Gloucestershire Hospital
NHS / Health Body
Action Taken
The hospital secured an additional trainee radiologist and aims to create a fellowship post. It is recruiting inpatient navigators for call triage, training radiographers to vet scans, and investigating an AI tool for scan triage. (AI summary)
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Dear Ms Skerrett Mr Donald Charles Brown -Inquest 13 December 2022 I am writing in response to your letter dated 31 January 2023 in which you raised concerns arising from the evidence heard this inquest. It is your view that there is a risk that future deaths will occur unless action is taken about these concerns. The matters of concerns are:
1. The significant understaffing of the Radiology department at the hospital
2. The national shortage of radiology trainee posts
3. The expectation that the reporting of all scans including non-urgent, will be done within one hour
4. The appointment of call handlers to triage calls to reduce the demands on the radiologist's time has been delayed due to cost The Trust's response is as follows:
1. The significant understaffing of the radiology department at the hospital The department has an establishment of 31 whole time equivalent radiologists and presently has one vacancy, which is filled by a locum consultant. This equates to a vacancy rate of c3% This compares to a national vacancy rate of 29%. The Trust has an excellent reputation for training radiologists, coming top in the national survey for trainee experience. The last four appointments have all been former trainees of the organisation and we are confident we can continue to maintain a fully established workforce.
Gloucestershire Hospita Is NHS Foundation Trust
2. The national shortage of radiology trainee posts The allocation of trainees is the responsibility of Health Education England. Concerns have been expressed about the distribution of trainees nationally, reflecting the bias to distribution to London. HEE is in the process of redistributing a proportion of these trainees and Gloucestershire Hospitals has been successful in securing an additional (eighth) trainee from the Severn Deanery commencing in post in August 2023. Additionally, we are aiming to create a fellowship post (post training role) for further applicants.
3. The expectation that the reporting of all scans including non-urgent. will be done within one hour The Trust works to the national NHS Seven Day Services Clinical Standards, Version 2, (8 February 2022) which for inpatients and patients attending the emergency department reflects the following minimum standards, which the department strives to exceed.
• Within one hour for critical patients (scans that immediately alter a patient's management)
• Within 12 hours for urgent patients (scans that will alter a patient's management, but not necessarily on that day)
• Within 24 hours for non-urgent patients.
4. The appointment of call handlers to triage calls to reduce the demands on the radiologist's time has been delayed due to cost The service has a number of initiatives in hand to reduce the administrative burden on radiologists including but not limited to
• Recruitment of three "inpatient navigators" who will undertake call triage amongst other duties.
• training our radiographers to 'vet' scans under the radiologist pre-defined protocols, to further reduce the administrative burden on the radiologists.
• Production of a list of 'Frequently Asked Questions' for radiography staff with the aim of reduce the need for interruptions to radiology sessions
• We are investigating an Artificial Intelligence tool to facilitate better triage between urgent and less urgent scans I have also enclosed a copy of the completed and updated Action Plan. I hope this information is useful. Please do not hesitate to contact me if I can be of further assistance.
1. The significant understaffing of the Radiology department at the hospital
2. The national shortage of radiology trainee posts
3. The expectation that the reporting of all scans including non-urgent, will be done within one hour
4. The appointment of call handlers to triage calls to reduce the demands on the radiologist's time has been delayed due to cost The Trust's response is as follows:
1. The significant understaffing of the radiology department at the hospital The department has an establishment of 31 whole time equivalent radiologists and presently has one vacancy, which is filled by a locum consultant. This equates to a vacancy rate of c3% This compares to a national vacancy rate of 29%. The Trust has an excellent reputation for training radiologists, coming top in the national survey for trainee experience. The last four appointments have all been former trainees of the organisation and we are confident we can continue to maintain a fully established workforce.
Gloucestershire Hospita Is NHS Foundation Trust
2. The national shortage of radiology trainee posts The allocation of trainees is the responsibility of Health Education England. Concerns have been expressed about the distribution of trainees nationally, reflecting the bias to distribution to London. HEE is in the process of redistributing a proportion of these trainees and Gloucestershire Hospitals has been successful in securing an additional (eighth) trainee from the Severn Deanery commencing in post in August 2023. Additionally, we are aiming to create a fellowship post (post training role) for further applicants.
3. The expectation that the reporting of all scans including non-urgent. will be done within one hour The Trust works to the national NHS Seven Day Services Clinical Standards, Version 2, (8 February 2022) which for inpatients and patients attending the emergency department reflects the following minimum standards, which the department strives to exceed.
• Within one hour for critical patients (scans that immediately alter a patient's management)
• Within 12 hours for urgent patients (scans that will alter a patient's management, but not necessarily on that day)
• Within 24 hours for non-urgent patients.
4. The appointment of call handlers to triage calls to reduce the demands on the radiologist's time has been delayed due to cost The service has a number of initiatives in hand to reduce the administrative burden on radiologists including but not limited to
• Recruitment of three "inpatient navigators" who will undertake call triage amongst other duties.
• training our radiographers to 'vet' scans under the radiologist pre-defined protocols, to further reduce the administrative burden on the radiologists.
• Production of a list of 'Frequently Asked Questions' for radiography staff with the aim of reduce the need for interruptions to radiology sessions
• We are investigating an Artificial Intelligence tool to facilitate better triage between urgent and less urgent scans I have also enclosed a copy of the completed and updated Action Plan. I hope this information is useful. Please do not hesitate to contact me if I can be of further assistance.