GMCA GMHSCP
Action Taken
Tameside and Glossop Integrated Care NHS FT implemented a mobile MRI scanner offering additional outpatient scanning capacity. GMCA GMHSCP are promoting Diagnostic Radiography during career events in 21/22. A NW implementation plan for the next 5 years will be developed. (AI summary)
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Dear Ms Mutch
Re: Regulation 28 Report to Prevent Future Deaths – Alfred Jones 07/09/2020
Thank you for your Regulation 28 Report dated 30/04/2019 concerning the sad death of Alfred Jones on 07/09/2020. Firstly, I would like to express my deep condolences to Alfred Jones’s family.
The inquest concluded that Alfred’s death was a result of 1a) Bronchopneumonia in combination with Covid-19; II) Falls with vertebral fractures, Type 2 diabetes mellitus, pulmonary fibrosis, heart failure and epilepsy.
Following the inquest you raised concerns in your Regulation 28 Report to Greater Manchester Health and Social Care Partnership (GMHSCP) that there is a risk future deaths will occur unless action is taken.
This letter addresses the issues that fall within the remit of GMHSCP and how we can share the learning from this case.
The Greater Manchester system is cognisant of the capacity issue in terms of slots for MRI scanners both in the Trust and the wider NHS. There is also the compounding issue of the shortage of radiology staff. This is an issue that is prevalent across the country as fundamentally there are insufficient numbers of qualified radiologists and radiographers.
Tameside and Glossop Integrated Care NHS FT At the time of Mr Jones’ referral, Tameside and Glossop Integrated Care NHS Foundation Trust (T&GIC FT) was sourcing additional scanner capacity by provision of a mobile MRI scanner. This was implemented on 20th September 2020, offering additional outpatient scanning capacity for 12 hours per day, 7 days per week. The mobile MRI van is still used currently to provide additional capacity. It is also worth noting that the Trust did not reduce or delay suspected cancer patient scans due to the pandemic, and therefore, the MRI scanner was being fully utilised.
In 2019, the division of clinical support services was established at T&GIC FT and encompasses diagnostics including Radiology. This was intended to provide coordinated leadership, oversight and governance.
Since this time, investment has been made to increase the clinical workforce, increasing the number of substantive Radiologist from three to five with a further two undertaking their CESR qualification (Certificate of Eligibility for Specialist Registration), there are also 3 locum consultants bringing a total establishment to 8.5 whole time equivalent. This is an increase of 3.5 in the last 18 months. In addition to this there is also a Consultant Sonographer and 5 Advance Practice Reporting Radiographers.
Regional Collaboration and infrastructure to address the shortfall A Greater Manchester Imaging Network has been established, and there are several examples of interventions taking place across GM to address the imaging workforce challenges. However, it has been agreed that a regional approach should be taken which has resulted in the three NW Imaging Networks working collaboratively to develop a NW Imaging Workforce Strategy (out for consultation until 12/6/21).
Health Education England NW (HEE) has commissioned a programme of work to support and progress Diagnostic Radiographer (DRAD) workforce planning priorities across the region, through scoping activities and targeted actions/ interventions. This will ultimately provide a North West (NW) imaging workforce framework and strategy. Although the overall approach is regional, each ICS has its own workforce team that will be required to deliver on local workforce priorities.
The NW Imaging Workforce Strategy The strategy focusses on the professions involved in delivering imaging services:
• Radiologists
• Diagnostic Radiographers and Sonographers
• Assistant Practitioner Radiographers
• Radiology Support Workers
Following approval and subsequent adoption of the strategy, a workforce implementation plan for the North West will be developed. This will provide a framework for imaging networks to develop their own workforce plans by offering a range of initiatives/ solutions/ interventions that can be developed and implemented for the imaging workforce in Cheshire & Merseyside (C&M), Greater Manchester
(GM) and Lancashire & South Cumbria (L&SC), taking into account the neighbourhoods and the populations they serve. Greater Manchester Allied Health Professions Workforce Programme The GM Allied Health Professions workforce programme has several interventions that aim to increase the supply, bridge the gap between education and employment and enable the workforce to develop and grow. Therapeutic and diagnostic radiography are priority areas including the following interventions:
• Pre-registration education expansion
• Placement expansion
• Widening participation and workforce diversity
• Careers activity
• Return to Practice
• AHP support workforce
• Apprenticeships (level 2 – 6)
• Reducing Pre-registration Attrition and Improving Retention (RePAIR), including preceptorship
• Leadership
• Better understand and utilise GM AHP workforce data
• Support AHPs to actively engage in GM Cancer programme ❖ Advanced Clinical Practice and consultant roles
Clinical Placement Expansion Programme The University of Salford is currently delivering a HEE funded project (Expansion of PreRegistration Placements for Diagnostic Radiography) to increase student numbers to support the workforce shortages in radiographers. Student numbers are projected to increase by 30 places over the 2019 baseline of 62 over a 3-year period. In addition to under-graduate increases in student numbers UoS is working in collaboration with the clinical collaboration lead for the Radiology Imaging Network to support workforce needs in the future with post-graduate offerings.
