Frequently Asked Questions - October 2008 update

 Clinical Section

1.      Can ward patients be scanned?

Yes ward patients can be scanned on the mobile unit, however the mobile units have limited facilities to accommodate patients with mobility problems. Please ensure that information is included on the referral form to indicate that the patient is a ward patient. InHealth will evaluate the patients on a per patient basis, using a checklist to ensure that patients attending are suitable for the mobile environment.

Due to the opening hours and clinical support at the site in Plymouth, there are restrictions on the type of ward patients that can be scanned. Restrictions also apply to ward patients in the East Midlands area due to radiation protection issues. Please contact us before referring.

2.      Which ward patients can be referred? 

Ward patients can only be referred if they can walk on and off the unit. The patient will be assessed at the time of booking using a triage process to evaluate patient needs and mobility and guidance given.

3.      My patient has nursing needs. How will these be accommodated?

If a patient has nursing needs, such as a drip, they must be accompanied by a nurse escort. The nurse escort should not be pregnant or breast feeding. Any equipment required for nursing must be brought with them. Food and drink required by the nurse escort and the patient must be provided by the hospital and brought with the patient. Nurses attending will be guided by the InHealth staff on a safe working practice around patients who have been injected with FDG.

4.      Who arranges transport for ward patients?

Transport must be arranged by the ward for both journeys.

5.      What should my ward patient wear when attending the unit?

Patients should not be in night wear; they should be dressed in clothes suitable for the outside environment. If a patient is too ill to attend in outside clothes, consideration should be made as to whether a mobile unit is the most appropriate environment for their scan.

IM&T Section

6.      What is the process for distributing the post scan data?

The DH contract requires that the clinical output be reported upon either via the local qualified reporter or nominated competent reporter. The KPI for the reporting element of the contract states that reporting must occur within two business days from end of scanning day. The report will be returned to the referring clinician.

All images are sent to the Clinician over the N3 Network and reported on using the Medstamp Reporter tool. When the reports are returned a copy is sent to the generic NHS.net email address as supplied by the trust another copy is sent along with the PET/CT images back to the referring trust PACS. There are a small number of trusts within the scheme where the PACS is not fully integrated to the medstamp infrastructure due to technical issues within the Trust infrastructure, these sites are sent images and reports via CD whilst the technical issues are being resolved, in the very near future these CD’s will be encrypted using the CfH approved software (Safeboot).

Referrers Section

7.      How do I request an appointment in the future (e.g. 3 months time) for a patient who needs a follow up scan?

A process is currently being piloted in the East of England SHA to accommodate this type of referral. On completion of the pilot, the process will be evaluated and adopted across all five SHAs.

Referrers should indicate the following in the box on the referral form under the inpatient information (bottom right): “Planned follow up patient – please book scan for week commencing ….………………..”.

Once this information is received and accepted, we will contact the patient immediately and book for the week specified at the most local site. Reminders will be generated prior to the appointment. Please inform us if the patient subsequently does not require the appointment. This applies to all pre planned follow up patients.

To simplify the process, InHealth are issuing some pre-printed stickers which will allow specific timelines for MDTs and follow up appointments be more accurately met.

8.      What do I do if I want to book in a patient for an appointment before they have been considered at the MDT?

A process is currently being piloted in the East Midlands SHA to accommodate this type of referral. On completion of the pilot, the process will be evaluated and adopted across all five SHAs.

Referrers should indicate the following in the box on the referral form under the inpatient information (bottom right): “Pre booked patient for ….……………….. Booked by (name of MDT contact ….……………….. on ….………………..”

This refers to patients who have slots pre booked prior to an MDT meeting and this referral form is the confirmation of that booking.

We are able to reserve appointments for patients who are likely to need a PET/CT following discussion at the MDT. Prior to the MDT, a named and designated liaison person contacts the PRC to inform them that there are a number of patients who may need a PET/CT scan and reserve the slots at the next session at the local site. If there are not enough slots available, alternatives will be provided.

Following the MDT, the same person contacts the PRC to confirm or cancel the slots. After confirmation and receipt of the referral form, the patient will be contacted to offer the appointment.  If the patient does not accept the appointment, the MDT liaison person will be contacted and they will liaise with the patient to agree if a further appointment is needed.

Each hospital needs to inform InHealth of the names, email and phone numbers of the designated liaison person, what day and time the call will be made and what time the confirmation /cancellation will be done.

9.      What do I do if I have a patient for who requires their scan urgently because they need treatment before a specific date (i.e. a patient on the 62 day treatment pathway)?

A process is currently being piloted in the South West SHA to accommodate this type of referral. On completion of the pilot, the process will be evaluated and adopted across all five SHAs.

Referrers should indicate the following in the box on the referral form under the inpatient information (bottom right): “Urgent treatment patient – book into next available local slot.”

This is for “two week wait patients” – we will book into the first available local slot – if this is more than five days, we will offer a non local slot and if the patient doesn’t accept it we will inform the agreed trust contact of the date of the rejected appointment. Alternative arrangements can then be made. This might include discussion on moving less urgent patients or arranging a longstop appointment. 

If there is a deadline to be met in returning results to an MDT or booking theatre, this can be indicated, however, we cannot guarantee to meet deadlines prior to seven working days from acceptance of the referral.

10. What communication will I receive once my referral has been received and accepted?

When a referral form is received and accepted, the following process is completed:

·         Confirmation of receipt is sent to the referrer by email and/or the designated generic email address

·         Once the appointment has been confirmed with the patient, an email confirmation will be sent to the referrer

A referral form must have all sections marked with an asterisk completed fully and a valid nhs.net email account.

If a referral is received with insufficient information, such as a Trust email address not an nhs.net account, the PRC immediately call the referrer to resolve the missing/incorrect information. They have up to 10 days to get the referral completed before it can be rejected.

11. How do InHealth communicate with the patient?

Patient communication is either by phone or email. There are four attempts to contact the patient over a two day period at various times during the day. We can also email if an email address was provided. After two days a letter is sent to the patient explaining we have been trying to contact them to arrange an appointment and the referrer is informed.

12. What is the turn around time from referral to report?

13. How do I get hold of the Referring Guide for Clinicians?

The Referring Guide for Clinicians is available by contacting Gemma Thomson, Marketing Manager, InHealth Molecular Imaging on 01494 561337 or email: gemma.thomson@inhealthgroup.com.

14. What is my local referral process?

This information can be requested from your SHA contact or by contacting Gemma Thomson, Marketing Manager, InHealth Molecular Imaging on 01494 561337 or email: gemma.thomson@inhealthgroup.com.

15. What formats is the referral form available in?

The referral form is available as a PDF or secure word document. It is available to download from our website www.inhealthgroup.com/diagnostic_and_imaging/patient_area/419.asp or by contacting Gemma Thomson, Marketing Manager, InHealth Molecular Imaging on gemma.thomson@inhealthgroup.com.

16. How do I find out where my patient is in the pathway?

The referrer will receive an email when the referral is received and accepted by the PRC. The PRC then have two days to try and contact the patient on all available contact numbers provided. If the patient is contacted and an appointment booked, confirmation is emailed to the referrer’s secure nhs.net email address or the designated generic email address which ever has been specified by your site.

If the PRC is unable to contact the patient after two days, we will call the referrer to advise them and send a letter to the patient to contact us. The referral will then be kept for 10 days during which the PRC continue trying to contact the patient. If after 10 days we have been unable to contact the patient, the referral is rejected and returned to the referrer with a covering letter.

17. How do I access reports on the number of appointments made and scans completed?

An email is sent to the referrer and/or a generic email address when appointments are arranged. We also send a work list for each scanning site out, the day before the appointment. If you wish to be added on this distribution list, please contact Claire Dilmen on claire.dilmen@inhealthgroup.com.

We prepare a weekly and monthly report for the DH which details patients referred, patients scanned and reports issued. These reports are based on the patients NHS number and give dates for each activity (i.e. referral, scan, report etc). This information is then shared with the SHA lead for your area.

We also produce and issue a PCT version of the monthly report and issue it to each PCT.

18. If our local NHS PET/CT scanning facility is full, what happens to our patients?

Your patient will be offered an appointment(s) at the nearest site(s) which has availability within the time period for the scan to take place – i.e. 5 days from referral as specified by the contract. If the patient turns down these appointments then we will make an appointment for the local site as soon as possible but outside the contract period (a Long Stop appointment) and on a date which the patient accepts. Once this appointment has been booked, we will contact the referrer and gain their consent for the Longstop Appointment date.

19. Can our cancer network agree with InHealth that our patients are only offered locally convenient sites?

Each of the SHA leads in conjunction with referring sites, have specified which three scanning sites they would prefer patients to attend, to ensure that patients are offered sites as locally as possible. A contract variation has been completed by the DH to complete this process.

It was agreed with the SHAs that if "reasonable" choice was given and the patient still refused to accept the appointment offered, then this constituted a legitimate reason for a long stop appointment and for the cancer network to stop the clock.

20. Can we refer patients to static units in London and Nottingham?

Yes, if a local site is not available and the patient is prepared or would prefer to travel to London or Nottingham.

21. How do I add new entries to the Authorised Referrers Database (ARD)?

InHealth can supply referrers with a form to complete for new entries to the ARD.

22. The reporting process is taking longer than anticipated. Why is this?

To send the scan data to the reporter, there needs to be N3 Network connectivity .The N3 installation process takes 4-6 weeks, working with several providers including CfH and the Trust IT department. 90% of Trusts now have N3 connectivity, however, where connectivity does not exist, you can report through the Medstamp portal at another location if available, or you can load CD’s into your communicator that are shipped to the Trust the day after the scan.

General Section

23. What is the process and frequency of invoicing?

InHealth do not invoice PCTs. This is done by the DH. Please refer to Phase 2 Funds Flow document circulated by your IS lead.

24. How is InHealth increasing capacity?

DH are monitoring capacity usage very closely and are working with the SHA leads and InHealth to evaluate the required activity for each SHA for the future where indicated InHealth are planning to extend working days to scan more patients per day. Additionally, plans are being reviewed to increase the number of attendances in the locations which require additional volume.

InHealth have also introduced a support vehicle to those locations which allow this to come on site. This unit docs to the scanner, providing additional patient space for injected patients to rest before scanning and a hot toilet which reduces patient transit during the scanning process making the whole process easier for patients.

The static units at the London PET/CT Centre and Nottingham PET/CT Centre are also available for very urgent patients only.

If you have any questions that are not answered in this document please contact:

Tel: 0845 600 2953
Email: infopetct@inhealthgroup.com

Frequently Asked Questions – for the archive please click here