Debbie Sze Wan Wai MBChB, Presenter: Nothing to Disclose

Rakesh Prafulchandra Patel MBBS, BSc, MRCS, Abstract Co-Author: Nothing to Disclose

Arun Kumar Dheer MD, FRCR, Abstract Co-Author: Nothing to Disclose

From 2007-2008, new central guidelines were implemented in our region, promoting open access to imaging services by primary care practitioners. The direct referrals included CT and MRI for neurology, musculoskeletal and body. This allowed general practitioners direct referral and easy access to these services without the need of secondary care referral in all cases. The aims of this audit were to assess the uptake and understanding of the newly offered pathways and to assess the impact of the service and appropriateness of referrals by GPs.

Presentations at beginning of services with details of referral pathways for body imaging were given to GPs to encourage and facilitate a good uptake and promote good referral practices. Pathways as detailed in the 6th edition of RCR guidelines ' Making the best use of clinical radiology services' (MBUR6) were highlighted. Electronic data on the uptake of the service was collected over a 12 month period and reviewed. Appropriateness of referrals was assessed according to pathways and MBUR6 guidelines.

27% of GP practices referred a patient through the open access service. The pattern of referrals for MRI and CT were compared with ultrasound requests from GPs in the Coventry and Warwickshire PCT areas. The majority of cases initially had an Ultrasound request. Age-ranges, sex and imaging request details were reviewed to assess the referral pattern. We reviewed whether the report answered the clinical query and whether the out-patient referral pathway was affected. 81% of referrals were appropriate.

The majority of referrals for CT and MRI were appropriate. Successful implementation of the service requires initial education to increase utilisation of this service. The future impact of this referral pathway can change medical practices. The primary care pathways will expand gradually and this may impact the management plans for many clinical services, and currently the new services redesign pathways are under review and changes to management will be drawn up accordingly.  

Open access to CT and MRI avoids unnecessary referrals facilitating faster treatment and appropriate management.

Wai, D, Patel, R, Dheer, A, Audit of Open Access Services to Primary Care, with Reference to Body Imaging.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8015420.html