Gyle Square 1 South Gyle Crescent Edinburgh EH12 9EB Telephone Fax

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1 National Services Division Gyle Square 1 South Gyle Crescent Edinburgh EH12 9EB Telephone Fax SCIN-QI Subject: Scottish Clinical Imaging Network (SCIN) Quality Improvement File ref: K:\07 Health Support Ser\Specialist & Screening\NMCNs & NMDNs\Networks\NMDN SCIN\Workstreams\SCIN Quality Improvement\Mins\ \ SCIN QI mins v0.3.docx Author: Miriam Wallace Date: 24 March 2016 Present: Dr Giles Roditi, Consultant Radiologist, NHS Greater Glasgow & Clyde (Chair) Dr Raj Burgul, Consultant Radiologist, NHS Forth Valley Mr Anthony McEachen, RIS System Manager, NHS Greater Glasgow Mrs Irene McLeod, Radiology Information Co-ordinator, NHS Lanarkshire Mr Gavin Moir, Data Manager, National Network Management Service, NHS Scotland Mrs Sandra Robertson, Radiology Department Manager, NHS Forth Valley Dr Anne Marie Sinclair, SCIN Lead Clinician, NHS Greater Glasgow & Clyde Mrs Morag Stout, Consultant Sonographer, NHS Greater Glasgow & Clyde In attendance: Dr Ian Rubin, Chief Executive & Medical Director, CAREIS LTD (left after item 2) Dr Anne Wales, Programme Director for Knowledge Management, NES (left after item 2) Apologies: Mrs Jeanette Burdock, Radiology & Diagnostics Services Manager, NHS Fife Ann Crowe, Radiology Systems Manager, NHS Forth Valley Dr Glen Gardiner, Medical Physicist, NHS Tayside Dr Fiona Hawke, Highly Specialist Radiographer, NHS Borders Lorraine Hudson, Associate Sector Manager, NHS Lothian Dr Hamish McRitchie, Consultant Radiologist, NHS Borders Mrs Kathleen Norris, Radiology IT Systems Manager, NHS Fife Secretariat: Mrs Alexandra Speirs, Network Manager, National Network Management Service, NHS Scotland Mrs Miriam Wallace, Network Support Officer, National Network Management Service, NHS Scotland 1

2 1. Welcome, Introduction & Apologies Dr Giles Roditi welcomed all to the second SCIN Quality Improvement meeting. Apologies were noted as above. 2. Decision Support Software Dr Anne Wales (Programme Director for Knowledge Management, NHS Education for Scotland (NES)) delivered a presentation on Clinical Decision Support (CDS) software developments that are being undertaken. Dr Wales informed the group that CDS was a large part of the ehealth Strategy. Dr Wales advised the group that her team in NES managed the subscription to CDS for the whole of NHS Scotland. Dr Wales informed the group that as part of a pilot a webpage had been created that included key points of care resources which NHS Tayside and NHS Lanarkshire have linked into from TRAK. Dr Wales informed the group that the high costs attributed to the CSD platform was the maintenance of the knowledge within the system, one aspect of Dr Wales role is to develop and co-ordinate links with the NHS Scotland librarian and establish a knowledge broker network, which includes knowledge managers in NES, HIS and the territorial boards, who have the expertise in sourcing and summarising evidence. Dr Wales shared that NES provide national search and summary services through Clinical Enquiry and Response service (CLEAR) ( and the National Evidence Search and Summary Service (NESSS) In addition to these NES are currently creating evidence summaries for a prototype for junior Doctors as part of the CDS work programme. Dr Wales shared that a draft road map had been prepared which was a toolkit covering a range of support from passive information giving resources (formularies, data set) through to interactive and proactive tools that work through algorithms and decision trees. Dr Wales acknowledged that it was anticipated that this would have more of an impact decision making and actions of clinicians. Dr Wales advised that SCIN may be most interested in the software linked with clinical systems straightforward links, or more context sensitive support where information interacts with information from patient records at the point of decision making; as this was a quick, one point of access which integrated with clinical workflow Dr Sinclair commented that she was keen for SCIN to be involved in any secondary care pilot, and in the process of selecting which guidelines were used to sit behind the software, and commented that Radiology could be a route into Secondary Care. Dr Roditi thanked Dr Wales for her presentation. CARE IS Clinical Decision Support Dr Ian Rubin delivered a presentation on CAREIS Clinical Decision Support. He gave an overview of the software, highlighting that CAREIS offered a single platform that could embed clinical support information into the electronic patient record, which had no breech of patient data. Dr Rubin demonstrated to the group how the CAREIS system had been implemented in a primary care setting in New Zealand. There was some discussion around the sources of clinical guidelines that would sit behind the software, and Dr Rubin reassured the group that if CAREIS was included in NHS systems, clinicians would be involved in the work around deciding what resources and guidelines would be built in to sit behind the software. 3. Review of minutes from 21 January

