Guidance

Examples of authorisation guidelines

Published 18 January 2023

Applies to England

The detail provided in these examples is not intended for direct adoption in the clinical environment. The guidelines must be adapted to reflect local practice.

Example authorisation guidelines for routine screening of women on mobile units

NHS breast screening service authorisation guidelines

These authorisation guidelines are issued by the IR(ME)R practitioner [name] to provide the flexibility for operators (radiographers or assistant practitioners) to authorise breast screening exposures providing all the criteria in the guidelines are adhered to.

The operator must check that the woman attending for screening meets all of the following guidelines before a mammogram can be performed.

Example authorisation guidelines

A mammogram may be performed for routine invitations when:

• the woman is registered with a GP practice
• the woman is aged between 50 up to their 71st birthday
• 6 months has elapsed since the woman’s previous mammogram
• the woman has not had a bi-lateral mastectomy

In the following situations a mammogram may be authorised following additional checks.

Women attending with an invitation letter but on the wrong day

Verification with the local breast screening assessment unit must be completed to ensure the woman is registered with the screening unit and fulfils the authorisation guidelines listed above.

Women with breast implants

Mammographers must follow the specific ‘imaging breast implants’ written protocol which outlines the requirements for exposure factors and additional views when imaging women with breast implants.

IR(ME)R practitioner: [name]
Signature:
Date of issue:
Version:
Review date:

Example authorisation guidelines for carers and comforters supporting a woman during a breast screening exposure

NHS breast screening service carer and comforter’s authorisation guidelines

These authorisation guidelines are issued by the IR(ME)R practitioner [name] to provide the flexibility for operators (radiographers or assistant practitioners) to authorise an exposure to a carer and comforter during a breast screening mammogram.

The mammographer must check that the support of a carer and comforter is absolutely necessary and this support cannot be provided by any other means. They must provide the carer and comforter with information on the benefits and risks of the exposure prior to gaining consent.

Support of a carer or comforter may be required for women who:

• cannot support themselves and where positioning may be difficult due to physical challenges
• have learning disabilities
• have visual or hearing impairments (help may be needed to provide instructions)
• lack capacity for other reasons, for example if they cannot be left alone for their own safety

Operator responsibilities

The mammographer should:

• ask if the carer and comforter is or may be pregnant
• ensure the carer or comforter is not pregnant and/or under 18 years.
• understand that the carer and comforter must knowingly and willingly take on this role and has the right to refuse supporting the individual at any time during the examination
• provide the benefits and risks of the exposure to the carer and comforter by saying ‘we believe the risks to you from providing this support are very small, and your assistance will help us to obtain the best image quality for your relative/friend’ – this must happen prior to gaining their consent
• ensure the carer and comforter reads and signs the carer and comforter consent form
• provide the carer and comforter with information on where to stand to minimise their exposure and avoid compromising the examination
• provide the carer and comforter with personal protective equipment
• note that when only emotional support is required, the carer and comforter may stand behind the protective lead screen of the console

IR(ME)R practitioner: [name]
Signature:
Date of issue:
Version:
Review date: