Direct Access Radiology (adults) DRAFT

Overview

**Update 3.6.24** - For UHBW (Bristol - BRI & SBCH) please note that open access walk ins are now available again for acute MSK and CXR. Details in UHBW (Bristol) section below.

Can referrers please ensure that a correct address and up to date telephone number is included in all referrals so that patients can be contacted if needed to arrange their appointment. Please also include all relevant clinical information so that an appropriate triage can be done by the radiology team.

The hospital trusts would very much value your help in managing patient expectations regarding waiting times at the time of requesting tests and potential delays in reporting results. We would ask that you advise them not to contact the Radiology departments directly regarding their place on the waiting list, as this will divert administrative resource away from making appointments.

If patients re-present with new or exacerbated symptoms and you wish to amend the urgency of a referral, please contact the relevant department using the contact details below, and include any relevant additional clinical information.

Radiology Advice

Please use the contact details on the Radiology Advice & Queries page.

Paediatric Radiology

Patients aged under 16 years of age should be referred to Paediatric Radiology

NBT - Direct access to x-ray and USS

North Bristol Trust (including Clevedon Hospital, Cossham Hospital & Yate West Gate Centre):

Plain x-ray (routine)

With effect from 24th September 2024, the CDC, based at Cribbs Causeway, will be the main location (for X-Ray examinations) offered to patients from the following GP practices:

• L81008 - SHIREHAMPTON GROUP PRACTICE
• L81017 - WESTBURY ON TRYM PRIMARY CARE CENTRE
• L81018 - SEVERN VIEW FAMILY PRACTICE
• L81019 - CONCORD MEDICAL CENTRE
• L81036 - CONISTON MEDICAL PRACTICE
• L81037 - PIONEER MEDICAL GROUP
• L81067 - SOUTHMEAD & HENBURY FAMILY PRACTICE
• L81077 - SEA MILLS SURGERY
• L81081 - PEMBROKE ROAD SURGERY
• L81085 - HEYWOOD FAMILY PRACTICE
• L81103 - ST MARY STREET SURGERY
• L81106 - STREAMSIDE SURGERY
• L81117 - PILNING SURGERY
• L81118 - STOKE GIFFORD MEDICAL CENTRE
• L81127 - ALMONDSBURY SURGERY
• L81649 - BRADLEY STOKE SURGERY
• L81004 - PORTISHEAD MEDICAL GROUP

From this date, InHealth will take over the majority of bookings for these patients and will contact them directly to agree a suitable appointment date and time.

Access to X-Ray appointments at the Community Diagnostics Centre is based on a 7-day per week, extended working day, model.

X-Ray Referral from Practices Listed Above:
Please submit an electronic referral for X-Ray Imaging as per standard practice.
From Wednesday 18th September 2024, please advise patients that there is no need for them to contact North Bristol NHS Trust in relation to their appointment (ready for first appointments on the 24^th). Instead, they will be contacted directly, by the InHealth Appointment Team, and will be offered a suitable date and time to attend for the X-Ray examination at the CDC, Cribbs Causeway.

There is a small group of patient exclusions, as follows:

• Patients under the age of 18 years.
• Patients requiring the assistance of a hoist.
• Patients attending their appointment via hospital transport.

If you are aware your patient requires a hoist or hospital transport, please make note of this in the clinical information. This is to ensure your patient is seen in the appropriate diagnostic setting.
For these groups of patients, they should be advised to contact the Imaging Department Contact Centre on (0117) 414 5175 to arrange an appointment.

All Other BNSSG GP Practices:

Please submit an electronic referral for X-Ray Imaging as per standard practice and advise the patient to contact the Imaging Department Contact Centre on: 0117 414 5175 to arrange their appointment.

Opening hours for the NBT Imaging Call Centre are 08:45 to 16:15 hrs, Monday to Friday (Closed Bank Holidays). Appointments will be offered at either Cossham Hospital, Southmead Hospital, Yate West Gate Centre, or North Somerset Community Hospital, Clevedon.

Please issue patient leaflet to all patients: GP X-Ray booking details: North Bristol NHS Trust - NHS BNSSG ICB)

Plain x-ray (urgent)

In those exceptional circumstances that a wait for appointment is inappropriate, i.e higher urgency such as suspected fracture, please ask the patient to attend Southmead Hospital, Gate 18, Imaging department between 9am – 4pm, Mon-Fri (closed Bank Holidays), to expedite the Imaging.

