Shortage of Mammographers in the UK

Steadily and surely, over the past 20 years, there has been a significant decline in trained mammographers leaving a shortage of mammographers in the UK.

Who are Mammographers?

Mammographers are trained radiographers who specialize in breast imaging. Because of the intimate nature of the positioning of breast tissue the speciality is exempt from the sex discrimination laws and consequently only female radiographers can apply for these positions.

Why Do we need them?

The high number of incidents of breast cancer in the UK lead to the introduction of the NHS Breast Screening service in the 1980’s. This service requires a high number of trained mammographers to work independently in the community often with no security and little facilities such as running water and toilets.
The NHS breast screening service requires two radiographers to screen a minimum of 40 women a day on mobile units which quickly run low and empty of running water. They do not have toilets and Mammographers are expected to use public facilities which can often be less than sanitary and some distance from the van.

What are the issues?

Female radiographers who enter the NHS Breast screening service often have to give up other skills they have learnt as a radiographer and pass an intensive post graduate certificate in breast imaging. This can take over a year depending on when they were recruited and the time of the course starting. Because of the high volumes of women who need to be screened, every woman from 50 to 70 years of age registered with a GP, many Mammographers suffer work related injuries to their shoulders.
From this perspective is it any wonder that there is a shortage? On the agenda for change pay scale a qualified mammographer was banded a tier 7 which starts at £31,383 and over annual increments rises to £41,373. With the extra learning and leaving your current skills behind this might make mammography appealing to some radiographers. Radiographers where also enticed to join the profession as they would train at band 6 a tier lower. This helped attract experienced radiographers to the profession.
However, over the past 20 years the profession has been down graded and radiographers are now expected to train at band 5, the same banding as a newly qualified radiographer. Many female radiographers would have been promoted to band 6 in other more departmental specialities such as CT and MRI quite quickly so mammography training wouldn’t be something they would consider. Mammography is almost always located remotely from the main department and is very rarely integrated.
With over half the mammography workforce due to retire in the next five years the NHS is now panic stricken and will undoubtedly not give pay as a reason for the lack of recruitment to this part of the radiography profession. Bad working conditions and very little room for career progression is at the crux of this scenario. Offering a band 5 salary to an already qualified and experienced radiographer is disgusting. Salary is and will be the main reason for the shortage of mammographers how this is dealt with by the department of health will be interesting. Watch this space!

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Radiographers Needed in disaster Zones

UK Radiographers needed for Disaster Zones

Radiographers needed! Can you work in a disaster zone? Many radiographers have an interest in adapting their skills beyond that of hospital work. UK Medical Emergency Team (UK EMT) could offer just that experience in the event of a humanitarian response. UK Med is a charity which was established in 1995 to help hospitals deploy radiographers needed in Sarajevo during the Balkans war. Since then it has helped with victims in disaster zones during the Sichuan earthquake in 2008, the aftermath of the Haiti earthquake in 2010, Typhoon Haiyan in the Philippines in 2013, Gaza in 2014 to help civilians stuck in a disaster zone.  More recently it helped, in 2015, to aid victims of the Nepalese earthquake.

Need To Know

This is a great way for radiographers, looking for disaster zone experience, to extend their knowledge and skills.  Radiographers can aid the most needy in parts of the world where medical aid is hard to organise. So if you are up for the challenge – you will need at least 5 years post qualification experience. Furthermore will also have to fulfill specified requirements which include a health assessment, DBS, references and the NHS trust release and finance agreement.

This initiative is driven by the world health organisation. It aims to help people and governments with a timely response. Therefore trained and qualified professionals which includes radiographers, from the UK, will be deployed to help.

There are two different types of on call radiographers can commit to, which can be found at http://bit.ly/2jMtis9.


How it Works

In the event of a disaster radiographers from UK Med be expected to arrive at the disaster zone within 72 hours. Your flight costs are redeemable and you may be required to stay in location for up to three weeks. Once you are deployed you will also be reimbursed for your basic rate of pay not your average earnings. In conclusion radiographers learning would far out way this valuable and rewarding experience in this field.

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Alice Turner – Principle Radiographer at the University North Staffordshire hospital talks about…..

