NIA Projects

Since July 2022 a regional mobile MRI van, funded by Scottish Government, has been rotating round the NHS boards in the North of Scotland. NHS Shetland had trialled hire of a van from provider company Diagnostic HealthCare Ltd to test the feasibility of a local MRI service in preparation for the installation of a fixed scanner in 2024. The regional van trial extended coverage to include additional boards.

Between July '22 and June '23 the van travelled between Tayside, Shetland and Orkney, from July '23 to March '24 the van also travelled to Grampian and Highland.

From April '24 to March '25, patients in Tayside, Orkney, Grampian and Highland have benefitted from increased capacity for scanning in the North of Scotland. Orkney patients are able to access the van when it visits The Balfour Hospital four times per year.

Patient feedback has been very positive and has reduced the need for people to travel from the island boards to the mainland to access MRI scanning facilities, as well as not having to take as much time off work.

The Health and Social Care (Staffing) (Scotland) Act 2019 comes into force in April 2024. In order to assess current staffing against a locally agreed safe staffing level and against professional judgement of safe staffing on any particular day, Claire Donaldson, lead radiographer with the North Imaging Alliance, has adapted the nursing assessment tools available through Healthcare Improvement Scotland, to make these more suitable for radiographer teams.

Following trials with teams in Tayside and Grampian, these tools are in final draft and will be published for general use shortly.

There are 2 tools;

• Indirect and Associated Workload
• Safe Staffing assessment

Each has a built-in summary report, which is generated once data collected by teams has been entered in each tool. These allow managers and supervisors to assess workload and staffing levels over a 2-week reference period and can be used in conjunction with other workforce planning tools.

Download the Safe Staffing tools here: 2024 NIA safe staffing.docx
(the download should start automatically)

The Excel tools are embedded in this document, double click to open, then File/ Save As and save to your own files. If you accidentally over-write the data in the embedded file, please download a fresh copy.

The regional IR strategy is being developed further as requested by North Chief Executives, with input from local multidisciplinary teams, and was approved at North Imaging Alliance Executive Board in November 2023. The strategy was presented and signed off by North Chief Executives in April 2024.

North Imaging Alliance, IR Strategy outline, approved by NCEs 11th November 22

• We will plan and deliver an integrated IR service which is sustainable and resilient across the North
• We will support staff to work flexibly in developing and maintaining skills
• We will provide a service to the population of the North which is of the highest quality and works seamlessly  to adopt new practices
• We will ensure that IR services across the North are safe and sustainable, both in and out of hours
• We will minimise variation in access to services and individual procedures, through a collaborative approach which serves the population of the North
• We will be an outward facing service which is open to new ways of working and which adapts to the needs of  the population

 We will deliver this strategy through specific actions:

• We will ensure there is a team approach to delivery of specialist IR services
• We will take a functioning and collaborative planned regional approach to all common scheduled procedures, and to low volume complex procedures
• We will agree and formalise pathways for unscheduled emergency procedures, in collaboration with patient  transport services, ensuring a safe and equitable service for patients, building on existing SLAs and transfer  arrangements
• We will develop a regional workforce plan which maximises the use of the multidisciplinary team.

The NIA core team has been working to assess the baseline position of the Alliance network against national quality standards published jointly by the Royal College of Radiologists (RCR) and the Society of Radiographers (SoR) in 2022.

The Quality Standards for Imaging Networks have been developed to support networks establish and assess their governance and quality improvement processes, for the benefit of patients, staff and services.

There are 6 standards;

• Involving Patients and Carers
• Workforce
• Network Equipment and Procurement
• Guidelines
• Network Organisation
• Network Assurance

Networks can choose to use the standards as reference tools, or to apply for formal accreditation through the RCR.

NHS Orkney

In November 2020, a trial of a Fuji portable x-ray unit FDR Xair was started in NHS Orkney. The purpose of the trial was for Radiographers to travel to islands within Orkney and provide clinics (within GP Surgeries) to patients that required an x-ray. The trial was undertaken to try and reduce travel times for patients; travel costs for NHS Orkney and the number of ‘Did Not Attend (DNAs).’  

The trial within NHS Orkney was successful in all three objectives which lead to the Board purchasing their own XAIR machine, to allow for the clinics to continue.  

The final report from the NHS Orkney trial has further details about the trial.  
NHS Orkney Mobile x-ray pilot - final report.pdf

Acknowledgements

The Fuji Xair was provided by Fujifilm UK. This was the first pilot of the Xair in Scotland, and we are grateful to Colin Brown and team for their support during this trial.

NHS Shetland

NHS Shetland have successfully trialed use of the Xair in collaboration with primary care colleagues on the Shetland mainland, to provide a service closer to patients' homes and to reduce footfall to the hospital.

Interventional Trainee survey – summary

The Community Apgar Questionnaire is a validated tool developed in the US in 2011 to identify advantages and challenges and associated importance for recruitment and retention to family medicine.  We developed a questionnaire based on this methodology, with a target group of IR trainees who were current - or recently - post CCT or CESR. The questionnaire was distributed in early 2022.

There were 22 responses. Key messages are that of the IR trainees who responded to the questionnaire, medical support was the most important factor, geography was seen as a barrier to working in the North of Scotland, but financial incentives and consideration of cross-boundary working may be potential solutions. Of the recruits who would not consider working in the North, family reasons and lack of accessibility were mentioned.

The feedback received from this questionnaire, was used to help develop the IR strategy. 

Radiographer workforce survey – summary of responses

The Community Apgar questionnaire was adapted for the radiographer workforce. 71 responses were received and analysed. Response values for each class and subdivision (factor) were converted into scores (vitally important = 4, important = 3, unimportant = 2, indifferent = 1), a cumulative total calculated for each class and then overall for the questionnaire. The scores were standardised to enable comparison across the classes.

The feedback received in this questionnaire will be used to help support work ongoing in relation to workforce in the North.