A Survey of Current Practice in Out of Hours Percutaneous Nephrostomy Insertion in the United Kingdom

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AIM: To establish the current out of hours service provided in the United Kingdom for nephrostomy insertion. MATERIALS AND METHODS: Using the Royal College of Radiologists' (RCR) database a questionnaire was sent to all the current clinical directors. RESULTS: Questionnaires were sent to 246 hospitals, with replies received from 178 (72.3%). The number of consultants doing nephrostomies as part of their routine work was 476; this increased to 625 including those who perform nephrostomies out of hours. Therefore 24% of consultants only perform nephrostomies out of hours. For the times when there was no formal out of hours nephrostomy service, the arrangements varied and included calling a consultant who was not on call (52%), or transferring the patient (37%). Only 19 hospitals (11%) had a separate interventional on call rota, the majority of these being teaching hospitals (68%). The availability of assistance was limited, with nursing staff available only 43% of the time. In institutions with specialist registrars, the registrars were involved with the nephrostomies 75% of the time. CONCLUSIONS: There is a wide variation in the out of hours service provided by radiology departments for nephrostomy insertion. A large percentage of out of hours nephrostomies are done by consultants who do not perform do the procedure as part of their routine clinical practice, which is contrary to the advice of the Royal College of Radiologists for out of hours working. In addition the provision of nursing assistance for the procedure is inadequate. Riddell A. M. and Charig M. J. (2002). Clinical Radiology57, 1067–1069.