The Scottish Radiological Society

THE SCOTTISH RADIOLOGICAL SOCIETY

Standing Scottish Committee

Report 2003

Trusts have been dissolved and are now to be called Divisions, responsible to and managed by Regional Health Boards with the development of "National Health Service Scotland" as a corporate body following the passing of the NHS Reform (Scotland) Act 2004. This now presents a quite different scene from the organisation south of the border. Over the last year a large number of new policies, initiatives, and programmes have been introduced. "Plus ca change, plus c'est la meme chose" (Karr, 1894). While these have been designed to improve the health of the people of Scotland many have been controversial and it remains essential that each is scrutinised closley, particularly when they affect Oncology and Radiology. The Standing Scottish Committee continues to supply information and advice to the Scottish Health Service on those issues concerning Clinical Oncology and Clinical Radiology while introducing and supporting initiatives from the membership of our two specialities.

Again this year workforce planning remains the most serious issue to affect both specialities. The Chief Medical Officer for Scotland, Dr Mac Armstrong, was appraised of the dire situation in Clinical Radiology and has been introduced to ITI with a presentation to his department from College Officers and Dr Fowler but as yet there has been no practical action forthcoming and worse - some reduction in training numbers by the Postgraduate Deans. All but two of the training slots are full and the situation remains critical. Dr R Mackenzie repeated the previous audit of consultant vacancies for the committee, which confirmed a worsening situation with an 19% shortfall in Radiology; this verified data has been sent to the CMO's Office. There are worries about the overall cost, lack of facilities and the source of trainers to support the ITI. Although it has not been possible this year, the committee intend to organise a meeting with the Scottish Office when College Officers can present the plan to NHS Education Scotland and the Postgraduate Deans. The crisis in the West at the Beatson Oncology Centre has been less newsworthy this year and Prof Alan Rodger has been appointed Director but further consultant staff and radiographers are still required. How the reforms in "Modernising Medical careers" will affect training in Oncology and Radiology remain to be seen but there is considerable concern about the year two content and the potential to "dumb down" consultant status.

Although the equipment base has improved, revenue costs for major capital equipment remain a problem. Substantial increased funding has been released over the last year but much of it is hypothicated to improve specific diseases or administrative areas such as cancer or waiting times. This has been supported by the "Golden Jubilee National Hospital" with selective capacity to deal with long waiting lists. Clinical Oncology has benefited but Clinical Radiology has found it difficult to gain access to these new funding streams. The Scottish Cancer Plan continues to be implemented. Professor F Gilbert is the Committee's link.

CiRiS is now running in all but one Division. The first tranche of National data was recovered in the New Year and included an assessment of the radiology asset base in Scotland and projected replacement dates in addition to waiting times for the various modalities. Most hospitals have now populated several of the modules and are using the system routinely for Clinical Governance. The Scottish aspects of its management are organised by the CiRiS Liaison Board for Scotland of which I am the chairman and Professor Weir the secretary. As the origional three year Grant from the Scottish Office terminates in April 2005 we are in the process of persuading the new Boards to continuing the funding.

The special advisors to the CMO remain as Dr John Reid for Clinical Radiology and Dr J Dewar for Clinical Oncology.

Our representation on SIGN continues. This organisation has settled down after undergoing considerable change with Professor Lowe as the Chairman and its sublimation into 'NHS Quality Improvement Scotland'. The guidelines are now influencing clinical practice throughout the country with expressions of interest from Continental Europe. The radiological and oncological aspects of their advice still need to be carefully scrutinised and it is essential that the College continue to participate actively in the formulation of the guidelines as they have far reaching influences on our day-to-day practice. Dr Walker as our representative with Prof. Wardlaw as deputy, has intimated that new areas where guideline development would be useful are being actively sought from radiologists and oncologists while areas, which have become outdated, are being reviewed. The implementation of several of them are causing problems at department level; in particular the provision of CT for stroke. Managed Clinical Networks are at present negotiating reorganisation of department procedures to accommodate them.

Members have been active representing the College in Scotland on multiple working parties and advisory boards set up by the Scottish Executive: stroke, dementia, epilepsy, various cancers and coronary heart disease. The Scottish Academy represents all the Royal Colleges and provides a cohesive voice when advising government. I represent the College on this body and on its behalf represent the College on the Scottish Joint Consultants' Committee.

The Scottish Radiological Society has had an innovative and informative series of conferences this year maintaining its close links with the Committee with representatives attending meetings of each group. This was found to be mutually beneficial allowing dissemination of ideas and information.

Ideas, problems and feedback from all fellows and members are always difficult to obtain but I would welcome any contacts either through your elected representatives on the Committee or directly to myself. I will endeavour to continue to ensure that the voice of our two Faculties is clearly heard at the College and that it influences the development of health care in Scotland.

Dr David Nichols has now taken over as secretary and I should like to thank him for his unstinting support. My thanks go to all members of the Committee for their hard work over the last year.

D. M. Hadley
Chairman - Standing Scottish Committee
Royal College of Radiologists