scholarly journals National audit of seven-day working care in radiology

BJR|Open ◽  
2021 ◽  
Vol 3 (1) ◽  
pp. 20200046
Author(s):  
HS Bailey ◽  
P Mehrotra ◽  
KJ Drinkwater ◽  
DC Howlett
Keyword(s):  
Interventional Radiology ◽  
Acute Care ◽  
Royal College ◽  
Technical Support ◽  
Radiology Department ◽  
Political Commitment ◽  
Out Of Hours ◽  
The Uk ◽  
Sunday Evening ◽  
Current Provision

Objectives To evaluate the extent to which our current provision of diagnostic and interventional radiology services matches existing clinical demand and future government proposals as set out in the Royal College of Radiologists published guidance on providing seven-day acute care. Methods In June 2018, all UK radiology department audit leads were sent a questionnaire designed to assess compliance for each standard of the Royal College of Radiologists published guidance on providing seven-day acute care. Results 135 hospitals (68%) responded. Of those that responded, 96% of departments have a diagnostic radiologist rota for clinicians to discuss acute cases and review imaging and 48% of departments do not have a fully staffed consultant rota 24 h a day, seven days a week for interventional radiology. There is significant variance in MRI radiographer availability within departments, ranging from 18.8% during Saturday/Sunday evening/overnight up to a maximum of 63.9% during Saturday daytime. 11% of departments participate in a regional out of hours cross-organisation reporting rota. 40% of departments have no 24/7 RIS technical support and 34% have no PACS technical support out of hours. Conclusion There is a wide variation in practice across radiology departments in the UK. Although there are some standards that the majority of hospitals are achieving, there is a significant short-fall in fundamental aspects of providing acute seven-day care. The multifactorial nature in which these problems have arisen means there is no easy solution to combat these issues. There is a requirement for significant investment and political commitment to improve staffing and infrastructure in order to address the current situation. Advances in knowledge A UK wide evaluation of the current provision of seven-day working in radiology showing 54% of hospitals do not have a UK working-time regulations compliant Interventional radiology rota, severe lack of availability of acute MRI out of hours and significant deficiencies in providing technical support out of hours. A sustainable and efficient seven-day service is currently not being provided.

scholarly journals Thy 3F and 3a malignancy rate, a multisite regional retrospective case series

2018 ◽  
Vol 100 (7) ◽  
pp. 545-550 ◽  
Author(s):  
V Alexander ◽  
J Rudd ◽  
D Walker ◽  
G Wong ◽  
A Lunt ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Royal College ◽  
Case Series ◽  
Thyroid Malignancy ◽  
Retrospective Case ◽  
Retrospective Case Series ◽  
Indeterminate Nodules ◽  
The Uk ◽  
Diagnosis Of Thyroid Cancer ◽  
Benign Thyroid

Introduction The aim of this study was to ascertain the incidence of thyroid cancer for patients categorised as Thy3, 3a or 3f across four tertiary thyroid multidisciplinary centres in the UK. Material and methods This is a retrospective case series examining patients who presented with a thyroid nodule and diagnosed as Thy3, 3a or 3f according to the Royal College of Pathologists modified British Thyroid Association and Royal College of Physicians Thy system. Results In total, 395 patients were included in this study. Of these, 136 turned out to have benign thyroid disease and 24 had micropapillary thyroid carcinomas. The overall rate of thyroid malignancy was 28.8%. For each subcategory, the rate of malignancy was Thy3 24.7.7%, Thy3a 30.4% and Thy3f 29.2. However, the incidence of thyroid malignancy varied considerably between the four centres (Thy 3f 18-54%). Discussion The diagnosis of thyroid cancer is evolving but detection for malignancy for indeterminate nodules remains below 50% for most centres around the world. In 2014, the British Thyroid Association subdivided the original Thy3 category into Thy3a and Thy3f and recommended a more conservative approach to management for Thy3a nodules. Despite this, only two centres yielded a higher conversion rate of malignancy in the new higher graded Thy3f group compared with Thy3a. Conclusion It is debateable whether the new ‘Thy3’ subcategories are more useful than the original. Local thyroid malignancy rates may also be more useful than national averages to inform treatment decisions.

The NACPDE: new opportunities for dentists trained overseas

2009 ◽  
Vol 91 (8) ◽  
pp. 283-283 ◽  
Author(s):  
Margaret Wilson
Keyword(s):  
Royal College ◽  
Clinical Training ◽  
Dental Education ◽  
Postgraduate Education ◽  
Dental Surgery ◽  
Department Of Health ◽  
The World ◽  
The Uk

The National Advice Centre for Postgraduate Dental Education (NACPDE) was founded in 1978 and is based in the Faculty of Dental Surgery of The Royal College of Surgeons of England and funded by the Department of Health. The UK has traditionally played an important part in providing clinical training and postgraduate education for dentists from all parts of the world. But it is equally important to recognise the contribution oversea-strained dentists have made to the NHS.

scholarly journals The International Fellowship Scheme for consultant psychiatrists: trainees' perspective

2006 ◽  
Vol 30 (6) ◽  
pp. 229-231 ◽  
Author(s):  
Sanju George ◽  
Bill Calthorpe ◽  
Sudhir Khandelwal
Keyword(s):  
Royal College ◽  
Home Country ◽  
Department Of Health ◽  
Job Opportunities ◽  
International Fellowship ◽  
The Uk

