About us

Members Information

Contents

  1. IR Speciality Vote result
  2. RCR Elections 2020
  3. BSIR Venous Registry
  4. Professor Anna Maria Belli Travelling Grant
  5. BSIR AGM 2019
  6. Important information prior to vote at the BSIR AGM Thursday 14th November 2019
  7. Provision of interventional radiology services, Second edition Sept 2019
  8. FREEMAN HOSPITAL / ROYAL VICTORIA INFIRMARY LOCUM CONSULTANT INTERVENTIONAL RADIOLOGIST
  9. The National Interventional Radiology Symposium (NIRS) 21/09/19
  10. Guidance management of gas embolism
  11. VS BSIR Joint Statement
  12. VASIG (BSIR AVM interest group) Meeting December 5th 2019
  13. Advanced Hepatobiliary Intervention Symposium 23/01/20
  14. Global Vascular Guidelines
  15. Paclitaxel Patient Letter V4040619 (1)
  16. Medical Device Alert MDA/2019/023
  17. IR Statement - POIRS
  18. New Guidance on Picture archiving and communication systems and guidelines on diagnostic display devices from the Royal College of Radiologists
  19. New guidance on implementing safety checklists for radiological procedures from The Royal College of Radiologists
  20. BSIR STATEMENT REGARDING DRUG ELUTING TECHNOLOGIES
  21. NCEPOD Common Themes
  22. SIRT registry for the CtE cases
  23. Dealing with the Press
  24. BSIR AGM 2018
  25. ‘Top Tips’ for Reconfiguring Vascular Services
  26. BSIR Guidance Document for Prostate Artery Embolisation (PAE)
  27. Joint Statement from the British Society of Interventional Radiologists and The Vascular Society
  28. NICE Guidance for Prostate Artery Embolisation (PAE)
  29. RCR and BSIR response to GIRFT report for vascular surgery
  30. BSIR 2018 Elections
  31. BIAS Registry 2018
  32. Retained interventional radiological sheaths in obstetric cases Final
  33. Mechanical Thrombectory for Ischaemic Stroke
  34. BIAS Registry
  35. BSIR statement_Obtaining informed consent after the Montgomery ruling
  36. Health Education England’s Learning Solution – Alpha phase complete and service assessment passed
  37. Training of Existing Consultants in Interventional Radiology
  38. NHS Reference Cost Collection 2016/17
  39. NHS Improvement - Patient Safety Alert
  40. HYBRID FACILITIES
  41. Analysis of Thrombolysis in acute DVT Surveys
  42. E Referral Changes
  43. BSIR Statement on UFE
  44. Re: NICE Guidance CG147 update
  45. Radiologist Recruitment
  46. Updates on national tariff related publications from NHS Improvement
  47. Letter to members and medical directors re IR data submission to NVR 2016
  48. Data capture paper tool for NVR
  49. Benchmarking Consent in Nephrostomy
  50. Out Of Hours Intervention for Haemorrhage - Snapshot Survey Results
  51. RCR statement on the junior doctors’ industrial action
  52. Duty of Candour
  53. FSSA Position Statement - Appointment to Heads of School
  54. RCR position statement on the appointment of a radiographer as Head of the Yorkshire and the Humber School of Radiology
  55. SEED GRANTS UK IO Practicioners Information
  56. Cancer Research UK research brief: The skills and capacity of the UK’s non-surgical, oncology workforce
  57. Registries & Audit Newsletter

IR Speciality Vote result

Dear Membership,

I write to inform you that the recent vote at the AGM was strongly in favour of council pursuing speciality status with 79.5% of votes.

The FAQ’s and debate at the ASM demonstrated that there is uncertainty in this process, and I am sure that there will be hurdles to overcome, but the first step has been made.

We need to keep to simple principles in this process to allow the appropriate training of interventional radiologists (image guided surgeons) for the future.  We would remain in the Royal College of Radiologists, diagnostic radiology would be central to our training and we need to ensure that run through training will allow individuals to cross over to diagnostic and vice versa. We also need to support those diagnostic radiologists who wish to perform a range of interventional procedures.

I feel this is the beginning of a long process that is essential for our future and we will keep you informed as the process progresses.

Kind regards

Dr Ian McCafferty

BSIR President

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RCR Elections 2020

Dear Members,

The Royal College of Radiologists has announced nominations for the Faculty elections for 2020.

The vacancies are as follows:

  • Vice President (Clinical Radiology)
  • Council (1 vacancy)
  • Faculty Board (2 vacancy)
  • Speciality Training Board (1 vacancy)
  • Professional Support and Standards Board (1 vacancy)

Nominations for these positions now open:

  • 2 nominees required
  • On-line application via the RCR website
  • Nominations deadline, noon Friday 13th December 2019
  • Ballot opens 3rd February 2020 and closes 21st February 2020.

