Welcome to the department of radiology.

 

This booklet has been written for both new junior doctors and medical students. Within this booklet is hopefully everything you need to know about what is available to you during your placement with us.

 

The Department – is very proud of its multi-national composition, with Radiologists from India, Iraq, Italy, Pakistan, Palestine, Spain, and all corners of the UK

 

Consultants

 

There are 15 consultants, Dr Etherington, Dr Kadhim, Dr Pulupula, Dr Ehsan, Dr Marusic, Dr Pablos, Dr Dwarkanath, Dr Paolino, Dr Alonso-Fiel, Dr Doyle, Dr Abbott, Dr Hilles, Dr Venturi, Dr Wright, Dr Boothroyd.

 

Clinical Tutor is Dr Andrea Paulino

 

Interventional Radiologists are Dr Abbott, Dr Doyle, Dr Hilles and Dr Venturi.

 

Breast Radiologist is Dr Alonso-Fiel.

 

Paediatric Radiologists are Dr Wright and Dr Boothroyd.

 

Consultants can be contacted via the radiology secretaries who are located in the general area of the radiologist offices.

 

Jodie Directorate PA and Secretarial Team Leader Ext 5163

Julie Secretary Ext 6729

Sam Secretary Ext 6712

Rachel Secretary Ext 6712

Eleanor IR Secretary Ext 6722

 

The team comprises 16 Radiologists up to 5 Specialist Registrars and 5^th year medical student.

 

CONSULTANT RADIOLOGIST SPECIAL INTERESTS

 

Dr G T Abbott BSc (Hons), MBChB, MRCPI, DMRD, FRCR, Clinical Lead

Special interest – Interventional Radiology, Vascular Imaging

 

Dr G Alonso-Fiel MD

Special interest – Breast Imaging, MSK Ultrasound

 

Dr A Boothroyd MBChB, FRCR

Special interest – Paediatrics

 

Dr G J Doyle BSc (Hons), MBChB, MRCP, FRCR, Clinical Tutor

Special interest – Ultrasound MSK, Interventional Radiology

 

Dr R Dwarkanath MBChB, DMRD, FRCR

Special interest – Nuclear Medicine, Gynae

 

Dr M Ehsan FRCR, FCPS

Special interest – Cross-sectional Imaging, Neuroradiology

 

Dr R J Etherington MBChB, FRCR

Special interest – Cross-sectional imaging, Chest Imaging

 

Dr A Hilles Specialist of Radiology GP, EDIR

Special Interest – Interventional Radiology, Vascular Imaging

 

Dr S Kadhim MBChB, FICM, FRCR, LMCC

Special Interest – Ultrasound, Gynae, MSK

 

Dr J Pablos MD, PhD

Special interest – Cross sectional imaging, Gastro Imaging

 

Dr W J Pilbrow MBChB, DMRD, FRCR

Special interest – MSK Ultrasound

 

Dr K Pulupula DMRD, FRCR

Special interest – CT with Neuroradiology & Liver

 

Dr C Venturi MD

Special interest – Uroradiology, Interventional Radiology, Vascular Imaging

 

Dr A E Wright MBChB, BAO, DMRD, FRCR

Specialist interest – Paediatrics

 

Mrs J Kelly DCR (R), PGC, MSc Consultant Radiographer

Special interest – Breast Imaging

 

Dr S Bundred MB, ChB, MRCGP, MSc

Special Interest – Breast Imaging

 

Breast Screening

Key Contact: Sara Millington ext 3606

The unit has a complement of 1 Consultant Radiologist, a Breast Consultant Radiographer, a Clinical Specialist, Superintendent Radiographer, an Advanced Practice Radiographer and highly skilled Radiographers, Radiographic Support Worker, Office Manager and Clerical Staff.

The NHSBSP invites women to attend for mammograms from the age of 50 to 70 on a 3-year rolling programme and 47-73 as part of the randomised age expansion trial. Women over 70 can request a mammogram every 3 years by contacting the screening office. The 47-73 year old women are invited via GP practices for a 2-view screening performed every day, with an Assessment Clinic on Wednesday mornings.

In addition to the Radiographic staff there are 3 Consultant Breast Surgeons, a Breast Specialist Nurse and 3 Breast Care Nurses. Women are invited back to an Assessment Clinic as a result of radiographic breast abnormalities being identified on the mammograms. These may be followed up with further imaging and may result in needle core biopsies being performed to sample areas of abnormal breast tissue. In most instances, this is done on the same day as the assessment. This is then sent for histopathological analysis.

Symptomatic work is carried out on Thursday mornings, providing the post operative surveillance/family history mammograms whilst on Monday and Tuesdays a Fast Track service to a dedicated Out-Patient Breast Clinic. A dedicated young woman clinic is offered every other Wednesday morning. These clinics provide all necessary imaging with instant reporting along with ultrasound guided interventional procedures on the day.

All cases which have undergone needle tests are discussed at the weekly multidisciplinary team meetings to ensure optimal management takes place. The unit is now fully digital and the images are stored on PACS. Vacuum assisted biopsy is available for cases which require this.

