Shared Services - Imaging Annual Event 2015

NHS Boards Chief Executives’ Group 14 January 2015 Shaping the future of shared services for NHS Scotland: Guiding principles and implementation proposals

SupportNon-Clinical SupportClinical Support Finance Human Resources e-Health Business Intelligence Laundry Central Decontamination Catering Waste Management Estates Maintenance Procurement Fleet Management Pharmacy - Aseptic Dispensing Laboratory Services Radiology Services Medical Physics Public Health

For Radiology Reporting - a range of options along the spectrum of a regional or nationally delivered or commissioned approach, with hybrids for in hours and out of hours.

Our hope is that in the future most radiologists will work in a distributed network fulfilling a dual role as generalists to their local healthcare community and as an expert resource to a wider network in their specialist areas of practice. Radiology in the UK – the case for a new service model Sept 2014

RCR – Networks of Expertise Population not institution based Collaboration to form networks servicing a population of several million Groupings of radiologists

RCR Audit In October 2014 – snapshot audit 6000 patients waited more than a month for results of a CT or MRI scan 300,000 waited more than a month for an X ray result

UK48 Germany 92 Spain 112 France 130 Radiologists/million population

Current Situation Demand vs capacity Workload complexity Recruitment/retention/early retirement Equipment issues

Current Situation Health Boards employ radiologists providing all local radiology services Insourcing and outsourcing is used to deal with capacity issues Post code lottery for certain modalities

Current Situation Delays in reporting of 4-6 weeks Radiology vacancy rate of 15% Radiologist burn out

Current Situation There is a lack of sufficient radiologists to meet demand for access targets and deliver a comprehensive inpatient and outpatient service Access to subspecialty expertise is restricted – this can lead to over diagnosis and under diagnosis

Barriers Financial

Barriers Financial Technological

Barriers Financial Technological Organisational/Contractual

Barriers Financial Technological Organisational/Contractual Cultural

Where do we want to be? Timely access to inpatient and outpatient imaging for all patients Fair and equitable access for patients – to specialist radiological opinion across geographical boundaries – to emergency interventional procedures

Where do we want to be? Scotland to be an attractive place to train and practise in Radiology