It is imperative that BSIR is represented at the Royal College of Radiologists, for a variety of reasons but in particular to help clear the path for Speciality status.

If any member is considering standing please let council@bsir.org know, and we can publicise your nomination. If you require any assistance with your application, please let us know.

Dr Ian McCafferty

BSIR President

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BSIR Venous Registry

Dear Members,

The BSIR Registries & Audit Committee are pleased to announce the launch of the BSIR Venous Registry, which is accessible to all clinicians managing patients with acute iliofemoral DVT and symptomatic chronic iliofemoral venous outflow obstruction (Interventional Radiologists, Vascular Surgeons and Haematologists).  

Current NICE guidance recommends Clinicians to enter details of all patients undergoing percutaneous mechanical thrombectomy for acute iliofemoral DVT on this Registry.This Registry will also collect data on patients undergoing percutaneous image-guided interventions in symptomatic chronic post-thrombotic and non-thrombotic iliofemoral venous outflow obstruction.

The main objective of the Registry is to improve quality of care by evaluating outcomes and assessing the safety of interventions in acute and chronic iliofemoral venous obstruction.

To apply for user access please click here.

Kind regards

Julie Ellison

BSIR Administrator

council@bsir.org

www.bsir.org

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Professor Anna Maria Belli Travelling Grant

Please click here to view the objectives and criteria for the Professor Anna Maria Belli Travelling Grant.

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BSIR AGM 2019

 

BSIRs Annual General Meeting will be held on Thursday 14th November 2019, 14:20 hrs at Manchester Central, Manchester.

Please see below Agenda, papers and draft minute of the last AGM for your reference.

Members who wish to raise any other matters for discussion should contact the Secretary Dr Philip Haslam or the Committees Administrator Ms Julie Ellison with an outline of the points they wish to raise. Contact council@bsir.org

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FAQs IR speciality Final version

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Important information prior to vote at the BSIR AGM Thursday 14th November 2019

Dear Members,

As we approach the Annual Scientific Meeting and the AGM, you will be aware that there is an item to debate at the meeting regarding Specialty status.

The first thing to say is that the intention is, as previously, that voting will be open to all members, those not at the meeting via electronic wizardry – more details to follow.

Many of you will recall that a motion was passed in 2017 to the effect that alongside the instigation of the IR Committee of the RCR, if Officer’s felt that this was not making sufficient progress, then the Society gave the Officers the mandate to pursue an option of requesting an IR Faculty.

It has always been clear that as IRs we would wish to remain a part of the RCR, it is the position within RCR that is being debated.

There has been considerable discussion and work done by the IR committee and the RCR Officers to try to understand better how best to promote and develop IR. As in all things there are pros and cons, which will be discussed more fully at the AGM, and it is certainly not my place to try to influence that debate ahead of time.

However, it has become clear to us that whilst Faculty would bring some change, the main issues driving change are such things as workforce planning, training/training capacity, and ensuring the highest quality of care to patients. It seems that Faculty status would not really achieve these objectives, this would require the setting up of an IR Specialty, preferably within RCR (and keeping the very important links with imaging and diagnosis – both in training and practice).

The recognition of a Specialty is complex, and requires approval from all manner of organisations, including the GMC. Whilst this is more complex and time consuming, Officers feel that this would be a more appropriate objective.

There are, of course, a whole raft of potential questions, many of which do not have simple or clear answers, alongside some threats as well as benefits.

We have put together some Qs and As, to try to at least air some of the questions that have arisen frequently.

Clearly this will require the support of RCR, and a discussion is due to occur at Faculty Board in the next few weeks.

I cannot possibly cover all the nuances of this process (even if I understood them all) in a short message, but I wanted to at least sow the seeds of debate for the ASM, as Officers are seeking to change the direction of travel from Faculty to Specialty, for the headline reasons above, and after very careful consideration.

I am sure there will be lots more water to go under the bridge, and I’m sure the debate will be lively at the ASM – please come.

Looking forward to seeing you all in Manchester.

Best wishes

Trevor

Dr Trevor Cleveland

BSIR President

The BSIR AGM will be held on Thursday 14th November 2019, 14:20 hrs, Manchester Central, Manchester.

Please click here to see the document outlining the proposal from BSIR regarding Specialty status. 

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Provision of interventional radiology services, Second edition Sept 2019

Please click here to view the Provision of interventional radiology services, Second edition, Sept 2019

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FREEMAN HOSPITAL / ROYAL VICTORIA INFIRMARY LOCUM CONSULTANT INTERVENTIONAL RADIOLOGIST

Hospital: Freeman Hospital / Royal Victoria Infirmary

Post: Locum Consultant Interventionsl Radiologist

Closing Date: 8 September 2019

Interview Date: 8 October 2019

Applicants are invited to apply for this new Locum Consultant Interventional Radiologist post for 6 months in the first instance, with a potential extension. 

