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Diagnostics and imaging

  • Knee MRI for osteoarthritis

    Knee MRI for osteoarthritis

    This guidance is produced by The Academy of Medical Royal Colleges (the Academy) as part of the Evidence-based interventions programme. It is based on recommendations from the Expert Advisory Committee and the National Institute for Health and Care Excellence (NICE).

    All guidance has been reviewed by the Birmingham and Solihull & Sandwell and West Birmingham CCGs’ Treatment Policy Clinical Development Groups (TPCDG). This was reviewed to establish if existing CCG policies were already in place which covered the proposed intervention / treatment in question.

    Where there was no current CCG policy for the area in question, the NHSEI policy has been implemented in full into the CCG’s Clinical Treatment Policy portfolio.

    Where there was a current CCG policy for the area in question, then the existing CCG policy has been reviewed by the TPCDG considering the NHSEI EBI policy rationale and evidence base.  A decision has then been taken by TPCDG based on the review as to the most appropriate policy for implementation by taking into account the healthcare needs of our local population.

    The aims of the Evidence Based Interventions programme is to ensure the quality and safety of patient care by, freeing up valuable resources such as time so that more effective interventions can be carried out, reducing harm or the risk of harm to patients, helping clinicians maintain professional practice, creating headroom for innovation, and maximising value and avoiding waste.

  • Knee MRI for meniscal tears

    Knee MRI for meniscal tears

    This guidance is produced by The Academy of Medical Royal Colleges (the Academy) as part of the Evidence-based interventions programme. It is based on recommendations from the Expert Advisory Committee and the National Institute for Health and Care Excellence (NICE).

    All guidance has been reviewed by the Birmingham and Solihull & Sandwell and West Birmingham CCGs’ Treatment Policy Clinical Development Groups (TPCDG). This was reviewed to establish if existing CCG policies were already in place which covered the proposed intervention / treatment in question.

    Where there was no current CCG policy for the area in question, the NHSEI policy has been implemented in full into the CCG’s Clinical Treatment Policy portfolio.

    Where there was a current CCG policy for the area in question, then the existing CCG policy has been reviewed by the TPCDG considering the NHSEI EBI policy rationale and evidence base.  A decision has then been taken by TPCDG based on the review as to the most appropriate policy for implementation by taking into account the healthcare needs of our local population.

    The aims of the Evidence Based Interventions programme is to ensure the quality and safety of patient care by, freeing up valuable resources such as time so that more effective interventions can be carried out, reducing harm or the risk of harm to patients, helping clinicians maintain professional practice, creating headroom for innovation, and maximising value and avoiding waste.

  • MRI scan of the hip for osteoarthritis

    MRI scan of the hip for osteoarthritis

    This guidance is produced by The Academy of Medical Royal Colleges (the Academy) as part of the Evidence-based interventions programme. It is based on recommendations from the Expert Advisory Committee and the National Institute for Health and Care Excellence (NICE).

    All guidance has been reviewed by the Birmingham and Solihull & Sandwell and West Birmingham CCGs’ Treatment Policy Clinical Development Groups (TPCDG). This was reviewed to establish if existing CCG policies were already in place which covered the proposed intervention / treatment in question.

    Where there was no current CCG policy for the area in question, the NHSEI policy has been implemented in full into the CCG’s Clinical Treatment Policy portfolio.

    Where there was a current CCG policy for the area in question, then the existing CCG policy has been reviewed by the TPCDG considering the NHSEI EBI policy rationale and evidence base.  A decision has then been taken by TPCDG based on the review as to the most appropriate policy for implementation by taking into account the healthcare needs of our local population.

    The aims of the Evidence Based Interventions programme is to ensure the quality and safety of patient care by, freeing up valuable resources such as time so that more effective interventions can be carried out, reducing harm or the risk of harm to patients, helping clinicians maintain professional practice, creating headroom for innovation, and maximising value and avoiding waste.

  • Shoulder radiology

    Shoulder radiology

    This guidance is produced by The Academy of Medical Royal Colleges (the Academy) as part of the Evidence-based interventions programme. It is based on recommendations from the Expert Advisory Committee and the National Institute for Health and Care Excellence (NICE).

    All guidance has been reviewed by the Birmingham and Solihull & Sandwell and West Birmingham CCGs’ Treatment Policy Clinical Development Groups (TPCDG). This was reviewed to establish if existing CCG policies were already in place which covered the proposed intervention / treatment in question.

    Where there was no current CCG policy for the area in question, the NHSEI policy has been implemented in full into the CCG’s Clinical Treatment Policy portfolio.

    Where there was a current CCG policy for the area in question, then the existing CCG policy has been reviewed by the TPCDG considering the NHSEI EBI policy rationale and evidence base.  A decision has then been taken by TPCDG based on the review as to the most appropriate policy for implementation by taking into account the healthcare needs of our local population.

    The aims of the Evidence Based Interventions programme is to ensure the quality and safety of patient care by, freeing up valuable resources such as time so that more effective interventions can be carried out, reducing harm or the risk of harm to patients, helping clinicians maintain professional practice, creating headroom for innovation, and maximising value and avoiding waste.

  • Use of upright /open MRI scanning

    Use of upright /open MRI scanning

    What is a MRI?

    MRI (magnetic resonance imaging) is a type of scan that uses strong magnetic fields and radio waves to produce detailed images of the inside of the body. A standard MRI scanner is a large tube that contains powerful magnets and the patient has to lie down inside the tube to be scanned.

    An MRI scan can be used to examine almost any part of the body, including:

    • Brain and spinal cord
    • Bones and joints
    • Breasts
    • Heart and blood vessels
    • Internal organs, such as the liver, womb or prostate gland.

    The results of an MRI scan can be used to help diagnose conditions, plan treatments and assess how effective previous treatment has been.

    Treatment

    There are three types of MRI scan:

    1. During a usual MRI (called a conventional MRI), the patient lies inside the tube during the scan
    2. An axially loaded MRI is a version of the usual MRI but weight is put on the body so the scans show how the body works when it’s moving or upright. To do this, the patient is given a special harness to wear when having the conventional MRI scan
    3. An upright/open MRI (called a positional MRI) has the patient sat down or stood up between two big magnets. This way, the scans will show how the body works when in certain positions. However, the machine is slower than a usual MRI and people who have pain or are unstable when either standing up or in certain seated positions or can find staying in one position for a long time difficult may find this treatment less suitable.

    Patient eligibility criteria

    Referrals for upright/open MRI scanning as an alternative to conventional MRI is only commissioned for:

    • Patients who suffer from claustrophobia where an oral prescription sedative has not been effective (flexibility in the route of sedative administration maybe required in paediatric patients as oral prescription may not be appropriate)

    OR

    • Patients who are obese and cannot fit comfortably in conventional MRI scanners as determined by a Consultant Radiologist/Radiology department policy

    OR

    • Patients who cannot lie properly in conventional MRI scanners because of severe pain despite adequate analgesia provision

    OR

    • Patients that require load bearing MRI images to be undertaken

    AND

    • There is a clear diagnostic need consistent with supported clinical pathways

    IN ADDITION

    • The CCG will only fund uMRI of the specific anatomy requested. This means (for patients who DO NOT meet the above criteria) the CCG will only fund the treatment if an Individual Funding Request (IFR) application proves exceptional clinical need and that is supported by the CCG.

     

    Advice and guidance

    • For more information, search for ‘MRI scan’ at www.nhs.uk
    • Choosing Wisely UK is part of a global initiative aimed at improving conversations between patients and their doctors and nurses.

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