Written Evidence Submitted by the Institute of Physics and Engineering in Medicine (IPEM)

(C190087)

About the Institute of Physics and Engineering in Medicine (IPEM)

• IPEM is a professional association and Learned Society with around 5,000 members working in hospitals, academia and industry, who are physicists, engineers and technologists working with applications of physics and engineering applied to medicine and biology.
• As a charity, IPEM’s aim is to advance the application of physics and engineering to medicine for the public benefit and to advance public education in this field. We do so by supporting and publishing research and supporting the dissemination of knowledge and innovation through project funding and scientific meetings; and by setting standards for education, training and continuing professional development for healthcare scientists and clinical engineers.
• We also produce information for the public about the role of physicists and engineers in their healthcare services and hold a series of public lectures each year. Our members are also involved in outreach events for young people and university students, to promote healthcare science careers.
• In preparing this response, we consulted with members of IPEM’s Diagnostic Radiology Special Interest Group.

IPEM’s response

1. It is clear that the COVID-19 pandemic has exposed the absence of resilience in the scientific (physics/engineering) service and the broader infrastructure.  
2. We understand the urgency with which some decisions were made, and we have detailed below some of the downstream issues that these decisions cause as follows:

• it has become very apparent that communication between Trusts, professional societies (IPEM, AXREM, SCoR), NHS Procurement etc has been poor. 
• equipment procured without expert advice that is non-compliant with radiation protection legislation (several mobiles x-ray units)
• equipment procured without consideration of radiation protection requirements of the location (mobile / relocatable CT scanners)
• equipment procured without considering legal responsibilities for insurances and maintenance / servicing
• poor communication has resulted in confusion over which Trusts will permit physics staff to perform essential performance testing of radiological imaging equipment. Each Trust has interpreted the guidance differently, and the guidance has changed frequently
• equipment purchases prior to COVID that had not been delivered have often been delayed. This has resulted in clinical departments being short of equipment from the beginning. This has also had a knock on effect onto the budgets across the financial year end (i.e. April)
• poor communication with vendors has led to multiple rearrangements of visits to commission equipment, which has affected the ability of physics services to juggle all the requirements of all their customers
• Access to hospital departments has varied between hospitals and over time as guidelines have changed
• Advice and provision of PPE has varied between Trusts and departments
• advice from different infection control teams has varied, especially the host employer and the visiting employer. Radiation protection is often overlooked, where infection control teams are unfamiliar with our work
• Remote working has been variable depending on existing IT infrastructures and the local policies of trusts. Some IT is so locked down that it has been impossible to use virtual meeting software. There are also training needs to be able to use the available software.
• An essential part of physics services is to provide training to users of radiological imaging equipment and our own trainees. This has been difficult to achieve remotely, either due to limitations with IT or the inability to maintain social distancing (or both). These times of change have meant that some aspects of training have been increasingly important, for instance, if roles have been temporarily extended, or new people trained into different roles. Radiation protection trainees have suffered as we have had to be mindful of social distancing and have often not been performing routine visits in the usual way. Examples of training include
• RPS training
• radiation protection update training to cover both IRMER and IRR
• specific training relating to temporary changes to systems
• training of junior members of staff and pre-registered trainees
• Along similar lines, holding routine radiation protection meetings has been difficult. These meetings are held to monitor radiation safety within the Trust and agree actions for improvements where required. These meetings are often the main communication about radiation safety throughout the organisation. it is even more important to maintain good communication under the current circumstances, where so many changes are occurring. Such meetings include
• ​medical exposures committee
• radiation protection committee
• compliance auditing
• Radiation protection departments were under a lot of pressure due to staff and equipment shortages before COVID. We have been stretched even more since March, which has not been helped by having to advise Trusts on how to make the best of a situation that is not ideal, and accommodate all the points stated above. The addition of so much new equipment without thought of staffing needs to maintain it is adding increased burden to radiation protection services in the future.

3. IPEM has been proactive with its members during this time, sharing intelligence and facilitating cooperation. The overriding impression across the community is that some, if not most, of these difficulties could have been avoided with appropriate communication. What we would suggest in the future is that professional bodies be consulted earlier in such processes, and that the scientific staffing capacity be considered as it is a limiting factor.

(July 2020)