For an informal discussion and further information regarding the opportunity and Directorate, please contact: Dr Tim Hoare, Clinical Director on 0191 2829041, or at Tim.Hoare@nuth.nhs.uk

Plesase click here to view the Recruitment Information Pack. 

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The National Interventional Radiology Symposium (NIRS) 21/09/19

The National Interventional Radiology Symposium (NIRS) for Foundation Doctors and Medical Students will be held on 21st September 2019 at the Royal Free Hospital, Hampstead, London. This event is kindly sponsored by the BSIR and the Royal Free London NHS Foundation Trust.

The Symposium will feature IR subspecialties including vascular, non-vascular and paediatric interventions, as well as interventional neuro-radiology. The afternoon workshops offer ample opportunities to experience endovascular simulation, graft stent simulation, ultrasound-guided biopsy, and the award-winning 'Scalpel and Beam' tutorial on surgical radiology.

Please visit our website https://www.uknirs.org, Facebook page https://www.facebook.com/NIRS19/ and Twitter https://twitter.com/UK_NIRS for more information.

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Guidance management of gas embolism

Please click here to view Management of Patients With Gas Embolism

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VS BSIR Joint Statement

The British Society of Interventional Radiology (BSIR) and Vascular Society (VS) have issued a joint statement following a successful meeting held 20th June 2019.  To see the full statement CLICK HERE

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VASIG (BSIR AVM interest group) Meeting December 5th 2019

Announcement of forthcoming meeting of VASIG 2019

(Vascular Anomalies Special Interest Group)

The UK Vascular Anomalies forum hosted by BSIR

Date:  December 5th 2019

Venue:  The Royal Free Hospital Medical School, Pond St, London NW3 2BQ

Organizer:  Dr Jocelyn Brookes

Email:  Jocelyn.brookes@nhs.net

Contact:  Ms Rita Makali , Administrator AVM service

Email:  rita.makali@nhs.net

Following the success of last year’s meeting which was attended by over 60 delegates from around the UK and Eire, we are delighted to invite you to this study day for those interested in the modern management of Vascular Anomalies and their associated syndromes. Interventional Radiologists, Vascular surgeons, Plastic surgeons, Dermatologists, Nurses, Geneticists, Haematologists  amongst other professionals involved in VM care attended last year and are most welcome to bring other colleagues with whom they offer this service.

The registration is offered gratis and 5 CPD points with certificate will be provided to delegates.

Refreshments will be provided during the day.

Local accommodation is available at reasonable rates for those travelling long distances.

This is a very exciting time in VM management and we will try to address as much of these developments  as possible in the time available and also seek collaborative standardisation between us in the form of a UK registry which was proposed at VASIG 3 years ago to be run through the BSIR registries committee.

As previously we would be delighted to see difficult cases brought by delegates to be discussed in open forum.

I look forward to seeing you there.

Dr Jocelyn AS Brookes MB BS FRCR FRCP

Consultant Endovascular Radiologist

Dept of Vasc Surgery

UCL Partners Hospitals

(University College and Royal Free Hospitals)

 

Themes and speakers: (provisional list)

Biomarkers in VM - Dr Calver Pang

Genetics - Prof Sahar Mansour

Starting the UK Registry - Mr Chung Lim / Dr Ian McCafferty

PROMs in VM - Dr Anthie Papodopoulou

Role of surgery in VM - Prof George Hamilton

Medical adjunctive therapies - Dr Jocelyn Brookes

Electroporation - Dr Tobian Miur

Anaesthetics in VM - Dr Jane Lowery

Complications in VM - Helena Smith

Imaging developments - Dr Brookes / Dr Parthipun

Favourites as usual:

Challenging cases chaired by - Dr Mo Khalifa

New session: Patient experience;

 “Grand Round with patients” - Nick Evans

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Advanced Hepatobiliary Intervention Symposium 23/01/20

Advanced Hepatobiliary Intervention Symposium

Date: 23rd January 2020

Venue: The Birmingham Conference and Events Centre, Holiday Inn Birmingham City, Hill Street, Birmingham, B5 4EW

Course organisers: Dr Simon Travis, Dr Neil Prasad and Dr Greg Ramjas (Nottingham University Hospitals NHS Trust)

This is a FREE event (requires a £30 refundable deposit donated to the British Liver Trust in the event of non-attendance) aimed at doctors with an interest in hepatobiliary intervention.

For further information and agenda please click here.