CT

Key contact: Emma Fondacaro Ext: 5756

CT stands for Computed Tomography. The scanner uses X-rays to produce cross-sectional images of the area to be scanned. These images can be reconstructed so that images can be viewed in any plane and when necessary a 3D image can be produced. The Trust has 2 Toshiba CT scanners at COCH. One 64-slice and an Aquilion One 320-slice scanner, which does a scan of the heart in one heartbeat.

Fluoroscopy

Key contacts: Shirley Houghton Ext: 5859

The Countess of Chester Hospital has one fluoroscopy room providing a comprehensive range of services.

Diagnostic contrast studies are now mostly performed by Specialist Radiographers. These include imaging the oesophagus, videofluoroscopy swallowing, stomach, duodenum, small bowel and large bowel.

Further diagnostic studies of the Biliary tract, Genito-urinary tract, Cystograms and are also undertaken. A paediatric service of voiding cysto-urethrograms and upper gastro-intestinal tract imaging is also provided.

The fluoroscopy room also has the capability of multi-functional use and can be used for all non- interventional procedures, otherwise undertaken in IR. It also has the capability of performing angiographic procedures, if IR is not available

Interventional Radiology

Key contact: Collette Markey ext 6721

Interventional Radiology is a speciality of Radiology which uses X-rays and Ultrasound guidance to diagnose and treat many different diseases of almost every organ.

The Countess of Chester Hospital is a hub for the SMART (South Mersey Arterial) Centre in our area, offering specialised imaging and treatment in this field, of which IR is an integral part.

In IR we have a wide ranging Multi-Disciplinary Team including Radiologists, Radiographers, Nurses, Support Workers, Admin staff and other specialist staff members all working together to provide an excellent service.

We also work closely with anaesthetists and surgeons from all specialities, to provide a service which includes the following procedures:

MRI

Key contact- Karen Hurley ext 5735

• The Trust currently had 2 Siemens 1.5 Tesla MRI scanners, one installed in June 2005 and the other more recently in January 2014, they feature major advantages in image quality, shorter scan times and a more open aspect than older scanners.
• MRI is now well established in providing non-invasive imaging for the central nervous system, abdomen and pelvis, musculoskeletal and cancer staging. A type of MRI known as magnetic resonance angiography (MRA) can also be used to image your blood vessels.
• One of the main advantages of MRI is that unlike x-rays it does not involve exposing the body to radiation. MRI scans instead use strong magnetic fields and radiowaves to produce detailed images of inside the body. Due to the magnetic fields all patients are required to fill in a medical safety questionnaire prior to their scan (please follow the link to find this document). A small number of patients are unable to have an MRI scan as it can disrupt the working of certain medical devices e.g. pacemakers. It is also unsuitable for patients who have brain aneurysm clips, metal fragments in the eye and some metallic implants that have been in for less than 6 weeks.

Nuclear Medicine

Key contact: Hazel Robertshaw ext 5276

• A comprehensive Nuclear medicine service is available here at the Countess of Chester Hospital. Our present camera is a GE 670 Discovery SPECT/CT camera capable of stand-alone CT scanning, whole body imaging, dynamic studies as well as static imaging. We currently offer a broad spectrum of diagnostic imaging which includes Myocardial perfusion scanning, lung perfusion, bone, thyroid, parathyroid, HIDA, labelled white cell imaging, Mag 3 and DMSA kidney scans, lymph node and sentinel node localisation.

Plain film

Key contact: Alison Miller ext: 5287

• Diagnostic Radiography (plain film imaging) is undertaken in the department for all outpatient clinics, GP practices, Emergency medicine and inpatients. The plain film imaging section is one of the busiest in the department and operates 24 hours a day 7 days a week. There are 4 general X-ray rooms, 1 dental room and a further 1 fluoroscopy room.
• Radiographers work across all areas of the department and outside the department on the wards and in theatres. All plain film images are now undertaken using digital radiography and the resulting images are then electronically stored on the Trusts' PACS system which is available at any location within the hospital where there is access to a PC.
• The department is a teaching centre with links to the University of Wales (Bangor) Department of Health Studies and the University of Liverpool and have undergraduate Radiography students here for the majority of the year. Ellesmere Port Hospital Radiology Department
• Situated in a small friendly community hospital which offers free parking and easy access for the physically impaired. On site there is a modern café (Port of Call) offering a wide range of refreshments and food.
• The Radiology Department is a compact 3 - roomed unit with ensuite facilities for the barium studies. Both general ultrasound and diagnostic radiography are undertaken as well as the fluoroscopy studies
• We offer a 9.00 am. - 5.00 pm. appointment and urgent same day service to the GP patients from the surrounding area including Chester, Neston, Ellesmere Port and South Wirral. They are integrated with the digital PACS system installed at the COCH, and are able to obtain image reports rapidly from Radiologists based at COCH. Inpatients and Outpatient clinics at Ellesmere Port Hospital also benefit from our PACS system. Fluoroscopy is undertaken by Specialist Radiographers.

