Project: RCR iRefer guidelines review
Background and scope of the work
The Royal College of Radiologists (RCR) has published a set of referral guidelines since 1989, formerly known as MBUR (making the best use of radiology) and now known as iRefer. Historically these were published in editions roughly every four years and we have now moved to continuous updating to allow the content to better keep pace with developments in best practice, research publication and technical developments. The review methodology has been accredited by NICE since 2010 and the RCR considers iRefer a flagship publication.
The guidelines are aimed at referrers into radiology, with the intention of supporting the practitioner’s decision-making process so that the patient receives the best test first time. This has benefits for the patient journey by speeding progress towards a diagnosis, but also efficiency within the organisation from better user of resources and improvements to the vetting workload. The guidelines are also accessed regularly by academic and training institutions, private healthcare and clinics, legal and insurance firms.
The NICE accreditation, and our own good practice and quality standards require lay involvement into the guideline content. The guidelines’ text itself is technical in in nature so lay involvement is seen as most valuable in the introductory section overarching the guidelines, where much essential information is located, although it may transpire that comment on the guidelines’ scope or specific content is sought on an ad hoc basis. There are sections on the different types of imaging modalities, their scope and limitations, what is it like to receive such a study, guidance around contra-indications and pregnant patients, and also a section on ionising radiation exposure (which is reviewed by PHE or its successor organisation).
The guidance in the introductory section has been developed by the iRefer Lead Editor and now requires review by a working party of lay members, and development as indicated during that review. The guidance will be reviewed and agreed by the Clinical Radiology Professional Support and Standards Board (CR PSSB). Guidance documents produced by the CR PSSB are usually reviewed every four years. The date of last review was 2017.
Term of office
The lay member will serve an initial term of one year for the review process, which is expected to run from 1 September 2021 until 31 August 2022. However, this term may be extended by mutual agreement.
Role and responsibilities
The lay member will be expected to contribute independent and objective views and not to act as a member of any specific organisation or body. The lay member will:
- Work with the lay working party and other identified clinical experts to contribute to the review and development of the introductory section guidance
- Assist in meeting the requirements for NICE accreditation of the methodology underpinning the guidelines (NICE accreditation 'focuses on the extent to which the guidance represents the views of its intended users and those affected by the guidance [patients and service users]')
- Provide advice about opportunities for seeking the views and experiences of patients/public in order to inform the development of the guidelines
- Raise awareness and understanding of relevant patient/public concerns and issues during the review and development of the guidelines, so that these may be taken into account
All participants in the review of the guidelines are expected to declare any relevant interests.
The following range of skills and attributes are desirable, but it is recognised that individuals will have different levels of experience in different areas:
- A keen interest in, and understanding of, healthcare in the UK
- Experience of developing guidance, guidelines and professional advice, or their equivalent, in a professional context (not necessarily in healthcare)
- Experience of working with medical or healthcare professionals and a willingness to share views from the user’s perspective
- Experience in the use of basic software packages e.g. MS Word and Outlook to review documents and communicate with colleagues online, and
- Political and commercial neutrality.
Lay Member Network
Lay people who serve on College boards, committees, etc are also automatically members of the Lay Member Network, which meets twice a year – generally in spring and autumn.
The Lay Member Network meetings bring all lay members together to learn more about and discuss the College’s activities and aims on a broad front and allow opportunity for networking. The topics discussed at Network meetings are wide-ranging, usually affecting both the College’s specialties, or are of general impact on medicine or healthcare. Meetings are chaired by the President (or a Vice-President) and attended by the Vice-Presidents and College staff members. The structure of Lay Member Network meetings is deliberately fluid to enable a two-way exchange of information and views.
The individual appointed to this role will be invited to meet the Medical Director, Professional Practice, the Head of Professional Practice and the iRefer Project Manager for an induction meeting (to be held remotely). The time commitment for this will be between 1-2 hours plus preparation time.
In relation to the guidance review and development process, it is difficult to quantify the exact amount of time that will be required to contribute to this, but it is anticipated that it will be between 1–4 days in total per annum, depending on the findings of the initial review and the extent of changes identified. Wherever possible, work will be conducted electronically i.e. via emails and/or through video and tele-conferencing in order to reduce the need for physical meetings and the requirement to travel. Access to video and tele-conferencing resources would assist the lay member in undertaking this role, however, individuals who do not have access to such facilities are welcome to attend meetings at the College.
In addition, the time commitment of the Lay Member Network is to attend two meetings a year, plus any other ad hoc meetings that may arise. The time commitment for each meeting is about 2-3 hours, plus travelling and preparation time.
The RCR will meet reasonable expenses incurred by a lay member attending meetings in line with the RCR Travel and Expenses Policy and is happy to discuss help with IT requirements to enable participation in meetings taking place remotely.
If the lay member attends an external meeting that is of interest to him/her, prior agreement with the College should be arranged and confirmation obtained that the lay member is attending on behalf of the College and is therefore able to claim travel expenses. Expenses for any meetings that the lay member is attending out of personal interest and not on behalf of the College cannot be claimed back through The RCR.
The lay member shall comply with the provisions of the General Data Protection Regulation (EU) 2016/679 as regards processing and disclosure of any personal data that is made available to them as part of their work for The RCR.
Lay members will from time to time be provided with documents at various stages of development, prior to their formal approval and publication. Lay members will always be asked to keep such drafts confidential, and not disclose any confidential information to an outside person or organisation.
Copyright and Intellectual Property
The RCR will hold the intellectual property and copyright of the final product. The lay member and any other individuals involved in the review process will be required to assign these rights to The RCR.