To register please visit www.hpbsymposium.com

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Global Vascular Guidelines

Please click here to view the Global Vascular Guidelines  CLTI Guideline Published in June 2019

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Paclitaxel Patient Letter V4040619 (1)

Dear BSIR Member

It is appreciated that the recent MDA from MHRA regarding drug eluting stents and drug coated balloons may mean that Trusts and departments want to write to/contact patients. To try to help reduce the potentially repetitive workload of formulating a letter, a group of IRs and Vascular Surgeons have put together the attached (click here to view). Undoubtedly individual organisations will want to produce their own version, or may not wish to write, but we offer the attached as a way to try to help. We hope you find it of assistance, if not, please feel free to ignore it.

Dr Trevor Cleveland

BSIR President

 

 

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Medical Device Alert MDA/2019/023

After careful consideration and consultation, the MHRA has issued a Device Alert, published on 4th June 2019, relating to drug eluting technologies. Members are advised to take note of the content, and make arrangements as they see fit, in the light of the Alert. 

To view the alert please click here.

Dr Trevor Cleveland

BSIR President

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IR Statement - POIRS

The Provision of Interventional Radiology Services (POIRS) has been revised, and the second edition is due to be published this summer (2019). A statement has been released by the Royal College of Radiologists (RCR) and British Society of Interventional Radiology (BSIR), to introduce the POIRS document, identify the benchmarks for Interventional Radiology and to highlight the competencies of interventional radiologists in patient management, both in an inpatient and outpatient scenario, obtained as part of their subspecialty training.

Click here to view the statement

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New Guidance on Picture archiving and communication systems and guidelines on diagnostic display devices from the Royal College of Radiologists

Please click here to view RCR New Guidance on Picture archiving and communication systems and guidelines on diagnostic display devices

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New guidance on implementing safety checklists for radiological procedures from The Royal College of Radiologists

Please click here to view RCR New Guidance on implementing safety checklists for radiological procedures

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BSIR STATEMENT REGARDING DRUG ELUTING TECHNOLOGIES

Click here to view / download BSIRs Statement regarding Drug Eluting Technologies

Click here to view / download FDA Letter to Healthcare Professionals onTreatment of PAD with Paclitaxel-Coated Balloons and Stents

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NCEPOD Common Themes

Dear BSIR member,

I would like to commend to you, and suggest taking a few minutes to read, the attached.

This is the NCEPOD Themes and Recommendations Common to all Hospital Specialties.

It is a review of the most common recurring themes seen in the many NCEPOD Reports.

The entire document is relevant, but I would draw your attention specifically to 2 themes:

Theme 5 – Consent. Among the notes there is a very clear support of the GMC guidance on taking consent and who should do this. In elective cases a deferred two stage process is recommended and also that consent on the day is not seen as appropriate. This is a very clear statement of need for IR clinics for non-emergency care.

Theme 9 – Managed Clinical Networks.  Again it has been clear that formal network arrangements need to be in place to allow patients to have access to the appropriate treatment. Ad-hoc arrangements are not considered suitable, and that Trusts need to have a clear refer and transfer policy. Again, I’m sure that this will ring in the ears of all of you, both in hubs and spokes, as there often in not a clear process for referral and transfer, leading to unnecessary delay (or even denial) of important IR procedures.

I am sure that there are a number of other areas in this document that you might find helpful in supporting your quality improvement programmes.

Best wishes

Trevor Cleveland

BSIR President

NCEPOD Common Themes

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SIRT registry for the CtE cases

This is the article from the SIRT registry for the CtE cases, published October 2018.

Analysis of a National Programme for Selective Internal Radiation Therapy for Colorectal Cancer Liver Metastases

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Dealing with the Press

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BSIR AGM 2018

BSIRs Annual General Meeting will be held on Thursday 15th November 2018, 14:20 hrs at the ICC, Bournemouth.

Please see below Agenda and draft minute of the last AGM for your reference.

Members who wish to raise any other matters for discussion should contact the Secretary Dr Philip Haslam or the Committees Administrator Ms Julie Ellison with an outline of the points they wish to raise. Contact council@bsir.org

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BSIR AGM Agenda 2018

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BSIR draft minute AGM 2017

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‘Top Tips’ for Reconfiguring Vascular Services

These ‘top tips’ are aimed at anyone, and everyone, involved in the reconfiguration of local vascular services to produce a united network of partner hospitals. They are based on practical experience of reorganisation and have been compiled from the experience of all disciplines within vascular services together with their commissioning and Public Health colleagues. 

Please click the link below to view download document.

 ‘Top Tips’ for Reconfiguring Vascular Services 

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BSIR Guidance Document for Prostate Artery Embolisation (PAE)

BSIR Guidance Document PAE

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Joint Statement from the British Society of Interventional Radiologists and The Vascular Society

Please see statement available to download below.

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Joint Statement from the British Society of Interventional Radiologists and The Vascular Society

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NICE Guidance for Prostate Artery Embolisation (PAE)

https://www.nice.org.uk/guidance/ipg611

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RCR and BSIR response to GIRFT report for vascular surgery

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.

