Recognising Royal Stoke for Their Commitment During COVID
HeartFlow would like to take a moment to recognise sites that are going
above and beyond to deliver an outstanding CT service to patients,
especially during this COVID pandemic.
We are excited and proud to recognise
Royal Stoke University Hospital for their
Outstanding CT Service!
Overview of Royal Stoke University Hospital’s Cardiac CT Service
Extensive high-volume cardiac CT service, performing around 3,000
cardiac CT scans in 2019. This number dropped to just under 2,000 CT
scans in 2020 due to reduced external referrals and reduced number of
The service has undergone significant expansion over the last few years
by taking on external referrals, most recently from Burton on Trent.
The trust caters to a population of 3 million within Staffordshire. As
one of the top three busiest Regional Trauma centres and one of the five
biggest cardiothoracic surgery centres in the UK, generates a sizeable
amount of cardiac and thoracic imaging work.
Changes to CT service due to COVID-19
Royal Stoke’s cardiac team began the coronavirus pandemic without any CT
scanning backlog. However, with the outbreak of the virus, scanning was
suspended and the team ended the first wave with a waiting list of 518
While services such as cancer treatment and 2WW imaging continued during
the first wave, Cardiac CT was not initially considered urgent. The
cardiothoracic radiologists supported by the imaging management team
highlighted the significance of the backlog and risk of potential adverse
cardiac events to patients awaiting cardiac CT given the higher mortality
for such an event compared to early cancer.
Scanning every Saturday and Sunday for two months
The team was able to start scanning again in September 2020 and to deal
with the backlog, the hospital’s team of four cardiothoracic
radiologists started undertaking weekend lists every weekend (both
Saturday and Sunday) from 13th of September. This schedule remained in
place for eight straight weeks, in addition to maximising weekday lists,
resulting in a drop of waiting list size to 44 patients by 11th of
November. Weekend Saturday-only lists were continued thereafter till
28th of November.
The team has continued to scan inpatient cardiac CT throughout the
pandemic including TAVI work and commenced routine week day outpatient
lists in September. All cardiac CTs are performed with onsite
cardiothoracic radiologist coverage.
To ensure that significant ramp up in scanning did not create a
reporting backlog, the team sought to minimise the hands-on supervision
of lists. This was achieved via the tactical use of systolic phase
imaging when heart rate was slightly higher than optimal rather than
beta block these patients.
To ensure heavier reliance on systolic phase imaging did not affect
image quality the team used the HeartFlow Analysis as a tool to
benchmark image quality. They recognized that a decrease in the image
acceptance rate for the HeartFlow Analysis would equate to suboptimal
image quality. The HeartFlow acceptance rates during the COVID recovery
remained comparable to pre-pandemic numbers which concurred with the
subjective option of reporting radiologists.
Before the second coronavirus wave hit, the team had worked their
scanning backlog down to 44 patients. There was no resultant reporting
back log with rapid turnaround of reporting facilitated by reducing
hands on supervision by radiologists. The cardiac radiographers
themselves selected the scanning protocol dependent on patient heart
rate and variability via pre scan check on table with minimal need of
beta blocking. This was particularly useful given that all four
radiology consultants involved are dual thoracic and cardiac
radiologists and the need for thoracic imaging expertise during COVID
has understandably seen a significant rise in demand.
One of the key benefits that Royal Stoke University Hospital has seen from
the HeartFlow Analysis has been the ability to minimise time spent in
hospitals. This has been invaluable throughout the pandemic, when patients
have been apprehensive about attending hospital due to infection risk.
With the HeartFlow Analysis, patients have often been able to get a
diagnosis in a single visit.
The clarity brought by HeartFlow’s technology has also allowed the Stoke
team to take a direct to intervention approach rather than bring patients
back for a diagnostic angiogram, with a significant reduction in
diagnostic angiograms for moderate coronary artery stenosis reported on CT
Royal Stoke University Hospital has gone to great efforts to ensure that
patients have been able to receive continued access to the best of cardiac
care throughout the COVID pandemic. We, at HeartFlow, are proud to be
working with them to enhance heartcare for their patients.
Dr. Samavia Raza, Consultant Cardiothoracic Radiologist at University
Hospitals of North Midlands NHS Trust, said:
“Chest imaging has been the front line of Radiology during COVID and our
CT radiographers deserve particular commendation for the work they have
done not only for COVID inpatients during the first and second waves, but
for simultaneously helping us ramp up to address massive backlogs such as
Cardiac CT post the first wave. We have continued to keep the waiting list
below 40 since mid-November with all external referrals now open.
With the HeartFlow Analysis, we can often avoid patients undergoing an
additional hospital visit and unnecessary invasive procedures to determine
a treatment plan. Given the current concerns with social distancing,
minimising unnecessary hospitals visits is now more important than ever
before. As we restore our diagnostic services to pre-COVID levels and
recover from long waiting lists, the HeartFlow Analysis has shown to be a
very useful tool in reducing the number of diagnostic tests a patient
needs, which in turn improves patient flow through the diagnostic