Autumn Forward: Strategic Focus, Clinical Preparedness and Innovation

As we step into autumn and a new academic year, the British Nuclear Medicine Society enters a season of renewed purpose. It is a time to refocus, re-energise, and recommit to the priorities that define our specialty and shape our future.

Strategic Focus

At the heart of our strategic direction are three pillars:

• Workforce sustainability: Supporting recruitment, retention, and wellbeing across nuclear medicine teams.
  

Workforce sustainability in nuclear medicine demands more than numbers. It requires a strategic, compassionate approach to recruitment, retention, and wellbeing. Supporting our teams means valuing diverse skill-mix while safeguarding service quality in an ever-evolving clinical landscape. Let’s build a workforce that’s not only sustainable but inspired.

• Equitable access to molecular imaging and therapies: Championing timely diagnostics and therapeutic pathways for all patients.

As nuclear medicine continues to evolve, so too must our clinical preparedness. BNMS continues to advocate for equitable access to diagnostics and therapies. Whether it is lobbying for wider availability of Ga-68 PET or ensuring that theragnostics are not limited to a handful of centres, we are committed to making nuclear medicine a national, not a postcode, priority. These efforts reflect our broader commitment to clinical excellence,
translational science, and proactive leadership.

• National policy influence: Ensuring nuclear medicine is embedded in strategic healthcare planning and future-facing policy.

Together with IPEM, we are advocating for statutory registration for technologists in nuclear medicine - a vital step not only for professional recognition, but for safeguarding patients and staff. This is about trust, accountability, and ensuring excellence at every level.

As we look ahead, expanding national training numbers for doctors is critical. The future of nuclear medicine demands bold investment in talent across all professional groups, visionary leadership, and a united commitment to progress.

Innovation- September spotlight

Innovation is the engine of progress in nuclear medicine. September offered a compelling glimpse into the future. This time through the lens of nuclear cardiology. This month our research BNMS webinar was calling attention to cardiac imaging. It’s like a forgotten hero of NM that deserves a comeback. Despite its historical importance, interest has waned. The suggestion to revive it using molecular techniques and total body imaging is compelling.

The recent BNMS webinar brought together leading voices in nuclear medicine to explore the evolving landscape of cardiac imaging through molecular techniques. With keynote speaker Dr Richard Southworth and expert panellists Prof Phil Blower, Dr Kshama Wechalekar and Dr Ian Armstrong, the session underscored the expanding role of radiopharmaceuticals in cardiovascular care, and the importance of interdisciplinary
collaboration in advancing diagnostic precision and patient outcomes.

Beyond the science, the webinar’s tone seems to emphasise hope and enthusiasm, which is vital for attracting new talent and driving innovation. The idea that enthusiasm can drive research forward despite staffing shortages is both hopeful and strategic. It’s not just about filling roles; it’s about inspiring people to shape the future of nuclear medicine. 

Furthermore, cutting-edge technology is essential, but it’s not cheap. “It comes with high cost” is a blunt but honest reminder. Balancing innovation with budget constraints is a real puzzle for healthcare systems.

The recent series of free research webinars, initiated by our Imminent Past President Jilly Croasdale, served as a powerful call to action-energising the future of nuclear medicine and keeping our members actively engaged.

I am thrilled to see the surge in UK-led research in radiopharmaceutical development and machine learning and AI-enhanced imaging. BNMS is exploring new ways to support early career researchers, including travel grants and mentorship schemes. If you’re working on something exciting and would like me to share this with our members, please let me know. I’d love to spotlight your work. I’m proud to serve as your president and look forward to the conversations, collaborations, and challenges ahead.

Stay tuned and save the date

As we move into a new season, there is much more to come! I am excited to announce a packed calendar of initiatives designed to inform, connect, and elevate the nuclear medicine community.

Monthly Webinar Series

Our monthly webinars will continue over the next six months, featuring insights from past presidents and leading experts. Our research/educational calendar is filling up fast. These sessions will spotlight key developments, foster collaboration, and keep our community engaged with the past, present and future of nuclear medicine and support ongoing professional education.