 

1 Vascular Surgery: GIRFT Programme National Specialty Report [link]

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BSIR 2018 Elections

Dear BSIR / BSIRT / Foundation Dr F1/2 / Medical Student Members,

The BSIR elections are now open.

For further information and link to the nomination form please visit:

BSIR Full Members - https://www.bsir.org/society/bsir-subcommittee-elections-2018/#col_right

BSIR Junior Members - https://www.bsir.org/bsirt/bsirt-elections-2018/#col_right

BSIR Foundation Dr F1/2 / Medical Student Members - https://www.bsir.org/bsirt/bsirt-foundation-year-medical-student-representative-elections-2018/#col_right

(You must be logged into the BSIR website to view these pages).

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BIAS Registry 2018

The British Society of Interventional Radiology

Fourth Iliac Angioplasty Study Report 2018

Foreword

My thanks to the many people who have contributed to the British Iliac Angioplasty and Stenting (BIAS) registry. The BSIR is very proud to have instigated and supported this project, which is now in its fourth (and nal) report stage. BIAS has been one of the vanguard registries in the United Kingdom. This report joins its three predecessors, and is not only useful for its content, but is also a tribute to all those BSIR members who have taken the time to complete data entry. The society realises that much of this has been given freely, and often in individuals’ spare time. As President, on behalf of The Society, I thank you all for that. 

Trevor Cleveland

 

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Retained interventional radiological sheaths in obstetric cases Final

The below has been forwarded to BSIR from the Patient Safety Team at NHS Improvement The Safety and Quality Committee and Council Officers wish to make members aware of the review, and to bring the subsequent reflections to the attention of BSIR members.

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Mechanical Thrombectory for Ischaemic Stroke

Training to deliver mechanical thrombectomy

In order to achieve the desired delivery of a 24/7 service in MT across England, the number of operators capable of contributing to MT services needs to expand more rapidly than will be achieved by current INR trainee numbers. This means training other specialists to perform MT.

The British Society of Neuroradiologists (BSNR) has produced “Training guidance for mechanical thrombectomy” (Lenthall R, McConachie N, White P, Clifton A, Rowland-Hill C. BSNR training guidance for mechanical thrombectomy. Clin Radiol 2017; 72(2): 175.e11–175.e18.) which details the training that will be required for practitioners from different clinical backgrounds to achieve the necessary skills and experience to effectively contribute to the acute stroke service. This guidance will underpin all routes to increasing the workforce.

https://www.rcr.ac.uk/clinical-radiology/being-consultant/mechanical-thrombectomy-ischaemic-stroke

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BIAS Registry

8000+ cases entered since last publication (BIAS III, 2008) 13000+ cases altogether. Largest registry of iliac intervention worldwide as far as I know 50+ cases per week at peak recruitment in 2013. Substantially better recruitment so far compared with NVR. Follow up data excellent - 97% for most data points. Very low complication rates High success rates. read more..

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Obtaining informed consent after the Montgomery ruling - please see BSIR statement attachment below, available to view and print.

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BSIR statement - Obtaining informed consent after the Montgomery ruling

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Health Education England’s Learning Solution – Alpha phase complete and service assessment passed

Dear Colleagues

Please see below for an update on the progress of Health Education England’s Learning Solution project.  Many of you have been involved in the project at some point to date so we were keen to share with you the exciting milestone it has now reached.  

Health Education England’s Learning Solution – Alpha phase complete and service assessment passed

Health Education England’s (HEE) Learning Solution project has reached a new milestone by completing the alpha* phase of the development.  This phase culminated in passing all aspects of the service assessment giving permission for it to move onto the next part of the process, which is the beta* development phase.

HEE’s Learning Solution will provide access to a full range of resources, guidance and educational innovations across the NHS, social care and higher education which can also be shared, signposted, evaluated and developed. As well as helping to drive up quality, the Learning Solution will help promote and harness innovation and draw on the best practice, talent and projects within and beyond the NHS.

Neil Ralph, Health Education England’s National Programme Lead for the Technology Enhanced Learning Programme, said: “This is a very exciting and much anticipated project for HEE.  As well as being a resource for the wider health and social care workforce we believe it will support and feed into the work that is taking place right across HEE.”

The report from the 18 point Digital Service Standard assessment, which provides feedback and recommendations for the beta phase, can be found on the Digital Health blog.

For more information about the Learning Solution project visit www.hee.nhs.uk/tel

*Alpha and beta phases refer to the agile methodology being used for the development of the Learning Solution, which is commonly used in the development of digital products.

With kind regards

Alex

Alex Drinkall

Stakeholder Manager

TEL Programme and e-Learning for Healthcare

Health Education England 
2nd Floor | Stewart House | Russell Square | London | WC1B 5DN

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Training of Existing Consultants in Interventional Radiology

Training of Existing Consultants in Interventional Radiology - please see BSIR statement attachment below, available to view and print.

