Scottish Clinical Imaging Network Mid Year Report 2018-2019

SCIN Mid Year Report (2018-2019)

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Scottish Clinical Imaging Network

Mid Year Report

2018-2019

Scottish Clinical Imaging Network (SCIN)

SCIN Lead Clinician: Dr Hamish MacRitchie

SCIN Imaging Manager: Dr Fiona Hawke

Programme Manager: Dawn Currie


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Title: Scottish Clinical Imaging Network Midyear Report 2018-19

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Author: Dawn Currie, Programme Manager

Owner: Dr Hamish MacRitchie, Lead Clinician

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Introduction

Having undergone review and a further commissioning cycle being endorsed by the National Specialist Services Committee (NSSC) the Scottish Clinical Imaging Network (SCIN) began the year with a refreshed workplan and a focus on implementing the recommendations from the review.

SCIN acknowledges the contribution of the network’s Lead Clinician, Dr Hamish MacRitchie and Imaging Manager, Dr Fiona Hawke (both of NHS Borders) for their leadership and drive in delivering the 2018-2019 workplan and long-term vision for the Network.

Highlights

SiSAT

The SCIN Quality Improvement group developed the Scottish Imaging Self Assessment Tool (SiSAT) to provide a comprehensive document that evidences service quality. This was in response to a number of instances across the British Isles where external agencies have criticised the lack of documentary evidence of quality standards within radiology services. The SiSAT provides a Quality Scorecard for imaging services using indicators assessing Clinical Performance, Environment, Workload and Workforce, Patient Experience and Safety Characteristics.

SiSAT will be completed by clinicians and managers responsible for the service in each NHS Board

area. The questionnaire findings are held within each service and remain internal documents. The

SiSAT will help identify gaps in quality and provide evidence of quality improvement via the

associated action plans.

The SISAT can also be used to benchmark quality against other centres if managers from both

services agree to this action. The resultant document can be submitted, if required, for any external

inspection. The SiSAT does not specify that any evidence to support the responses be submitted,

however it is expected that supporting evidence is available and could be supplied during an external

inspection.

SiSAT was presented to the Scottish Association of Medical Directors (SAMD) who were supportive of it being adopted by Boards through SCIN on a voluntary basis as they see it as a useful tool to inform and support good governance. This would allow a no cost self assessment while allowing the evidence to be collated, should accreditation by an external agency be required. SiSAT has also been endorsed by the Scottish Imaging Managers Group and DSG.

PET-CT

Key Performance Indicators for PET-CT were agreed and data is now being collected, to ensure these are reported to the working group bi-annually. This data is reviewed at the PET-CT Working Group meetings where variation in quality can now be readily identified.

. SCIN has therefore worked with the Information Management Service (IMS) to develop a way to measure and evidence the quality of the service across the centres and to look at capacity and demand. The IMS are also collecting and collating monthly data from all the PET centres which helps illustrate the growing demand on the PET-CT service. The PET-CT Working Group will monitor patient pathways, ensuring capacity is appropriately utilised.

The PET-CT Capital Funding Strategic Business Case was endorsed by the Diagnostic Steering Group and then presented to Scottish Government’s Capital Investment Group and the Directors of Finance. A ten year investment programme has been agreed which includes a new cyclotron for Grampian, a third PET-CT scanner in Glasgow and development of the Gallium service. A Short lIfe


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Working Group consisting of a member from each centre is being reconvened to progress implementation.

Education Events

SCIN has organised two events this year – Paediatric Imaging in September and also an Annual Education Event in October. The paediatric event was over-subscribed. Feedback from the event was excellent, indicating that this first opportunity to focus on issues impacting on paediatric services was welcomed by the service.

This has led to the creation of a paediatric workstream within the SCIN workplan, based on key issues that arose from a strategic planning session at the workshop. The workstream will consider a range of issues including flexible approaches to working that enable the service to meet demand.

SCIN have been invited to host a breakout session at the British Society for Paediatric Radiologists conference in November when further engagement will take place with key stakeholders to develop the workstream.

Two events are being planned for 2019 – a radiographer event in November to coincide with World Radiography Day (8

th) and an inclusive annual event.

Interventional Radiology

Scotland’s Chief Medical Officer issued a short report highlighting a crisis in Interventional Radiology (IR), citing the report SCIN had produced in 2016 as part of the proposed solution. Refreshing the 2016 report and producing an Atlas of Variation for IR had been part of the five year vision for SCIN. The Steering Group agreed in August that SCIN would begin to develop a skills matrix to provide information on available services at practitioner level. This work is being progressed in collaboration with the Scottish Radiology Transformation Programme (SRTP) and Scottish Government’s Access Collaborative. A Short Life Working Group has been convened by government and SCIN will be represented.

Scottish Radiology Transformation Programme (SRTP)

SCIN remains a stakeholder in the SRTP work and has worked with colleagues to align workplans and provide joint opportunities for engagement with the imaging community. The Imaging Manager has made a significant contribution to the development of the clinical governance framework, within which the remote reporting will function. There has also been a major contribution to SRTP work on development of a sustainable model for the training and support of reporting radiographers.

