Access to radiology by Podiatrists in UK

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Hi everyone,

I am doing some research into the access of Podiatrists requesting diagnostic imaging within the NHS.

I would ideally like to request x-rays for patients with suspected osteomyelitis without having to refer the patient to the G.P. I would also like to be able request x-rays and ultrasounds for certain MSK pathology.

Do any Podiatrists have this level of access within the UK (apart from Pod Surgeons). If you do, are you hospital based (acute trust) or community based and does the Podiatry dept hold a budget for this in particular?

Any information would be much appreciated. I have a meeting with the head of Radiology at the borough hospital at the end of Sept to discuss this possibility so If any of you have been through this process before I would love to hear from you!

Thank!

Paul.

 

Hi Paul,

Have you spoken to Cathy Bowen at Southampton uni? She would be a good person to ask about diagnostic imaging as she has been using it in the podiatry clinical environment for different aspects of musculoskeletal disorders for some time.

Cheers,
Bel


Refs;

Bowen, Catherine J., Culliford, David, Dewbury, Keith, Sampson, Madeleine, Burridge, Jane, Hooper, Lindsey, Edwards, Christopher J. and Arden, Nigel K. (2009) The clinical importance of ultrasound detectable forefoot bursae in rheumatoid arthritis. Rheumatology, 1-2. (doi:10.1093/rheumatologykep307)

Bowen, Catherine J., Culliford, David, Dewbury, Keith, Sampson, Madeleine, Burridge, Jane H., Edwards, Christopher J. and Arden, Nigel K. (2009) Investigation of the natural history of forefoot bursitis detected by musculoskeletal ultrasound and predictors of its change after one year. Rheumatology, 48, (Supplement 1), 336-[i132]. (doi:10.1093/rheumatology/kep739)

 

Hi Paul,

You will need to pursue IRMER regulations.... There is a short course that leads to a private practitioner being allowed to refer directly to a radiology dept for x-ray.

The letters stand for,,,,,,,,Ionising Radiations Medical Examination ....


http://www.e-radiography.net/regsetc/Ionising Radiation Medical Exposure Regs 2000.htm

 

Hi Paul
In my area all NHS podiatrists can refer to radiology for x-ray as we have all completed the IRMER training that Johnpod alludes to. We also have an agreement with our local radiologists regarding requesting ultrasound scans.
The vast majority of our clinicians are community podiatrists.
I'm not aware of a budget for this - it was designed to make referral for these investigations more streamlined, as previously we would have merely asked the GP to refer the patient and then waited for the GP to share their report (or not!!).

We've merely cut out that step in the process.

As far as I'm aware it hasn't increased referrals to radiology as they would have had these requests anyway.

No one has undertaken the training to interpret x-rays (we don't get paid enough to do that anyway , but we merely request a report direct from radiology.

Additionally we have access to the PACs system ( that's Picture Archiving And Communications system), which allows you to view digital images of any imaging (x-ray/ ultrasound/MRI etc ) on your PC. So if you want to view the x-ray / ultrasound etc you type a patient identification number and you can view any investigations on that particular patient.

Hope this helps

 

Thanks for your replies!

A number of the team have attended IRMER reg's training and have certification for this so that is thats a good start. I have spoken to the Nuclear medicine dept at the local general hospital and they provide IRMER training to trust staff free of charge - so the whole team can attend that if we get the go ahead.

From what you say, the access that you have for x-rays and ultrasound is just what we are looking for. My main issue was the budget - as in my initial contact with the radiology dept they asked me how we would fund Podiatry referrals for diagnostic imaging.

But like you say, the number of imaging requests should not increase, as we would still be requesting the x-ray for example from the G.P!

We are looking to bypass the GP to speed up the pateints clinical journey, reduce duplication of work (i.e to be seen by 2 health profs for the same problem) and reduce the workload and strain on local GP services.

We also have access to the PACs system when we are working in our hospital sites, and a couple of our new polyclinics, but the majority of the Podiatry team in community would not have this access so would rely heavily upon the radiology report.

Thanks again for your help, if anyone has any further info please let me know and I will be sure to keep you updated with our progress.

 

Hi Paul,

We can refer directly for US/X-ray of any region, and MRI foot/ankle/Distal tibia

We are Primary care, and I think the cost comes from a set budget from Primary care to acute unit for imaging referrals.

Does this help?

 

Cheers Peter,

Very helpful,

Thanks.

Paul.

 

There seems to be, yet again, no consistency when it comes to access to radiology services. It is a geographical lottery going by the preceding posts. In addition, there is the established practice of doctors referring only to other doctors, although this is not as absolute as in the past. In a primary care team setting, it seems to be a sensible pragmatism to have access to diagnostic radiology. But then, who will read the X-Ray film and issue the report and to who will the report be sent and to what purpose? If the patient is ultimately due to be referred for a surgical opinion, present U.K. and Ireland podiatry practice and its limitations seems to be redundant step in the patient's progression to a final satisfactory resolution of their problems.