12 May 2022 14:00 — 16:00 (2 hours)

Agenda

AGENDA

• Introduce SIG Project Managers
• Non- Contrast CT Protocols
• Regionalised pathway neck lump refferal
• Pathway for Pineal cycsts
• AOB

Minutes

Minutes

Attendace

Elizabeth Loney, Helen Cliffe, Stuart Viner, Brook Adams, Seung Choi, David Langler, Shishir Karthik, Tony Goddard, Kate Clough, Jonathan McConnell, Jo Housley, Debra Punshon

Minutes

EL asked KC to give a brief update on shared reporting:

KC -Mid Yorkshire and Harrogate who are connected, test patients not live patients, next trusts are CHFT, Airedale, Bradford and Leeds. 5 reporters will take part in the pilot, will last till end of June. Issue around indemnity-reporters are covered under WYAAT portability agreement.

Initially work will be allocated but eventually people will be able to pick what they want, hoping to move to some sort of hybrid model with some work set. Need to balance work available to radiologists. Payment will be linked to NICIP codes. Minimum data sets, you need to know what you are going to see.

SV and EL asked for the top twenty codes that are likely be put out to report-KC to action

KC gave example that CCHAPC is sometimes separated by some trusts, the system will know that they equal the same, it will not matter in what order they are reported. Hope that 80% will be covered, analyst will run a stat to identify any exams that don’t fit a code.

Payment tiers have been set 1,2,3 based and how long it takes to report not necessarily by body part. There will be a process where people can challenge the payment, this will be discussed and agreed by the SIG. Payment can go down as well as up!

BA asked where York fit in as they are currently in the process of agreeing protocols across 3 trusts.

KC replied saying that we are hoping to get agreement across all nine trusts. Initially working with the 6 WYATT trusts. Need to get list of codes and cost groups that they will fall into. Look at other codes and try work out which band they fit into (to be agreed by the SIG)

KC says people need to talk about things as this is the only way things will get resolved

Protocols discussed

FACE-CFACE (post meeting - Helen C and Helen J organising)

A maximum of 1mm, recons may or may not be provided, bone and soft tissue windows, to cover from above frontal sinuses to maxilla

-EL asked if we should include mandible if trauma? It was agreed to only include mandible if asked for and to add CMAND code if that was the case.

EL said surgeons do like 3D images also especially for trauma, to assist surgical planning

TEMPORAL BONES-CTEMP

0.5mm or 0.625mm-below mastoids to above petrous ridge-soft tissue and bone for recons.

Ok to have different codes if they are all paid the same

SINUSES-CSINU

A maximum of 1mm to include from maxillary dentition to above frontal sinus including tip of nose, bone and soft tissue.

Contrast for malignancy to be discussed at next meeting

BRAIN-CSKUH

0.5mm OR 0.625mm bone and soft tissue, maybe to also include 5mm axials, HC to look at this

CSKUHC

0.5mm OR 0.625mm bone and soft tissue

Need to standardise the timing of contrast injection-too early and it looks like a CTA, anything up to 5 minutes?

DL suggested that to inject before localising might be the best option as this would utilise the time the patient is on the scanner, rather than have a delay on the scanner.

To be discussed at the next meeting as wide variation in volume of contrast used also, SIG PM’s to sort?

CTA/CTV-CAICN/CVENO

0.625mm-Arch to Vertex, need to include to C2-C3

Need to look at volume of contrast used

PULSATILE TINNITUS

Exact protocol not discussed but should be coded as CSKUHC + CNECKC as it is a complex examination, must also include C2-C3

Need a regional protocol

CT Pituitary-CPITFC

Only used when MRI contra-indicated and should just be a post contrast brain

Pineal cyst referral on HC’s to do list

AOB

SV asked if the cauda equina draft document had been finalised-NICE guidelines are in draft format at the moment!

BA asked if radiographers were vetting cauda equina’s, HC said not at Leeds

Aim to meet next in early September

Most common MRI protocols to be discussed at next meeting