Activity to promote Radiography as a career choice Throughout the year several activities take place where Allied Health Professions career are showcased and promoted to our communities in GM. We are committed to prioritising Diagnostic Radiography during career events in 21/22.
Next steps The NW Imaging Workforce Strategy has been informed by engagement with the workforce groups from the three NW ICS, the NW DRAD WAG, HEE, various groups undertaking specific workforce projects and colleagues in other regions.
To support delivery of the strategy, a NW implementation plan for the next 5 years will be developed, which will inform the local implementation plans for the three ICS.
The implementation plan will describe the clear steps we will take to embed and progress the priority areas articulated here. It will importantly contain an approach to
communication and support for ICS to enable each system to build and deliver on the areas of focus critical for their systems.
Actions taken or being taken to prevent reoccurrence across Greater Manchester.
1. Learning to be presented/shared with the Greater Manchester Quality Board. This meeting is attended by commissioners, including commissioners of specialist services, regulators, Healthwatch and NICE.
2. Learning to be shared with the Greater Manchester commissioners of services to consider the findings of the investigation within the context of the services they commission
The Greater Manchester Health and Social Care Partnership (GMHSCP) is committed to improving outcomes for the population of Greater Manchester. In conclusion key learning points and recommendations will be monitored to ensure they are embedded within practice.
I hope this response provides the relevant assurances you require. Thank you for bringing these important patient safety issues to my attention and please do not hesitate to contact me should you need any further information.
Re: Regulation 28 Report to Prevent Future Deaths – Alfred Jones 07/09/2020
Thank you for your Regulation 28 Report dated 30/04/2019 concerning the sad death of Alfred Jones on 07/09/2020. Firstly, I would like to express my deep condolences to Alfred Jones’s family.
The inquest concluded that Alfred’s death was a result of 1a) Bronchopneumonia in combination with Covid-19; II) Falls with vertebral fractures, Type 2 diabetes mellitus, pulmonary fibrosis, heart failure and epilepsy.
Following the inquest you raised concerns in your Regulation 28 Report to Greater Manchester Health and Social Care Partnership (GMHSCP) that there is a risk future deaths will occur unless action is taken.
This letter addresses the issues that fall within the remit of GMHSCP and how we can share the learning from this case.
The Greater Manchester system is cognisant of the capacity issue in terms of slots for MRI scanners both in the Trust and the wider NHS. There is also the compounding issue of the shortage of radiology staff. This is an issue that is prevalent across the country as fundamentally there are insufficient numbers of qualified radiologists and radiographers.
Tameside and Glossop Integrated Care NHS FT At the time of Mr Jones’ referral, Tameside and Glossop Integrated Care NHS Foundation Trust (T&GIC FT) was sourcing additional scanner capacity by provision of a mobile MRI scanner. This was implemented on 20th September 2020, offering additional outpatient scanning capacity for 12 hours per day, 7 days per week. The mobile MRI van is still used currently to provide additional capacity. It is also worth noting that the Trust did not reduce or delay suspected cancer patient scans due to the pandemic, and therefore, the MRI scanner was being fully utilised.
In 2019, the division of clinical support services was established at T&GIC FT and encompasses diagnostics including Radiology. This was intended to provide coordinated leadership, oversight and governance.
