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Case Study – University Hospitals Coventry and Warwickshire NHS Trust

Breast Screening Unit improves service delivery with the development of two new practitioner roles saving up to 1,400 patients a year

When the National Cancer Plan set out targets for the expansion of breast screening services, it was estimated that this would require a 40% increase in skilled staff to deliver the required improvements in a safe and effective way. Recognising the need for changes to staffing structures to increase the capacity of radiologists, a new model was proposed by the University Hospitals Coventry and Warwickshire NHS Trust’s Breast Screening Unit, which would supplement the existing structure with two new roles – Assistant Practitioner and Advanced Practitioner.

The design of these new roles was based on competence requirements and Skills for Health was asked to work with four development sites to test the model and ensure the new roles were robust in meeting the needs of patients and supporting service delivery.

This was achieved by working closely with the pilot teams to establish the competences needed to fulfil each of the roles and linking these to National Occupational Standards to provide clear definitions of these requirements. In this way, a role profile could be constructed and used by individual staff and their managers to identify the areas where the required level of knowledge and understanding had already been reached as well as those where additional experience, training or development may have been required.

Warwickshire, Solihull, and Coventry Breast Screening Unit were one of the pilot sites which successfully introduced the new roles and has been able to record tangible benefits from the new staffing structure.

“The introduction of a new skill mix based on competence has transformed the way we provide breast imaging and enabled us to successfully expand our service while maintaining and improving standards.”

Dr Matthew G Wallis, Warwickshire, Solihull & Coventry Breast Screening Unit


  • The number of views taken at each screening increased to 2
  • Extended breast screening invitations to all women up to the age of 70
  • In 90% of cases where the screening showed a normal result, patients are informed within 2 weeks
  • Where screening indicates the need for further assessment, 90% of patients are informed and seen within 3 weeks
  • All needle biopsies can now be carried out on the same day in both screening and symptomatic cases

The Advisory Committee on Breast Cancer Screening reported that the NHS Breast Screening Programme was highly effective saving up to 1,400 lives a year.

Our work to support the development of roles and improved services means organisations and the wider healthcare sector deliver tangible benefits that impact patient outcomes.

A key aim of Skills for Health is to develop and manage a bank of national workforce competences that describe the performance criteria, knowledge, and understanding required to carry out a work activity effectively. Because competences describe what individuals need to know and to do, regardless of who is performing the activity, they can be used in many different ways.

As the Sector Skills Council for the UK health sector, we support the NHS, independent healthcare providers, and voluntary organisations. Our purpose is to help develop solutions that can deliver a skilled and flexible workforce to improve health and healthcare.