Risks and Issues

The network was without a Programme Support Officer for several months due to unplanned, long term leave and there was also a gap in Programme Manager support, which may result in slippage in some areas of the workplan. Dr MacRitchie technically finished his term as lead clinician at the end of August efforts to recruit a replacement have so far been unsuccessful Dr MacRitchie continues to support SCIN however a longer-term plan for ensuring appropriate clinical leadership is required.


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Workplan – SCIN 2018/19

Objective

Number SMART Objective

Linked

Dimensions

of Quality

Planned

start / end

dates

Detailed

plan/available

owner

Description of progress

towards meeting

objectives

Anticipated

outcome

RAGB

Status

2018-01

Education and

Training

SCIN will facilitate 2

education events

3:4:5 June

2018-

December

2018

Programme

Manager and

Imaging Manager

2 education events will be

organised for the Imaging

community and its

stakeholders

The events will

align and

contribute to the

work that is being

progressed in the

Scottish

Radiology

Transformation

Programme

B

2018-02

PET-CT Data

Collection

The Information

Management

Service will collate

and analysis the

data returns from

the 4 PET-CT

centres

3:4:5:6 April 2018-

March

2019

Data Analyst

Information

Management

Service

The data analyst will

collate analysis the PET-

CT data returns

The PET-CT

centres are

providing PET-

CT to the same

clinical

indications.

PET-CT trends

can be observed

and proactively

managed

G


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Objective


Linked

Dimensions

of Quality

Planned

start / end

dates

Detailed

plan/available

owner


towards meeting

objectives

Anticipated

outcome

RAGB

Status

2018-03

PET-CT

KPI’s

The Information

Management

Service will analyse

the agreed 6 KPI’s

1:2:3:4:5:6 April 2018-

March

2019

Programme

Manager /Data

Analyst Information

Management

Service

The data analyst will

collate analysis the PET-

CT data returns

The KPI’s will be

used to monitor

and improve the

quality of service

delivered to all

NHS Scotland

patients.

G

2018-04

PET-CT

Capital

Funding

The PET-CT

Capital Funding

Business case will

be finalised.

3:4:5:6 April 2018-

March

2019

PET-CT Capital

Funding Group

The finalised report will be

presented to the Directors

of Finance/Board Chief

Executives/Diagnostic

Steering Group /National

Cancer Strategy Group

and the Scottish

Government.

The PET-CT

Business will be

accepted and

endorsed by the

Scottish

Government as

the agreed

national strategy

for PET-CT

B


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Objective


Linked

Dimensions

of Quality

Planned

start / end

dates

Detailed

plan/available

owner


towards meeting

objectives

Anticipated

outcome

RAGB

Status

2018-05

PET-CT

Health Board

Boundaries

The PET-CT

working group will

monitor the patient

pathways with a

view of re-drawing

these between the

PET-CT centre

3:6 April 2018-

March

2019

PET-CT Working

Group

This will be reviewed at

the PET-CT working

group meetings

Patient pathways

could be

redefined to

improve access

to PET-CT G

2018-06

Scottish

Imaging Self

Assessment

Tool

(SiSAT)

The SiSAT will be

piloted in 2 NHS

Boards and revised

in line with findings

2:3:4 April 2018-

March

2019

Dr Fiona

Hawke/Programme

Manager/IMS

The SiSAT be presented

to the Scottish

Association of Medical

Directors who will be

asked to endorse the

SiSAT for it to be

accepted by Health

Improvement Scotland in

order for it to become a

validated quality

improvement tool.

SiSAT aims to

provide a

comprehensive

document that

evidences

services quality

for NHS Scotland

Imaging Boards

G


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Objective


Linked

Dimensions

of Quality

Planned

start / end

dates

Detailed

plan/available

owner


towards meeting

objectives

Anticipated

outcome

RAGB

Status

2018-07

DNA and

Urgency

Codes

SCIN will continue

to work with the RIS

users group and

monitor how

national DNA and

Urgency code

processes are

being standardised

in NHS Scotland

3:4 April 2018-

March

2019

Dr Fiona

Hawke/Programme

Manager

SCIN is communicating

regularly with the RIS

users group to ascertain

the progress of how the

national DNA and

Urgency code processes

are being standardised in

NHS Scotland

DNA and

Urgency Codes

are standardised

in NHS Scotland G

2018-08

Demand

Optimisation

SCIN will provide

clinical expertise as

requested by the

SRTP in order to

enable the Clinical

Decision Support

Software and Cross

Boundary Reporting

streams to continue

within the

designated

timeframe.

