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Facilities and workforce (FW) standard

Rationale
Providing a PMC-SI service requires access to specific equipment and trained personnel. This domain describes the requirements for these facilities and the workforce required to deliver the standard. 

  • FW1  Facilities and environment
  • FW2  Standard of education and competency of imaging staff

FW1  Facilities and environment

Rationale:
The service should be properly commissioned with clear identification of referral pathways, timescales and service availability plus other contractual requirements. This will be down to local agreement. Risk assessments for the whole work process should be included in any service specification.

Criteria:
Systems in place for a service level agreement for provision of a PMC-SI  whether undertaken in NHS or private sector Imaging Departments,

Systems in place to ensure that that the imaging equipment for any PMC-SI service is appropriate for the whole pathway from acquisition, reporting and review by the referrer,

Systems in place to ensure that required accessory equipment is available eg aids for lifting and handling of cadavers (see also HS 5).

Commentary:
Consideration to age of equipment, specification and replacement plans may need to be considered within the service specification due to the fast developing nature of CT and MRI technology. It would be anticipated that PMC-SI would be performed using contemporary equipment.

FW 2 Standard of education and competency of imaging staff

Rationale:
Applying standards for education and training supports consistency in service provision between service providers.
Criteria:
a. Systems in place that demonstrate those performing or assisting in post-mortem imaging studies are appropriately qualified and trained,
b. Systems in place to ensure that HCPC registered radiographers performing PMC-SI have undertaken postgraduate level education and training in forensic radiography.

Commentary:
All radiographers graduate with a standard competency in CT scanning. A workforce, therefore, currently exists that can be further developed to provide a minimally invasive autopsy service.  The need for an experienced radiographer to adjust scan parameters to obtain optimal images cannot be underestimated, even with good protocols in place. By adjusting imaging parameters and by post acquisition processing and reconstruction of images, optimum images are available to aid the clinician interpreting and reporting the examination to provide an opinion on the underlying pathology and cause of death. Postgraduate radiographer experience in the field of MRI will provide them with similar skills.

Education and training to support post-mortem and forensic imaging are currently offered as postgraduate programmes by some universities approved for radiography education and the SCoR works with the IAFR to develop the skills and knowledge related to this area of radiographic practice. As part of the SCoR approval process, courses are reviewed against other appropriate standards such as the Skills for Justice Skillsmark  (http://www.sfjuk.com)

The image recognition and reporting skills of radiographers means they are able to provide considered views/information on findings to assist the pathologist. Radiographers have skills in angiography that are transferrable to post-mortem imaging.

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