Vikki, I see your point, but there is much more to this problem than just
lack of staffing. Most radiology departments have around three to four times
the number of consultants than their respective A&E departments. Granted,
they have a huge elective workload and we don't, but radiology departments
run their core services for 40 hours per week, while we run ours for 168
hours per week. But it's all about priorities, and the government are partly
to blame for that. Why should elective work have priority over emergency
work? It obviously shouldn't and the government are slowly beginning to
realise this at last. We don't yet have specific imaging targets for
emergency work, but I suspect that they will come soon. There's no way we
will be able to hit our four-hour A&E targets without pathology and
radiology support.
In the example I gave, the radiologist initially told my registrar that he
couldn't do the scan. I thought this may have related to radiography
shortage (which is a big problem with us at the moment) or may have related
to some technical problem. That is partly why I invited him to write in the
notes, to allow him to clarify his position should any problems arise. My
request wasn't presented in a confrontational manner; I merely wished to
document the precise reason for refusal (perhaps we could divert some
responsibility on to management) and I also wished the radiologist to share
some responsibility for the patient's outcome. It transpired that the
radiologist simply wouldn't do the scan, for no apparent reason. Hence the
scan was then done without further quibbling.
Most of our emergency work is carried out by radiology registrars; again our
radiologists have around four to five times the number of registrars that I
have in my emergency department. They are all paid to provide an emergency
service, both in office hours and out of hours. There is no excuse for
refusing an emergency scan based on the arguments you have put forward.
Adrian Fogarty
----- Original Message -----
From: "Vikki Chase" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Sunday, September 15, 2002 9:49 AM
Subject: Re: radiologists compromise timely emergency care
> I'm a radiographer who enjoys the out of hours side of things- namely A &
E
> work- and rarely see radiologists ( unless the image link for CT isn't
> working....) but you have me wondering how many of the occasions you would
> need to contact a radiologist would be before the 10 pm mentioned in your
> debate about consultant contracts?
> Prompted by the debate on this list I hunted out our clinical director to
> enquire if this would mean more 'out-of-hour' sessions in CT /MRI
> /Ultrasound, however I was told they haven't enough radiologists to cover
> lists during the day, let alone running additional sessions at any time.
> Perhaps when more 'willing' volunteers take up the job vacancies there'll
be
> more radiologists about and more willing to take on requests. If the
> radiology department is already failing to meet targets on waiting times
for
> scans etc that are on a government hit list ( and things are getting worse
> not better!) then I guess they will be unlikely to satisfy other sources
of
> referral.
> Hope its a better service for you where they have the staff!
>
> Vikki Chase
> Senior Radiographer
> In a department where all in-patient and most out-patient plain films are
> not routinely reported on by radiologists unless personally returned to a
> radiologist, 2 radiographers and a locum consultant try to keep up with
the
> A&E and GP reporting, and CT and MRI no longer run full lists Mon- Fri 9-5
> due to lack of radiologist cover, and the waiting lists are getting
longer!
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