The clinical history must include the term: `Urgent walk-in X-Ray`

The patient will be directed to return home and report issued to GP within 3-4 working days.(Unless the patient is clinically unwell, the radiographer is concerned or has informally identified a significant finding. In this case the report will be issued to GP within 1 working day.)

Pneumothorax pathway for stable Primary care patients

Please ask the patient to attend Southmead Hospital, Gate 18, Imaging department between 9am – 4pm, Mon-Fri (closed Bank Holidays), to expedite the Imaging.

GP referral within ICE should be listed as category 3.

The clinical history must include: ‘? Pneumothorax urgent same day report required`

The patient will be directed to return home (unless the patient is clinically unwell, the radiographer is concerned or has informally identified a significant CXR finding).The report will be issued to GP within 1 working day.

Ultrasound

Request via ICE and patients will then be sent an appointment (please check patient contact details are up to date). Patients will then be booked according to urgency. Please see the USS requesting guidelines for details of justified USS requests agreed for BNSSG.

Gynae ultrasound:

Request via ICE and patients will then be sent an appointment (please check patient contact details are up to date). Patients will then be booked according to urgency. Please see the USS requesting guidelines for details of justified USS requests agreed for BNSSG.

UHBW (Bristol) - Direct access to x-ray and USS

UHBW (Bristol - BRI & SBCH) - updated 3.6.24 - open access walk ins now available again for acute MSK and CXR.

Plain x-ray (routine)

Routine Plain X-ray (MSK non-fracture, chronic conditions and follow up imaging) should be requested on ICE and an appointment will be sent within 6 weeks. Please check that the address on ICE is correct. Patients should not be advised to walk-in and wait.

Plain x-ray (urgent MSK)

Urgent requests for MSK / suspected fracture should be requested on ICE . Patients can then attend BRI or SBCH – walk in open access.

X-rays for pelvis, hips and spines should attend BRI only and not SBCH.

Chest x-rays

Open Access is available for Chest X-Ray across UHBW sites (BRI, SBCH, WGH). Requests should be made on ICE and patients advised to attend one of the hospital sites between 0900-1700, Monday to Friday.

SBCH will still be offering appointments outside of those core hours (evenings and weekends), with the same conditions of urgency and mobility as before.

• To arrange appointments. For adults (16 and over) patients will need to call the department on 0117 342 2407 (Mon-Fri, 9am-4pm) or 0117 342 9695 (Mon-Fri, 5-7pm or Sat/Sun, 8.30am-7.30pm). For children (under 16) parents will need to call the children's xray department on 0117 342 8120 (Mon-Fri 8.30 am- 4pm)
• Please issue patient leaflet attached. (link to leaflet on ICB Website: X-Ray booking details: University Hospitals Bristol and Weston NHS Foundation Trust - NHS BNSSG ICB

Ultrasound

Please request the USS on ICE and patients will be sent an appointment. Please remember to include an up to date telephone number. 

Please see the USS requesting guidelines for details of justified USS requests agreed for BNSSG.

Gynae ultrasound (St Michaels)

Please request the USS on ICE and patients will be sent an appointment. Please remember to include an up to date telephone number. 

Please see the USS requesting guidelines for details of justified USS requests agreed for BNSSG.

UHBW (Weston) - Direct access to x-ray and USS

UHBW (Weston):

Plain x-ray

Please request on ICE and patients will be contacted to arrange an appointment (except CXR). Please remember to include an up to date telephone number. 

Chest x-ray

Open access for Chest x-ray as detailed above for UHBW (Bristol).

Ultrasound

Please request on ICE and patients will be contacted to arrange an appointment. Please remember to include an up to date telephone number. 

Please see the USS requesting guidelines for details of justified USS requests agreed for BNSSG.

Gynae ultrasound

Please refer via ICE and patients will be sent an appointment. Please remember to include an up to date telephone number. 

Please see the USS requesting guidelines for details of justified USS requests agreed for BNSSG.

USS Guided Steroid Injections

See the Image guided steroid injection page

Efforts are made to ensure the accuracy and agreement of these guidelines, including any content uploaded, referred to or linked to from the system. However, BNSSG ICB cannot guarantee this. This guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer, in accordance with the mental capacity act, and informed by the summary of product characteristics of any drugs they are considering. Practitioners are required to perform their duties in accordance with the law and their regulators and nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties.

Information provided through Remedy is continually updated so please be aware any printed copies may quickly become out of date.