Innovations in Community based Practice

1. The Arklow Story a dedicated local GP
radiology service.
Sinead O’Connor, GM
Global Diagnostics Ireland
s.oconnor@globaldiagnostics.ie

2. How it all started?
Local hospitals unable to manage the GP radiology
demand for x-ray & ultrasound services
Rapidly growing local population - 12% increase
between 1998 & 2002 & a further10% by 2006.
Excessive wait times for outpatient x-ray &
ultrasound appointments
Excessive delays getting results back
GP’s referrals were lowest priority
Patients travelling long distances for services

3. Solution??
HSE Initiative & Pilot Project
• A new x-ray & ultrasound service to be located
in the Arklow HSE Centre
• Direct access for 46 local GPs only
• Region: South Wicklow and North Wexford
region
• Free service for patients within their own
community

4. Defined Service Requirements
• An end to end radiology managed service
solution, including equipment, fit out,
infrastructure & staff
• Appointments offered within 48 hours of initial
request
• X-ray appointments available in 48 hours
• Ultrasound appointments available within 5
days
• Same day urgent appointments
• All exams reported within 48 hours

5. Our Team
• 2 administrators
• 1.5 radiographers
• 1.5 sonographers
• Team of 11 consultant radiologists
Team behind the team - managing quality &
includes clinical audit & risk management. Feeds
into the larger Global clinical governance
organisational structures

6. Our Service Today
•
•
•
•
53,000 patients imaged in total since 2008
37,000 x-rays
16,000 ultrasounds
Average 8,000+ per annum
• All exams reported with 24 hours.
• Critical, urgent and clinically significant but un
expected result communication closed loop
process
• Radiologists accessible for follow –up &
questions on reports or follow up
• CHKS accredited service since 2011

7. How we measure our service?
Feedback from our GP’s on our Arklow Service
(survey 2012)
• 100% rated it as ‘Excellent’ or ‘Good’
• 97% responded that it positively affects initial
patient management.
• 50% agree it leads to quicker treatment in the
case of an adverse result
• 27% responded that it prevents unnecessary
referrals to A&E.
• 97% agreed that urgent referrals are
appropriately managed by the service
• 76% agreed radiologists were available to
discuss reports

8. Over referral risk due to
accessibility?
40% of GPs surveyed felt that this was a risk
Year on year volumes show that this has not happened.
Year
Patient
Volumes
2009
8715
2010
8368
2011
8592
2012
8059
Numbers have remained stable even with the introduction of 6
new GPs over 5 years.

10. From little acorns……..
Arklow was Global Diagnostics 1st project
We now see over 160,000 patients per annum across 8
hospitals providing emergency and speciality radiology and
ophthalmology services to public and private healthcare
partners.
Sole radiology provider in 2 hospitals
National Healthcare Award Winner in 2012 for innovation in
quality service delivery within a hospital
Awarded NCSS national contract to deliver diabetic
retinopathy screening services & established Global Vision.
Latest new service started 2 weeks ago in Vista Medical
Imaging in Naas
Irish owed & operated - employs 81 staff