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Picture imperfect

It has become clear in recent weeks that the highly praised EMRAD integrated imaging system rolled out across eight hospitals in the East Midlands was not quite the success it was portrayed as.

Clinicians working at hospitals in the region have become increasingly frustrated and worried about the impact of system breakdowns, faults and delays that were hampering their work “on a daily basis”.

Despite EMRAD being held up as an example because of its NHS England vanguard status, on the ground, doctors have been raising concerns that images were not viewable and, in some cases, advice by specialists had to be given based solely on paper records. In extreme cases, images in emergency situations had to be burned to a CD and sent in a taxi.

EMRAD signed a 10-year, £30m contract with GE Healthcare in 2014 to deliver the integrated imaging system, but earlier this week we revealed the implementation at Leicester had led to a backlog of image reports of more than 30,000. Similar issues, including examples of patient harm, were highlighted at Kettering General Hospital last year.

The intention behind EMRAD has been right for patients, but the implementation is obviously not going to plan. The departure of Leicester from the consortium leaves the mission of integrating a single imaging system across the whole East Midlands impossible to achieve.

Sharing the workforce crisis

NHS England has set each sustainability and transformation partnership a GP recruitment target for 2020.

HSJ has seen the targets given to the 17 STPs in the Midlands and East, which collectively have been tasked with finding 1,300 fully qualified GPs. The national commissoner said it couldn’t share the remaining 27.

The reaction from a some readers has been one of derision, with a few pointing out that STPs are not statutory bodies with any power to actually recruit GPs – and others claiming NHSE is attempting to “pass the buck” for the increasingly difficult target of finding 5,000 extra doctors by 2020.

Readers may have a cause to be sceptical about STPs’ power to actually implement any recruitment schemes. To really give STPs the power to make improvements, you could argue that workforce budgets need to follow the targets. Of course, not being legal entities, STPs couldn’t actually hold budgets… so in reality they may only be able to coordinate schemes or make suggestions about where money should be spent.

There is the theory that accountable care systems could eventually hold Health Education England budgets, but considering the slow pace of development, this is unlikely to happen soon.

What the targets do show is that if NHS England wants to get anywhere near reaching 5,000 GPs in three years’ time, it better get a move on.