Clinical Standards for Emerging Therapies

With the rising use of GLP-1 receptor agonists (e.g., Ozempic, Vegovy) and dual GLP-1/GIP receptor agonists (e.g., Mounjaro) for weight loss, obesity management and diabetes, BNMS is taking proactive steps. The Professional Standards Committee (PSC) is working to issue a position statement to address their potential interference with nuclear medicine procedures. This will support clinicians in navigating scan interpretation and timing.

BNMS Autumn Meeting – Kia Oval London

Finally, as we step into a new season, the changing landscape brings fresh opportunities to reconnect, collaborate, and reimagine the future of our field. Join us at Kia Oval London on 29th–30th September for the BNMS Autumn Meeting, where professionals from across the discipline will gather to share insights, spark innovation, and shape what comes next in nuclear medicine. Let’s move forward, together.

Warmest wishes
Prof Sabina Dizdarevic
BNMS President

BNMS recent highlights: on the global stage

I hope everyone is enjoying the summer season. As I ease back into work, I’ve found myself reflecting on the past six months, a period marked by immense lows and unexpected highs, including four weddings that kept me on the move!  

Three weeks ago, I attended the beautiful wedding of Dr Guglielmo La Tore and Dr Ines Costa in Portugal, a union brought together by nuclear medicine (NM). Many of our NM colleagues joined in the celebrations. Guglielmo, a former student of mine, was the BNMS Young Investigator Prize winner and the founding force behind the BNMS Student Committee and Membership nearly a decade ago. Ines, who used to work as a NM technologist, recently completed her PhD at KCL. Together, they truly embody brilliance and kindness, my heartfelt congratulations once again! Their story is a moving reminder of how nuclear medicine can bring us together in life, love, and work. 

While there, I had the chance to catch up with many BNMS members, including a helpful chat with Marisa Botelho Cruz from the Autumn Meeting local organising committee. So here is a gentle reminder: abstract submissions are due by 4th August, so do get yours in!

BNMS at SNMMI 2025 – New Orleans  

Our multiprofessional approach and patient-centred focus were proudly represented at SNMMI through a vibrant session on Targeted Radionuclide Therapy (TRT) / Molecular Radiotherapy (MRT). Presentations included: 

• Jilly Croasdale – strategic pathways for optimising patient services 
• Jo Weekes – growth of advanced practice roles across disciplines 
• Richard Fernandez – radiation protection challenges in high-risk therapy 
• Myself – therapeutic sequencing and combined treatment in prostate cancer.

I was thrilled to learn that my presentation was recognized as the Top Story of the Meeting by SNMMI SmartBrief! This delightful news was brought to my attention by Prof. Ralph McCready and Prof. Vineet Prakash—thank you both for sharing it with me. If you’d like to read more, here’s the link to the article: 
SNMMI SmartBrief – Top Story 

A lively panel Q&A explored biomarkers, training, accreditation, regulation, and international collaboration. On terminology: while SNMMI/EANM favour ‘TRT’, NHS 
commissioning recognises ‘MRT’ - watch this space for future harmonisation efforts.

Research Recognition

• Dr John Dickson shared pilot results of the EANM/EARL standard for quantitative Lu-177 SPECT-CT imaging, paving the way for full accreditation. 
• I presented final analysis from the global multicentre REASSURE study (150 centres), eight-year patient’s outcomes for Radium-223 therapy, now the longest 
outcome study of any radiotherapeutic agent. 

Education & Global Perspectives

Luísa Roldao Pereira’s presentation on Theranostics and Advanced Practice explored how evolving technologies are reshaping not only patient care, but career pathways too, allowing technologists to work more closely with physicians to support and care for patients and actively lead therapeutic journeys. 

The World Federation of Nuclear Medicine and Biology also delivered an inspiring session, featuring President-Elect Dr Gopinath Gnanasegaran’s presentation on advancing NM education globally. 

Personal Honours & Congratulations 

• Professor Alan Perkins PhD, HonFRCP, MBE was awarded an MBE for services to clinical science — the first clinical scientist to serve as BNMS President, Alan’s 
impact continues to shape our field. 
• Earlier this year, Professor Jamshed Bomanji received an OBE for his outstanding contributions to global NM and the NHS. Two distinguished honours in one year — 
how proud we are of our BNMS community! 