Whilst trawling through the hundreds of You Tube posts on the NHS I found a short video on the NHS’s need for agency staff from 2015. Alice Turner, the Principle Radiographer at the University North Staffordshire hospital, speaks out about radiology not keeping pace with demand and the important role agency staff play in rectifying this. With new Radiologists hard to recruit and the length of time it takes to train employed radiographers to film read a quick solution was to organise agency radiographer film readers. This helped share knowledge and experience amongst a group with a common goal and help this hospital ‘keep pace’ whilst radiologists focused on CT and MRI scan reports. If the agency staff now stop due to the agency pay cuts how will the NHS keep pace?

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Some pension calculations!

So if you want to reduce your tax contributions, working within IR35, you can by saving to a pension. The Government will contribute up to 49% of your pension which can give a very healthy return.
So I chose 3 different pay rates which under an umbrella contract should have at least a £6p/h uplift when the new contract goes through to cover the cost employers NIC and the the umbrella company fee.
So for £28p/h a contribution of 100 per month will reduce your salary by £59 and a £1000 per month contribution will reduce your salary by £597 per month. After 23 years of contributions you would have saved £167920 which will be topped up by tax savings to £276000 (www.contractorcalculator.co.uk 11/03/2017).

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Check how much you need to contribute to your pension to make tax efficient savings

To make your umbrella company work – you need a descent pension contribution – find out how to balance your earnings and off set your tax here https://www.fidelity.co.uk/investor/pensions/fidelity-pension-ppc.page or search google for ‘pension investment offset’ and choose another pension company. This is not a recommendation, it’s just one I have found and been using. You don’t have to use their pensions but I can’t get any descent advise out of the umbrella companies .

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The Agency Radiographer and IR35 – Time to stop being coy about pay

HMRC have brought out new legislation which comes into effect at the start of the new UK tax year on the 6th April 2017. It will affect radiographers working as agency on the NHS who are paid through a limited company.

This means that the previous tax relief benefits of operating under a limited company are going to be a thing of the past and tax and national insurance will now have to paid under the PAYE effect, as though you were employed. This effectively will take 50% of your limited company earnings and you won’t receive any of the benefits of employed staff. It should also be highlighted that you will still take home considerably more than employed staff.

The current UK government have declared, in the budget, that we are moving towards a ‘more tax, less spend model’ and have their eyes on the third largest employer in the world, the NHS. So what does this mean to limited company Locums? Your agency is now responsible for you paying the correct tax and national insurance, if you are now deemed to be within IR35.

What is IR35?

IR35 is tax legislation, largely ignored by the government, until now which can enable an individual without a limited company to operate as a contractor and have their tax calculated either through their agency or pay an umbrella company to do this for them. Most agency staff take out the third party and form a limited company which means they have tax deducted from them under company tax legislation which is generally capped at 20% and pay themselves a salary which falls under the taxable allowance. By forming a limited company, they can afford to save part of their gross income for sick and holiday pay. If you are paid by the agency as PAYE or through an umbrella company, you have very little rainy day money and are probably better off being employed if you are the main income provider.

What to do now?

The government have now set up a tool on the government website which enables you to check if your contract falls within the IR35 legislation. This does give various different outcomes and has been reported to classify the similar contracts as both in and outside of IR35 and is a pretty useless tool (I wonder if IT contractors were asked to make this?). Most NHS trusts have put a complete blanket IR35 stamp on all contractors leaving no room for manoeuvre.

Other non-clinical fields, working in the public sector, have demanded a 15-20% increase in their contract rate, says Neil Lupin of Green Park recruitment agency. This is something that all agency radiographers in a contract with the NHS should be doing in order to obtain holiday and sick pay.

How you want to be paid

From the 6th of April if you are a Locum radiographer working for the NHS through a limited company and are within the IR35 or have been told you are, by the trust you’re currently working for, you will have to seek a different method of payment. Your responsibility for self-assessment is no longer.

This isn’t entirely true you can still operate a limited company and be paid a net salary, after tax and national insurance into your business account and still complete a self-assessment. This way if you do any private work you can be paid gross.

You can choose an umbrella company and pay them a weekly fee for deducting tax and national insurance. It is illegal for your agency to stop you from using any IR35 compliant umbrella company. Agencies may have their preferred list but you can choose your own.

