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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 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
SRTP
0
200
400
600
800
1000
1200
1400
1600
21
/08
/20
17
28
/08
/20
17
04
/09
/20
17
11
/09
/20
17
18
/09
/20
17
25
/09
/20
17
02
/10
/20
17
09
/10
/20
17
16
/10
/20
17
23
/10
/20
17
30
/10
/20
17
06
/11
/20
17
13
/11
/20
17
20
/11
/20
17
27
/11
/20
17
04
/12
/20
17
11
/12
/20
17
18
/12
/20
17
25
/12
/20
17
31
/12
/20
17
08
/01
/20
18
15
/01
/20
18
22
/01
/20
18
29
/01
/20
18
05
/02
/20
18
12
/02
/20
18
19
/02
/20
18
26
/02
/20
18
05
/03
/20
18
12
/03
/20
18
19
/03
20
18
26
/03
/20
18
02
/04
/20
18
09
/04
/20
18
16
/04
/20
18
23
/04
/20
18
30
/04
/20
18
07
/05
/20
18
14
/05
/20
18
21
/05
/20
18
28
/05
/20
18
04
/06
/20
18
11
/06
/20
18
MRI Production Board
Work in progress referrals received per week (excluding inpatients)
Weekly Activity (including inpatients) weekly Activity including mobile van
SRTP
0
500
1000
1500
2000
2500
3000
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