As we approach the BNMS 60th Anniversary, I’m so grateful to all who have shared ideas and energy — here’s to continuing our historic journey and forging a bright, united future together. 

Warmest wishes

Prof Sabina Dizdarevic

BNMS President

The Last One

This is the last blog I will be writing as your President, and it seems like a good time to look back on the last 2 years to reflect on how things have gone. I certainly do feel that I’ve grown and hopefully developed personally and a lot has happened.

Being the BNMS President has been one of the best things I’ve ever done. But if you read these blogs from the beginning, you will know that at the start I didn’t feel too confident I could do it. In fact, those first couple of months I was pretty overwhelmed by the Imposter Syndrome – and wrote about it in my second blog. I felt very much that I wasn’t good enough – and found it hard not to compare myself to other Past Presidents and felt very inferior. The thought of writing a monthly blog was frankly terrifying. But in the end, it’s probably one of the things I’ve enjoyed the most. After attending that session at the SNMMI on the Imposter Syndrome, I realised that constantly comparing myself to other people was a fool’s game and in fact, I should focus on things I myself do well. 

It wasn’t always easy at first though, I have to admit, but instead of trying to emulate blogs written by other people, I focused on things I felt were important. I drew from my own experiences – something we can all do and from the things people would say to me, I certainly was not alone in any of it. 

You all shared my frustrations with poor communication and care experienced by my lovely mum and appreciated the importance of maintaining the dignity of people in our care – as evidenced when my father was not properly covered when he was in hospital at the end. You were all with me when I lost Mammy last February. Thank you so much for all the lovely messages you sent – they did help.

The experience we all went through as a family really focused my mind on how we need to support older people, particularly those who are suffering from cognitive impairment. I definitely think there is more we can do to support patients who have dementia when they come to our departments. As I said at the time, please remember the extraordinary ordinary person they were before this disease started to steal them away. My mum only developed dementia in the last couple of years of her life. For all the years before she was Barbara Hepplewhite, hard-working teacher and lovely friend to all who were lucky enough to know her and the best mum my sister and I could have wished for. We are so lucky to have had her for so long.

You also heard recently about my friend who was recently diagnosed with cancer. Again, this really makes you stop and think about what is important – both in how we care for our patients and in life generally in how we look after ourselves and support our loved ones. 

You also may know how passionate I am about us being inclusive. In all ways. We work in a caring profession and should care for all our patients without judgement. In fact, I feel we need to do more than not judge people – we should support people. You may already know my son is gay. He has many friends within the LGTBQ+ community, including some who are trans. I can proudly state here and now that I am and always will be, a trans ally. Because I care for people, and don’t like to see anyone being targeted as I feel they are. We have people coming into and indeed, working in, our departments who will identify in all sorts of different ways. Our business is not to judge them; it’s to care for and support them. End of. 

One thing which happened over the last couple of years has to be mentioned. It is something I consider to be a huge and terrible blot on the landscape of our history as a country. These were the riots that happened after the tragic and senseless murder of those poor young girls in Southport. Those families will never recover from what happened to their daughters – as a parent, the thought of it tears me up now as I write this. But what happened afterwards was by no means justified in any way. Outraged doesn’t even come close - I really hope we never see anything like that again. But as so often seems to be said at the moment, the world is changing, and we are looking ahead at uncertain times everywhere. All we can do is pull together and support each other and our patients as best we can. For now, I would just like to reiterate that Nuclear Medicine needs all of you and rather than the colour of your skin or your religion being something that makes you a target, I think it is something that makes you a special part of our wonderful, diverse, Nuclear Medicine community. 

Something that happened more recently was the Molybdenum shortage. This was a tough time for many of us, but we achieved something remarkable together. We managed to work together across the various borders within our country to redistribute the available activity so that patient appointments were prioritised according to clinical need in all areas. I know if was tough, but it was absolutely the right thing to do. I really feel it is something we should be proud of – and I do think it set a precedent for how this sort of shortage would be managed in the future. 

