1. ‘ Watch out’ there’s an IR(ME)R Inspector about! Jane Barrow Hemel Hempstead Hospital.

2. Sequence of Events. Chief Executive informed. Chief Executive informed. Notice given. Notice given. What actually happens? What actually happens? Feed back from inspection. Feed back from inspection. Follow up from inspectors. Follow up from inspectors.

3. What actually happens? Arrange a seminar room or similar. Arrange a seminar room or similar. Someone from Trust board should attend. Someone from Trust board should attend. Introductions and formalities. Introductions and formalities. Patient path way. Patient path way. Look at all Employers Procedures and standard operating procedures. Look at all Employers Procedures and standard operating procedures. Request Form. Request Form. Walk through department, talk to staff and looks at work practices. Walk through department, talk to staff and looks at work practices.

4. Patient Pathway. Referrers, who are they? Referrers, who are they? Practitioners, who are they? Practitioners, who are they? Referral criteria, is it adhered to? Referral criteria, is it adhered to? Operators, tasks and responsibilities. Operators, tasks and responsibilities. Standard operating procedures, and Q.A of. Standard operating procedures, and Q.A of. Radiopharmacy. Radiopharmacy. Therapy considerations (?). Therapy considerations (?). Flow diagrams. Flow diagrams.

6. Responsibilities. Referrers. Who are they? Who are they? How do you ID them? How do you ID them? Do they know who they are? Do they know who they are? Do they know their responsibilities? Do they know their responsibilities? Non justifiable requests. Non justifiable requests. Practitioners. Who are they? Who is responsible for what session? Do they justify every examination? Do they know their responsibilities?

7. Operators. Who are they? Who are they? Tabulate tasks, days of weeks etc. Tabulate tasks, days of weeks etc. Responsibilities: Responsibilities: Patient ID, pregnancy/breast-feeding, etc. Specify who is responsible for what. Specify who is responsible for what. What is done if criteria is not correct? What is done if criteria is not correct? Make sure everyone knows their role. Make sure everyone knows their role.

8. Radioisotopes. Where do yours come from, have you checked their QA? Where do yours come from, have you checked their QA? Do they have/need a manufacturers licence? Do they have/need a manufacturers licence? Consider who draws up, who injects etc. Consider who draws up, who injects etc. Document radioisotope pathway with responsibilities. Document radioisotope pathway with responsibilities.

9. Standard Operating procedures. Procedures for every thing else! Procedures for every thing else! Scan protocols. Scan protocols. Injection protocols. Injection protocols. QA of equipment, e.g. calibrator. QA of equipment, e.g. calibrator. Special considerations e.g paeds. Special considerations e.g paeds. Every protocol must have a date and a review date. Every protocol must have a date and a review date. Must be adhered to. Must be adhered to. Audit! Audit!

10. Request Form. Have a separate form for Nuc. Med. Have a separate form for Nuc. Med. IR(ME)R statement on the front. IR(ME)R statement on the front. Referrer information on front. Referrer information on front. e.g patient info, LMP, referrer status & signature, examination requested. Practitioner & operator on back. Practitioner & operator on back.

11. Back of the form. Practitioners justification. Practitioners justification. Operators authorisation. Operators authorisation. Radioisotope details. Radioisotope details. Scan details. Scan details. 10/28 day rule. 10/28 day rule. Pregnancy/breast-feeding info. Pregnancy/breast-feeding info. Section if patients are pregnant/feeding. Section if patients are pregnant/feeding. ID check box. ID check box. Section to override 10/28 day rule. Section to override 10/28 day rule.

12. Feed back. Everyone concerned called back into room. Everyone concerned called back into room. Blunt and to the point. Blunt and to the point. Praise if it’s due! Praise if it’s due! Time scale to get things done. Time scale to get things done. Proof that it has been done. Proof that it has been done.

13. Tips! Coffee and biscuits. Coffee and biscuits. Chief Executive or as senior as possible. Chief Executive or as senior as possible. Do NOT argue with the inspectors. Do NOT argue with the inspectors. Be professional. Be professional. Ask his opinion, use as a learning experience. Ask his opinion, use as a learning experience. Make sure you follow up his recommendations, he certainly will! Make sure you follow up his recommendations, he certainly will!