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CSC Phase 2 Radiology and Urology Dr Richard Seymour Radiology bottleneck in most tumours diagnosis staging follow-up prebooking skill mix Radiology and Urology IVUs US TRUS Bone scans CT MRI Patient experience Where are we now? Phase 2 still early days
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CSC Phase 2Radiology and Urology Dr Richard Seymour
Radiology • bottleneck in most tumours • diagnosis • staging • follow-up • prebooking • skill mix
Radiology and Urology • IVUs • US • TRUS • Bone scans • CT • MRI • Patient experience
Where are we now? • Phase 2 still early days • some sustainable changes made
What the CSC can give you • Service Improvement Guide • the confidence to fail • money (CSC, Trust, PCT) • clerical staff • project manager • the luxury of perspective v use of clinical time
What the CSC can’t give you • Resources • but it can give you the evidence that resources are now the only solution
Format • Presentations of projects • Discussion • successes • failures • problems • challenges
Different ways of working Weekend CT staging scans
Ways of working • flexible rotas • 7-day radiology
7-day radiology • introduced as part of a package to streamline treatment of emergency admissions • routine work in addition to emergencies • double time off in lieu
CT staging • some departments dedicate lists to a tumour type • difficult to cover all tumours • difficult in terms of cover for a DGH consultant-led service • the weekend sessions are always covered
Before mean wait 17 days <50% within 2 weeks Now mean wait 6 days 100% within 2 weeks sustainable Weekend CT staging
CSC Phase 2Radiology and Urology Dr Richard Seymour
Radiology • bottleneck in most tumours • diagnosis • staging • follow-up • prebooking • skill mix
Radiology and Urology • IVUs • US • TRUS • Bone scans • CT • MRI • Patient experience
Where are we now? • Phase 2 still early days • some sustainable changes made
What the CSC can give you • Service Improvement Guide • the confidence to fail • money (CSC, Trust, PCT) • clerical staff • project manager • the luxury of perspective v use of clinical time
What the CSC can’t give you • Resources • but it can give you the evidence that resources are now the only solution
Format • Presentations of projects • Discussion • successes • failures • problems • challenges
IVUs; a problem area • long routine wait (40 weeks) • screening rooms used as general and IVU rooms • landlocked department • no progress possible until rebuild of hospital • excess demand
The facts • no knowledge of true capacity • no process mapping • inefficient use of resources (1 IVU on morning session) • all of the previous slide does still hold true
IVUs • process mapping; change appointment times, radiologists available, bleep • inefficient working/reporting • insufficient lists • ?try link to CT rather than reporting, protected reporting time to compensate • wait reduced from 40 to 8 weeks in two months
Nuclear Medicine • prebooking prostate cancer bone scans • increase capacity by matching scan to patient • reduce wait • increase patient satisfaction
Others • patient experience • multidisciplinary team working
Ultrasound • skillmix • capacity and demand • one-stop TRUS clinic • rapid access and prebooked TRUS