Consultant physicians working with patients - Royal College of ...

More documents

Recommendations

Info

2 Specialties Nuclear medicineTable 1 Guidelines for reporting times for nuclear medicine studies. Please note the times are additive so if thereis a routine planar imaging and SPET-CT in the same patient it is important to add the times taken for bothimaging modalitiesTime required (min)Non-training environmentTraining environmentProcedureRoutine non-imaging studies,planar imaging and bonedensitometryTomographic imaging (SPET andSPET–CT)10–15 13–2015–20 20–30Complex procedures and image 30–40 40–50co-registration studies ∗PET 30–45 ∗ 45–60 ∗∗Stressing before cardiac imaging,including prior assessment andadvice on drug treatment25 30Outpatient thyroid therapyNew patient 45 60Follow-up 15 20Inpatient therapy and otheroutpatient therapiesVariable according to length of patient stay and amount of careshared with other specialties. On average, allow 40 min for apretreatment, 60–120 min on day of administration and 15 min perday per patient on subsequent days or follow-up visitsMultidisciplinary meetings ∗∗∗Preparation 60–240 60–240Presentation 60–240 60–240CT, computed tomography; PET, positron emission tomography; SPET, single-photon emission tomography.∗ This would include most paediatric studies.∗∗ In patients with lymphoma multiple studies may need to be viewed and quantification performed.∗∗∗ These may vary in length and complexity from a few patients per month to over 100 patients every week.An allocation of 300–350 whole-time equivalent (WTE)consultants in the UK was proposed 12 equating to about100–150 WTE nuclear medicine specialists within hubslinked to cancer centres and 200–250 WTE nuclearmedicine specialists or radionuclide radiologists in thespokes.Thisnumberisregardedastheminimumrequired to manage increasing workload complexityand rising commitments to MDT participation. As allexisting training places are linked to expectedretirements, there is no training capacity for consultantexpansion. The 2011 RCP census indicated that a 5%per annum increase in current consultant WTEnumbers would be required to meet European WorkingTime Directive targets 14 and manage current workload.Twenty-two per cent of nuclear medicine consultantswill reach the age of 65 years within the next 10 years. 14Current training numbers for nuclear medicine andradionuclide radiology (10 per annum) are justsustainable but do not allow for early retirements.Workforce planning will need to take into accountchanges in working practice, prospective cover forcolleagues and an increase in part-time work for periodsof an individual’s career. Consultant expansion will beC○ Royal College of Physicians 2013 185
Consultant physicians working with patientsnecessary to accommodate proposals for 7-day serviceprovision. A significant increase in allied professions(physicists, radiographers, medical technologists,radiopharmacists and administrative staff) will berequired to support this change.9 Consultant work programme/specimenjob planConsultant work programmes will vary according tohospital size and range of nuclear medicine servicesprovided. Fixed commitments include reportingsessions, outpatient clinics, special procedures andMDT meetings. Additional time is required forpaediatric imaging and cardiac stress testing. Dutiessuch as administrative work, teaching and training areconsidered flexible commitments. The figures inTable 2 are an average guide and assume uninterruptedclinical activity. These new centres should be outsideLondon and the north west and provide for treatmentof both benign and malignant conditions.10 Key points for commissioners1 Nuclear medicine investigations detect functionalchanges that occur early in disease, allowingprompt diagnosis and accurate, cost-effectiveassessment of treatment response.2 Demand for nuclear medicine services isincreasing, particularly in cancer diagnosis,cardiology and neuropsychiatry. The majority ofdiagnostic nuclear medicine investigations areundertaken as outpatient procedures.3 Services should be commissioned only fromdepartments that demonstrate compliance withstatutory requirements and are led by a certificatedTable 2 Consultant job planProgrammedActivity Workload activities (PAs)Direct clinical careGeneral nuclear medicine Depends on casemix 2–3Myocardial perfusion stressing 8 patients 1Myocardial perfusion reporting 8 patients 0.5PET-CT imaging and reporting 8 patients 1SPET-CT imaging