Ultrasound

Superintendent: Catalina Macdonald

• Clinical Lead: Judy Trumper
• Diagnostic Medical Sonography (ultrasonography) is an imaging technique whereby high-frequency acoustic energy, typically between 2 and 18 megahertz, is transmitted into the human body using transducers in contact with the skin. The ultrasound transducer functions as both a loudspeaker to create the sounds and a microphone to record them. As the sound waves reflect from the body’s organs due to differing tissue density, the transducer records the tiny changes in their pitch and direction. These changes are measured and interpreted by the computer, which then creates a picture on the monitor. A water-based gel is placed between the patient's skin and the probe to further assist the transmission of the sound waves. Ultrasound is used to visualize the internal organs such as the liver, pancreas, gallbladder, spleen, urinary tract, pelvis, thyroid and testes for possible pathology as well as tendons, muscles, joints and blood vessels. Ultrasound is also used as a guide for aspirations and joint injections. Obstetric sonography is routinely used during pregnancy to observe and measure the fetus prior to birth and assess the uterus and placenta.
• Ultrasound staff
• The Ultrasound Department has 11 sonographers and is a training department for student sonographers. The sonographers are either qualified radiographers who have specialised in ultrasound and hold a minimum of a Diploma/Post Graduate Diploma in Medical Ultrasound or qualified midwifes who have undertaken a Post Graduate Certificate in Medical Ultrasound.
• Three ultrasound support workers
• Four clerical officers

General Ultrasound

• All the Consultant Radiologists within the Radiology Department have an ultrasound session each week and specialise in different areas of the body.
• There are 4 ultrasound rooms within the Radiology Department and 1 ultrasound room at Ellesmere Port Hospital.
  • The sonographers also have ultrasound sessions which are held at Tarporley Memorial Hospital, Malpas Laurel Bank Surgery and Frodsham Princeway Health Centre.

Obstretic Ultrasound

• All pregnant women are offered a dating scan at between 11 weeks 2 days and 14 weeks 1 day and an anatomy scan at between 18 weeks and 20 weeks 6 days. Many women also have growth scans and if required are usually at 28 and 34 weeks.
  • The Obstetric Ultrasound Department has three ultrasound rooms.
  • There are three Obstetric Consultants which specialise in Fetal Medicine and have ultrasound sessions. There are also two midwifes who have a Post Graduate Certificate in Medical Ultrasound and scan within the Obstetric Ultrasound Department.
  • The sonographers also scan within the Early Pregnancy Assessment Clinic and Gynaecology Clinic each day

PACS System (Carestream)

PACS Manager – Adam McCaig

• PACS Assistant Manager and PACS Administrator.
• Introduction
• The Picture Archiving and Communication System (PACS) is used for the storage, Trust-wide communication and review of radiology imaging. This includes Computed Radiography (CR), Digital Radiography (DR), CT, MR, Nuclear Medicine (NM), Fluoroscopy (RF), Ultrasound (US), Mammography (MG) & Angiography (XA) images.

Information for Registrars

 

Professional Appearance

It is compulsory that staff members wear their ID badges at all times

 

Meditech

A radiographic examination is completed only when the radiographer has entered the radiographic details on the ‘Meditech’ computer system.

 

Colour coding of request forms

 

Outpatients/Inpatients/A&E/ DVI/ Breast Screening White computer printout

 

CT/MR Scanning/ Nuclear Medicine Green computer printout

 

Ultrasound Blue computer printout

 

GP Patients White e-refferal or Handwritten

 

Training days

Mandatory training and any updates are organised by the secretaries.

On Call Rota

Dr Etherington organises the on call rota for Consultants. IR on call rota’s are organised by Dr S lea.

Annual leave

Should be requested 6 weeks in advance. SpR Annual leave form must be filled in and signed by Dr Doyle prior to the Radiology secretaries processing your request (Radiology Secretaries can find Dr Doyle for a signature if required). Copies off the annual leave form can be found in the secretary’s office.

 

Study/Professional leave

 

As you now complete online, copy of study/professional leave, once approved by the deanery you must email to coc-tr.COCH-Radiology-Secretaries@nhs.netfor this to be reflected in the weekly rotas.

 

On Call Commitments

 

A calendar is on the wall outside the Radiology secretaries office – any on call commitments (pre on call, nights or post on call) should be noted on this calendar so we can reflect this on the weekly rota.

 

Sickness & Absence

If you need to leave early/late or are unable to come in due to sickness please let one of the secretaries know on 01244366729, 01244366712 or 01244365163, they will advise medical staffing of both your absence and your return.

 

Clinical Commitments within the department

If you are unable to attend any of your clinical commitments within the department or Breast Unit, please let the radiology secretaries know so we can advise the relevant area of your absence.

Salaries

These are paid monthly, either into a bank or building society account on the 28^th of each month.

All additional hours worked, on-call sheets, travel claims must be submitted to the Radiology Services Manager promptly at the end of the month for submission by the 6^th of the month.

Travel claims must be submitted within 3 months of the journey.