SRTP

NHS Highland Approach to

Future Service Provision

Mrs Karen McNicoll

Divisional Manager

NHS Highland

Dr Ken McDonald

Associate Medical Director

NHS Highland

SRTP NHS Highland

challenges

• Radiologist vacancy

• Increasing demand

• OOH fragility

• Deteriorating time to

report

• IR provision

• Dispersed population &

geography

• £££+++

SRTP

SRTP

SRTP Last radiologist?

Scottish Daily Mail, 30/05/2018

SRTP

SRTP

So…what’s the plan?

SRTP Initiatives

• Focus on local radiologist recruitment

• Reporting radiographers

• Acceleration of MRI replacement

• IR SLWG established

• SG review – establish capacity & shortfall

– review of admin processes

• Production board

• Radiology strategy SLWG

SRTP SG access support

team/NHSH review

• Recommendations relating to:

– booking & admin processes

– RIS information & management reports

– access performance

– radiographer staffing

– radiologist rotas

– duty radiologist role

• Analysis of reporting demand vs capacity

SRTP Production board

SRTP Production board

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MRI Production Board

Work in progress referrals received per week (excluding inpatients)

Weekly Activity (including inpatients) weekly Activity including mobile van

SRTP

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08/01/2018 08/02/2018 08/03/2018 08/04/2018 08/05/2018 08/06/2018

Axi

s Ti

tle

Plain Film Reporting Production Board 2018

exam reports per week

exams waiting for report

exams performed

SRTP Radiology Strategy

SLWG: aims

• Strategic, long term sustainable vision meeting needs of local patients and clinicians

– specify the range of services required

– specify standards for service delivery

– define key performance metrics

– identify key additional requirements

• Develop potential models of service delivery

• Identify requirements from patient & service user perspective

SRTP SLWG membership

• Board MD (co-chair)

• Non exec director (co-chair)

• Clinical service users – Primary care

– Acute medicine

– ED

– Acute surgery

– Outpatient dept.

– Rural General Hosp.

• Radiographer

• Radiologists x2-3

• Divisional general manager

• Partnership rep

• Patient booking rep

• eHealth rep

• SRTP prog director

• Project officer

SRTP SLWG phases

• Phase 1

Consider individual components of the service stratified by requestor location, imaging modality & urgency. Define timescale standards for requesting, image acquisition & reporting. [workshops x 4]

• Phase 2

Develop models for delivery of the service specified in phase 1 taking account of opportunities for regional & national working. Identify preferred model and current barriers to implementation.

SRTP Specification of

service range

SRTP Access & service

delivery standards

SRTP Define key

performance metrics

SRTP SLWG: additional

requirements identified

• Fully electronic booking & processing

• Trusted professional relationships

• Input to MDT meetings

• Automated notification of reports

SRTP SLWG: phase 2 topics

• Minimisation of paper

• Clinical decision support

• Advisory discussions with imaging expert

• MDT – value, waste, workflow, streamline

• Duty radiology team

• Regional duty radiology framework

• Workforce

SRTP Patient experience

• Feedback questionnaire

– Variety of sites

– Sample full range of services/modalities

SRTP Patient feedback

questionnaire

• Perspective on length of waiting time

• Communication of result

• Travel time/distance

• What went well?

• Suggestions for improvement

SRTP SLWG: potential

barriers

• Supply of radiologists

• Funding models

• Co-working with other boards

• Capacity to train new roles

• Change not welcome

SRTP Coordination with

regional & national

programmes

SRTP SLWG process:

reflections

• Progress sometimes slow

• Facilitation expertise essential

• Good mix and range of service users

• Primary care input valuable

• Clear outcomes for each workshop

• Range of other issues uncovered along the way

• Phase 2 detail, development of service models = more challenging