Who should be delivering? The Workforce Challenge Tony Nicholson, Consultant Interventional Radiologist,Leeds TH NHS Trust

Can we provide safe interventional radiology services Equitable Effective

UK- 43/million Scandinavia – 60/m France- 67/m Germany-67/m Australia-67/m USA-100/m Consultant Delivered Service

2009 IC census there are 2,235 FTE (2354 HC) consultant radiologists ??????? Interventional Radiologists BSIR 540 members

Survey BSIR members 2007 UK data Non Vascular IRVascular & Non Vascular IR 515 Replies IR>50% JP1267 Formal 24/7 IR /7 Nephrostomy2157 IR for Haemorrhage 057 UAE Trusts

= Foundation Trusts 1:6 IR 1:5 IR 1:6 IR =24/7 IR 3.7 million people UAE 5 IR/DR 1 IR/DR 2 IR/DR 1 IR/DR 4 IR/DR 5 IR/DR 600K people 1 million people 5 DR/IR 52 Vascular Surgeons 63 ObGyn 53 Gastroenterologists

Who should be delivering IR? Image guided minimally invasive therapy IR is a GMC recognized subspecialty of radiology requiring 6 years of training through the only GMC approved IR curriculum Allied Health Professionals? Other Medical/Surgical Groups? Properly Trained Interventional Radiologists

88 delegates 2 IRs 4 X 6 TH YEAR IR FELLOWSHIP (2 STAYED IN CANADA) 2 APPLYING FOR FELLOWSHIPS. 56 RADIOLOGY TRAINEES 32 NON RADIOLOGY TRAINEES

No clear training pathway 90% No clear career structure 90% Not lifestyle choice 55% Negative discrimination 35% No IR jobs advertised 35% No financial rewards 15%

1.Recognition 2.Training 3.Networks

1.Recognition - Subspecialty, IR Consultant Jobs, separate funding from DR inc HRGs, BPTariffs 2.Training - NTNs, Deaneries, Training Departments, Curriculum, Trainers, Sustainable career pathway and prospects 3.Networks – Internal market barriers How Many IRs do we Need?

England :60 trained Interventional Radiologists providing 24/7 and comprehensive CONSULTANT DELIVERED IR service 140 extra Interventional Radiologists = 340 Vascular Surgeons for England Networks NTN’s Separate Funding Consultant IR posts 240