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Found 25 results
  1. Content Article
  2. News Article
    The share of referrals waiting more than three months for a diagnostic test — one of the key problems behind long waits for cancer treatment — is worse than at any point since February 2021, during the second national covid lockdown. NHS England data released this morning for September shows 12.4% of the 1.6 million awaiting a test had been on the list longer than 13 weeks. At the peak of June 2020, 32% waited more than 13 weeks, but the proportion dropped back beneath 1 in 10, in May 2021, as services ramped up activity following the impact of the major winter 2020-21 Covid wave. Echocardiography patients and those needing endoscopies had the highest proportion of patients waiting more than six weeks – these specialties jointly comprise about a third of the total national waiting list and had 48 and 38%, respectively, of their lists over six weeks. Katharine Halliday, president of The Royal College of Radiologists, said: ”Today’s cancer waiting times data is alarming. We know the longer patients wait for a diagnosis or treatment, the less their chance of survival. “Our members are clinical radiologists and clinical oncologists, and much of their work involves diagnosing and treating cancer. Today’s figures show the NHS in England would have to employ 441 radiology consultants, the equivalent of a 16% increase in the current workforce, in order to clear the six-week wait for CT and MRI scans in one month.” Read full story (paywalled) Source: HSJ, 10 November 2022
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    The Faculty of Clinical Radiology has developed guidance on the duty of candour with the aim of providing radiologists with guidance and real-world examples on the implementation of the duty of candour. The document recognises the unique circumstances faced by radiologists and all who work in imaging. It is not possible to provide guidance for every situation, but the aim is to provide an approach which will help colleagues navigate an unfamiliar process in the best possible way for our patients and the professionals who care for them. The Royal College of Radiologists is hosting a webinar to discuss this new guidance and answer any queries. Please submit any questions in advance to guidance@rcr.ac.uk by Friday 24th June to ensure we are able to answer as many as possible. Register for the webinar
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  10. News Article
    A crisis in cancer care at NHS Tayside could have been averted if the health board had publicly supported doctors who were criticised by an official report, according to a top oncologist. The last remaining breast radiotherapy specialist left at the end of January, with the board unable to replace him. Patients must now travel to Aberdeen, Glasgow or Edinburgh for radiotherapy. The situation has emerged three years after an investigation into chemotherapy treatment at Ninewells Hospital. NHS Tayside apologised to patients in 2019 after an investigation found doctors deviated from national standards on chemotherapy dosages given to breast cancer patients after surgery. A subsequent review found that the lower dosages were highly unlikely to have led to the deaths of any patients. Last year the doctors involved were cleared of any wrongdoing by the General Medical Council (GMC), who also found no fault with the treatment patients received. Some clinicians close to those involved told BBC Scotland the cancer doctors felt they had no choice but to leave because they did not have the backing of the board. Colleagues who support the oncologists say none of this needed to happen. Prof Alastair Munro, emeritus professor of radiation oncology at Dundee University, who previously worked as a cancer doctor in the department, said: "It's a totally avoidable tragedy, this should not have happened. "The first thing the health board need to do is to come clean, and say we got it wrong, we put our hands up, we want to start again with a clean slate and we want to attract good people to come to Tayside to deliver breast cancer services to the patients whose needs we serve." Read full story Source: BBC News, 9 February 2022
  11. News Article
    A cervical cancer patient has been treated with the aid of artificial intelligence (AI) for the first time in the UK. Emma McCormick, 44, was treated at the St Luke's Cancer Centre in Guildford, Surrey. The Royal Surrey NHS Foundation Trust treated Ms McCormick, who is from West Sussex, using adaptive radiotherapy. The AI technology uses daily CT scans to target the specific areas that need radiotherapy. This helps to avoid damage to healthy tissue and limit side-effects, the hospital said. Patients are given treatments lasting between 20 and 25 minutes, although Ms McCormick's was slightly longer as she was the first patient, a hospital spokesman said. Ms McCormick received five AI-guided treatments per week for five weeks before having a further two weeks of brachytherapy. She said: "If it works for me, and they get information from me, it can help somebody else. It definitely worked and did what it was meant to do and so hopefully that helps others." Dr Alex Stewart, who treated Ms McCormick, said one of the benefits of the treatment was that it allowed for more precision, meaning there were fewer side-effects for the patients. Read full story Source: BBC News, 21 January 2022