Going back to the Imposter Syndrome – if anything could hammer home that we all have our own strengths and should play to them, then this did it for me. It made me finally stop comparing myself to other people, because I do feel that this event was something I was well placed to deal with. But I couldn’t have done it without you getting on board with it. Thank you so much to you all. 

I’ve also been trying to think about what it means to be a BNMS member. Obviously, I love our Society and want everyone to join! But apart from cheaper conference rates, what is the benefit to you? So, we introduced our pre-conference members event, which went so well in Belfast that we are doing it again in Glasgow. We also introduced our monthly Research Webinars, which have been very popular. I hope we will continue these on other subjects – watch this space. 

We’re looking to see what we can do to act upon the things you told us were important to you through our members survey. Unsurprisingly, the biggest concerns related to workforce. Whilst BNMS can’t solve all the problems, we can definitely take the lead in looking at what can be done and trying to get some action taken. 

I will be handing the chain of office over at the end of the Glasgow conference to a more than worthy successor; Sabina Dizdarevic. Without Sabina, I would never have put my name forward to be BNMS President. It was she who first encouraged me. She is someone who is not only a bright shining star in the world of Nuclear Medicine, she is something even more special. She is a good friend, and someone who supports other women. 

If you aren’t already registered, please have a think about coming up to join me for my last conference as BNMS President – it really would be great to see you. 
So, as I finish this last blog, my hope is that you have all felt supported by me and by our Society. I hope that when times have been tough you have felt that BNMS is somewhere you can look to for leadership, help and advice. And when good things happen, I want BNMS to celebrate them with you, so please do share these things with us. 

But most of all, the thing I want most fervently to leave behind is the feeling that our Society belongs to you. To each and every one of you. It is a Society for us all. It is a Society where all professional groups are equally valued. 

It’s certainly been the Society for me, and it’s been the privilege of my life to have been lucky enough to act as your leader for the last two years. Thank you all so much for everything. I can’t finish this by saying until next time. So, I will just finish by signing off and saying as I’ve said many times before, always be kind. And thank you.

Dealing with a death in the Nuclear Medicine department

Now this may seem like a bit of a morbid subject, but I think it’s an important one.

Unlike many other departments in the hospital, it is unusual to have a patient die while they are in our care. Where I work, there was only one other case some years ago that anyone could remember – until about 18 months ago, when I was the most senior manager on site. When something doesn’t happen very often, it can make it more difficult to know what to do and in Nuclear Medicine, we have some very specific things which need to be considered.

I’ll start with what needs to be done as soon as it is clear there is a problem. Our patient was having a VQ scan, and what alerted our technologist was that they stopped seeing Krypton update on the ventilation scan, as the patient had stopped breathing. They called immediately for a doctor and CPR was commenced. This may seem like the right thing to do, but someone does needs to check whether there is a DNR (Do Not Resuscitate) order in place. If there is, then resuscitation shouldn’t be attempted. Accompanying ward staff should know this, but in this case, a student had been left with the patient who didn’t. When it was checked with the ward, it became clear in this case there was a DNR order in place for this gentleman, and resuscitation was stopped immediately. There had been a couple of instances just before this in Imaging where patients had been resuscitated despite having a DNR and this is viewed very dimly as it goes against the patient’s wishes.

If the patient’s study has started, they are likely to have been injected with radioactivity. In essence, the body is a radioactive source, so care must be taken with handling and transporting the body. In our case, the patient was a Muslim and so his family wanted to hold the burial within 2 days, as is tradition in their religion. Because his body was radioactive, it wasn’t going to be possible to transport it to the funeral home, so careful and sensitive explanation was necessary, mindful that not all members of his family spoke good English. The family agreed that they would wait until after the weekend to arrange the burial.

This happened on a Friday, so we needed to identify somewhere where the body could be kept over the weekend. By the time we were ready to move it from the Nuclear Medicine department, it was after 5pm, so most of the staff in the morgue had gone home. We had to consider proximity of the body to people working in the morgue over the weekend, so arrangements were made for it to be kept separately, to minimise exposure to staff. It is important to get your physicist to provide support for these arrangements. On the day in question, there were no senior physicists available, so I and the junior physicist in attendance decided to proceed on the cautious side.

