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Team-working in Radiology: Optimising CareNICK WOZNITZA BSC, PGD, PGC, MIR(AP)CL INICAL ACADEMIC REPORTING RADIOGRAPHERHOMERTON UNIVERSITY HOSPITAL & CANTERBURY CHRIST CHURCH UNIVERSITY

@xray_nick @MedRadJclub

NHS England 2014; Independent Cancer Taskforce 2015

230,000 patients waiting >30 days

Achievable?NHS England 2014; Independent Cancer Taskforce 2015; Royal College of Radiologists 2015

Radiology across England Sustained and significant increases in radiology activity1 Chronic shortage of consultant radiologists2

Ambitious plans for improved cancer outcomes3

Unrelenting pressure on emergency medicine4

1 – National Diagnostic Imaging Dataset 2016; 2 – Royal College of Radiologists 2014; 3 – Independent Cancer Taskforce 2015; 4 – NHS England HSCIC 2016

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Aim & Objectives Expand contribution of radiographer advanced practice

Meet anticipated activity increased Maintain/improve reporting times

College of Radiographers & Royal College of Radiologists 2012

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Project 1: Neonatal service Large, tertiary neonatal unit: 60 cots; 3,000 X-rays per annum 2010: No clinical report

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Project 1: Neonatal service Radiographer-led neonatal X-ray reporting All x-rays reported, next working day; 90% by radiographer Weekly MDT; radiographer deputises for consultant paediatric radiologist

Project 2: Emergency service ED activity at record levels1,2

Radiographer immediate reporting shown to be effective3

8Homerton University Hospital Quality Accounts 2014-15; NHS England HSCIC 2016; Hardy et al. Br J Radiol 2013;86:20120112

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Project 2: Emergency service Radiographer-led immediate reporting of ED skeletal X-rays X-rays reported prior to patient leaving Radiology Reporting radiographer lead for all X-ray queries

Radiology Activity & Reporting Times

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2010-11 2011-12 2012-13 2013-14 2014-15 2015-160

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Reporting Times Current reporting times: X-ray: 34 hours (74% within 24hrs) CT: 16 hours (73% within 24hrs) MRI: 72 hours (36% within 24hrs)

Royal College of Radiologists: 170,000 examinations waiting 30 days for a report

Royal College of Radiologists 2016

Contribution of Advanced Practitioners

3 Consultant Radiologists

6 Consultant Radiologists

4.5 Consultant Radiologists

2013-14 2014-15 2015-16

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Key Learning Points Team-based approach essential Radiographer reporting provides a significant contribution Effective, efficient, safe Essential component of patient focused service

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Plans for Spread Exemplar site for College of Radiographers, National Diagnostic Imaging Board Strategy & audit freely available Radiographer neonatal X-ray reporting highly commended BIR Service Improvement award 2015

Questions?nicholas.woznitza@nhs.net

@xray_nick