The Radiology Quest

The COVID-19 crisis has put our NHS under extraordinary pressure. As we move beyond the initial response, which interrupted elective diagnostic services to make way for the surge in COVID-19 patients, the recovery of diagnostic imaging services is now a top priority

However, it is important to acknowledge that imaging services were under pressure before the pandemic took hold. Work had already begun via the NHS Long Term Plan and Transforming Imaging Services initiatives under which NHS Improvement (NHSI) was updating the ageing installed base of CT and MRI scanners. What is new is that in this new climate there is greater emphasis on the urgency for increased capacity and the provision of COVID-secure environments to encourage patients back into the healthcare system and restore service levels.

Adopt and adapt means thinking differently and innovating quickly

Radiology has always been, and will continue to be, a key element of a patient’s journey. It goes well beyond the initial investigation of symptoms, to confirmation of diagnosis, monitoring and the progression of a condition over time. As treatments become increasingly more targeted and sophisticated, the use of both CT and MRI has become routine in patient pathways. Driving innovation and change in the busy healthcare environment is challenging. The day-to-day service delivery in a large organisation continues at pace under extraordinary pressure. To then introduce and adopt new innovation is a significant undertaking. So, what are the key steps that NHS radiology can continue to take to adopt and adapt in this new COVID-era?

Firstly, it is time to think differently; to think beyond the walls of the traditional hospital establishment. Physical space on the hospital estate has to date been the insurmountable barrier to service expansion. Today, solutions exist that create new imaging rooms quickly and without causing existing capacity downtime. This use of mobile, relocatables and community locations will greatly help expansion. For example, 15 relocatable CT units were mobilised by Canon Medical Systems UK as part of NHS England’s COVID-19 recovery plan, and were placed in unused car parking spaces, ambulance bays or small garden areas.

The CT systems utilise ‘InnerVision’, the remote diagnostics software solution that can predict, diagnose or fix system issues immediately without the need for engineers to visit hospital sites in person. This was particularly useful to keep systems monitored and resolve issues during COVID-19 restricted physical access.

Mark Kon, Consultant Thoracic Radiologist & Clinical Director of Radiology at Bradford Royal Infirmary states, “The relocatable CT scanner allows us to keep ‘Green’ patients (without suspected COVID-19) separate from ‘Red’ (suspected COVID-19 patients), mirroring the cohorting we have on the wards. Although our teams of radiographers were divided into red and green at the start of the pandemic, they shared a common CT control room. Having an entirely separate scan facility means there is much less risk of cross infection.”

Helen Lancaster, Director of Operations at South Warwickshire NHS Foundation Trust states, “Yearon-year demand for CT scans has grown significantly and is unlikely to decrease given the changes required in cancer pathways and diagnostic techniques. With the added considerable impact that the COVID-19 pandemic has had on our Trust’s capacity to perform many diagnostic procedures, the implementation of the CT scanner at Stratford Hospital is significant in ensuring our patients are seen and treated as soon as possible.”

“Year-on-year demand for CT scans has grown significantly and is unlikely to decrease given the changes required in cancer pathways and diagnostic techniques.”

Helen Lancaster, Director of Operations at South Warwickshire NHS Foundation Trust The importance of internal and external collaboration

Secondly, embracing the spirit of collaboration within the NHS organisation and partners is key. The procurement and installation of CT and MRI scanners are important and demanding projects that require input from many stakeholders across multiple organisations, often taking the best part of a year to complete. Collaborative teamwork to date has been key to making advancements. For example, NHSI and NHS Supply Chain have been instrumental in supporting Trusts with an accelerated selection and procurement process; they also liaised closely with suppliers to ensure the timeline commitments were both understood and met.

From a supplier perspective, installing large, complex imaging equipment is dependent on an intricate network of interconnected companies that all need to work collaboratively and be customer driven. Allocating units, appointing builders and securing installation slots whilst meeting the unique requirements of each project is not without its challenges. Two-way partnership working is essential.

Linda Horsfall, National Sales Manager at Canon Medical Systems UK, concludes, “Unity at a time of crisis enabled the NHS to fight back against coronavirus. It serves as a good example of how, looking ahead to the recovery and renewal of imaging services and the continued success of the Adopt and Adapt initiative, we need to all work together - from collaborating on new ideas within the NHS environment, to championing each stage of the radiology industry supply chain. Linking hands and pulling together is the only way we will facilitate faster adoption of new ways of working, adapt to unpredictable environments and encourage service innovation to make significant positive differences to patients.”//

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