3 The minutes were accepted as an accurate representation of the last meeting. 4. Matters Arising a) Siemens MRI Data presentation In the previous meeting, Mrs Margaret Sherwood shared data that had been collated by Siemens to the National Imaging Equipment Group (NIEG). Dr Sinclair informed the group that a profoma had been circulated around the Health Boards requesting them to identify specific criterion which could be used to identify best practice. Following discussion of the feedback from the proforma the decision was taken by the group to look at information collected from the national data collection system and not Siemens. Dr Anne Marie Sinclair will write to Dr Iain Robertson, previous network Lead Clinician regarding ascertaining if the Managed Diagnostic Imaging Clinical Network (MDICN) had written to the Board Chief Executives about accessing data Action: Dr Sinclair b) SCIN Dashboard Dr Raj Burgal provided an update on the progress of the development of the national dashboard. He highlighted the following; Looked at what fields were needed. Proposal to compile a business case for a system for NSS to pull data from RiS. Visualisation layer. Cost was set up cost running cost of 15,000 all agreed this was inexpensive. Tableau software would be used for reporting data. Dr Sinclair clarified that if the Board of Chief Executives group sign off the business case, this would give the mandate for the dash board to be rolled out. She informed everyone that the resources required to develop the dashboard would be provided by ISD. Dr Burgal advised that the Shared Services Portfolio were exploring how to get permission to collect data through the Public Health Advisory Forum. Dr Sinclair thanked Dr Burgal for the amount of work he has done. The group were pleased that this was moving forward. c) NHS Scotland Visioning Workshop Dr Sinclair gave feedback from the visioning workshop. The workshop took place in February 2016 and was facilitated by the Programme Management Service (PgMS) within National Services Scotland. The workshop was attended by other services, not just radiology and had been positive. There were six main outcomes from the visioning workshop the main focus being to produce a National Radiology Strategy to include: nationally agreed imaging pathways a co-ordinated approach to out of hours services support for remote and rural boards for in-hours reporting national approach to radiography reporting mapping exercise to identify demand, capacity, staffing and equipment specify the IT requirements necessary to support a radiology service for Scotland 3

4 Dr Sinclair noted that outcomes from this workshop would inform the future work streams of the SCIN Horizon Scanning Group Dr McRitchie informed the group that following the Visioning workshop that the NHS Shared Services Portfolio Board would write a business case for each of the items, Dr Hamish McRitchie informed the group that it would be good practice for the SCIN Horizon Scanning group to share information with the NHS Shared Services Portfolio Board so that they were aware of the work that SCIN was doing. Mrs Speirs agreed to circulate outcomes of the Visioning Workshop with the group once they were issued. 5. Workforce Action: Mrs Speirs Mr Gavin Moir presented workforce trend data over a 12 year period for Radiologists and Radiographers in Scotland. Mr Moir confirmed that he had obtained the information from the ISD website. Mr Moir noted that there had been a steady increase since Sept 2003 till Sept 2015 in WTE Radiologists of 56%, with a similar increase in WTE Radiographers of 51% but commented that WTE trainees had only increased by 8.7% over the same period. He had discovered that there was no information available on the ISD website regarding trainees to distinguish between radiology and radiography. Dr Sinclair commented that at the time of the Diagnostic Collaborative, numbers of machines and radiologists increased, but since then had not kept up with demand. Mr Moir highlighted that there were some corrections to be made to the data. He agreed to make these changes and share the amended data with the group. Action: Mr Moir Following discussion, the group agreed that workforce data should sit in the SCIN horizon scanning group as there was a need to demonstrate what the workforce deficit will be in the future. Mr Moir agreed that he would look to show the uplift of activity for the five main modalities against the latest staffing data over the same period this should provide a crude approximation of the workforce productivity. Action: Mr Moir 6. Documents for Noting The following documents were shared for noting prior to the meeting; 7. AOCB SCIN Annual Event a. CMO Annual Report for Realistic Medicine b. National Clinical Strategy Dr Sinclair confirmed that the SCIN Education day would take place on Friday 21 st April 2016 at the Beardmore Hotel. She confirmed that the focus of the event was shared services. QI DNA Shortlife Working Sub-Group Dr Sinclair advised that a questionnaire had been circulated by Dr Ann Crowe looking at DNA rates, who would report the results back at the next meeting. Two further meetings were planned; 4

5 Thursday 05/05/ Thursday 16/06/ Dose Optimisation Dr Roditi informed the group that a Dose Optimisation pilot had taken place at the Royal Hospital for Children, NHS GG&C where a server pulls Dose Optimisation data from scanners. Dr Andrew Watt, Radiologist at NHS GG&C, could provide further information. Dr Roditi informed the group that he would liaise with Dr Watt about the pilot and share it with the group. Action: Dr Roditi Dr Sinclair asked that this be put on the agenda at the next meeting. 8. Dates of Next Meeting Action: Mr Liam Anderson The next meeting was arranged for Thursday 26 th May Meridian Court,