proc:ct_vetting [RadRegWiki]

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====== CT Vetting ======

Practice varies a lot between sites, but in general the minutia doesn't matter too much - for Today and Plymouth use the vetting module in CRIS, and for all other sites set as "request received", leave an event comment, and contact the radiographer. Detailed guides below:

==== Plymouth ====
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Vetting done though the vetting module in CRIS

**To accept:**
  * From the Event Info tab sure the examination code is correct, set the urgency code as 1 - routine, 3 - urgent, 5 - immediate, tick the "justify" check box, then click on Vet. Any bespoke instructions go in the event comments but aren't mandatory.
  * On the Vetting page choose the relevant protocol and modify if needed, then click "complete". 
  * Patients with low eGFRs with need contrast specifically prescribed in the protocol.
  * It is not mandatory to contact the radiographer team, they will generally just pick it up.
**To reject:**
  * Reject through CRIS event info page - Reject > Cancel Event leave a comment then select a "hospital cancel" option.

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=== Notes ===
Derriford policy is that overnight all referrals from SAU are to be accepted regardless of urgency and not deferred to the morning, however the PROC team only needs to report the clinically urgent scans - i.e. those with an urgency code of "3" or "5". Low priority "1" scans are to be sent to Medica. This does not apply to MAU scans as it stands.

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==== Truro ====
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**To accept:**
  * Leave a comment in the event comment stating the scan protocol & urgency -/+ any relevant details. This is the official vetting step.
  * On CRIS from the Event Details tab make sure the examination code is correct, then go to Request - set as "request received".
  * Message the CT radiographer on MSteams or give them a call on ext. 5196.
**To reject:**
  * On CRIS from the Event Details tab go to Request - set as "unjustified" and leave a comment in the box giving rational. Don't use "rejected"

**Urgency coding in Truro:**
  * 1 - Routine (scanned in chronological order as capacity allows)
  * 3 - Today
  * 5 - Urgent - ASAP - To maintain flow in ED this is applied to most ED patients
  * 6 - Stroke and Trauma scans - should come pre-assigned
  * 8 - Awaiting clinical information
  * 9 - Awaiting radiologist vetting
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==== Exeter ====
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**To accept:**
  * Leave a comment in the event comment stating the scan protocol & urgency -/+ any relevant details. This is the official vetting step.
  * On CRIS from the Event Details tab make sure the examination code is correct and set the urgency code as 2 for all overnight scans, then go to Request - set as "request received"
  * Give the radiographer a call, or message them on teams if possible.
**To reject:**
  * On CRIS from the Event Details tab go to Request - set as "rejected" and leave a comment in the box giving rational

**Urgency Coding:**

Exeter uses urgency coding slightly differently to the rest of the region but all you need to know for PROC is -
  * 2 = Overnight
  * 3 = Tomorrow
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==== Torbay ====
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Torbay now uses the CRIS vetting module


**To accept:**
  * Navigate to the relevant event on CRIS, click the "justified" check box, add a protocol in the protocol window, and click "completed".
  * Leave an event comment stating the urgency of the scan and any comments needed.
  * Instruct the referrer to contact the on-call radiographer on 55641 - It isn't essential to message the radiographer yourself.

**To reject:**
  * Click the rejected button in CRIS. You will want to leave a comment.

Urgency coding isn't essential in Torbay so long as you have left an event comment, but codes can be used as follows:
  * 1 = Routine GP and Outpatient
  * 3 = Standard ED and Wards
  * 5 = Urgent
  * 6 = Research
  * 7 = Urgent/2WW

[[https://nhs.sharepoint.com/:b:/r/sites/msteams_e1797f/Shared%20Documents/General/PROCuments/Torbay/CRIS%20vetting%20module%20guide.pdf?csf=1&web=1&e=60Zc8A|Torbay CRIS CT Vetting Guidance]] - guidance has changed since this was created.

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==== Barnstaple ====
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Vetting in Barnstaple is a bit variable, quite a few scans will just get directly accepted by the radiographer, and quite often there isn't anything on CRIS when called. As long as the radiographer knows the scan should happen.

**To accept:**
  * Leave a comment in the event comment stating the scan protocol & urgency -/+ any relevant details.
  * On CRIS from the Event Details tab make sure the examination code is correct, then go to Request - set as "request received"
  * Contact the radiographer - generally through switch or MSteams
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==== General Points ====

Other important details to give in the event comments include and communicate to team: 
  * If the patient is pregnant
  * If the patient is confused or agitated
  * If the patient has a reduced GCS or intubated
  * If there are any major mobility issues

==== Sources ====

[[https://nhs.sharepoint.com/:b:/r/sites/msteams_e1797f/Shared%20Documents/General/PROCuments/Torbay/CRIS%20vetting%20module%20guide.pdf?csf=1&web=1&e=60Zc8A|Torbay CRIS CT Vetting Guidance]] - up to date Torbay guidance as of 07/24.

[[https://nhs.sharepoint.com/:w:/r/sites/msteams_e1797f/Shared%20Documents/General/PROCuments/General/Justification%20of%20Requests%202020.docx?d=wd8df711804d4437da157356e470b320a&csf=1&web=1&e=6Hhoe6|Relevant PROCument]] - this document, while still apparently in official circulation is very out of date.

[[https://nhs.sharepoint.com/:w:/r/sites/msteams_e1797f/Shared%20Documents/General/PROC%20Mega-Guide%20-%202023%20Copy.docx?d=w5fd39d77f7e545dc976da029dbff8000&csf=1&web=1&e=ZLKTUC|PROC Mega-Guide]] - contains useful information, but can be variable in accuracy.