Out-of-hours Emergency CT and MRI Cover

The Crisis in out-of-hours radiologist support

Increased demand for emergency head and body CT
All District General Hospitals (DGHs) with an Accident and Emergency Department now possess CT scanners, and over 95% of acute hospitals provide emergency CT scanning. There has been a progressive increase in demand for emergency CT, particularly out of normal working hours (i.e. between 5pm and 9am weekdays and at weekends). The greatest increase in demand has been for head CT, which currently accounts for over 80% of emergency CT in many DGHs. Several recent guideline documents issued by Royal Colleges and subspecialty groups have increased the expectation and demands of patients and clinicians for out-of-hours imaging, including the Royal College of Physicians guidelines on imaging in acute stroke, and the British Society of Neurosurgeons guidelines on head CT in acute head injury.

Shortage of Consultant Radiologists
There is an acute shortage of experienced consultant radiologists throughout the United Kingdom. Though the number of radiology training posts has been expanding, there will be a delay of at least five years before these trainees qualify. Moreover the increase in newly funded consultant posts continues to outstrip this expansion. The problem is particularly severe in DGHs where only one half of advertised posts are filled, and over one quarter of advertised consultant radiology posts receive no applicants at all. The situation is likely to deteriorate over the next five years.

Many DGH radiologists are being woken repeatedly to report CT at night when on-call, and yet are still expected to work a full and demanding days’ work the following day. The lack of sleep can affect performance and is detrimental to health. Increasingly it is leading to staff sickness, consultants moving to better staffed hospitals, and applications for early retirement. In some hospitals, the increase in demand for emergency cover has resulted in crisis or even collapse of the out-of-hours emergency imaging service. The prospect of an anti-social on-call commitment that is so demanding is little incentive for new radiology graduates to take up DGH consultant posts.

The problem will be exacerbated by the implementation of the EC Maximum Work Time Directive at consultant level by the year 2003. This will make the current provision of an out-of-hours CT service unsustainable in many DGHs.

Expert Eye, Emergency CT and Teleradiology

Expert Eye provides radiological cover for emergency CT and MRI.
Expert Eye can provide a solution to this crisis. With the advent of affordable teleradiology, and the availability of teams of radiologists experienced in emergency head and body CT, a comprehensive out of-hours service can be maintained using remote reporting. It is now feasible to provide image links that allow fast, efficient, reliable transmission of original CT imaging data, in a secure form, across any distance, using routinely available telephone lines.

Expert Eye is the largest independent UK teleradiology reporting service. We provide teams of widely experienced consultant neuroradiologists for head and spine CT, and highly-qualified body CT radiologists for other emergency CT imaging. We can provide a comprehensive, year round, emergency CT reporting service for DGHs.

All Expert Eye consultants are carefully selected, and curriculum vitae and references are available.

Cost-effective imaging.
Because of the nature of emergency medicine, it is impossible to predict when out-of-hours CT scans will be needed. Using conventional services, a radiologist must be available (and paid), for the entire on call period to provide continuous cover.

Expert Eye out-of-hours radiology support is costed on an item-of-service basis, not on an hourly rate. This means that your hospital only pays for what it needs. Compared to the cost of a locum consultant radiologist, who is paid an hourly locum rate overnight whether they are working or sleeping, this is an extremely cost-effective use of financial resources.

Crisis cover.
There are a number of unexpected situations when out-of-hours cover may be required at short notice or in the medium term. Examples include, sudden illness, unexpected sick leave, holiday cover, maternity leave, unfilled consultant posts, or simply insufficient numbers of consultant radiologists to provide a comprehensive on-call service. If a crisis arises, and with an image link in place, a single phone call is all that is required, and Expert Eye will provide telephone support for local clinicians, triage of scan requests, and reporting of out-of-hours CT scans for the entire on-call period.

If you are interested in out-of-hours radiological cover contact us now.