

(This note is not part of the bye-law and does not purport to be a legal interpretation).

This bye-law adopts the Code of Professional Conduct and Ethics agreed by the Radiographers Registration Board.