Thursday, April 14, 2011

Improving the quality of Imaging Services

I recently came across a paper on the NHS Improvement website about delivering a Quality Imaging Service for Children across the NHS. When thinking about changing the service model of the NHS to ensure that there is no variation and every patient gets equal treatment this paper is directly realted- it raised a number of interesting points about the Imaging Service:

  • There is a shortage of professionals in the area of paediatric imaging – at the time the paper was written there were three major hospitals without paediatric radiology consultants
  • There is no incentive for radiographers to specialise because there is no formal career structure in paediatric radiography
  • Much of the routine, emergency and trauma work takes place in DGH’s with variation in levels of expertise and support offered from specialist centres
  •  A review of children’s imaging services finds it “necessary to balance the need for local imaging, with the need for an integrated service offering specialist support and expertise, which may not necessarily be provided local to the patient’s home."

The paper continues to discuss a potential model of serv ice delivery across three levels, ranging from level 3 being a service that provides the minimum plain radiography and ultrasound (essentially a satelite imaging dept.) to level 1 being a service located in a children’s hospital/major teaching hospital providing all possible modalities and services. The key to such a model is the networks between the three layers – communication is vital and the children’s hospitals should provide that expert support when needed (IT links are also essential).

It’s also worthwhile noting that this service delivery model is similar to one that can work for paediatric pathology across a geographical area. The concept of having a specialist paediatric laboratory that offers a number of specialised (and expensive) tests is similar to that of level 1 of the Imaging Services model for Children. The lab will also offer support to a laboratory in a DGH, which will perform a number of less specialised tests on children (similar to levels 1 and 2). The model is an interesting one because it encourages networking and improves quality and (potentially) cost as specialist work is only performed by few hospitals with the expertise.

My next question is how much data is available about Imaging Services for Children and what the next steps will be. I think it will be an interesting space to watch.

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