Another thing to consider is what to do with any cannulas or lines. As these would be radioactive, they were removed and disposed of by the Nuclear Medicine staff.

As well as the practical considerations, is important to remember that this is a person, with a family. In one way, it being a Friday afternoon was advantageous, as the department was relatively quiet. This meant the man’s body could be kept in a separate room. The immediate family came to the department quickly and asked if others could join them. We agreed to this, but quickly the department filled up with a large number of relatives and they stayed quite some time. It did become a bit difficult for the staff and remaining patients. In the end, a senior nurse from the ward politely steered them away. That is something we felt unwilling to do, but the ability to do this comes with experience, so we were very grateful to the nurse for her support.

A key message here is to have good communication links with the ward and ask for their help on all things that don’t relate to the patient having received an administration of radioactivity.

The patient’s culture and religion must be respected. This patient was a Muslim, so there were traditions which the family wanted to observe, such as wrapping the body. We agreed to this, although asked that it wasn’t all carried out by the same family member, so that they weren’t individually spending too much time in close proximity.

it is important to look after everyone in the department who is involved with caring for the patient, including scanning, attempting to resuscitate and providing support to relatives. Asking if they are OK at the time and afterwards is important so they know that if they need to talk about it, then they can. Although no-one felt they needed it, counselling was offered. This is important – I was OK with it then, but if it had happened in those first few months after I lost mammy, I definitely would not have been.

Finally, this has to be logged as an incident and an investigation must be held with an independent investigator. This part of the process was quite hard. It felt like we were in some way being blamed for his death. It is important to release that this is not the case. Any death in the hospital must be taken seriously and it is important to question and learn from it. This man was very poorly and one question was whether, given those circumstances, he should have been moved to Nuclear Medicine for a scan at all. However, having been asked to scan him and believing a diagnosis would be of benefit, it was felt that that the decision made at the time was the right one with the information available.

After this happened, it made me think about what happens if a patient who has had a radioactive injection dies shortly afterwards when the radiation is still within their body. This could happen anywhere, not necessarily in the Nuclear Medicine department. So, guidance on how to manage that situation is needed. This is something we have started looking at in the BNMS UK MRT Consortium, since it is more likely to be a problem if the patient has had therapy.

I can’t apologise for the somewhat serious subject matter this month, as it is something that I think we should think about, even if it’s uncomfortable. On 26^th February it will be a year since I lost my lovely mum, and I feel it is so important that we, as Nuclear Medicine staff entrusted with the care of other people’s loved ones, look after them as well as we can – particularly if we are the people there at the end. Until next time.

Ms Jilly Croasdale

BNMS President

What is important to you – feedback on the BNMS survey (workforce!)

Thank you so much for those of you who managed to find time to fill it in our membership survey. I know from experience that completing these surveys can be a bit of a bind and with so many demands on our time, it’s not always our top priority. So it is wonderful to get so many responses.

Something that is important but not always done well is making sure those who complete surveys see some feedback or action, so I thought I’d try and give you a little bit of both.

Overwhelmingly the most challenging part of our jobs is staff, time, workload and budget. This is not a surprise, I’m sure. Many of us are keeping our services running in the face of staffing shortages, difficulty in recruiting and retaining staff. Covering sickness is also a big issue. Lack of time and competing demands causes stress and many of us feel under constant pressure to scan patients faster in the face of the staffing challenges so many of us face.

Some of us also find the challenges around ageing infrastructure and radiopharmaceutical supply problems add more pressure and poor management is a problem for some. The regulatory burden on us is high and keeping up with this can be difficult. Lack of statutory Technologist registration is another concern as is career progression and training.

This paints a pretty grim picture and I really want to try and do something about at least some of it. I wish I could wave a magic wand and improve things for us, but the issues are complex, are not unique to Nuclear Medicine and have been going on for some time. So difficult to fix and certainly not quick.

However, having read your feedback, I feel we have to try and do something. To this end, BNMS have set up a task force within our Council to look at our workforce issues and consider what we can do to help.

