5.8. "operator"

5.8.1. An operator is anyone who carries out a practical aspect. The range of functions covered by the term 'practical aspects' is broad. It is unlikely that a single operator will carry out all these functions for any individual medical exposure.

5.8.2. Nevertheless, an operator usually will carry out a variety of functions and therefore it is essential that the functions and responsibilities of individual operators are clearly defined within standard operating procedures. The operators who can undertake certain tasks may be identified in a variety of ways in the employer's procedures, for example, by profession, grade, or individual name. In some cases, detailed job descriptions may help.

5.8.3. In some cases, the practitioner may also undertake practical aspects of an exposure e.g. fluoroscopic screening. In these circumstances, the practitioner becomes an operator with regard to these specific functions.

5.8.4. Examples of operators include doctors, medical physicists, medical physics technicians, nurses, radiographers and radiopharmacists. Third party service engineers would not normally be considered as operators. Where significant changes to equipment have been made, these should be checked where practicable by an operator (e.g. an employee of the NHS Trust) before equipment is brought into clinical use.

5.9. "practical aspects"

5.9.1. The range of functions covered by this term is extensive and includes the supporting functions prior to the exposure taking place e.g. the calibration of equipment that emits ionising radiation, the preparation of radioactive medicinal products, computer planning and calculation of monitor units to be delivered in radiotherapy etc, as well as of performing the exposure itself.

5.10. "practitioner"

5.10.1. Decisions on who is entitled to act as a practitioner should be taken at local level by agreement between the employer and the healthcare professionals involved in medical exposures. Such decisions should be based on the type of medical exposure and on specific circumstances and may be restricted e.g. it may be appropriate to agree that certain health professionals can act as a practitioner for radiographic procedures for extremities, but not for complex interventional examinations.

5.10.2. The primary responsibility of the practitioner is to justify medical exposures. This requires the practitioner to have a full knowledge of the potential benefit and detriment associated with the procedure under consideration. Clearly all practitioners need to be adequately trained to undertake this function

5.11. "radiological"

5.11.1 By stating that the term 'radiological' applies to planning and guiding radiology, activities such as those associated with radiotherapy simulation, the planning of radiotherapy treatments etc are included as well as those associated with interventional radiology.

5.12. "referrer"

5.12.1. As with practitioners, decisions on who is entitled to act as a referrer should be taken at local level by agreement between the employer and the healthcare professionals involved in medical exposures. Such decisions should be based on the type of medical exposure and on specific circumstances and entitlement to act as a referrer may be restricted e.g. it may be agreed for example, that certain health professionals can act as a referrer for radiographic procedures for extremities, but not for complex CT examinations. Further examples, where agreed locally, might include certain requesting of specific planning procedures involving ionising radiation for patients on whom it has already been agreed that radiotherapy is appropriate.

5.12.2. The range of procedures that can be requested by a referrer should be agreed locally between the referrer and the employer of the radiological installation. It is intended that the healthcare professionals involved in imaging and/or therapy as appropriate at that site will advise that employer.

5.12.3. In situations where an individual, following an invitation, undergoes an exposure as part of a national screening programme, there is no requirement in practice for a named referrer.