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Abstract Cardiac computed tomography (CT) is a rapidly evolving technique for assessing cardiovascular disease which usually requires direct, time-consuming supervision by a radiologist or cardiologist for the whole examination. The cardiac radiologists at our institution decided to train CT radiographers to perform CT Coronary Angiography (CTCA) examinations independently. The aim of the initiative was to enable appropriately trained radiographers to perform the CTCA examination autonomously and to a high standard. Following the programme of training and development, participating radiographers have been shown to undertake CTCA examinations to the required standard, providing a safe, effective and patient focused experience, with no detriment to patient care or radiation dose received. Evidence of service enhancement which allows radiologists to undertake other work, has also been established. This paper describes the steps in the design of this new service and how advanced practice role development has been established and assessed at our institute.