Dear Members

 I thought it might be helpful to have an update on where the Society is heading and an indication of some of the important issues which are likely to impact on us in the next year or so.

 Best wishes for 2010

 David Kessel

 BSIR Strategy

 Many years ago there was a joke about the newly founded Social Liberal Democratic Party which went along the lines of “the SLDs do have a policy, …….. third party fire and theft”.  Like any organization BSIR strategy has evolved through several key phases.

 In the beginning: When the BSIR began as a collection of enthusiasts the strategy was simply to spread the word and keep up the momentum of enormous technical and technological invention that occurred in the early years of Interventional Radiology.

 Thereafter: As the Society matured and the annual meeting blossomed then the need to ensure that the Society was financially viable enough to support the meeting became a predominant strategic theme. The huge efforts of previous Council and members have secured a larger dynamic society with a much more secure financial position.

Onwards: The next phase must be to build upon these good foundations. In addition, to continuing to support that position in a difficult economic climate, we need now to define and develop the direction of travel for the next 3-5 years.

 We hope to set the stage for the future of the society by clarifying some core strategic objectives for the BSIR. These will encompass: 

• Improving quality of provision of IR across the UK.
• Improving quality of care for patients undergoing IR therapy.
• Acting as a source of relevant and up to date information and support for you the members and also patients and healthcare providers.
• Providing advice on IR to Government, Royal Colleges and Healthcare Commissioners.

 Other topics of Interest

 There are several highly topical issues on the event horizon which are relevant to all BSIR members and the Society’s core strategic objectives.

 Subspecialisation

 For the benefit of grammarians I recognize that this may not actually be a word in which case you may be fearful that there is a similarity to the unlamented George W Bush. On the bright side at least I don’t have a button to push.

 This is an exciting time for interventional radiology. UEMS has recognized the specialty of IR in Europe. You will recall that at the AGM in 2008 you voted that we lobby for subspecialty recognition for IR. This was duly proposed at the next RCR Interventional Radiology Committee (which was then immediately disbanded!) Following due process it was passed up through RCR Boards and Officers. To cut a long story short we were given a benediction to apply to PMETB. The first stage documentation was enthusiastically received and an early submission requested. The presentation has now been made and the full application will go before a PMETB panel in March 2010. Our thanks go to Andy Adam, Tony Nicholson and Ian Francis for taking this process forward from the RCR.

Training

 The timing of these changes is impeccable and affords new opportunities not least for training. Some of you will be aware that the RCR is currently revising the curriculum for training in radiology. The design of the curriculum is such that all radiologists have to study and be examined in “core” radiology. This is the basis of what is needed to provide an acute service. It is expected that many radiologists will choose to develop a special interest in 1 or 2 areas in which they will practice to a higher level. This is well suited to subspecialisation in IR. An IR curriculum is being developed for presentation to PMETB.

 Selection into training in IR will occur either at the time of entry into radiology and these doctors will be expected to undergo Focused Individual Training with at least 2 attachments in intervention during the first 3 years. It is possible that up to 20 new training numbers will be provided to allow this to occur. The Warden of the RCR has already written to all heads of training to ask whether they have the capacity to be able to take additional trainees in IR. Doctors entering general radiology training will also have the opportunity to see the light and turn to IR when they tire of climbing endless mountains of cross sectional imaging. It is not yet certain whether the final CCT will be in Radiology or Radiology (intervention). 

 European Certificate of Interventional Radiology

 On the subject of training you should note that CIRSE is introducing a European Certificate of Interventional Radiology follow the link to learn more (ECIR). This will be a common European qualification in Interventional Radiology and will help to standardise training and expertise in Interventional Radiology across Europe. Until the next CIRSE meeting CIRSE fellows can obtain the ECIR without the need to take an exam. Follow the link to find out how to become a fellow (CIRSE fellowship). The good news for future trainees is that the ECIR is based on the CIRSE IR syllabus which is based on the UK IR syllabus developed by the BSIR. This syllabic material will also be used as the basis for special interest training in IR the new RCR curriculum. Hence future trainees should be well prepared to gain the ECIR qualification which will potentially help them gain employment albeit at the cost of a further €500! We have enquired of CIRSE whether it would be possible for the BSIR to act as a sponsor for members applying for CIRSE fellowship, unfortunately this is not possible under their regulations at present so you will need to find a couple of CIRSE fellows to act as your sponsors.

 Service Delivery

 The aim of training is to equip IRs to deliver high quality services across the country.  At present there is considerable interest in service provision or more specifically the lack of organized services to cater for acutely ill patients with conditions as diverse as urinary obstruction and haemorrhage. If we are to step up to the plate and be taken seriously as a specialty we will need to make sure that we are able to deliver these services across the country, 24 hours a day, 365 days a year. There are few centres which currently provide round the clock services and those which do are not recognized for this. There is no simple one size fits all solution for this or there would no longer be an issue. If we work on the basis that our prime directive is to provide service for patients finding answers becomes simpler. What is clear is that elective services should be delivered locally if possible but that doctors or patients may need to travel to ensure comprehensive cover for out of hours work. We hope that the Society will be able to help provide guidance and suggestions on how to achieve this.

 It is essential that IR is seen as having an attractive career pathway and sustainable work life balance. This means that the on call commitment must not be too frequent especially as it becomes busier.

For this to work we need to raise the profile of IR with healthcare commissioners, purchasers and providers. To this end the Society is preparing two key documents. The Provision of Endovascular Services dealing with the “vascular” elements of IR and the Provision of Interventional Cancer Services covering all “non-vascular” intervention. These documents are being developed in collaboration with other relevant specialties. It is hoped that the Provision of Endovascular Services document will appear in the first quarter of 2010.

 Standards of practice

 Like all members of the medical profession our performance will fall under scrutiny by the public and our managers. We will work with the RCR to try to set standards which are achievable and in the best interests of the public. The easiest way to do this is to have robust outcomes data on performance. This will allow us to demonstrate acceptable practice outcomes. Support the registries and they will support you!

 BSIR relationship with RCR

 As already mentioned the RCR interventional radiology subcommittee has been laid to rest, some might think put out of its misery to be more appropriate. The BSIR remains the SIG for interventional radiology and will continue to advise and be consulted on matters relating to IR.

 Hopefully some of you have managed to read this far; congratulations on your diligence and perseverance. It might of course be that you feared further horrors would be hidden at the bottom in the small print. The good news is that all of the small print is in German and has little relevance to anyone who is not a or the Tony Nicholson.

 David Kessel

* Schadenfreude: vicarious pleasure derived from someone else’s suffering. In this case my smugness at having been able to contexturalise the good Dr Nicholson’s 2 favourite words in a more imaginative way than he ever managed.