Bro Taf Local Medical Committee Ltd
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BRO TAF LMC- CWM TAF UHB LABORATORY MEDICINE AND RADIOLOGY GROUP
NEWSLETTER – OCTOBER 2014
The first meeting of the Bro Taf LMC- Cwm Taf UHB Laboratory medicine and radiology group was held on
11th September in the Department of Radiology, Royal Glamorgan Hospital. The meeting was attended by
three elected LMC members, Fiona Ricci (LMC Executive Secretary), a practice manager and four
representatives of the department of radiology. Dr Peter Brooks of Eglwysbach Medical Practice,
Pontypridd, agreed to chair the meeting. The discussion was wide-ranging.
INDEX
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Communication
Radiology request forms
Waiting times
Ultrasound scans at University of South Wales
Investigations ordered by trainees, salaried GPs, retainers
Trauma
Patients with Impaired Mobility
Red flags
Radiology user guide
Radiology – a Cwm Taf wide directorate
Next meeting
COMMUNICATION
The arrangements for telephone advice from an on-call radiologist were discussed. Between 12 and 2 pm a
duty radiologist is available for emergency consultation, but not for non-urgent discussion. At this time,
radiologists are often involved in MDT meetings or catching up on reporting and representatives from
radiology did not feel it feasible to change the current system. There was agreement, however, to discuss
setting up an e-mail enquiry service which successfully operates with some other departments.
Radiology reported difficulty in speaking to GPs when they feel it appropriate and asked that the contact
details of the practice are always recorded on any request form. They would like to have ex-directory
numbers, but the LMC members present felt that this was a decision for individual practices.
RADIOLOGY REQUEST FORMS
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Radiology prefer typed request forms, but when these are used they would like GPs to confine their
clinical details to the box provided.
Few practices are currently using typed radiology referral forms. Eglwysbach Medical Practice has
used these for some years now and it was agreed that the practice would share their practice with
the LMC and practices in the area.
LMC/Cwm Taf UHB Laboratory Medicine & Radiology Group: October 2014
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Concern was expressed that some GPs are attaching a summary of significant history, often
containing sensitive and irrelevant items of history, which has caused distress to patients. It was
agreed that information provided should be within the radiology form and be relevant to the
clinical problem and investigation requested.
It was agreed that the LMC representatives will be invited to contribute to radiology request form
design in the future
Practice labels are attached to some forms to identify the practice. Radiology do not use the same
codes as pathology and GPs are encouraged to use a stamp with details of the requesting GP,
address and contact details.
Radiology reported that on occasions patients have arrived at the department with a form that has
clearly been completed (name, address etc.) by the patient and not the GP. It was agreed that this
is unacceptable practice.
For open access investigations the request form should be given to the patient to take to the
department during the opening hours. Posting a request form can delay investigations significantly.
Copies of request forms already given to the patient to use for open access should not be copied
and posted to the department. This has potential for causing unintended repeat
investigation/exposure.
WAITING TIMES
Radiology agreed to provide GPs with indicative waiting times for investigations that are not open access. It
was recognized that growing demand has resulted in long waiting times – up to 22 weeks - for some
investigations. Work is being done internally to manage demand.
In contrast to RADIS, the current GPTR system does not allow GPs to view whether an investigation request
has been received. It was agreed to look into this.
ULTRASOUND SCANS AT UNIVERSITY OF SOUTH WALES
LMC members were unaware of the agreement in place for some ultrasound scans to be undertaken at the
University of South Wales. Training for ultrasonographers is undertaken at the Glyntaf campus. The
radiology department is involved in the training. Ultrasound scans of pelvis and abdomen are undertaken
at this site with supervision of a fully trained ultrasonographer.
INVESTIGATIONS ORDERED BY TRAINEES, SALARIED GPS, RETAINERS ETC.
This is a constant irritation for practices with several GPs who are not partners in the practice. It was
agreed to liaise with John Lewis at RGH and Philip Jones at PCH to try and resolve this. Some of this relates
to prescribing numbers etc.
TRAUMA
Radiology wished to remind GPs that any patients with suspicion of a fracture should be directed to RGH or
PCH and not to the smaller units where injuries cannot be treated.
PATIENTS WITH IMPAIRED MOBILITY
There are no hoisting facilities at the radiology departments of Ysbyty Cwm Rhondda, Ysbyty Cwm Cynon
or Dewi Sant Hospital. Such patients should be directed to RGH or PCH.
LMC/Cwm Taf UHB Laboratory Medicine & Radiology Group: October 2014
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RED FLAGS
The LMC was concerned that the system of red flags has changed without GPs being aware of the change.
One of the LMC members described how a CXR with a red flag report was not acted on by the requestor
(A&E) and was detected only after the patient attended his GP – 3 months after the report had been
issued. This has been reported by the practice as a significant event.
GPs should be aware of the current system that operates in the radiology directorate:
When a red flagged report is issued, a copy is sent to cancer services where appropriate. However any
suggested other action e.g. further radiological investigation is not specifically looked for by the radiology
department. A follow-up report is issued two weeks later as a reminder but the department no longer
chases up or ensures that follow up or other appropriate action has been undertaken. The department
used to go through patients hospital system to see if tests had been arranged, referrals sent etc. This no
longer happens in line with the NPSA advice that it is the requestor’s responsibility to read and act on their
report.
USER GUIDE
It was agreed that an electronic user guide for the department of radiology which might be viewed via the
GP portal would be a useful development. It was agreed that the LMC should have input into this.
RADIOLOGY - A CWM TAF WIDE DIRECTORATE
Some concern was expressed following the meeting that the agenda largely referred to items relevant to
the South of Cwm Taf only. Prior to the meeting calls for agenda items had been distributed to LMC
members and via the LMC newsletter to all practices in Cwm Taf.
Items were submitted by three LMC members from the Taff Ely and Rhondda areas, but none were
submitted from the Cynon and Merthyr Tydfil areas. It will be important for the future that agenda items
or concerns are raised by GPs and practices both in the north and south of Cwm Taf prior to the meeting.
Radiology will also be asked to ensure that there is representation from both the south and north of Cwm
Taf UHB area.
NEXT MEETING
The next meeting will be held with Laboratory Medicine in December 2014 and with Radiology in March
2015.
LMC/Cwm Taf UHB Laboratory Medicine & Radiology Group: October 2014
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