General Hospital out of hours staffing levels (FOI)

Request

A

Please confirm what staffing provisions are in place at the General Hospital outside of normal working hours (nights, weekends and bank holidays) for providing emergency x-rays, CT and MRI scans.

B

If staff are available on a callout basis please confirm what criteria must be met to attend the hospital out of hours for imaging and if this follows NICE guidance.

C

Please also confirm the number of call outs out of hours over the past five years and the number of patients who did not receive the above investigations outside of normal working hours due to no staff being on site.

Response

A

For general x-ray, CT scanning and ultrasound, the hours of 5pm to 8.30am on weeknights and 24-hours per day on weekends and Bank Holidays are covered by an on-call radiographer or sonographer, one for each modality.

For general x-ray, the radiographer is on-site until midnight and all day at the weekend. For CT scanning and ultrasound, the radiographer or sonographer is called from home.  

Radiologist on-call services include reporting of acute on-call CT scans when required by the acute teams.  There is no formal x-ray on-call reporting service, but difficult to interpret radiographs can be discussed when required. 

Health and Community Services (HCS) provides no formal MRI on-call service, though an ad-hoc best endeavours service exists.

B

Where NICE guidance is published, guidelines are followed where local services and on island specialties allow.

All other requests for diagnostic imaging, if justified, are performed if the result will change the clinical management of the patient before the next working day.

For Radiologist on-call services, each case is discussed between a senior clinical member of the relevant team and on the on-call Consultant Radiologist.

C

As noted above, for general x-ray the radiographer is on-site until midnight and all day at the weekend. For CT and ultrasound, the radiographer or sonographer is called from home. Irrespective of whether the respective radiographer or sonographer is on-site or comes in from home to attend, if the requested scan is clinically justified and would change the clinical management of the patient, it is always performed.

With regards to Radiologist on-call services, there are no known cases of patients not receiving their scan due to lack of staff being able to attend the site for CT and x-ray (the agreed on-call services). HCS have staff available to attend on-site whenever the need requires this.

A central record of the number of on-call scans performed across x-ray, CT scanning and ultrasound for the past 5 years is not held. 

The Radiology Information System records dates, rather than days, so identifying on-call scans would require significant manual input to create new datasets for the day and time parameters in scope of on-call services. A Scheduled Public Authority is not required to create new datasets nor manipulate existing datasets in order to respond to Freedom of Information requests. Furthermore, the time necessary to identify and extract the data requested from the records that are available would exceed the timescales prescribed in the Freedom of Information (Costs) (Jersey) Regulations 2014. Therefore, Article 16 of the Freedom of Information (Jersey) Law 2011 has been applied.

Average figures for on-call scans performed are as follows:

5pm to 8:30 am weeknights

Weekends and Bank Holidays (24-hour on-call period)

Article applied

Article 16 - A scheduled public authority may refuse to supply information if cost excessive

(1) A scheduled public authority that has been requested to supply information may refuse to supply the information if it estimates that the cost of doing so would exceed an amount determined in the manner prescribed by Regulations.