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    The investigation: sought to understand the context and contributory factors influencing a delay in lung cancer diagnosis in a patient repeatedly attending primary care with non-specific symptoms. identified the systemic factors that help or hinder the detection of lung cancer on chest X-rays. considered the utility of chest X-ray to assess for lung cancer in symptomatic patients being seen in primary care. identified the implications of the findings for mitigating the risk of delayed diagnosis of lung cancer. Safety recommendations HSIB recommends that NHS England and NHS Improvement work with research partners to explore options for commissioning research to address whether low-dose computed tomography (CT) is clinically- and cost-effective for the diagnosis of lung cancer in symptomatic patients seen in primary care compared to chest X-ray. HSIB recommends that the National Institute for Health and Care Excellence (NICE) reviews its current safety netting advice to healthcare professionals with respect to the investigation of possible lung cancer. The wording of the advice should be amended as required to make it clearer what should be offered to patients with ongoing, unexplained symptoms who have had a negative chest X-ray. HSIB recommends that NHSX, in collaboration with relevant stakeholders such as The Royal College of Radiologists and The Society and College of Radiographers, develops guidance to support independent benchmarking and validation of artificial intelligence algorithms for the identification of lung diseases such as cancer.
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  15. News Article
    About a third of NHS trusts in England are using “technically obsolete” imaging equipment that could be putting patients’ health at risk, while existing shortages of doctors who are qualified to diagnose and treat disease and injuries using medical imaging techniques could triple by 2030. According to data obtained through freedom of information requests by Channel 4’s Dispatches programme, 27.1% of trusts in NHS England have at least one computerised tomography (CT) scanner that is 10 years old or more, while 34.5% have at least one magnetic resonance imaging (MRI) scanner in the same category. These are used to diagnose various conditions including cancer, stroke and heart disease, detect damage to bones and internal organs, or guide further treatment. An NHS England report published last year recommended that all imaging equipment aged 10 years or older be replaced. Software upgrades may not be possible on older equipment, limiting its use, while older CT scanners may require higher radiation doses to deliver the same image, it said. Dr Julian Elford, a consultant radiologist and medical director at the Royal College of Radiologists (RCR), said: “CT and MRI machines start to become technically obsolete at 10 years. Older kit breaks down frequently, is slower, and produces poorer quality images, so upgrading is critical." “We don’t just need upgraded scanners, though; we need significantly more scanners in the first place. The [NHS England report] called for doubling the number of scanners – we firmly support that call, and recommend a government-funded programme for equipment replacement on an appropriate cycle so that radiologists can diagnose and treat their patients safely." Read full story Source: The Guardian, 18 October 2021
  16. News Article
    A review of the work of a former locum consultant radiologist in the Northern Trust has identified major discrepancies in 66 images. The trust has concluded a review of 13,030 scans and x-rays. The review was launched in June after the General Medical Council raised concerns about the locum consultant radiologist's work. The highest level of hospital investigation will be carried out into the cases of 17 patients. More than 9,000 patients were contacted as part of the review. The review identified six images at level one - a major discrepancy where errors or omissions in reporting could have had an immediate and significant clinical impact for the patients concerned. A further 60 images were level two - a major discrepancy with a probable clinical impact. "Most of the images categorised as having Level 1 and Level 2 discrepancies are CT scans but some are MRI scans, chest x-rays and other x-rays," said the trust's medical director, Seamus O'Reilly. "That detailed clinical assessment, which has resulted in 69 patients being called back, was to determine whether any clinical harm occurred as a result of the discrepancies found in the lookback review," "I can confirm that following careful consideration, the clinical assessment group has determined that 17 patients should now be part of a Level 3 Serious Adverse Incident (SAI) review." Read full story Source: BBC News, 13 October 2021
  17. News Article
    A review into the work of a locum consultant radiologist has so far identified "major discrepancies" affecting 12 cases. A full lookback review of 13,030 radiology images was launched last month. The doctor worked at hospitals run by the Northern Health Trust between July 2019 and February 2020. The review steering group chair said it was "images in levels one and two that we are most concerned about". "To date there are 12 level ones and twos [approximately 0.5% of the total number reviewed]," said Dr Seamus O'Reilly, the Northern Trust medical director. "Most of these concern CT scans where inaccurate initial reading of the scans could, or is likely to, have had an impact on the patient's clinical treatment and outcome." More than 9,000 patients have been contacted as part of the review, which is looking at radiology images taken in Antrim Area, Causeway, Whiteabbey and Mid Ulster Hospitals as well as the Ballymena Health and Care Centre. Read full story Source: BBC News, 28 July 2021
