Nurse practitioners and AHPs can become qualified and registered to organise x-ray and ultrasound investigations.

To be able to request these investigations there are several steps which the GP practice and clinician have to go through.

• The practice has to have a protocol in place for non-medically qualified clinicians to make x-ray requests and ultrasound request- an example this protocol is available here.
• The practice should be signed up to the local radiology provider’s policy for non-medical radiology requests- an example policy from ULHT is available here.
• The individual clinicians have to have completed an Ionising Radiation (Medical Exposure) Regulations (IRMER) course and have an up to date certificate from this (an e-IRMER course is available from e-Learning for Health) covering these topics.
  • 00_01_01 – Making the most of e-IRMER
  • 00_01_02 – Introduction to radiation protection
  • 01_01_01 – Properties of radiation
  • 01_02_01 – Biological effects
  • 01_02_02 – Biological effects at high doses
  • 01_02_03 – Radiation units
  • 01_02_04 – Radiation doses
  • 01_02_05 – Risk vs. benefit
  • 01_03_01 – Special circumstances
  • 02_01_02 – General radiation protection and dose reduction
  • 03_01_01 – IRR99 and other regulations
  • 03_01_02 – IR(ME)R 2000 2000
  • 03_01_03 – Risk assessments
  • 03_03_01 – Clinical audit
• The clinician should send their IRMER certificate along with an application to be a non-medical requestor to their local radiology department- an example application is attached to the practice protocol as Appendix A.
• The clinician also needs to complete Appendix 1 of the “Policy for requesting ultrasound examinations for non-medical advanced practitioners in primary and community care” and send this to the radiology department of their local provider.

For ULHT these applications should be sent to Julie.baddon@ulh.nhs.uk.

For NWAFT contacts are david.truman@nhs.net and d.hosking@nhs.net

Best practice guidelines for NOUS Referral Guidance for Primary Care is available Best practice guidelines for NOUS Referral Guidance for Primary Care FINAL DRAFT.