#swanseauniversityhealthboard — Public Fediverse posts

SWANSEA: Thousands of old cancer centre X-rays destroyed — but their silver is heading to the Royal Mint

Thousands of old X-ray films from Swansea’s cancer centre are being destroyed – but not before the silver they contain has been extracted and sold on to the Royal Mint in Llantrisant, where it could end up as Welsh jewellery.

Staff at the South West Wales Cancer Centre at Singleton Hospital teamed up with specialist metal extraction firm Betts to recover silver from more than 8,000 X-ray films that had passed their retention period and were due for destruction.

The process generated a rebate of more than £1,000 for the radiotherapy department.

Anna Iles, interim head of service for radiotherapy, said the films were a legacy of an older era of cancer treatment. “Historically, for radiotherapy treatment we would produce hard copy X-ray films to verify treatment,” she said. “Now it’s all done electronically.”

The films had originally been stored in the radiotherapy department at Singleton, but as the department expanded the space was needed for other uses.

They were moved to an external storage facility in Cardiff – at a cost to the health board.

When Swansea Bay University Health Board later acquired its own storage facility in Llansamlet, space became available at Singleton for the films to be brought back from Cardiff. That repatriation in itself generated a significant saving for the department.

Of the more than 16,000 X-rays held in storage, around half had passed their retention period and could be lawfully destroyed. Rather than simply disposing of them, the team identified that the films contained recoverable silver and linked up with Betts to extract it.

The process required careful sign-off before it could go ahead. “We worked closely with colleagues in information governance to get sign off that we could send the X-rays to Betts, where they extracted the silver and we then got a rebate of more than £1,000,” said Iles.

The story has an additional Welsh twist. While Betts is based in England, the firm works in partnership with the Royal Mint in Llantrisant – meaning the silver recovered from X-rays taken in Swansea could return to Wales in an entirely new form.

“Betts works in partnership with the Royal Mint, selling the recovered silver, which is then used in the creation of jewellery,” said Iles. “It is quite nice that there is the potential for the silver to come full circle back to Wales.”

The remaining 8,000 or so films that are still within their retention period will continue to be stored until they too can be lawfully destroyed – at which point the same silver extraction process is expected to be repeated.

The South West Wales Cancer Centre provides radiotherapy and oncology services for patients across the Swansea Bay University Health Board area and beyond. It is based at Singleton Hospital on the edge of Swansea Bay.

Swansea Bay University Health Board says the project demonstrates how clinical teams can find creative and sustainable ways to generate savings and reduce waste – while also ensuring sensitive patient information is securely destroyed in the process.

Smaller is better when it comes to affairs of heart monitoring 

Recent advances in technology have enabled devices – designed to monitor a patient’s heart rhythm – to become so small they can now be injected under the skin by a specialist cardiac physiologist.

The tiny and thin monitor, which is less than two inches long, is implanted using a syringe.

The benefits are plentiful to patients and the NHS alike.

The procedure is performed in an outpatient setting, so operating theatres and physicians are freed up to carry out more complex procedures. This not only reduces costs, but frees up beds, as patients no longer need to be admitted.

The time from referral to procedure has significantly reduced as a result of this service, which allows quicker diagnosis to treatment times – now down to between two to three weeks instead of almost 60 weeks. The service treats around 130 patients a year.

The follow-up of these implantable cardiac monitors is done from the comfort of the patient’s home. Once the implantable monitor is in place, the patient is given another monitor which is plugged in at home.

This communicates with the implanted device when the patient is near it, and readings are then transmitted to the team of cardiac physiologists at Morriston Hospital. 

Consultant cardiologist Dewi Thomas is responsible for the exciting development having trained the Morriston Hospital based physiology led clinics team.

Dr Thomas said:

“This technology provides the best form of continuous heart rhythm monitoring that we have, and automatically alerts us to any episodes of heart rhythm disturbance.

“In recent years, has been improved and miniaturised to the extent where this devise can now be injected under the skin rather than requiring a small operation in one of our theatres.

“By virtue of this, we’ve been able to move the implant procedure into an outpatient setting where it’s now performed by Aled, our senior physiologist.

“This has a number of potential advantages. It has massively speeded up the time that patients have to wait for one of these – previously, patients were booked 6 monthly appointments for monitor checks while now, they are all home monitored so any arrhythmias are seen within 24 hours.”

Dr Thomas said the device – known as an ILR or implantable loop recorder – detects arrhythmias, or disturbance of heart rhythm, which can result in collapse, stroke, and dangerous heart rhythm disturbances that can place people at risk of sudden cardiac death. 

He added: “The innovative practice is not so much putting this device in – it’s the way that we have built a physiologist led service around that.”

Aled Phillips, senior cardiac physiologist, said Dr Thomas had been instrumental in enabling Swansea Bay University Health Board become one of the first in Wales to adopt this approach.

He said: “Dr Thomas’s guidance, training and ongoing support has enabled us to successfully implement this service in Swansea Bay UHB.

“It’s an advanced procedure for our profession, it’s not something that’s routinely done by cardiac physiologists – it’s usually done by physicians. 

“It’s an injectable monitor. It is delivered using a “syringe-like” system, the implantable monitor sits under the skin layer over the heart. 

“The device itself is around 45mm long and 5mm wide and 3mm thick – which is a third of the size its predecessor.

“It’s something extra that we can do to help with waiting times, costs and patient safety/outcomes”.

“This service has reduced footfall in the hospital as the follow-up for this device is done from the patient’s home via a home monitoring device, which means that patients no longer need to attend the hospital for routine appointments”.

Aled also echoed Dr Thomas’s view that the development in technology benefitted all.

He said: “It allows physicians to carryout complex procedures in the catheter lab and displaces this minor procedure to an outpatient setting which increases compliance and is less daunting for the patient.”

[Lead image: Swansea Bay University Health Board]

#cardiology #SwanseaUniversityHealthBoard