and reporting 8 patients 1X-ray/MDT meetings 2 patients per week 0.5–2Inpatient therapy 2 patients 1Outpatient clinics 3 new patients + 7 follow-up 1Outpatient therapy ∗ 4 patients 0.5Clinical administration Internal cover arrangements † 0.5–1Supporting professional activitiesWork to maintain and improve healthcare qualityOther NHS responsibilities †External duties †Education and training, appraisal, servicedevelopment, audit, governance, CPD, revalidation,research, departmental managementeg medical director, clinical director, lead localclinician, educational supervisor, etceg work for deaneries, royal colleges, specialistsocieties, Department of Health, governmentalbodies, etc2.5Variable by localarrangementVariable by localarrangement∗ Allows time for consent and further discussion prior to treatment.† These programmed activities are subject to local negotiation.186 C○ Royal College of Physicians 2013
Page 1 and 2:
Consultant physiciansworking with p
Page 3 and 4:
The Royal College of PhysiciansThe
Page 5 and 6:
AcknowledgementsWe would like to th
Page 7:
AbbreviationsA&EAACsAMUsARCPCCGsCCS
Page 12 and 13:
1 Physicians in the NHS todaycan be
Page 15 and 16:
Consultant physicians working with
Page 17 and 18:
Page 19 and 20:
Page 22 and 23:
2 The work of the specialties2 The
Page 24 and 25:
2 Specialties Acute internal medici
Page 26 and 27:
Page 28 and 29:
Page 30 and 31:
Page 32:
Page 35 and 36:
Page 37 and 38:
Page 41 and 42:
Page 43 and 44:
Page 45 and 46:
Page 47 and 48:
Page 49 and 50:
Page 51 and 52:
Page 54 and 55:
2 Specialties Cardiovascular medici
Page 56 and 57:
Page 58 and 59:
Page 60 and 61:
Page 62 and 63:
Page 64 and 65:
Page 66 and 67:
2 Specialties Clinical geneticsClin
Page 68 and 69:
2 Specialties Clinical geneticsPati
Page 70 and 71:
2 Specialties Clinical genetics6 Cl
Page 72:
2 Specialties Clinical geneticswork
Page 75 and 76:
Page 77 and 78:
Page 80 and 81:
2 Specialties Clinical pharmacology
Page 82 and 83:
Page 84 and 85:
Page 86 and 87:
Page 88 and 89:
2 Specialties DermatologyDermatolog
Page 90 and 91:
2 Specialties Dermatology run monit
Page 92 and 93:
2 Specialties DermatologyDermatolog
Page 94 and 95:
2 Specialties DermatologyTable 1 Ex
Page 96:
2 Specialties Dermatology4 Parkin D
Page 99 and 100:
Page 101 and 102:
Page 103 and 104:
Page 106 and 107:
2 Specialties Gastroenterology and
Page 108 and 109:
Page 110 and 111:
Page 112 and 113:
Page 114 and 115:
Page 116:
Page 119 and 120:
Page 121 and 122:
Page 123 and 124:
Page 125 and 126:
Page 127 and 128:
Page 129 and 130:
Page 131 and 132:
Page 134 and 135:
2 Specialties HaematologyHaematolog
Page 136 and 137:
2 Specialties HaematologyTable 2 A
Page 138 and 139:
2 Specialties Haematologythey have
Page 140 and 141:
2 Specialties HaematologyTable 4 Sp
Page 142: 2 Specialties Haematology11 Departm
Page 145 and 146: Consultant physicians working with
Page 160 and 161: 2 Specialties Medical oncologyMedic
Page 162 and 163: 2 Specialties Medical oncologyaroun
Page 164 and 165: 2 Specialties Medical oncologyset b
Page 166 and 167: 2 Specialties Medical oncologyTable
Page 168 and 169: 2 Specialties Medical ophthalmology
Page 174 and 175: 2 Specialties Metabolic medicineMet
Page 176 and 177: 2 Specialties Metabolic medicineof
Page 178: 2 Specialties Metabolic medicinemet
Page 191: Consultant physicians working with
Page 196 and 197: 2 Specialties Palliative medicinePa
Page 198 and 199: 2 Specialties Palliative medicine-
Page 200 and 201: 2 Specialties Palliative medicineA
Page 202 and 203: 2 Specialties Palliative medicineTa
Page 204: 2 Specialties Palliative medicine24
Page 212 and 213: 2 Specialties Rehabilitation medici
Page 220 and 221: 2 Specialties Renal medicineRenal m
Page 222 and 223: 2 Specialties Renal medicineLocal a
Page 224 and 225: 2 Specialties Renal medicineInvolve
Page 226 and 227: 2 Specialties Renal medicineAcademi
Page 228 and 229: 2 Specialties Renal medicineTable 1
Page 230: 2 Specialties Renal medicinekidney
Page 243 and 244:
Page 245 and 246:
Page 247 and 248:
Page 249 and 250:
Page 251 and 252:
Page 253 and 254:
Page 255 and 256:
Page 257 and 258:
Page 259 and 260:
Page 261 and 262:
Page 263 and 264:
Page 265 and 266:
Page 267 and 268:
Page 270 and 271:
3 Supporting the delivery of high-q
Page 272 and 273:
Page 274 and 275:
Page 276 and 277:
Page 278 and 279:
Page 280:
show all

Consultant physicians working with patients - Royal College of ...

Create successful ePaper yourself

Delete template?

Save as template?