NMR Responsibilities

This below information sets out the criteria and procedure to be followed by referrers when requesting imaging. You must read and agree to these responsibilities by singing the application form.

Responsibilities

It is the responsibility of the referrer to:

Only request following a full history and assessment process.
Only request imaging within the inclusion criteria of the agreed protocol.
Read and adhere to the Trust IRMER employers procedures (NMR webpage/IRMER).
Complete an ICE referral or a Diagnostic Imaging Department paper referral (if no ICE access) providing a clinical history summary and provisional diagnosis, ensuring that their name, designation, professional registration number and consultant code (if applicable) are clearly legible. Paper forms must be signed.
Check the reproductive capacity of all patients of child – bearing potential and record the outcome on the imaging referral for radiation exposures between diaphragms and knees, ages 10-55 years.
If requesting cross-sectional imaging understand the risks associated with imaging contrast agents and be familiar with the Diagnostic Imaging policy on Contrast Administration and also to provide information on the referral form of the appropriate renal function for requests for CT.
Read and act upon the subsequent radiology report in the electronic system ICE to comply with NPSA notice 16 “Failure to act on radiological reports”.
If, prior to a report being generated, an urgent opinion on the images is needed, the referrer will be able to contact the Duty Radiologist at DCH (extension 6964).
Maintain audit compliance to ensure that imaging has been appropriately requested in respect of the patient’s management.
Attend IRMER training reviews every three years and submit an audit to demonstrate compliance with this protocol every two years to Dorset County Hospital Radiology Department.
To understand that their status as a referrer cannot be transferred to a new post and that they must inform Diagnostic Imaging when they have given notice for their current position.

Competence criteria

The referrer may request imaging providing they meet the following criteria:

Has a minimum of two years post-registration experience.
Has attended the DCH in-house IRMER course for new referrers.
Has been assessed as competent to request imaging by responsible clinicians.
It has been agreed that they are competent to request imaging (providing the criteria as outlined in this document are adhered to) by the Chair of the MEG (consultant radiologist) at DCHFT for and on behalf of the Diagnostic Imaging Department.
Entitlement to refer for imaging does not provide entitlement to make a clinical evaluation, this should be managed through applicant’s specific departmental processes.

Record keeping

The named referrer will request imaging via the electronic referral system ICE or by completing and signing the Diagnostic Imaging Department request form.
If a paper request form is used the named referrer will clearly state their name, designation, professional registration number and consultant code on the imaging referral.
The named referrer will provide information to include a clinical history summary, provisional diagnosis (or reason why imaging is requested) and examination required.
I-communicator alert must be acknowledged. The report should be read as soon as possible using the electronic results system ICE and actioned and filed accordingly in ICE leaving an auditable trail.

Audit

Standards will be audited every two years to ensure that practice standards within the agreed protocol are being met and that the protocol is being adhered to.
A random sample of 10% or a maximum of 50 of the imaging requests by the above referrer will be taken and reviewed in consultation with the responsible clinicians to ascertain that the inclusion criteria has been adhered to and that imaging has been appropriately requested in respect of their having bearing on the patient’s management.
A copy of all audits must be sent to the NMR Team, Diagnostic Imaging, DCH, NMR@dchft.nhs.uk
Where any standards are not met, it will be the responsibility of the above referrer, the responsible Clinicians and the Radiology Services Manager to develop an action plan or review the existing standards.
If the referrer fails to attend IRMER training review and / or submit their audits in a timely fashion, Diagnostic Imaging reserves the right to revoke their referral status.