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Training of Existing Consultants in Interventional Radiology

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NHS Reference Cost Collection 2016/17

NHS have now published this year’s reference cost collection (2016/17 costs) all the spreadsheets and supporting documentation can be found here: https://improvement.nhs.uk/resources/reference-costs/

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NHS Improvement - Patient Safety Alert

Please see below Patient Safety Alert - Confirming removal or flushing of lines and cannulae after procedures, from NHS Improvement for your information.

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HYBRID FACILITIES

BSIR has been asked to advise on the development of so called hybrid facilities. These facilitate combined image guided procedures and open surgery. They may also be referred to as Interventional Radiology Theatres and others. A number of hospitals and organisations are investing substantial funds into such facilities, to improve the care of vascular, cardiac and trauma patients. Most will not find it financially viable to have more than one such suite.

BSIR was invited by the MHRA, to contribute to a Joint Working Group, which issued a report in 2010. This report was precipitated by a number of reports to the MHRA of EVAR (endovascular aneurysm repair) devices being placed in environments with poor imaging equipment. This was resulting in poor device placement, and high radiation doses to patients and operators. The subsequent report highlighted the need for improved facilities, and provided information intended to give details on the facilities that NHS and other organisations should aspire to provide. Of note, it was specifically stated that there was a need for back up imaging facilities in close proximity.

It was also recognised that, at the time, there was a preference for such facilities to be located close to a theatre environment (to allow for anesthetic and recovery areas). In the intervening time, Major Trauma Centres have developed, and the need to accommodate the rapid treatment of such patients. As a consequence of this, and other, changes there has been an expansion of the routine nature of delivery of anesthetic and recovery facilities outside theatre complexes. It has also become clearer that there is a pivotal role of Interventional Radiology (IR) in bleeding control. Trauma investigation and treatment (including image guided techniques) need to be co-located with Emergency Departments.

As a result, BSIR considers that, whilst the underlying principles of good imaging and environments remain current, requirements (and modern practice) of trauma care have changed the landscape of hybrid facilities. In the modern environment, these need to not just cater for EVAR delivery, but also trauma care. IR departments are generally located close to diagnostic radiology, CT scanners and Emergency Departments, ensuring safe and rapid patient treatment pathways. Such places offer considerable advantages in terms of back up imaging, power supply, power injectors and disposables, which are essential to the resilience for delivery of trauma care and combined image guided/open surgery. In many circumstances, these needs may outweigh other factors, making them more functional and economically viable if placed close to other IR and imaging facilities.

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Analysis of Thrombolysis in acute DVT Surveys

Dear Colleagues,

I would like to offer my sincere apologies for the delay in the publication of the analysis of my two recent Surveys about Thrombolysis in acute DVT and the second on the possible reasons behind not providing this service. Also, I would like to thank those who participated in these surveys.

Since the introduction of NICE guideline* for Thrombolysis in acute Ilio-Femoral DVT in 2012, a selection of Interventional radiologists (IR) started providing this form of treatment to patients with a history of DVT of less than 2 weeks’ duration.

The second survey showed that several IR’s colleagues have shown an interest in providing this form of treatment even though a small number (22%) are put off by the recent presentation of ATTRACT trial which claimed that there was no benefit in acute DVT thrombolysis in terms of preventing Post Thrombotic syndrome (ATTRACT fails to meet primary endpoint, but experts agree results are “hypothesis-generating” Vascular News 6th March 2017).

The purpose of both surveys is to pave the way to establish a registry on Thrombolysis in acute Ilio-Femoral DVT sponsored by BSIR. The surveys show that a number of Interventional radiologists and vascular surgeons, albeit small, do offer both Mechanical and or Catheter directed Thrombolysis.

As you can see from my summary report below, we are all providing the recommended pathway of treatment and utilizing available technologies to achieve the best outcomes. However, to gain some insight into the efficacy of these techniques, I would recommend a formal registry, run by the BSIR. I would recommend at least two years’ follow up. In addition, the registry is going to be used as a tool to determine how we define a successful primary outcome (i.e. preserved valve function, speed of flow, absence of reflux and whether there is a residual clot or stenosis) and whether this translates into good medium to long term outcomes.

Meanwhile, there are two controversial issues which require a consensus. The first issue is related to the use of IVC filter prior to thrombolysis and rather than putting my views on this topic I would like to share with you several publications on this issue which are worth reading:

PREPIC-1 (Decousus et al.  A clinical trial of vena caval filters in the prevention of pulmonary embolism in patients with proximal deep vein thrombosis.  NEJM 1998; 338:409)

PREPIC-1 Follow-Up Study (Eight-year follow-up of patients with permanent vena cava filters in the prevention of pulmonary embolism.  Circulation 2005; 112: 416-422)

PREPIC-2  (Effect of a retrievable inferior vena cava filter plus anticoagulation vs. anticoagulation alone on risk of recurrent pulmonary embolism: A randomized clinical trial.  JAMA 2015; 313: 1627)

Prasad V, Rho J, Cifu A.  The IVC Filter: How could a medical device be so well accepted without any evidence of efficacy?  JAMA Internal Medicine 2013; 173(7) 493-495.

