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

2 Specialties Nuclear medicine(ARSAC) clinician trained to CCT level (orequivalent) in nuclear medicine.4 Clinical evaluations should be made byappropriately trained staff who demonstrate andmaintain competence in nuclear medicine orradionuclide radiology imaging.5 Where NICE guidance is available (chest pain,cancer pathways) providers should demonstratesufficient capacity to comply with thecommissioned activity.6 A ‘hub-and-spoke’ model for service delivery isencouraged. Providers should demonstrate thatservices are patient centred and that appropriateclinical and imaging data transfer facilities areavailable.7 Nuclearmedicineexpertadviceshouldbeavailableat MDT meetings in compliance with cancerstandards for diagnostic and therapeuticintervention decisions.8 General diagnostic nuclear medicine may beincluded in overall imaging activity. Providersshould demonstrate indicative clinical pathways todemonstrate appropriate diagnostic serviceutilisation.9 Outpatient therapy for benign disease such ashyperthyroidism may be available in smalldepartments if local skills are available.10 There needs to be provision for expected expansionof nuclear medicine into new diagnostic areas suchas amyloid imaging for the diagnosis of earlyAlzheimer’s dementia.11 High-activity radionuclide cancer treatment shouldbe provided by tertiary centres attracting sufficientnumbers of patients to provide treatment in MDTs.Radionuclide therapy may require inpatientadmission to a dedicated facility with radiationprotection shielding. These new centres should beoutside London and the north west and provide fortreatment of both benign and malignantconditions.References1 Royal College of Physicians. Nuclear medicine: provisionof clinical service. Working party report. London: RCP,1998.2 Intercollegiate Standing Committee on NuclearMedicine. Nuclear medicine and radionuclide imaging:a strategy for provision in the UK. London:RCP,2003.3 British Nuclear Medicine Society. Clinical procedureguidelines. www.bnms.org.uk/bnms-generic4 European Association of Nuclear Medicine. Scientificguidelines. www.eanm.org/scientific info/guidelines/guidelines intro.php?navId=545 Department of Health. A framework for the developmentof positron emission tomography (PET) services inEngland. London: DH, 2005.6 Joint Royal Colleges of Physicians Training Board.Specialist training curriculum for nuclear medicine.www.jrcptb.org.uk/specialties/ST3-SpR/Documents/2010%20Nuclear%20Medicine%20Curriculum.pdf7 National Institute for Health and Care Excellence.Myocardial perfusion scintigraphy for the diagnosis andmanagement of angina and myocardial infarction. NICEtechnology appraisal guidance 73, 2003. www.nice.org.uk/guidance/TA738 Anagnostopoulos C, Harbinson Mm, Kelion A, et al.Procedure guidelines for radionuclide myocardialperfusion imaging. Heart 2004;90(suppl 1):1–10.9 Royal College of Physicians. Radioiodineinthemanagement of benign thyroid disease: clinical guidelines.London: RCP, 2007.10 Royal College of Physicians. Guidelines for themanagement of thyroid cancer, 2nd edn. London: RCP,2007.11 British Institute of Radiology. Molecular radiotherapy inthe UK: Current status and recommendations for furtherinvestigation. London: British Institute of Radiology,2010.12 Federation of the Royal Colleges of Physicians of theUnited Kingdom. Census of consultant physiciansin the UK, 2002: data and commentary. London:RCP,2003.13 Royal College of Radiologists. Clinical radiology UKworkforce report 2011. London: RCR, 2011.14 Federation of the Royal Colleges of Physicians of theUnited Kingdom. Census of consultant physicians andmedical registrars in the UK, 2011: data and commentary.London: RCP, 2012.C○ Royal College of Physicians 2013 187