CSC Phase 2 Radiology and Urology

1. CSC Phase 2Radiology and Urology Dr Richard Seymour

2. Radiology • bottleneck in most tumours • diagnosis • staging • follow-up • prebooking • skill mix

3. Radiology and Urology • IVUs • US • TRUS • Bone scans • CT • MRI • Patient experience

4. Where are we now? • Phase 2 still early days • some sustainable changes made

5. 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

6. What the CSC can’t give you • Resources • but it can give you the evidence that resources are now the only solution

7. Format • Presentations of projects • Discussion • successes • failures • problems • challenges

8. Different ways of working Weekend CT staging scans

9. Ways of working • flexible rotas • 7-day radiology

10. 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

11. 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

12. Before mean wait 17 days <50% within 2 weeks Now mean wait 6 days 100% within 2 weeks sustainable Weekend CT staging

13. CSC Phase 2Radiology and Urology Dr Richard Seymour

14. Radiology • bottleneck in most tumours • diagnosis • staging • follow-up • prebooking • skill mix

15. Radiology and Urology • IVUs • US • TRUS • Bone scans • CT • MRI • Patient experience

16. Where are we now? • Phase 2 still early days • some sustainable changes made

17. 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

18. What the CSC can’t give you • Resources • but it can give you the evidence that resources are now the only solution

19. Format • Presentations of projects • Discussion • successes • failures • problems • challenges

20. IVUs

21. 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

22. 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

23. 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

24. Nuclear Medicine • prebooking prostate cancer bone scans • increase capacity by matching scan to patient • reduce wait • increase patient satisfaction

25. Others • patient experience • multidisciplinary team working

26. Ultrasound • skillmix • capacity and demand • one-stop TRUS clinic • rapid access and prebooked TRUS