The second issue which is equally very important and is to do with the future follow up of our patients following thrombolysis and whose responsibility it is.

Please, enjoy reading the analysis of the surveys’ outcomes and don’t hesitate to reply with your invaluable thoughts and suggestions on what questions should be included in any planned future registry.

Best wishes

Said Habib

Consultant IR, Nottingham University Hospitals

*NICE guideline:

Deep vein thrombosis

1.2.6Consider catheter-directed thrombolytic therapy for patients with symptomatic iliofemoral DVT who have:

  • symptoms of less than 14 days' duration and
  • good functional status and
  • a life expectancy of 1 year or more and
  • a low risk of bleeding. [2012]

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E Referral Changes

Many RCR Fellows are routinely consulting with patients in an out-patients setting, particularly before and after interventional procedures.  Some of these referrals will be coming from consultant teams, others from GPs. Such out-patient activity is encouraged by the RCR and GMC, to allow patients to consult with an expert before undertaking invasive treatments, and to ensure appropriate aftercare. Radiology clinics, like any other, are subject to a tariff payment, should be programmed into routine work, and be available for booking via e-referral.

Fellows should be aware, that the NHS e-referral Roadmap states an expectation that there will be availability of online patient booking and that for 2017/2018 there is a CQUIN payment available to incentivize Providers to publish all services and appointment slots on the NHS e-Referral service. In addition, from October 2018, appointments not available to e-referral will no longer attract a payment tariff.

Therefore, we would encourage all radiologists to consult with patients undergoing elective interventions in out-patients, have these available on the Trust Directory of Services, attract the appropriate tariff income for your department, and ensure availability for e-Referral.

http://content.digital.nhs.uk/media/24761/NHS-e-Referral-Service-Roadmap-July-2017/pdf/e-RS_Roadmap_July_2017.pdf

http://content.digital.nhs.uk/referrals

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BSIR Statement on UFE

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Re: NICE Guidance CG147 update

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Radiologist Recruitment

RCR have now introduced a Radiology Jobs corner on the colleges website, which is linked to the jobs site https://radjobs.co.uk/

This site is free of charge and allows employers to advertise vacant positions without the fees incurred on other recruitment sites.

Please share this information with your colleagues and contacts, to enable departments to actively engage in the recruitment process.

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Enquiries and frequently asked questions

NHS Improvement now publish the queries they receive on the national tariff.  The 2016/17 enquiries log now updated with questions and FAQs up to January and this can be found here:

https://www.gov.uk/government/publications/nhs-national-tariff-payment-system-201617

NHS Improvement have also launched the 2017/19 document with a selection of FAQs, that document can be found here:

https://improvement.nhs.uk/resources/national-tariff-1719/

 

Tariff doc corrections

NHS Improvement have updated a number of documents on the 2017/19 webpage due to small errors.  The main national tariff has had a date correction made in paragraphs 271 and 272 (relating to MFF recalculation).  They have corrected a column header issue on the MFF page of the national prices spreadsheet and further to feedback have removed the non-mandatory price for adult hearing services from the non-mandatory prices spreadsheet.  The documents can all be found here:

https://improvement.nhs.uk/resources/national-tariff-1719/

 

Reference cost collection guidance.

NHS Improvement have now published the reference cost guidance for 2017, it can be accessed here:

https://improvement.nhs.uk/resources/approved-costing-guidance/

 

Whole population budget webinars.

Following NHS Improvement latest webinar on new payment approaches, a page as been set up to bring all of the webinars on the subject together.  This will be added in the next month or so with further material.

https://improvement.nhs.uk/resources/whole-population-budgets/

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Letter to members and medical directors re IR data submission to NVR 2016

Please find attached a position statement from the BSIR about time allocation (in job planning) and administrative support for IR data entry into NVR. We hope that members may find this useful in negotiations with trust management over these issues.

Yours faithfully,

Chris Hammond

Chair: BSIR R&A Committee

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Data capture paper tool for NVR

Please find attached a paper consent and data collection tool that you may find helpful in data collection for peripheral angiographic procedures for the NVR. While this document does not circumvent the requirement for eventual electronic data submission, we hope that IRs will find it useful to collect data immediately after a procedure. Ideally some administrative support should be made available by trusts to enable data entry direct from the document without the need for the IR to do this personally.