Your agency can pay you under their own PAYE scheme.

What benefits can I claim

In 2016 new legislation was brought in affecting what you can claim working under an intermediary. An employment intermediary is (ESM5510 www.gov.uk)

  • An agency
  • A recruitment or employment business
  • An umbrella company
  • An MSC
  • A PSC

You can no longer claim for ‘ordinary commuting’ so you are expected to pay for

  • Travel in the performance of your duties
  • Travel to or from a place the necessarily attend in the performance of their duties (excluding ordinary community)
  • Travel between a worker’s home and a temporary’ workplace

You can no longer claim for meals or food consumed as part of your working day even if you have a receipt.

You can claim for the cost of protective clothing or clothing required for the performance of your role.

You are able to claim for subscriptions to professional bodies or societies.

The big Tax Break

Umbrella companies do give people an opportunity to gain massive savings through pension contributions which would enable you possible to take early retirement. After ploughing through the mine fields of umbrella companies, you will probably want to take opportunity of the pension tax break!

I called 5 umbrella companies each of them without fail and before quoting asked me which agency I was with and who was my contact at this agency. When I questioned them why that was relevant most of them backtracked and said it wasn’t it’s just information they took as part of their sales quotation. I know what your all thinking! One umbrella company advised me it was because the agency contribute to the fee and that if I was with RIG I would get a bigger reduction in my fee than my current agency!

So this is what I found when I made a few enquiries, I chose a random rate as an example: –

Umbrella
Company
Rate Hours worked Assumed
Expenses
Quotation for take home pay Fee Pension contribution Take home -pension
My pay £32p/h 37.5 5% 820 £14p/week £100 p/wk £810
CPS £32p/h 37.5 0% 761.50 £10p/week Do not offer
Brookson £32p/h 37.5 0% 753 £25p/week £100 p/wk £702
Ricson Services £32p/h 37.5 0% 757 £24p/week £100 p/wk
Liquid Friday £32p/h 37.5 0% 748.20 £24p/week After 12 weeks @1%

Correct as of March 2017

The Break Down

Working still with £32 an hour you will pay roughly –

Gross pay      £1200

Tax £218

Employees NI contribution £85

Employers NI contribution £125

Umbrella company fee £24

Total         £452

Net pay £748

You can reduce all three of these elements by significantly adding to your pension through an umbrella company. You can contribute up to 48% of your salary, although by ringing around a pension was never offered to me and caused a slight headache when I asked about one. Some umbrella companies would only allow you to use their own affiliated company otherwise I was told I would have to seek a tax rebate at the end of the tax year which slightly defeats the purpose and the main perk of an umbrella company. Some of the advisers also seemed to think that a 1% contribution was set in stone which I found frustrating. I was told by one umbrella company that £24 a week fee was the maximum fee but, as you can see, one company charged me £25. They all told me that the fee was not negotiable but from working previously as an agency radiographer some years ago, under an umbrella company, I regularly would negotiate the fee.

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What is IR35?

IR35 is tax legislation largely ignored by the government, until now. It can enable an individual, without a limited company, to operate as a contractor and have their tax calculated either through their agency or pay an umbrella company to do this for them. Most agency staff take out the third party and form a limited company. This means they have tax deducted from them under company tax legislation which is generally capped at 20%. Then they pay themselves a salary which falls under the taxable allowance. By forming a limited company, they can afford to save part of their gross income for sick and holiday pay. Being paid by an agency through PAYE or an umbrella company gives you very little rainy day money. Therefore you are probably better off being employed if you are the main income provider.

HM Revenue and Customs IR35

How to check if your in or out of IR35

The government have now set up a tool on the government website which enables you to check if your contract falls within the IR35 legislation. This does give various different outcomes. It has been reported to classify the similar contracts as both in and outside of IR35 and is a pretty useless tool (I wonder if IT contractors were asked to make this?). Most NHS trusts have put a complete blanket IR35 stamp on all contractors leaving no room for manoeuvre.

Other non-clinical fields, working in the public sector, have demanded a 15-20% increase in their contract rate, says Neil Lupin of Green Park recruitment agency. This is something that all agency radiographers in a contract with the NHS should be doing in order to obtain holiday and sick pay.

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