Monday 26 May 2008

Case Study - Assistant and Advanced Practitioners in Radiology

As medical care becomes more proactive and subtle, so better and more rapid diagnostics are needed. This typically falls to the imaging disciplines, such as Radiography.
NHS Modernisation Agency's Changing Workforce Programme (CWP) ran an Accelerated Development Programme to assist the implementation of these roles, and one site was City Hospitals, Sunderland.

Why this was needed?
Increased numbers of tests have not been accompanied by increased numbers of radiologists; radiologists take many years to train and the increased volumes of referrals meant that for example in City Hospitals Sunderland the waits for routine barium enemas had increased to 30 weeks.

What happened?
Radiologists ran barium enema lists themselves under the supervision of a radiographer, with their reports checked by the supervisor rather than the whole reporting process remaining with the senior radiographer.

What difference did it make?
Waits dropped from 30 weeks to 2 weeks over a period of 11 months. Turnover of staff in role dropped by 10%, and agency spend by 47%.

Lessons learnt
Staff want to do the best job they can, so giving them more opportunity and the responsibility to know their own limits and ask advice can deliver tremendous wins for all parties.
The same staff handing more patients means lower cost per patient - this has to be offset against the cost of training to enhanced levels but the results were conclusive that it was cost-effective.
We also audited the number of changes the radiologists made to radiographer reports and found that the radiographers achieved excellent reporting with only a few changes needed.

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