Since this time, investment has been made to increase the clinical workforce, increasing the number of substantive Radiologist from three to five with a further two undertaking their CESR qualification (Certificate of Eligibility for Specialist Registration), there are also 3 locum consultants bringing a total establishment to 8.5 whole time equivalent. This is an increase of 3.5 in the last 18 months. In addition to this there is also a Consultant Sonographer and 5 Advance Practice Reporting Radiographers.
Regional Collaboration and infrastructure to address the shortfall A Greater Manchester Imaging Network has been established, and there are several examples of interventions taking place across GM to address the imaging workforce challenges. However, it has been agreed that a regional approach should be taken which has resulted in the three NW Imaging Networks working collaboratively to develop a NW Imaging Workforce Strategy (out for consultation until 12/6/21).
Health Education England NW (HEE) has commissioned a programme of work to support and progress Diagnostic Radiographer (DRAD) workforce planning priorities across the region, through scoping activities and targeted actions/ interventions. This will ultimately provide a North West (NW) imaging workforce framework and strategy. Although the overall approach is regional, each ICS has its own workforce team that will be required to deliver on local workforce priorities.
The NW Imaging Workforce Strategy The strategy focusses on the professions involved in delivering imaging services:
• Radiologists
• Diagnostic Radiographers and Sonographers
• Assistant Practitioner Radiographers
• Radiology Support Workers
Following approval and subsequent adoption of the strategy, a workforce implementation plan for the North West will be developed. This will provide a framework for imaging networks to develop their own workforce plans by offering a range of initiatives/ solutions/ interventions that can be developed and implemented for the imaging workforce in Cheshire & Merseyside (C&M), Greater Manchester
(GM) and Lancashire & South Cumbria (L&SC), taking into account the neighbourhoods and the populations they serve. Greater Manchester Allied Health Professions Workforce Programme The GM Allied Health Professions workforce programme has several interventions that aim to increase the supply, bridge the gap between education and employment and enable the workforce to develop and grow. Therapeutic and diagnostic radiography are priority areas including the following interventions:
• Pre-registration education expansion
• Placement expansion
• Widening participation and workforce diversity
• Careers activity
• Return to Practice
• AHP support workforce
• Apprenticeships (level 2 – 6)
• Reducing Pre-registration Attrition and Improving Retention (RePAIR), including preceptorship
• Leadership
• Better understand and utilise GM AHP workforce data
• Support AHPs to actively engage in GM Cancer programme ❖ Advanced Clinical Practice and consultant roles
Clinical Placement Expansion Programme The University of Salford is currently delivering a HEE funded project (Expansion of PreRegistration Placements for Diagnostic Radiography) to increase student numbers to support the workforce shortages in radiographers. Student numbers are projected to increase by 30 places over the 2019 baseline of 62 over a 3-year period. In addition to under-graduate increases in student numbers UoS is working in collaboration with the clinical collaboration lead for the Radiology Imaging Network to support workforce needs in the future with post-graduate offerings.
Activity to promote Radiography as a career choice Throughout the year several activities take place where Allied Health Professions career are showcased and promoted to our communities in GM. We are committed to prioritising Diagnostic Radiography during career events in 21/22.
Next steps The NW Imaging Workforce Strategy has been informed by engagement with the workforce groups from the three NW ICS, the NW DRAD WAG, HEE, various groups undertaking specific workforce projects and colleagues in other regions.
To support delivery of the strategy, a NW implementation plan for the next 5 years will be developed, which will inform the local implementation plans for the three ICS.
The implementation plan will describe the clear steps we will take to embed and progress the priority areas articulated here. It will importantly contain an approach to
communication and support for ICS to enable each system to build and deliver on the areas of focus critical for their systems.
Actions taken or being taken to prevent reoccurrence across Greater Manchester.
1. Learning to be presented/shared with the Greater Manchester Quality Board. This meeting is attended by commissioners, including commissioners of specialist services, regulators, Healthwatch and NICE.
2. Learning to be shared with the Greater Manchester commissioners of services to consider the findings of the investigation within the context of the services they commission
The Greater Manchester Health and Social Care Partnership (GMHSCP) is committed to improving outcomes for the population of Greater Manchester. In conclusion key learning points and recommendations will be monitored to ensure they are embedded within practice.
I hope this response provides the relevant assurances you require. Thank you for bringing these important patient safety issues to my attention and please do not hesitate to contact me should you need any further information.