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REMEDY : BNSSG referral pathways & Joint Formulary

Radiology during COVID-19

Checked: 21-04-2020 by Rob.Adams Next Review: 21-07-2020

Overview

**Update 14.4.20**

The following radiology advice during COVID-19 has been agreed by all providers in BNSSG and signed off by the system Gold Command.

The approach is intended to balance a reduction in the strain on Radiology services, while still allowing referrals for urgent imaging that is required during this period. The guiding principle behind these measures is to provide safe Radiology services for as long as possible, ensuring diagnostic capacity for COVID and for other conditions.

In order to achieve this, the system will need referrers to consider the following:

  1. Is this scan going to change the patient’s treatment imminently?
  2. Does the balance of risk support sending a patient into a hospital where COVID infection risk may be higher?
  3. If the scan is positive, can the condition be treated now given the COVID restrictions on other services?

The proposal is to support the safe management of patients in primary care as well as ensuring that where it is safe and appropriate for patients to wait for a diagnostic test that they wait, but that suitable safety netting is in place that GPs can expedite if the person’s condition worsens or this balance of risk shifts.

Please also refer to the Radiology guidelines for primary care

This plan is subject to change depending on the severity of the current pandemic and flexibility required to manage demand during the pandemic; review of further changes to this plan if required will be discussed and agreed at a system level in a collaborative with referrer representatives but will need to be rapidly adaptable to ensure safety for all patients and staff.

See complete document:

BNSSG Radiology Response to COVID-19

New routine imaging requests

Patients referred for routine non-cancer imaging in any modality will be be returned to the referrer , on the basis of the clinical information provided; the following statement will appear as the reason, when the request is returned to the referrer:

'Due to the current COVID-19 pandemic, routine imaging and/or image-guided interventional referral has been rejected and the responsible clinical practitioner will need to re-request this, if still clinically indicated, once the Trust services return to normal practice.’

If the referring practitioner feels that it is still necessary for imaging to be performed, or if a patients symptoms get worse, then they should contact the Radiology Service directly on these email addresses:

Existing imaging requests

Routine non-cancer imaging in any modality is temporarily suspended. Patients will be placed on the waiting list which will be reviewed and reinstated once safe to do so.

Exceptions to the above are patients with routine but time-critical imaging, eg. Antenatal ultrasound.