Supporting information for GPs and professionals – please click the link below to be taken to that section:
Booking radiology examinations for a future date
iRefer Clinical Decision Support
Trust process for suspected lung cancer
Wait times
PLEASE NOTE – radiology request to attend figures are now being presented in weeks rather than days.
| Request to attend (WEEKS) | Attend to report (days) | |||||
| Week ending 28/04/24 | 2WW | Urgent | Routine | 2WW | Urgent | Routine |
| CT | Contrast:1 NonContrast:0 | Contrast:12 NonContrast:14 | Contrast:14 NonContrast:15 | 14 | 30 | 36 |
| DEXA | N/A | 25 | 30 | N/A | Same day | Same day |
| MRI | 2 | 22 | 27 | 8 | 15 | 21 |
| US | General: 2 Specialist: 1 | General: 13 Specialist: 19 | General: 16 Specialist: 24 | Same day | Same day | Same day |
| X ray | N/A | 4 | 5 | 12 | 28 | 28 |
Contacts
radalerts.enh-tr@nhs.net – For queries regarding an imaging report, please email the team – GP SURGERY USE ONLY
01438 284028 – Secretaries (for who is duty on-call, or to be put through to consultant) – GP SURGERY USE ONLY
01438 284030 – Helpdesk (appointment queries)
Booking radiology examinations for a future date
When it has been recommended that a scan or X-ray should be undertaken at a specific time in the future, we wanted to make you aware that you can put a request on ICE at the time the recommendation is received.
Please ensure you state, in the clinical detail section, when the examination should be performed, i.e in 6 weeks time.
Our radiology booking team will then book the patient an appropriate appointment date. Please do not wait until a week or two before the examination is due to put the request on ICE.
Radiology requesting by non-medically qualified health professionals
The Trust has an established protocol, since 2020, for eligible registered health professionals in primary care to request chest x-rays.
For further details, please contact the ICB’s local training hub hwetraininghub@nhs.net who manage the application process for us.
We recognise the need for access to other requesting for minor illnesses and minor injuries and are looking to collaborate further with the training hub on this.
Work is also well underway on a requesting protocol for appropriately trained/qualified physios in primary care. Further details to follow.
Ovarian cyst pathway
The process for following up ovarian cysts is different for premenopausal or postmenopausal women.
Postmenopausal
For postmenopausal women the GP must do a CA125 blood test and if this is normal the GP should then request the first surveillance scan (four months’ time). If the CA125 is abnormal the GP should refer on the 2ww pathway to gynaecology.
Perimenopausal For perimenopausal women, the sonographer can suggest further follow up and will be explicit on the report about who should book the next scan.
iRefer Clinical Decision Support (CDS)
iRefer Clinical Decision Support (CDS) is a new addition to ICE, designed to make it easier for staff to request radiology examinations and other tests. iRefer provides quick, evidence-based guidance to help improve quality of care and reduce costs.
The Royal College of Radiologists (RCR) has been curating, refining and producing its referral guidelines, iRefer, for over 25 years. iRefer CDS enables seamless access to the iRefer guidelines within electronic referral workflows, guiding GPs, clinicians and other healthcare professionals to the most appropriate imaging investigations or intervention for any diagnostic or imaging problem.
Some of the benefits of using iRefer CDS include:
- Reduce inappropriate testing
- Reduce unwarranted radiation exposure
- Increased diagnostic yield
- Reduce number of changed/ cancelled tests
- Reduce call-backs to referrers
- Improved communications between teams
This will help improve the patient pathway and achieve better evidence-based practice for radiology departments and the wider healthcare system.
Further information is available from the Royal College of Radiologists.
I have an urgent question/problem regarding iRefer. Who do I contact?
Please contact our ICE team for any issues regarding iRefer:
ICE Order Communications Systems Team
01438 284798
9am-5pm, Monday – Friday
How do I provide feedback on the iRefer system?
Please use the feedback button in iRefer located on the left-hand side of the system.
Supporting videos
6-minute iRefer demonstration video
2-minute iRefer training video – Reason for indication does not appear on CDS hint list
6-minute iRefer training video with scenarios (no sound)
Scenario 1 – requesting an US Abdomen for Acute Abdomen
Scenario 2 – requesting an X-ray Lumbar Spine for Chronic Lumbar Back Pain (LBP)
Scenario 3 – Requesting an X-ray Chest for a Cough (custom)
Useful documents
iRefer CDS frequently asked questions
iRefer CDS reference guide – standard operating procedure
Useful links on iRefer CDS:
MedCurrent (developer of the iRefer CDS service)
EPOS (with supporting information on iRefer CDS)
Document on from GIRFT on radiology that mentions iRefer CDS
Links from Royal College of Radiologists:
Guide on how to use on iRefer CDS
New digital tool to help clinicians could save millions of pounds and facilitate faster diagnosis
Trust process for suspected lung cancer
At the point that a chest X-Ray (CXR) is reported, if there is a suspicion of lung cancer, the report will have a unique flag (CALALERT). All CXR reports with a CALALERT, are sent to dedicated respiratory email address.
The radiology secretaries contact the CT booking team with details of all patients with a CALALERT report.
A member of the radiology booking team raises a request for the patient to have a CT Chest and Abdomen with contrast and contacts the patient to arrange an appointment, which is usually the following day.
The CXR report will be available on ICE for the referrer to review in the usual way.
Once the CT scan is completed and reported, usually within 2 working days, a consultant respiratory physician/or lung clinical nurse specialist will review the report and decide whether the patient is for straight to test or clinical assessment.
You will be informed at this point, by letter, of the planned pathway for the patient.
Having prior knowledge of patients with a potential cancer the respiratory team can ensure that there is urgent clinic capacity available.
How can GPs help?
As radiology offers a walk-in service for CXR, if you have a strong suspicion of cancer, please encourage your patient to attend for their CXR in a timely manner.
