STATEMENT OF AUTHORISATION, SCOPE OF PRACTICE AND SCHEME OF WORK FOR

Transcription

1 STATEMENT OF AUTHORISATION, SCOPE OF PRACTICE AND SCHEME OF WORK FOR NON MEDICAL PRACTITIONERS TO REFER FOR DIAGNOSITC IMAGING INVESTIGATIONS (Excluding Clinical Trials and Research) PHYSIOTHERAPY PRACTITIONERS Non-Medical Practitioners Referral Policy Development Group (Appendix 1) NMR (Non-Medical Referrer) Lead of Group Classification Clinical Policy Issued Area Applicable Radiology Review Ref No: NMR Version No: 1

2 NON MEDICAL REFERRERS APP/ESP STATEMENT OF AUTHORISATION This is to certify that First Name: - Surname: - Position held: - Regulatory Body and Registration No: - Directorate/Dept: - MSK/Orthopaedics (via Physiotherapy) Professional Head for: - MSK Physiotherapy Clinical Mentor Service Director, NPT Service Delivery Unit Clinical Director, Directorate (Imaging) Radiology Services Manager Non Medical Referrer Professional Status: - Physiotherapy I agree to abide by the conditions as set out within the Health Boards policy for the requesting of diagnostic imaging investigations for non-medical referrer. Print name

3 Requirement for Referrer status Scope of Practice To request imaging investigations for patients clinically assessed within MSK Clinics who have not undergone the relevant diagnostic imaging via another source. The imaging requested will help confirm diagnosis and guide ongoing management of the patient. Direct referral to imaging (rather than referring on to a medical doctor) will improve the efficiency and flow of the patients MSK pathway. Referrer will operate within agreed MSK pathways within AMBU Health Board supported by XXX XXX (Clinical Mentor), XXX XXX (Director, Service Delivery) and XXX XXX (MSK Physiotherapy Lead). Diagnostic imaging will only be requested when the results are likely to influence patient management. Investigations will be requested from Referrer while working within the role of a Musculo-skeletal Primary Care Practitioner. Investigations will be requested in the working day Monday Friday between 8:30 16:00hrs Process for Referral The referral process will be by completion of a Radiology Request form by Referrer. The form will need to be completed fully providing the patient s identity and demographics, investigation required & appropriate and relevant clinical details to allow Referrer to justify any investigation. The referral form will need to identify which Consultant/Medical Doctor is in charge of the episode of the patients care. Referrer will sign the request form and print their name and contact telephone number. Referrer will identify their status as NMR. Image Interpretation and/or Radiological report. All radiological investigations will be performed via an appointment system and then formally reported with the report being sent to the Referrer. The report can be accessed electronically via Indigo/RADIS II/IMPAX systems GP red star reports are faxed to the practices as well as being automatically sent via the GP messaging system. Responsibility for acting on the radiological report The responsibility for the review of the Radiological report and initiation (when necessary) of any active management/treatment as a result of that report lies with the Page 3 of 8

4 Referrer. Any concerns or queries regarding the investigation findings/ ongoing management of the patient will be discussed with XXX XXX(Clinical Mentor). Audit Referrer s requests for imaging will be audited annually to determine whether the use of imaging positively impacted on the diagnosis and subsequent treatment plan. They will be discussed with the clinical mentor and MSK physiotherapy lead. A report will be provided to Radiology. Monitoring The MSK physiotherapy lead will maintain an up to date database of all staff that are able to refer for imaging. With dates of IR(ME)R training. The information will be shared with the Radiology Department. Training records including dates will be kept. Page 4 of 8

5 Scheme of Work The following categories of Diagnostic Imaging investigations may be requested by the Referrer. 1. Plain film for diagnostic purposes of appendicular skeleton. Pelvis, and vertebral column (routine standard views) Anatomical area Possible reasoning Comment Cervical Spine AP/LATERAL (standard request) Additional views based on clinical presentation/reasoning Shoulder Multiple view dependant on presentation Un-resolving mechanical neck pain Cervical spondylosis Trauma that otherwise has not presented to emergency care Onward referral for consultant review Un-resolving shoulder pain/calcific changes Pre injection depending on clinician Mechanical fall/trauma Bony tenderness Acute joint pain Gross joint deformity Pre onward referral to Orthopaedics based on Primary Care MSK neck pain pathway. Awareness of Canadian C- spine rules. based on Primary Care MSK shoulder pain pathway Page 5 of 8

6 Elbow/Hand (very rare) Thoracic Spine AP/Lateral Likely to be based around trauma but prevalence of these plain film requests will be extremely low Un-resolving mechanical Thoracic back pain. Osteoporoitic changes/wedge fracture Lumbar Spine AP/Lateral Pelvis /Hip Multiple view dependant on presentation Trauma that otherwise has not presented to emergency care Onward referral for consultant review Un-resolving mechanical lower back pain (as per NICE) Lumbar spondylosis Trauma that otherwise has not presented to emergency care Onward referral for consultant review Osteoarthritis Trochanteric pain Mechanical fall/trauma Pre onward referral to Orthopaedics MSK Lumber Spine pain pathway MSK hip pain pathway Page 6 of 8

7 Knee AP/Lateral Skyline (rare) Ankle Foot Dorsal/Oblique Osteoarthritis/compartmental changes Pre injection if concerned re gross OA changes Mechanical fail/trauma Pre-onward referral to Orthopaedics Osteoarthritis Trauma/Avulsion Pre onward referral to Orthopaedics Osteoarthritis Mechanical fall/trauma Stress fractures Liaison with Foot Specialist/Podiatry MSK Knee pain pathway ankle pain pathway Ottawa Ankle rules foot pathway Page 7 of 8

8 Record of Relevant Training IRMER Training sessions Other professional training list:- EXAMPLE: XXX XXX has undertaken a recognised programme of training with ABMU Health Board which enables them to request Diagnostic Imaging Investigations as specified within their Directorate business case, IRMER S.O.P. and in accordance with the relevant NHS Health Board policy. The scope of practice; Scheme of Work; and Certificate of Attendance are attached as Appendices. Abertawe Bro Morgannwg University local Health Board (ABMU LHB) indemnity Statement The Health Board will indemnify the non-medical referrer (NMR) individually named in their document for work undertaken on behalf of the Health Board and performed within working environment(s) recognised by the Health Board. This is stated on the basis that the named individual does not deviate from the specified Scope of Practice and Scheme of Work contained herein. Where changes occur due to service needs or otherwise the NMR practitioner must inform their direct line manager, DM or professional Head of Service and ensure a review of their Business Case, Scope of Practice and Scheme of Work is undertaken and agreed by all signatories. Non compliance with the relevant ABMU HB policy and/or deviation from the scope of practice and scheme of work will result in the immediate removal of requesting rights and the likely implementation of the Health Board Disciplinary Policy. Professional Indemnity The Health Board recognises that role development is subject to the provisions of the statutory and professional Codes of Conduct. It therefore, expects all such staff to comply with the requirements imposed by their own statutory body as well as taking into account any advice or guidance from their professional body. In the event of non compliance or when an individual changes role or leaves the Health Board, their direct line manager must inform the imaging department to facilitate their removal from the Radiology Information System. Page 8 of 8