The issues aren’t the same for all professional groups, so the task force has representation from all of them. However, there will be some overlap, so working together is the right way to progress. For example, even if we improve the arrangements for training, we need to make sure potential trainees are aware of us. We are a small specialty and from my experience of going into schools to talk to students about careers, typically they know of very few outside of doctors, nurses, midwives (probably because they’ve watched Call the midwife) and physiotherapists. So, we need to market ourselves and get the information out to the right people. At the same time, we don’t need lots of applicants (although wouldn’t it be lovely to have too many?)

Apprenticeships have the potential to be helpful, but the funding model for these can work against us, since you often need a vacancy to fund an apprentice and when you have a vacancy, the remaining staff may not have much time to train an apprentice.

The Scientist Training Programme is great – I have certainly found this to be the case in Radiopharmacy and I’m sure this is the same for many of you. However, this course may not be suitable for all applicants. We need people who are practical and hands on to care directly for our patients and to make the radiopharmaceuticals for us to give to our patients. In both in Nuclear Medicine and Radiopharmacy we have big gaps in our Practitioner workforce.

We used to have more Nuclear Medicine nurses, but they are getting harder and harder to find. When you think of it, Nuclear Medicine hours are often very favourable for those with families (and for those without, to be honest!) as there may be no weekend working, for example. So, I’m often surprised there isn’t more interest in our positions when we advertise them. Maybe the radiation puts people off. If this is the case, we need to try to educate people. Because there are risks in many other jobs – try being a sea fisherman. It’s very risky! If you’ve ever watched those extreme sea fisherman documentaries, you’ll already know this. They carry a 1 in 500 risk apparently, compared to our 1 in 15,0000 risk with a 2mSv radiation exposure (according to a well-known physicist I know).

So what can we do about it? The BNMS Task Force are going to meet outside of Council to develop an action plan and we have made workforce a regular standing agenda item for Council to discuss and track its progress each time we meet. I will make sure we keep you updated on what we are discussing and how we are progressing. I’m not sure yet what the best way of doing this is, but I want to have something in place before I finish my term as President, so I will let you know what that is going to look like once I know. (Please remember we volunteer our time on top of our day jobs, but I can promise you we’ll do our best.)

One thing which we have been working on for some time is statutory Technologist registration and after a long time getting nowhere, we have recently seen some progress. Following a letter written by IPEM to the NHS guardian, both IPEM and BNMS are working together on this and BNMS have now prepared a paper to go to the DHSC, supported by the UK Health Security Agency. We have put together a strong argument and it feels like the time may be right to get somewhere on this finally.

The benefits in terms of professional standing and patient safety are significant. The role of the Nuclear Medicine Technologist has developed a lot, with many of you reporting, processing scans, administering therapy doses and consenting patients, for example. You should not be limited in what you can achieve and certainly should be of an equal standing to registered Radiographer colleagues doing similar roles.

However, it is not all bad news. There are many things you find rewarding about working in Nuclear Medicine. Being involved in research, making changes for the better, supporting colleagues and working within a team are all things you have said you enjoy. So, for those of you who manage other people, this is good to bear in mind. Whether it be getting more of your team involved in research or involving them in making changes to improve your service, being a part of positive things like this means a lot.

It was not a surprise to hear that much of your enjoyment of your job is related to helping our patients and providing a good service. We all come to work to help patients. It’s what we do and in our amazing Nuclear Medicine community we do it brilliantly. But another thing a lot of people mention as the most rewarding thing is how nice it is to be thanked. Taking the time to notice what other people are doing, to say thank you, and to mean it, is important.

So, in this festive edition, I’d like to finish by saying a big thank you to all of you. Thank you for all you do every day for your patients and for your colleagues. Thank you specifically from me for all you did to help with the recent Molybdenum shortage. We are all Nuclear Medicine’s biggest asset. Please remember that and be proud of what you achieve every day.

I hope those of you who celebrate it have a happy Christmas and those who don’t please enjoy a few days relaxation or time with friends and family. For me it will be bittersweet.  The first without mammy, but I am determined to enjoy some quality family time and to make the most of it with the people I care about. I hope you do the same. Until next time.

Ms Jilly Croasdale

BNMS President