RCR and BSIR response to GIRFT report for vascular surgery

Created - 26.03.2018

RCR and BSIR response to GIRFT report for vascular surgery

The Royal College of Radiologists (RCR) and the British Society for Interventional Radiology (BSIR) welcome the publication of the Getting It Right First Time (GIRFT) programme report¹ for vascular surgery and the drive to achieve efficiencies in delivery of services and improve the quality of patient care.

We welcome especially the recognition given to the need for an increase in the interventional radiology workforce who are essential to the delivery of vascular services, particularly in patients who need care urgently. The challenges in delivering seven-day services are all too familiar to radiologists, who already deliver this for diagnostic imaging in a very challenging environment of personnel and funding.

We concur that the formation of networks to deliver consistent standards of care across organisational boundaries is important. However, unlike vascular surgery, interventional radiology services more regularly deliver emergency and urgent care to patients, including treatment of sepsis, acute bleeding, obstetrics, renal replacement and trauma. While being supportive of the recommended NHS England model of hub and spoke networks, it is critical that these do not destabilise the ability to deliver urgent care to patients located outside the vascular networks.

One important objective of the GIRFT process is the efficient procurement of devices and consumables. We welcome progress in this regard with the implementation of the NHS Future Operating Model. However, the coding process and tariff reimbursement of interventional radiology procedures remains problematic for many trusts and we would welcome further tariff development beyond HRG4+. This would enable funding of the minimally invasive and innovative treatments which patients call for.

We agree that there is a need to improve the collection of outcome data. The national audit programme for interventional radiology procedures is incompletely delivered by the National Vascular Registry, which was adapted for interventional radiology procedures and requires modification. Work is continuing in this regard. Such registries are only as good as the data that is included, and trusts are urged to support the development of infrastructure and allow physicians sufficient time to record meaningful data.

There are now over 30 clinical leads for the GIRFT programme and we look forward to integration across those workstreams. The radiology GIRFT process is continuing and will inevitably explore effective cross-specialty partnerships, which we are confident will clarify the direction of travel.

We also hope the positive outcomes of the GIRFT process, which apply to England only, can be extended to the three devolved UK nations and we look forward to helping in that process.