The NHS International Fellowship Scheme for consultants offers overseas consultants, in specialties including psychiatry, an opportunity to work in the UK (Goldberg, 2003). This was launched by the Department of Health in 2002 and so far over 100 consultant psychiatrists have been recruited. However, there are several aspects of the project that are unclear. How long will this recruitment continue? Are there any arrangements in place to encourage overseas consultants to return to their home country at the end of their fellowship? Are they eligible to train senior house officers (SHOs) and specialist registrars (SpRs)? Will the recruitment under the scheme have an impact on job opportunities for SpRs currently training in the UK? Why is membership of the Royal College of Psychiatrists being granted to the newly recruited consultants without an examination? These and many more concerns have arisen in the wake of this scheme. In this article, we evaluate the scheme, discuss its implications and suggest possible ways forward.

scholarly journals Liaison psychiatry services in south England

2010 ◽  
Vol 34 (7) ◽  
pp. 270-273 ◽  
Author(s):  
Jackie Gordon ◽  
Sonia Wolf
Keyword(s):  
Royal College ◽  
Full Time ◽  
The South ◽  
Liaison Psychiatry ◽  
Hospital Size ◽  
Staffing Levels ◽  
The Past ◽  
Patient Groups ◽  
The Uk ◽  
And Function

Aims and methodTo investigate liaison psychiatry services across 38 acute trusts in the south of England. We used a telephone survey and compared the results to service structure and function as recommended by the Royal College of Physicians and the Royal College of Psychiatrists.ResultsApproximately two-thirds of trusts surveyed had a dedicated liaison service and this was not significantly related to hospital size. Most liaison teams were understaffed in all disciplines and only a third had a full-time consultant. Services for specialist patient groups were generally well provided for; 37% of teams had been created in the past 5 years and 33% were planning to increase their staffing levels in future.Clinical implicationsLiaison services in the south of England are similar to those in other parts of the UK that have been surveyed. Although the services did not meet the Colleges' recommendations, our study shows some recent growth and development in this specialty.

scholarly journals Tick, tock, lock: night-time confinement in high security – history, practice, ethics and practicalities

2018 ◽  
Vol 43 (1) ◽  
pp. 1-3
Author(s):  
Ed Silva ◽  
Andrew Shepherd
Keyword(s):  
Royal College ◽  
Night Time ◽  
Advisory Body ◽  
High Security ◽  
The Future ◽  
The Uk

SummaryNight-time confinement, locking patients in their bedrooms overnight, is practiced within high-secure hospitals in the UK. This article provides context, sets out the history and reviews the ethical and pragmatic issues at stake. Thought is given to the future, where we appear to be moving toward a different approach.Declaration of interestE.S. is a consultant forensic psychiatrist at Ashworth Hospital. All his patients are confined at night. He represents the Royal College of Psychiatrists Forensic Faculty at the National Oversight Group, which is the strategic advisory body providing assurance to NHS England regarding the commissioning and provision of high-secure services.

scholarly journals The EWTD: friend or foe to quality patient care?

2006 ◽  
Vol 88 (9) ◽  
pp. 318-319
Author(s):  
MBS Brewster ◽  
R Potter ◽  
D Power ◽  
V Rajaratnam ◽  
PB Pynsent
Keyword(s):  
Patient Care ◽  
Medical Staff ◽  
Junior Doctor ◽  
European Working Time Directive ◽  
Junior Doctors ◽  
Out Of Hours ◽  
Quality Patient Care ◽  
European Working ◽  
The Uk ◽  
Working Time Directive

For the last few years all the hospitals in the UK have been changing junior doctors' rotas to become compliant with the European Working Time Directive (EWTD). The first stage, requiring a junior doctor to work a maximum of 58 hours per week averaged over a 6-month period, became law in August 2004. In addition to new posts for junior doctors there have been schemes to facilitate the transition, such as the Hospital at Night programme. This was designed to use the minimum safe number of doctors from appropriate specialties with supporting medical staff to cover the hospital out of hours. It was required to make the most efficient use of this team and allow the junior doctor rotas to be compliant with the appointment of as few new posts as possible.

Prolonged disorders of consciousness: a critical evaluation of the new UK guidelines

Brain ◽  
2021 ◽  
Author(s):  
Neil Scolding ◽  
Adrian M. Owen ◽  
John Keown
Keyword(s):  
Royal College ◽  
Critical Evaluation ◽  
Disorders Of Consciousness ◽  
National Guidelines ◽  
Recent Developments ◽  
Nutrition And Hydration ◽  
Primary Focus ◽  
The Uk ◽  
American Academy Of Neurology ◽  
Neuroimaging Techniques

Abstract Earlier this year, the Royal College of Physicians in the UK published national guidelines on the management of patients with prolonged disorders of consciousness, updating their 2013 guidance ‘particularly in relation to recent developments in assessment and management and … changes in the law governing … the withdrawal of clinically assisted nutrition and hydration’. The report’s primary focus is on patients who could live for many years with treatment and care. This update, by a neurologist, an imaging neuroscientist, and a lawyer-ethicist, questions the document’s rejection of any significant role for neuroimaging techniques including functional MRI and/or bedside EEG to detect covert consciousness in such patients. We find the reasons for this rejection unconvincing, given (i) the significant advances made in the use of this technology in recent years; and (ii) the wider scope for its use envisaged by the earlier (2018) guidelines issued by the American Academy of Neurology. We suggest that, since around one in five patients diagnosed with prolonged disorders of consciousness are in fact conscious enough to follow commands in a neuroimaging context (i.e. those who are ‘covertly conscious’ or those with ‘cognitive motor dissociation’), and given the clinical, ethical and legal importance of determining whether patients with prolonged disorders of consciousness are legally competent or at least able to express their views and feelings, the guidance from the Royal College of Physicians requires urgent review.

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