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REMEDY : BNSSG referral pathways & Joint Formulary

Radiology during COVID-19

Checked: 09-09-2020 by vicky.ryan Next Review: 08-12-2020

Overview

With effect from Monday 6th July 2020 routine requests for Radiological investigations reopened in the Imaging departments at NBT & UHBW.

Patients referred after this date have been added to the waiting lists at each Trust, however please be aware that there are going to be long waits for these appointments.

The hospital trusts continue to prioritise available capacity for cancer and urgent referrals, which will be followed by prioritisation to clear the extensive backlog of patients that has accumulated. Please note that there are capacity issues affecting all imaging modalities at all hospital sites.

The key messages for primary care are:

The hospital trusts would very much value your help in managing patient expectations regarding waiting times at the time of requesting tests. Once the full extent of the waiting list is visible, they will endeavour to advise you on expected waiting times for examinations. In the meantime, we would ask that you advise your patients of the current situation and ask them not to contact the Radiology departments directly regarding their place on the waiting list, as this will divert administrative resource away from making appointments and will add further delay into the system.

Work is on-going in relation to demand management and it may be possible that following this piece of work, the thresholds for certain diagnostic examinations are changed. This could result in some requests being removed from the waiting list and returned to the referrer. As a system we are doing everything possible to use all available imaging capacity in the region, including independent sector options, but there will be significantly less capacity than before COVID.

If any of your patients re-present with new or exacerbated symptoms and you wish to amend the urgency of your referral, please contact the relevant department using the contact details below, and include any relevant additional clinical information.

Please see the full updates which includes priorities, referral considerations and escalation for patients clinically deteriorating:

BNSSG System-wide Radiology - Restarting Routine Referrals 24.06.20

BNSSG Radiology COVID-19 Update to Primary Care 05.06.20

RUH presents a similar picture RUH Radiology Update to Primary Care 20.05.20

Direct access to x-ray and USS

As part of the process to restore Imaging Services following the outbreak of COVID-19, both North Bristol Trust (NBT) and University Hospitals Bristol and Weston (UHBW) have amended their ways of working to ensure patient and staff safety when booking in plain imaging referrals.

****Can referrers please ensure that a correct address and up to date telephone number is included in all referrals so that patients can be contacted if needed to arrange their appointment. Please also include all relevant clinical information so that an appropriate triage can be done by the radiology team. Please warn patients of the potential for long delays for appointments at this time. ****

North Bristol Trust (including Clevedon Hospital, Cossham Hospital & Yate West Gate Centre):

  • Plain x-ray - From Monday 27 July 2020, patients requiring Plain X-ray will no longer be able to walk-in and wait. All patients will need to have an appointment. To make an appointment at NBT, Cossham or Yate West Gate Centre they will need to call 0117 4145175. For Clevedon then need to call 01275 342571. Lines are open Mon-Fri 8.45am to 4.15pm.
  • Please issue patient leaflet attached. (link to leaflet on CCG Website: https://bnssgccg.nhs.uk/library/x-ray-booking-details-north-bristol-nhs-trust/)
  • For very urgent requests i.e. Query Pneumothorax, or query fracture; please ask the patient to attend Southmead Hospital, Gate 18, Imaging department between 9am – 4pm, in order to expedite the Imaging. For this group of patients there will be no need for an appointment but if the patient has any symptoms of Covid-19 please ask them to contact the appointment team to be offered instruction relating to the most appropriate way to attend for X-Ray.
  • Ultrasound: Please refer via ICE and patients will be sent an appointment.
  • Gynae ultrasound: Please refer via ICE. An appointment will be sent to the patient. Patients will then be booked according to urgency.

UHBW (Bristol - BRI & SBCH):

  • Plain x-ray - All patients requiring Plain X-ray will no longer be able to walk-in and wait to have their X-ray. All patients will need to have an appointment. For adults (16 and over) patients will need to call the department on 0117 342 2407 (Mon-Fri, 9am-4pm) or 0117 342 9695 (Mon-Fri, 5-7pm or Sat/Sun, 8.30am-7.30pm). For children (under 16) parents will need to call the children's xray department on 0117 342 8120 (Mon-Fri 8.30 am- 4pm)
  • Please issue patient leaflet attached. (link to leaflet on CCG Website: https://bnssgccg.nhs.uk/library/x-ray-booking-details-university-hospitals-bristol-and-weston-nhs-foundation-trust/)
  • For urgent adult requests; there is no need for practices to book an appointment for this cohort of patients, but should ask patients to attend the BRI between 9am-5pm. If the patient has any symptoms of Covid-19 please ask them to contact the radiology department prior to their imaging.
  • For urgent paediatric requests; patients are asked to attend the BRHC between 9:30am-11:30am or 2pm-4pm. There will be no need to book an appointment for this cohort of patients. If the patient has any symptoms of Covid-19 please ask them to contact the radiology department prior to their imaging. 
  • Ultrasound - patient bookable access to USS has been suspended. Please refer using ICE and patients will be sent an appointment.
  • Gynae ultrasound: St Michaels - Please refer via ICE. An appointment will be sent to the patient. Patients will then be booked according to urgency. Direct patient booking to this service has been suspended and patients should not routinely ring the departmentPatients should only ring the Gynae Ultrasound Department and leave a message if they are not able to attend the appointment they have been sent OR if they are a patient who requires a Day 4 scan.

UHBW (Weston):

  • Plain x-ray and USS - Referrals for x-ray and USS remain the same at Weston who have never had patient bookable-access. Please use ICE system to make a referral.
  • For urgent x-ray and USS requests (including chest XR & possible fractures) patients should also be referred via ICE and will be contacted to arrange an appointment - please see attached communication ). Please remember to include an up to date telephone number.
  • Gynae ultrasound -Please refer via ICE and patients will be sent an appointment.

Radiology Queries and Advice

These are very testing times for the radiology teams, and we acknowledge how difficult it is for GPs and patients. The hospital departments are happy to discuss any patients that you are concerned about, and will endeavour to accommodate any patients who are in need of urgent diagnostic imaging.

NBT

Please call the Imaging Secretary of the Day on 0117 414 9110 (for urgent enquiries) or otherwise email the GP specific inbox: nbn-tr.radiologygpqueries@nhs.net if you have a specific query regarding any of your patients that requires discussion with a Radiologist. 

UH Bristol

If there is any clinical concern about any of your patients please contact the Radiology Admin Team on:

ubh-tr.radiologyadminbri@nhs.net (Adults)

ubh-tr.RadiologyAdminBRHC@nhs.net (Paediatrics)

Weston General

For queries please call 01934 647 203

or email:

Wnt-tr.radiologysecretaries@nhs.net

RUH Bath

ruh-tr.radiologyresults@nhs.net

For urgent Radiology advice 8am – 5pm Mon-Fri, please contact the Radiology secretaries (ext 1174/6985) who will be able to put you through to the most appropriate subspecialty Radiologist to answer your query. Please indicate if a call back or email communication would be more convenient.

For urgent out of hours queries (5pm-8pm Mon - Fri and 8.30am - 5.30pm Sat and Sun), please contact the on call Radiologist (ext 6927/6875).

USS Guided Steroid Injections

See the Image guided steroid injection page