University College London Hospitals NHS Foundation Trust, 235 Euston Road, London NW1 2BU, UK.
Clin Radiol. 2010 Apr;65(4):297-301. doi: 10.1016/j.crad.2009.12.009. Epub 2010 Feb 18.
To review the provision of out-of-hours interventional radiology (IR) services in the London Strategic Health Authority (SHA).
All 29 acute hospitals in the London SHA were contacted between November 2008 and January 2009. A questionnaire based on the Royal College of Radiologists (RCR) guidelines assessed the provision of out-of-hours IR services. An "ad-hoc" service was defined as on-call provision where not all the radiologists could perform intervention: If IR was required out of hours, an interventionalist came in when off-duty or the patient was transferred.
Seventeen out of the 29 (59%) hospitals provided ad-hoc out-of-hours services, eight (28%) provided a 24-hour rota, and four (14%) provide no out-of-hours cover. No ad-hoc service had formal transfer arrangements to a centre providing a 24h service. Only two hospitals providing a 24h service had six radiologists on the rota.
Strategic planning for out-of-hours IR across London is recommended. This is likely to be welcomed by the hospitals involved, allowing informal arrangements to be formalized, and collaboration to provide comprehensive regional networks, provided appropriate funding is made available. A national audit is recommended; it is unlikely these findings are unique to London.
回顾伦敦战略卫生局(SHA)非工作时间介入放射学(IR)服务的提供情况。
2008 年 11 月至 2009 年 1 月期间,联系了伦敦 SHA 内的所有 29 家急症医院。一份基于皇家放射科医师学院(RCR)指南的问卷评估了非工作时间 IR 服务的提供情况。“临时”服务被定义为值班医生无法进行干预时的随叫随到服务:如果需要在非工作时间进行 IR,介入放射医师将在休息时间或患者转来时进行干预。
29 家医院中有 17 家(59%)提供了临时非工作时间服务,8 家(28%)提供了 24 小时轮班服务,4 家(14%)则不提供非工作时间服务。没有临时服务有正式的转至提供 24 小时服务的中心的安排。仅提供 24 小时服务的两家医院的轮班医生有 6 名。
建议对伦敦的非工作时间 IR 进行战略规划。这可能会受到相关医院的欢迎,使非正式安排正式化,并进行合作以提供全面的区域网络,只要提供了适当的资金。建议进行全国性审计;这些发现不太可能仅在伦敦出现。