Iain Robertson, BSIR Council,
David Shaw, Chair BSIR Membership and Rules Committee
Regional Reconfiguration of Vascular Services
Most Strategic Health Authorities in the UK are in the process of undertaking a review of regional vascular services which is likely to result in significant changes for both vascular surgery and interventional radiology.
There are two main drivers for change
1. A quality improvement focus, in particular considering mortality rates following AAA repair, to support the National Aneurysm Screening Programme/
2. The inequality of access to emergency interventional radiology services across populations, particularly emergency embolisation procedures for haemorrhage.
These processes typically involve setting core standards against which centres are measured to assess their suitability to provide particular services. The criteria used are from a variety of sources, which include National Guidance, published evidence, patient outcome data and cost effectiveness. The aim is to provide high quality comprehensive vascular surgical and interventional radiology services that are accessible to all, robust and sustainable.
It is anticipated that external advisors may be required to facilitate further service reconfigurations which impact on interventional radiology. Individual members may be directly approached by organizations or the BSIR may be asked to nominate members. Members must make it explicit whether they are acting as an individual or representing the Society. Council is keen to reassure members that anyone representing the Society will follow a transparent process based on best possible evidence.
To assist members in these processes the Membership and Rules Subcommittee has been charged with amalgamating the available standards and evidence. In the interim, the most relevant sources of guidance and standards are:
Royal College of Radiologists;
2011 Standards in Vascular Radiology
2008 Standards for providing a 24 hour interventional radiology service
National Imaging Board;
2010 NIB Interventional Radiology: Guidance for Service Delivery
Joint Working Group (RCR, BSIR, VS, VAS, MHRA);
2010 Guidance on Delivering an EVAR Service
Royal College of Radiologists and Royal College of Nursing;
2006 Guidelines for Nursing Care in Interventional Radiology
The Vascular Society;
2009 The Provision of Services for Patients with Vascular Disease
2009 Framework for improving the results of elective AAA repair