diagnostic imaging examination, many clinical departments rely on the ‘green of this may be seen in the publication of Towards Safer Radiotherapy (2008)
5
and
By giving
book’ published in 1998 by the NRPB
3
. This publication ‘Advice on Exposure to A Guide to Understanding the Implementation of the Ionising Radiation (Medical
Ionising Radiation during Pregnancy’ has been updated and was published in Exposure) Regulations (2008)
6
.
individuals
February 2009
4
. The reappraisal of the likely health effects to the embryo or
foetus following exposure to ionising radiation during pregnancy was undertaken The National Patient Safety Agency (NPSA) has an established system of voluntary
the confidence
in collaboration with the Royal College of Radiologists and Society and College reporting of radiotherapy incidents and near misses called the National Reporting
of Radiographers. This document takes into account the increase in the national and Learning Service (NRLS). Last year the NPSA engaged expertise from the
to challenge
baseline of childhood cancers from 1:650 in 1998 to 1:500 today and reiterates department to undertake analysis of these radiotherapy incidents. The first analysis
that the likely radiation dose to the foetus resulting from any diagnostic procedure was reported on the NPSA website in its quarterly report in May 2008
7
. The HPA
their practices,
in current use should present no risk of causing foetal death, malformation, growth now have a data sharing agreement with the NPSA to provide the expertise to
retardation or impairment of mental development. However, exposure of pregnant undertake the analysis of data collected on radiation incidents on a regular basis. It
more efficient
women to the higher dose procedures may lead to foetal doses in excess of a few is envisaged that these reports will be routinely published on the NPSA website as
mGy and at the highest doses may result in a doubling of the childhood cancer risk part of their quarterly reports. This will enable the national sharing of any lessons
ones can be
compared to the natural rate, and therefore should be avoided where possible. learnt from incidents and near misses.
implemented
To formalise the relationships which produce this type of work, the department Further work with the NPSA Steering Group on Patient Safety in Radiotherapy is
holds Memoranda of Understanding with both the Society and College of being undertaken on how to implement the ‘Towards Safer Radiotherapy’ coding
Radiographers and the Royal College of Radiologists to allow and promote and classification locally. A guidance document
8
is currently being piloted in six
communication on matters relating to radiation protection in clinical practice and radiotherapy departments and this document will be launched at a national
regulatory requirements as well as policy development. workshop in Birmingham on 4 June 2009, hosted by the NPSA steering group.
Some of the department’s staff provide advice on regulatory matters, specifically The department is also responsible for supporting two major government advisory
the Ionising Radiation (Medical Exposure) Regulations 2000/2006 [IR(ME)R]. Part committees, Administration of Radioactive Substances Advisory Committee (ARSAC)
of this work involves working with the inspectorates and accompanying inspectors and Committee on Medical Aspects of Radiation in the Environment (COMARE).
during their visits in Scotland and Wales, however it must be emphasised ARSAC advises ministers on the administration of radiopharmaceuticals in the clinical
that none of the staff in the department holds a warrant nor takes part in any environment and the department provides this committee with secretariat support.
enforcement decision or action under IR(ME)R. This approach helps to ensure some On the advice of the committee, the ARSAC Support Unit is responsible for issuing
consistency across the UK and, in addition, that inspectors are familiar with the certificates, without which these administrations cannot be made.
challenges of providing a clinical service within a regulatory context. Advice has
also been provided to the Healthcare Commission and liaison will continue with COMARE is an independent expert advisory committee which offers advice to
the Care Quality Commission from April 2009. all Government Departments and Devolved Authorities, not just the Health
Departments, and is responsible for assessing and advising them on the health
In Scotland, some staff have been involved in a programme of study days arranged effects of natural and man-made radiation. It is also asked to assess the adequacy
by the IR(ME)R inspector. These have been attended by senior Health Board of the available data and advise on the need for further research. COMARE
management as well as healthcare professionals of all disciplines to discuss the has recently expanded its work programme to cover medical exposures as
regulatory requirements concerning the use of ionising radiation in healthcare. demonstrated in its recent twelfth report regarding CT scanning of asymptomatic
The department has also been involved in the training of inspectors at Healthcare individuals
9
.
Inspectorate Wales (HIW), who are responsible for IR(ME)R in Wales. This training
covers the use of ionising radiation in healthcare as well as the regulatory Many department members also carry out work at an international level
requirements to assist the inspectors in appreciating the different environments in either through European projects on radiation dose or with bodies such as the
which medical exposures are carried out. International Atomic Energy Agency (IAEA). This allows UK input into international
work as well as enabling an early knowledge of matters which may ultimately
The department also contributes to the drafting of national guidelines. Examples impact on clinical practice in the UK.
30
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IMAGING & ONCOLOGY
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2009
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