Quality time…

Created - 12.08.2011

I remember a few years ago attending a lecture by Fred Keller when he showed a video interviewing members of the public asking them what an Interventional Radiologist did. After a lot of negative replies, one women got it spot on with a brilliant description of the life of an Interventional Radiologist… the punchline was her name – Mrs Keller. The point of the presentation was that Interventional Radiology seriously needed to raise it’s profile in order to survive. 

I think largely we have been very successful in doing that in the UK. Individual members have worked hard locally to establish services and nationally we now have excellent links with the Department of Health, NICE, MHRA and other statutory bodies. We have worked to demonstrate the importance of access to Interventional Radiology in improving patient outcomes and have been helped by very significant support from the RCR and National Imaging Board. A measure of our success is that attention has now focused on how we deliver services both in partnership with other specialties such as vascular surgery and as clinicians in our own right. 

In the spotlight at present, is the provision of out of hours services for Interventional Radiology. We know the importance of providing 24/7 IR services but are equally aware that providing 24/7 services is a major challenge for many departments. We need to develop a focus that will help departments improve their services. 

Over the last six months we have been working on two linked projects. Firstly we have been working with NHS Improvement (England) to understand what the current baseline of 24/7 IR services are within the UK. Over the summer all departments in England have been surveyed by the DOH with an aim of developing a map of services across England. The aim is to develop a red/amber/ green map of services across England so that we can measure future improvement. Clearly it isn’t appropriate or possible that every site provides 24/7 services and for some sites the answer will lie in developing patient pathways and networks to adjacent units. 

NHS Improvement will visit sites over the next few months that have already submitted information indicating their current status. We hope that sites will share information and solutions that have allowed them to improve the quality of Interventional Radiology services. 

Secondly we are acutely aware that while access to 24/7 services is vital it isn’t all that defines a quality service in Interventional Radiology. We have been developing the BSIR Quality Improvement Initiative which aims to develop a series of key areas that help define the quality of Interventional Radiology services. The areas are drawn from existing documents and include:

 - Scope of services: defining services both in hours and out of hours.

 - Providing good quality care

 - Patient focus

 - Service improvement

The initial process is by self assessment proforma which is available for download from www.bsir-qi.org. We encourage all services to complete the assessment and submit it to us. We recognise that many sites will be working towards some of the criteria. Sites that fulfill all the key criteria will become an exemplar site. Those sites that are still working towards fulfilling the criteria will be registered as pilot sites.

The web address above links to a website that we are developing to focus on the BSIRQI initiative. The site includes information for commissioners, patients and interventional teams. The site currently contains only the core information just now but we are keen this expands as we learn move from units about how they have managed to develop services. I’m also pleased to say that we have been successful in generating support from industry partners and are grateful to Phillips Healthcare, Cook and Boston Scientific for their support.

The focus on 24/7 IR services will undoubtedly be a challenge but it is good news. It represents a major step forward in the recognition of the importance of Interventional Radiology in improving patient outcomes. Please take time to visit the BSIRQI website and consider submitting information if you haven’t already done so.

Iain Robertson