Medical imaging services in hospitals across Northern Ireland are under review and health officials have stated: “Not every service can be maintained in every current acute site on a 24-hour basis.”

Around 80 local people attended a public meeting on the consultation into imaging services which was held in Fermanagh House on Monday evening. Many voiced concern that the consultation would lead to imaging services being taken away from the South West Acute Hospital.

A consultation response from Fermanagh and Omagh District Council states: “The Council is adamant that local imaging services should not be removed from the current location (South West Acute Hospital). To do so, and to include these imaging services within a ‘regional hub/centre’ would be damaging to the sustainability of the hospital and to patients locally.”

The consultation ends on Monday, January 22.

A three-year review of medical imaging looked at the four main services of MRI, CT, non-obstetric ultrasound and X-rays. 

The review included an assessment of the configuration of acute services. Reviewers spoke about creating new ‘networks of care’ and concluded: “If services are to be sustainable and viable in the long term then new models of working will be needed, particularly with regard to out-of-hours services, and/or in vulnerable sub-specialty areas. Put simply there is recognition that not every service can be maintained in every current acute site on a 24-hour basis. This is not a question of resources … it is rather a fundamental recognition of the requirements of safe clinical practice. The clinical evidence suggests that it is only through networked models that the full spectrum of safe care can be sustained for a population our size.”

Among the 19 “challenging” recommendations are that a regional hub and spoke network model be put in place by 2018-19 for the delivery of interventional radiology services in Northern Ireland. 
“Urgent action” is needed to close the unfilled vacancy positions in the radiology workforce, the consultation states.

In adult radiology, the consultation suggests that the skills of the 125 consultants in Northern Ireland could be better used to provide regional network solutions to reporting pressures or gaps across HSC Trusts.
It also recommends “appropriate clinical pathways and supporting network models to ensure children can access safe clinical paediatric radiology services, in and out-of-hours.”

Referring to obstetric imaging, the consultation calls for appropriate levels of scanning for all expectant mothers and recommends that “the HSC should establish a regional obstetric imaging clinical network to take forward the development of a new service model for obstetric imaging and ensure regional uniformity in the quality and provision of care.”
It also recommends that the HSC “should put in place enhanced pathways for patients with chest pain which include early access to imaging investigations in line with the regional model developed by the cardiology workstream.”

The consultation points out that the radiotherapy centre in Altnagelvin and the Cancer Centre in Belfast are operating different Picture Archiving and Communication Systems (PACS) and says this is unsustainable – it recommends a single regional NIPACS solution across all sites in Northern Ireland with sufficient integration with the electronic care record system so that both images and reports can be reviewed on ECR alongside other patient information. 

Commenting on the meeting, UUP MLA Rosemary Barton said: “While the Imaging review panel members constantly gave reassurances about the future of imaging services at the South West Acute Hospital, there was and still is a large element of scepticism. The proposals based around five themes particularly networks of care tended to be rather vague with very limited explanation regarding the location of the hub and spoke models recommended. It was recognised and excepted however that there had not been enough training places for radiographers and radiologists over this past number of years and more training places were needed. Also it was fully recognised that the retention of staff needs to be examined and greater effort will have to be made to recruit staff.”