NHS Western Isles (which is part of NHS Scotland) has collaborated with long-standing partner, Canon Medical Systems UK, to help ‘reduce the need for travel’ under the ‘Sustainable Travel’ initiative – one of five main drivers in NHS Scotland’s net-zero ambitions, as set out in the Climate Emergency and Sustainability Strategy (2022-2026).
Based in Stornoway, Western Isles Hospital is the largest of three hospitals operated by NHS Western Isles across the Outer Hebrides, the remote island chain off the northwest coast of Scotland. Serving a population of 26,640, it is also home to the only Computed Tomography (CT) scanner on the isles.
As well as cutting CO2 emissions by reducing unnecessary travel, the introduction of a pioneering and multi-award-winning cardiac CT service to Western Isles Hospital has brought healthcare closer to the community, reducing the need for patient referrals to the mainland.
Western Isles’ CT team has undertaken around 320 cardiac examinations since 2019 and seen a 100% reduction in the need to send patients elsewhere to be scanned. In addition, remote access servicing to the CT system via Canon Medical’s InnerVision has further reduced the need for travel and optimised workflow efficiency. Between January 2019 and March 2024, there were 10 separate interventions via InnerVision, saving an engineer from having to visit the site.
In 2018, NHS Western Isles replaced their previous CT system, the 10-year-old Aquilion 64, with the Aquilion Prime SP, using this as an opportunity to launch a radiographer-led cardiac CT service. “Retaining a full-time radiologist has always been problematic. Currently, there are no radiologists or cardiologists on the isles. This places greater responsibility on our team of radiographers and, in 2018, this called for a pioneering approach to service delivery,” explained Jane MacDonald, Radiology Manager at Western Isles Hospital.
The Aquilion Prime SP includes fluoroscopy (Advanced Image Processing) and cardiac packaging, whilst also utilising Vitrea Advanced Visualisation, a platform that provides clinical workflows to boost productivity and efficiency. Offering faster patient throughput, robust cardiac scanning, and enhanced diagnostic capabilities, the CT system enabled Western Isles Hospital to offer a cardiac CT service for certain patients, such as those suffering from stable angina, for the first time. Since then, the department has been able to scan more patients efficiently and closer to home without having a radiologist or cardiologist present.
Jane commented, “Working closely with our partner of 16 years, Canon Medical, we were able to use the replacement of the CT system as an opportunity to launch our radiographer-led cardiac CT service. By providing diagnostics locally, without the need for a radiologist or a cardiologist on site, we’re addressing environmental and sustainability goals by reducing unnecessary travel, as well as radically improving the patient experience.”
The success of the initiative has been such that NHS Western Isles cardiac CT radiographers were given three awards by the Society of Radiographers: Scottish Team of the Year 2023, UK Team of the Year, and Patient Choice Award for Exceptional Care in November 2023.
Canon Medical’s Applications Team has been supporting NHS Western Isles via remote connectivity to the CT system. Through remote access, InnerVision increases productivity by catching problems before they affect imaging performance. This streamlines the identification, diagnosis, and resolution of system issues. Additionally, remote servicing minimises the necessity for engineers to travel to and from the rural and remote isles, further optimising workflow efficiency.
Jane continued: “Canon Medical’s customer service is second to none. They gave us vital application support when we launched the cardiac CT service in 2018, providing off-site training for radiographers, who would ordinarily work closely with specialists, and onsite support for the first cardiac patients.
"They also installed a mobile CT in our car park to ensure continuity of service to patients as we transitioned from an Aquilion 64 to an Aquilion Prime SP. We’ve found that having remote engineers makes such a difference to how quickly we can manage a query or fault on the system – another important factor for a remote and rural team with only one CT system at our disposal.”
In addition to the Aquilion Prime SP, Western Isles Hospital has also installed Canon Medical’s Aplio i700 and Aplio i600 ultrasound systems in Stornoway, further aiding diagnostics for the local community. The new systems enable high-quality images to be captured, enhancing confidence and accuracy during interventional procedures.
The addition of Shear Wave Elastography, for example, calculates the elasticity of tissues and provides a dynamic visual display to evaluate and monitor liver stiffness. The highly reliable and reproducible tool provides fully integrated measurement and reporting for seamless integration which helps improve workflow.
Laura McGibbon, Ultrasound Applications Specialist at Canon Medical Systems commented, “The installation of both systems offers the hospital the ability to deliver more complex interventional procedures in-house, whilst providing the diagnostic confidence and clarification needed and increasing patient throughput.
"Traditionally, the islanders had to be flown to Raigmore Hospital in Inverness for a non-invasive test but the utilisation of shear wave technology means the team can now offer this on the island with the support of Hepatology in Inverness. We’re pleased to see that the installation of the equipment has helped to reduce carbon footprint by further reducing unnecessary travel for patients.”
