Intermediate Care

Allows rule-out x-rays to be performed in the patient’s own home (including care homes), avoiding unnecessary conveyance and enabling wraparound care from our Hospital at Home/Virtual Ward and Acute GP services.

 

HOW DOES IT WORK?

• If you’re triaging a patient in whom imaging would meaningfully steer management  (eg ruling out an unlikely fracture after a fall), call the XRC radiographer directly.

• If imaging is indicated, proceed with a radiology request on Maxims (or ICE if you're a GP referring).

• Refer the patient to Virtual Ward/Hospital @ Home

  • For Acute GPs: via the Adastra email output (from Current Consultation tab, click ‘Actions’ at the top of the screen, Email case Report, cft.nhsathome@nhs.net)

  • For GPs: via cft.nhsathome@nhs.net

• The x-ray car will attend the patient, upload images remotely, and results will be hot-reported to guide onward care.

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Exclusion criteria

• Clinical factors (such as shortening and rotation of leg in ?NOF fracture) can inform likelihood making something not 'rule-out', and so not for X-ray car.

• Patients referred aged 50 and under who are normally fit and well will not be imaged portably. These patients have different patterns of injury to the frail/elderly and missing an injury in this age group may have significant long-term effects. Advise the requester to revert to the normal clinical pathway without the X-ray car for these patients. 

• Pelvis X-rays in obese patients: The portable unit has a low dose output and cannot penetrate a depth of more than 30cm. Manual handling considerations.

• Spinal x-rays

• Abdominal x-rays

• Face/Skull x-rays

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KEY THINGS TO KNOW:

• Operational Monday–Friday, 8am–5pm

• Only for patients where hospital imaging would otherwise be required, and it will change clinical management

• Frailty and functional risk are key – not just fracture suspicion

• Covers the RCHT footprint (unfortunately not Derriford-facing patients at this time)

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CONTACTS:

If you're an HCP below, recruiting the X-ray car is via the Acute GP Service:

• Urgent Community Response (UCR) teams 

• South-West Ambulance Service Foundation Trust (SWASFT) – via 999 

• Community Clinicians via 111 

• CHSS. 

• Hospital At Home Clinicians  

• Right Care Car 

• Falls Car 

• District Nurses 

• SPOA

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If you're a GP or RCH Consultant, call the XRC radiographer directly on 07770 745828

 

NB. This is not a referral service – it’s a diagnostic tool to support a clinical plan.