  18. News Article
    A man who died from lung cancer might have been saved if a hospital trust had not "failed to act" on two abnormal chest X-rays, an investigation found. Growths identified in the patient's examinations were not followed up for three years and were then untreatable, the health ombudsman said. North Cumbria University Hospitals NHS Trust also failed to correctly handle a complaint from the man's daughter. The trust, which runs hospitals in Carlisle and Whitehaven, apologised. The investigation was carried out by the Parliamentary and Health Service Ombudsman (PHSO), which deals with unresolved NHS England complaints. The patient, referred to only as Mr C, was admitted twice to hospital with stroke-like symptoms in 2014 and 2015. On both occasions X-rays were carried out which found abnormal growths in his lungs, but no action was taken. In July 2017, Mr C was found to have advanced lung cancer and he died weeks later. Read full story Source: BBC News, 29 April 2021
  19. Content Article
    Findings The PHSO analysed 25 complaints relating to failings in the imaging journey since 2013. Most concluded between 2018 and 2020. This report focuses on four key findings they have seen in their casework Failure to follow national guidelines on reporting unexpected imaging findings. Failure to act on important unexpected findings. Delays in reporting imaging findings. Failure to learn from past mistakes. Recommendations For the system as a whole: Recommendations from previous work related to imaging must be implemented as a priority (referring to previous reports by the Healthcare Safety Investigation Branch, Care Quality Commission and the Independent Review of Diagnostic Services). Digital infrastructure must now be treated as a patient safety issue. Department of Health and Social Care and NHS England and NHS Improvement should ensure there is national guidance on the roles and responsibilities of clinicians, and expected timeframes, at each stage of the imaging journey. Department of Health and Social Care and NHS England and NHS Improvement should write to the Health and Social Care Select Committee and the Public Administration and Constitutional Affairs Committee by the end of March 2022. For imaging services specifically: All NHS-funded providers that have a radiology service should ensure staff working in those services have sufficient allocated time in their job plans for meaningful learning and reflection. Clinical directors and senior managers of NHS-funded radiology services should triangulate the learning from across their departments on a regular basis. The Royal College of Radiologists should review existing guidance on reporting unexpected findings and peer review of radiological reports to learn from the findings of PHSO’s casework.
  20. News Article
    The Health Information and Quality Authority (HIQA) has today published an overview report on the lessons learned from notifications of significant incident events in Ireland arising from accidental or unintended medical exposures in 2019. In 2019, HIQA received 68 notifications of significant events of accidental or unintended medical exposures to patients in public and private facilities, which is a small percentage of significant incidents relative to the total number of procedures taking place which can be conservatively estimated at over three million exposures a year.The most common errors reported were patient identification failures, resulting in an incorrect patient receiving an exposure. These errors happened at various points in the patient pathway which, while in line with previous reporting nationally and international data, highlights an area for improvement.John Tuffy, Regional Manager for Ionising Radiation, said “The overall findings of our report indicate that the use of radiation in medicine in Ireland is generally quite safe for patients. The incidents which were reported to HIQA during 2019 involved relatively low radiation doses which posed limited risk to service users. However, there have been radiation incidents reported internationally which resulted in severe detrimental effects to patients so ongoing vigilance and attention is required." John Tuffy, continued “As the regulator of medical exposures, HIQA has a key role in the receipt and evaluation of notifications received. While a significant event is unwanted, reporting is a key demonstrator of a positive patient safety culture. A lack of reporting does not necessarily demonstrate an absence of risk. Reporting is important, not only to ensure an undertaking is compliant but because it improves general patient safety in a service and can minimise the probability of future preventative events occurring.” Read full story Source: HIQA, 9 September 2020
  21. Content Article
