Multicentre audit shows lifesaving role of 24/7 interventional radiology

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This new data reveals the importance of access to 24/7 interventional radiology and the need to ensure availability of interventional radiologists in emergency care. There is a wide variation in the availability of 24/7 interventional radiology across the UK, which means that patients in some parts of the country do not receive the benefits of minimally invasive modern medicine in the emergency setting.

Leading interventional radiologists in the UK presented a unique snapshot of 24/7 interventional radiology in acute hospital care at the British Society of Interventional Radiology (BSIR) Annual Meeting (12–14 November, Liverpool, UK). This new data reveals a fascinating picture of the importance of access to 24/7 Interventional Radiology and the need to ensure availability of interventional radiologists in emergency care.

Seven major hospital sites took part in this innovative study including Hull, Manchester, Glasgow, Royal Devon and Exeter, Nottingham, St Georges and Sheffield.  The results will form part of a debate at the BSIR’s 27th Annual Meeting in Liverpool, exploring the challenges of providing a 24 hour Interventional Radiology service and the subsequent need to develop the interventional radiology workforce of the future. The session was chaired by Neil Carmichael MP and chair of the All Party Parliamentary Group on Vascular Disease. 

The pilot study titled “7 days 7 sites 24/7 Interventional Radiology” recorded data over the course of a week from seven UK hospital sites providing acute interventional radiology care. In total, 63 cases in which interventional radiology was successfully performed were recorded as part of the audit and including

  • An endovascular aneurysm repair for a 62-year-old male patient
  • Embolization to achieve haemostasis in a 22-year-old patient with post-partum haemorrhage
  • Insertion of a colorectal stent to successfully clear a large bowel obstruction avoiding the need for immediate surgery for a male patient
  • Patient given successful dialysis within hours of emergency interventional radiology treatment for end stage renal failure and vascular access 

 
Experts hope that the study will reinforce the diversity and importance of interventional radiology as central to the provision of acute hospital care and how, if used more effectively, patient outcomes could be improved. However, a national survey in England (2012) showed that 45% of hospital sites in England do not have local or formal access to “round the clock” Interventional Radiology.   In addition, the Centre for Workforce Intelligence (England) estimates that the health care workforce is short by over 200 Interventional Radiologists. 

Iain Robertson, consultant interventional radiologist and past president of the BSIR, who led the study says, “There is a widely acknowledged challenge in providing access to 24/7 interventional radiology. We need to work further to develop equity of access and ensure the best patient outcomes. However, getting universal access to interventional radiology will be very challenging given that there is a major under-provision of interventional radiologists in the UK.  In the medium-term, we need to expand the trainee numbers in interventional radiology substantially but this workforce will take 5–10 years to come through training and make an impact.  In the short-term, we need to utilise resources more effectively across hospital networks and ultimately this will need central leadership from the NHS.

“We hope that results of the audit will trigger some interesting debate amongst experts at BSIR’s Annual Meeting and help to influence those designing and delivering acute hospital services in the future.”

Boston Scientific hosted an Industry Technological Workshop session with Neil Carmichael MP called ‘Stand and Deliver – The Challenges of Providing emergency interventional radiology treatment’. Neil Carmichael MP also spoke at the BSIR Meets Parliament session as part of the main BSIR Annual Meeting on 12 November. 

Iain Robertson, consultant interventional radiologist and past president of the BSIR, who led the study says, “There is a widely acknowledged challenge in providing access to 24/7 interventional radiology. We need to work further to develop equity of access and ensure the best patient outcomes. However, getting universal access to interventional radiology will be very challenging given that there is a major under-provision of interventional radiologists in the UK.  In the medium-term, we need to expand the trainee numbers in interventional radiology substantially but this workforce will take 5–10 years to come through training and make an impact.  In the short-term, we need to utilise resources more effectively across hospital networks and ultimately this will need central leadership from the NHS.

“We hope that results of the audit will trigger some interesting debate amongst experts at BSIR’s Annual Meeting and help to influence those designing and delivering acute hospital services in the future.”

Boston Scientific hosted an Industry Technological Workshop session with Neil Carmichael MP called ‘Stand and Deliver – The Challenges of Providing emergency interventional radiology treatment’. Neil Carmichael MP also spoke at the BSIR Meets Parliament session as part of the main BSIR Annual Meeting on 12 November. 

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