Interventional Radiology: moving on from the troublesome teens Iain Robertson President British Society of Interventional Radiology Consultant Interventional Radiologist Greater Glasgow & Clyde Health Board

History of IR

UK Interventional Radiology Founded members 490 members 140 junior members 2 associate members

Identity & Responsibility

Vital, clinical service of proven effectiveness National Imaging Board Report NICE/ MHRA/ DOH RCR Chief Medical Officers

What is an Interventional Radiologist?

Internal Identity

External Identity Subspecialist accreditation Defined curriculum Defined training pathway 3 years core 3 years IR Defined assessment

Dependability (Responsibility)

How do we know a good quality IR service?

Vital means dependable 24/7 Clinical means patient focused Proven effectiveness means data driven

Scope of Services Patient Focus Data Service Improvement

RAG status Core 24/7 services England only just now Map revision March 2012

Key Steps 1.Define the scope of services 2.Define staff involvement 3.Procedures manual 4.Unify equipment 5.Embobags

Scope of services

Key Steps: Scope of service Range of procedures appropriate for sites Understand what is done in hours Understand what you aim to do out of hours Set a defined target: hemorrhage control for most of us Define sites that will participate and how

Make new friends Upskill new friends as reqd Set the bar EVAR Primary operator: 4 TIPPS Primary operator: 5 Embolization: 9 Nephrostomy around 15 1:6 is the minimum target Radiology Teams

Hard Facts If you won’t do it OOH – you don’t do it in hours!

Nurses Need nurse leadership Longer negotiation Cross-city service Staff rotation for training Reduce variability -Protocols Develop a manual

Procedures manual Defines service Referral process & responsibilities Site specific info Protocols Equipment lists

Unify equipment stock Everyone uses the same Supports the nurses/ radiographers Provides resilience Saved the hospital 150K Responsible control

Embobags “Portable” consumables 2 embo bags Catheters Embolics Contrast Needles Everything……….

Scope of Services Patient Focus Data Service Improvement