2:3:4:5:6 April 2018-

March

2019

Dr Fiona Hawke SCIN will provide the

clinical expertise to the

SRTP to enable the

SRTP to deliver its

programme of activity

within its designated time

frame

SCIN will report the

progress of this work to

the National Demand

Optimisation Group

The Scottish

Radiology

Transformation

Programme will

develop Clinical

Decision Support

Software and

Cross Boundary

Reporting

G


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Objective


Linked

Dimensions

of Quality

Planned

start / end

dates

Detailed

plan/available

owner


towards meeting

objectives

Anticipated

outcome

RAGB

Status

2018-08

Develop an

Atlas of

Interventional

Radiology

SCIN will establish

if there is a need to

develop an Atlas of

Interventional

Radiology

procedures and if it

aligns with the

National Atlas of

Variation that is

being compiled by

the Scottish

Government.

3:4 April 2018-

March

2019

Programme

Manager

SCIN is liaising with the

Major Trauma Network,

SRTP and Scottish

Government to ensure the

work that is progressed

aligns to national priorities

SCIN will

develop an Atlas

of Interventional

Radiology that

can contribute

the strategic

work that is

occurring in the

Scottish

Government or

the Regional

Trauma Network

G


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Objective


Linked

Dimensions

of Quality

Planned

start / end

dates

Detailed

plan/available

owner


towards meeting

objectives

Anticipated

outcome

RAGB

Status

2018-10

Scottish

Imaging

Pathway for

Primary Care

for Patients

with

Unidentified

Suspected

Malignancy

SCIN will work with

the Ministerial

Cancer

Performance

Delivery Group to

enable Boards to

spread the uptake

of the Imaging

Pathways

3:4:5:6 April 2018-

March

2019

SCIN Core Team Data that has been

collated by SCIN will be

presented to the

Ministerial Cancer

Performance Delivery

Group

There is equity of

access for all

patients with

suspected

malignancy to

imaging.

G


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Objective


Linked

Dimensions

of Quality

Planned

start / end

dates

Detailed

plan/available

owner


towards meeting

objectives

Anticipated

outcome

RAGB

Status

2018-11

Developing a

sustainable

workforce

SCIN is engaging

with the National

Education Scotland,

College of

Radiologists,

Society and College

of Radiographers,

HEIs Scottish

Radiology

Transformation

Programme (SRTP)

and the Scottish

Government to

develop a

sustainable Imaging

workforce.

3:4:5:6 April 2018-

March

2019

Dr Fiona Hawke SCIN will present the

work that it is undertaking

to the DSG and the SRTP

This work

informs the

Scottish

Government of

vacancies, likely

impact of retrials

and succession

planning.

Constraints to

education such

as funding,

training time and

backfill are also

on the agenda

for continued

discussion

G


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Objective


Linked

Dimensions

of Quality

Planned

start / end

dates

Detailed

plan/available

owner


towards meeting

objectives

Anticipated

outcome

RAGB

Status

2018-12

Advanced

Practice in

Radiography

in Scotland

There is a need to

identify service

requirement for

Advanced Practice

roles and to ensure

that these roles

meet the other

pillars of Advanced

Practice other than

the clinical skill.

SCIN will provide

clinical expertise

with regards to how

these roles should

be developed in

NHS Scotland.

3:4:5:6 April 2018-

March

2019

Dr Fiona

Hawke/Society of

Radiographers/

Scottish Radiology

Transformation

Programme

SCIN and the Society of

Radiographers will scope

what the current practice

is for band 5

radiographers How

Radiography skills base

are built in CT/MR and

how the boards

succession plan for

ultrasound?

SCIN and the

Society of

Radiographers

will be able to

advise the

Scottish

Government of

what needs to be

implemented to

ensure that

Radiographers

are sufficiently

trained to meet

the future

demands of

health care

needs.

G

2018-13

Communication

and

Engagement

SCIN will promote

its refreshed

network brand on

all of its

communication to

the Imaging

community and its

stakeholder

1:3:4:5 April 2018-

March

2019

Programme

Manager /SCIN

PSO

SCIN will issue quarterly

bulletins.

The Imaging

Community and

its stakeholders

are informed of

the work that

SCIN has

undertaken

G


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RAG status key

RAG status Description

RED (R) The network is unlikely to achieve the objective/standard within the agreed timescale

AMBER (A) There is a risk that the network will not achieve the objective/standard within the agreed timescale, however progress has been made

GREEN (G) The network is on track to achieve the objective/standard within the agreed timescale

BLUE (B) The network has been successful in achieving the network objective/standard to plan

The Institute of Medicine’s six dimensions of quality are central to NHS Scotland’s approach to systems-based healthcare quality improvement; therefore objectives should be linked to these dimensions:

1. Person-centred: providing care that is responsive to individual personal preferences, needs and values and assuring that patient values guide all clinical decisions;

2. Safe: avoiding injuries to patients from healthcare that is intended to help them;

3. Effective: providing services based on scientific knowledge;

4. Efficient: avoiding waste, including waste of equipment, supplies, ideas, and energy;

5. Equitable: providing care that does not vary in quality because of personal characteristics such as gender, ethnicity, geographic location or socio-economic status; and

6. Timely: reducing waits and sometimes harmful delays for both those who receive care and those who give care.

Documents

Scottish Clinical Imaging Network Mid Year Report 2018-2019