The BSIR is progressing a number of other projects that may eventually assist in electronic data entry.

Yours faithfully

Chris Hammond

Chair: BSIR R&A Committee

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Please see attached a survey of nephrostomy outcomes (also performed earlier in 2016), which we hope may aid you in benchmarking your practice and assisting in consent processes.

Chris Hammond

Chair: BSIR R&A Committee

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Out Of Hours Intervention for Haemorrhage - Snapshot Survey Results

Please see attached a summary of results of the OOH intervention for haemorrhage snapshot survey done in October 2016.

Chris Hammond

Chair: BSIR R&A Committee

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RCR statement on the junior doctors’ industrial action

Friday 2 September 2016

The Royal College of Radiologists is unable to support the statement issued yesterday by the Academy of Medical Royal Colleges (http://www.aomrc.org.uk/wp-content/uploads/2016/09/Proposed_further_strike_action_010916-5.pdf) because it does not advance a positive solution for patient care or the provision of safe and sustainable NHS services.  We remain of the view that the dispute between junior doctors and the Government can only be resolved by resuming negotiations. Once again, we call on both parties to re-start the discussions and reach a workable solution as soon as possible, to avoid further distress to and impact on patients.  Each individual junior doctor will make up their own mind on taking strike action – and we should all respect those decisions.

The underlying problem remains that the NHS is under resourced, under staffed and overstretched.

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Duty of Candour

Statement below for your information.

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Duty of Candour BSIR Statement

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FSSA Position Statement - Appointment to Heads of School

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FSSA position statement regards heads of school

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RCR position statement on the appointment of a radiographer as Head of the Yorkshire and the Humber School of Radiology

'BSIR fully support the position of the RCR and agree's with the statement that the appointment of a Radiographer to the head of school is an ill conceived appointment by Health Education England' 

Raman Uberoi

BSIR President

The RCR position statement can also be viewed at: https://www.rcr.ac.uk/posts/rcr-position-statement-appointment-radiographer-head-yorkshire-and-humber-school-radiology and http://www.bsir.org/mediacentre/news/

RCR position statement on the appointment of a radiographer as Head of the Yorkshire and the Humber School of Radiology

Wednesday 3 August 2016

The RCR was informed last week that the post of Head of the Yorkshire and the Humber School of Radiology has been offered by Health Education England (HEE) to an individual who is not a radiologist and not medically qualified. The RCR was not consulted about this appointment and was not involved in the appointment process in any way. We understand that there was no radiologist member of the appointment panel and also that a suitably qualified and experienced consultant radiologist was interviewed for the post.

Radiology training and service delivery involve specific and complex challenges.  The role of Head of a School of Radiology includes the management of issues including trainees in difficulty, trainers about whom concerns are raised, the interface with clinical departments including the provision of out of hours services, the management of reporting discrepancies, radiology service whistleblowing concerns and the provision of strategic leadership and planning. The RCR considers that only consultant radiologists have the skills and experience to command the respect of radiology trainees and trainers in this role.

The RCR has unambiguously communicated in writing to HEE that the College does not support this appointment. We have requested an urgent meeting with the local Postgraduate Dean to explore how the damage caused by this ill-informed and ill-conceived decision can be limited.

The RCR recognises the anxiety and distress that this will cause radiology trainees and trainers not only in Yorkshire and the Humber, but also across the country.

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Cancer Research UK research brief: The skills and capacity of the UK’s non-surgical, oncology workforce

Cancer Research UK research brief: The skills and capacity of the UK’s non-surgical, oncology workforce

Cancer Research UK would like to commission research on the UK’s non-surgical oncology treatments workforce. The brief for this study is attached. The closing date for submissions is 1st September 2016.

We know that delivering world-class cancer outcomes relies on a vast array of health professionals. They are crucial at all stages of an individual’s journey, ranging from GPs offering smoking-cessation advice to the therapeutic radiographers and clinical nurse specialists involved in cancer treatment.

We are seeking to commission a new study to focus on current and future capacity and demand as well as providing potential solutions such as new models of care and changes to education and training programmes.

The findings will input into our policy development on workforce in all four nations and it will be used to inform our evidence and recommendations to Health Education England’s review of the cancer workforce in early 2017.

We would like the research to start by October 2016 with the view to complete by end of March 2017, for publication at the end of May 2017.

Please respond with expressions of interest by 22nd August 2016 and your full proposal for this work by 5pm, 1st September 2016.

All enquiries should be sent to Helen Beck, Policy Research Manager, helen.beck@cancer.org.uk<mailto:helen.beck@cancer.org.uk><mailto:helen.beck@cancer.org.uk<mailto:helen.beck@cancer.org.uk>>
 

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Research brief - Non-surgical oncology workforce

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Registries & Audit Newsletter

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Registries & Audit Committee Newsletter July 2016

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