An economic evaluation of introducing a skills mix approach to CT head reporting in clinical practice

摘要

Background: Computed Tomography (CT) head examinations are a common diagnostic examination in National Health Service (NHS) acute hospital trusts. Current NHS England and Royal College of Radiologist (RCR) reports estimate the year on year increase of examinations to be 10%, with the designated workforce of radiologists disproportionate to the increase in demand of imaging reporting. Objective: To determine an economic evaluation of cost, risk and feasibility of introducing skills mix CT head reporting by radiographers.Design: Applying a PICO framework study to evaluate the patient workflow demand from retrospective audit data of CT head examination attendance (n = 7266) at an acute NHS district general hospital (DGH) to model an example workflow demand over 12 months. Reviewing potential outcome risk data (diagnostic thresholds), and feasibility (workforce capacity) of both interventions. The economic evaluation calculated hourly unit costs for comparison estimation of consultant radiologists and reporting radiographers using Netten et al.'s Ready Reckoner. Report unit costs were calculated utilising the Gishen's Ready Reckoner to estimate the uninterrupted time of reporting a non-complex CT report using RCR, Centre for Workforce Intelligence (CfWI) and Department of Health (DoH) estimates for both interventions.