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

2. Can we provide safe interventional radiology services Equitable Effective

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

4. 2009 IC census there are 2,235 FTE (2354 HC) consultant radiologists ??????? Interventional Radiologists BSIR 540 members

5. Survey BSIR members 2007 UK data Non Vascular IRVascular & Non Vascular IR 515 Replies406 109 IR>50% JP1267 Formal 24/7 IR2157 24/7 Nephrostomy2157 IR for Haemorrhage 057 UAE053 14 Trusts

6. = 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

7. 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

8. 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

9. 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%

10. 1.Recognition 2.Training 3.Networks

11. 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?

12. 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