    Findings In 2019, HIQA received 68 notifications of significant events of accidental or unintended medical exposures to patients in public and private facilities, which is a small percentage of significant incidents relative to the total number of procedures taking place which can be conservatively estimated at over three million exposures a year. The most common errors reported were patient identification failures, resulting in an incorrect patient receiving an exposure. These errors happened at various points in the patient pathway which, while in line with previous reporting nationally and international data, highlights an area for improvement. A varied approach to patient safety was evident on review of the corrective measures applied following the occurrence of a significant event. High efficacy corrective measures such as forcing functions, which can eliminate risk, were evident. However, in some cases, the corrective measures put in place to prevent recurrence were limited to low efficacy strategies such as re-education of staff. Undertakings should consider the risk management strategies applied to incident investigations and corrective measures to ensure they are robust and help prevent errors from reoccurring rather than punish. Overall, many of the investigation reports received by HIQA were comprehensive and showed systems based approaches to reviewing incidents. Some, however, focused on human error in isolation, without consideration of human error as a symptom of system weaknesses. Undertakings should ensure a just culture is in place where individuals feel free to report errors, assured that the response will focus on what happened, rather than who failed. This was not always evident in reports received by HIQA. Finally, it is noted that radiation incidents reported to HIQA in 2019 have involved relatively low radiation doses with limited risk to service users. The findings in this report indicate that overall the use of radiation in medicine in Ireland is generally quite safe for patients. However, radiation incidents have been reported internationally with severe detrimental effects to service users. The potential for such serious adverse events highlights the need for ongoing vigilance in relation to radiation protection and the necessity of reporting and learning frameworks. It is hoped that areas of improvement noted in this report would help reduce the likelihood of such events and drive quality improvements in safety mechanisms for medical exposures in Ireland.
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    The COVID-19 pandemic has further amplified the need for radical change in the provision of diagnostic services, but has also provided an opportunity for change. Many beneficial changes in relation to diagnostic pathways, such as increased use of virtual consultations and community services, have already been made. These changes must now be embedded. However, much more now needs to be done in the recovery period to establish new pathways to diagnosis, so that both patients and healthcare professionals can be assured that investigations will be done safely. To deliver the increase in diagnostic activity required now and over the coming years, and to provide safe, patient-centred pathways for diagnostics, new service models are needed. Availability of COVID-19 virus testing for patients and healthcare professionals is likely to be critical, especially when community prevalence of the virus is high. Without such testing, patients will have to be considered as ‘Covid-19 uncertain’, which will slow throughput in imaging and particularly in endoscopy. The following key actions can be defined: Acute and elective diagnostics should be separated wherever possible to increase efficiency. Acute diagnostic services (for A&E and inpatient care) should be improved so that patients who require CT scanning or ultrasound from A&E can be imaged without delay. Inpatients needing CT or MRI should be able to be scanned on the day of request. Community diagnostic hubs should be established away from acute hospital sites and kept as clear of Covid-19 as possible. Diagnostic services should be organised so that as far as possible patients only have to attend once and, where appropriate, they should be tested for Covid-19 before diagnostic tests are undertaken. Community phlebotomy services should be improved, so that all patients can have blood samples taken close to their homes, at least six days a week, without needing to come to acute hospitals. These new services will require major investment in facilities, equipment and workforce, alongside replacement of obsolete equipment. Training of additional highly skilled staff will take time but should start as soon as possible. International recruitment should be prioritised when possible but national workforce solutions will also be critical. Alongside this, skill-mix initiatives involving more apprenticeships and assistant practitioners, and using qualified staff at the top of their licence will be essential, as will learning lessons from staff flexibility and roles undertaken during the COVID-19 pandemic.
  25. Content Article
    In recent years there has been an ongoing growth in demand for radiology services, especially MRI and CT. This pattern of growth is likely to continue as radiology is being used earlier and more widely in diagnostic pathways. This report recommends several measures aimed at maximising existing capacity and expanding services, including: reducing outpatient non-attendance by ensuring imaging can be arranged to suit the patient, through online booking and extended hours. opening day case units or beds for patients having interventional radiology procedures, to help prevent delays and hospital-acquired infections, and free up beds elsewhere. delivering faster results by increasing the amount of reporting carried out at home by radiologists and reporting radiographers. reducing the stress of delays by using artificial intelligence (AI) tools to support scheduling and prioritisation. Watch a short video summary of the report
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