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BNMS President's blog - August 2025

Posted By On behalf of Sabina Dizdarevic, 23 August 2025
Updated: 22 August 2025

August Reflections: Working Together Through Challenge and Change

As August draws to a close, it’s been a month defined by teamwork, resilience, and quiet determination. With resident doctors on strike and many colleagues away on well-deserved summer breaks, departments across the UK have pulled together to ensure continuity of care, covering rotas, adapting workflows, and supporting one another through the seasonal pressures. I’m deeply grateful to all of you who stepped in, stepped up, and kept our services running smoothly.

One of the more pressing challenges this month has been the temporary shortage of technetium-99m pyrophosphate (PYP) kits. With Curium confirming a supply disruption and no UK alternative currently available, BNMS, in collaboration with the DHSC supply team, issued interim guidance to support departments through this period. Your adaptability, whether through protocol substitutions, patient communication, or governance planning, has been exemplary.

Looking ahead, I’m delighted to announce our upcoming BNMS research and educational webinars after the summer break. On Tuesday, 9th September from 6–7 p.m., Dr Richard Southworth will present new opportunities for cardiac molecular imaging in the era of total body PET. As you may recall these webinars are free to attend, recorded for later viewing, and offer 1 CPD credit in line with the Royal College of Radiologists’ CPD Scheme.

This year’s BNMS Autumn Meeting is already generating a buzz. I’ve been energised by conversations with our local organising committee, Matt, Saira and Marisa, and by the enthusiasm surrounding the programme and poster presentations. The meeting promises to be a celebration of innovation and the evolving landscape of nuclear medicine, with a rich programme spanning both diagnostic and therapeutic advances. Whether you’re presenting, attending, or supporting, your contribution matters.

Internationally, our collaborations continue to grow. I’ve been in touch with colleagues from SNMMI and EANM around and the potential for joint initiatives. These dialogues remind me how interconnected our field truly is, and how much we gain from listening across borders.

On a personal note, August has been a month of quiet resilience. Like many of you, I’ve been balancing professional with family responsibilities and personal grief. This month, I experienced one of the most difficult moments any pet owner can face: seeing the CT scan of my beloved cat, Simba, and hearing the diagnosis, aggressive nasal lymphoma. It was heart breaking. Thank you to those who’ve reached out with compassion and encouragement. It means more than you know.

But in that moment of grief, I was also reminded of the extraordinary things medicine can do. The precision of diagnostics, the compassion of oncology, and the tailored treatment plans available today, all of it speaks to how far we’ve come.

For those of us who share our lives with animals, we know they are not just companions, they are family. Simba’s care has become a deeply emotional journey, one that mirrors the same principles we hold dear in human medicine: empathy, excellence, and hope.

Our PET scanning service has witnessed remarkable remission of disease in patients with lymphoma, whose disease burden has melted away further to their treatment. These moments are more than clinical milestones; they are triumphs of science, compassion, and perseverance. They remind us that medicine has come so far and continues to evolve with breath taking speed. We now have tools that not only diagnose with precision but offer real hope, hope for healing, for time, for one more day of life.

And sometimes, that one day is everything.

To every clinician and researcher working to improve outcomes, whether for people or pets, thank you! Your work touches lives in ways that go far beyond the scan room.
To every colleague who makes these outcomes possible: thank you!
To every patient who walks through our doors, thank you! You are the reason we keep going.

Warmest wishes,
Prof. Sabina Dizdarevic
BNMS President

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BNMS President's blog - July 2025

Posted By On behalf of Sabina Dizdarevic, 19 July 2025
Updated: 18 July 2025

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 Pereiras 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

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BNMS President's blog - June 2025

Posted By Caroline Oxley, 28 June 2025
Updated: 23 June 2025

Embracing the Past and Future of BNMS

As I write my first blog as BNMS President, I feel honoured to have been elected to serve our nuclear medicine community. Over the next two years I am excited to embrace this role to the fullest, so together we can ensure nuclear medicine in the UK continues to thrive. I would also like to thank my predecessor, Jilly Croasdale, once again, who did such a fantastic job over the last two years.

The past year has been both professionally energising and personally profound for me. This year’s BNMS Spring Meeting in Glasgow was more than a professional milestone. It was a moment of stillness during a time of extraordinary momentum. The meeting buzzed with innovation, from the trailblazing thera(g)nostic and cutting-edge sessions to the energising radiopharmacy and physics tracks, and a vibrant RTN booth. The enthusiasm of our trainees
reminded us that the future of nuclear medicine is not only bright, but also already here.

Yet Glasgow held a quieter resonance for me, too. Scotland has always had a way of holding space for both celebration and sorrow. This year, I have attended weddings brimming with joy and promise, and funerals that reminded me of the fragility of life. Most poignantly, I lost my mother unexpectedly - a loss that reshaped my year and deepened my understanding of what it means to care.

In medicine, we often speak of outcomes, protocols, and precision. But in grief, we learn the immeasurable value of presence, kindness, and simply being. My mother’s passing reminded me that love, like medicine, is both a science and an art. It is in how we listen, how we advocate, and how we show up for one another. These values, so often unspoken, are the true heart of our profession.

I saw those values reflected in our community: in mentorship exchanged over coffee, pride in poster presentations, and moments of shared laughter and quiet support. The 52nd Annual Spring Meeting was a celebration of innovation and resilience. It reaffirmed that nuclear medicine in the UK is not only thriving, it is evolving with purpose.

As we look ahead to the 60th Anniversary Meeting in Manchester (20–22 April 2026), I invite you to join me in shaping a roadmap that honours our legacy while boldly stepping into the future. This milestone is more than a celebration. It is a chance to ask: What kind of society do we want to be? How do we lead in clinical excellence, research, and education, while staying rooted in empathy and equity?

In the context of this broader journey, we have had a welcome boost following the difficult months of radionuclide shortages: the resumption of HDP supply and renewed availability of the SeHCAT test are both encouraging signs of progress.

Special thanks go to our forward thinking Immediate Past President, Jilly Croasdale; UKRG Chair, Clint Waight; all the UKRG Regional Representatives; and our valued industry partners at Curium and GE Healthcare for their tireless collaboration with BNMS in streamlining and allocating HDP stock during this challenging period. This collective effort has been instrumental in sustaining patient care across the UK.

Our first stop on our journey to Manchester is the BNMS Autumn Meeting at The Oval in London, taking place on 29–30 September 2025. The programme, brilliantly shaped by local organisers, Drs Saira Reynolds, Nicola Mulholland, Matt Aldridge, and their team, promises a rich opportunity to share, learn, and connect. I look forward to reading your abstracts and hearing about your latest work.

Over the coming months, I’ll be working alongside the BNMS Council, Officers, Scientific & Education Committee, and working groups, as well as you, our members to co-create a vision for the year ahead. Whether it is advancing nuclear medicine, strengthening the workforce pipeline, or amplifying patient voices, the road to our 60th Anniversary Meeting will be paved with collaboration and care.

If you have ideas, memories, or ambitions for Manchester 2026, I would love to hear them. Whether you are a trainee with bold visions or a longstanding member with stories to share, this is our moment to shape a legacy, together. 

Thank you for your trust, your passion, and your presence. Let’s walk this journey forward side by side.

Prof Sabina Dizdarevic

BNMS President

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BNMS President's blog - April 2025

Posted By Caroline Oxley, 26 April 2025
Updated: 25 April 2025

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.

Ms Jilly Croasdale

BNMS President 

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BNMS President's blog - March 2025

Posted By On behalf of Jilly Croasdale, 26 March 2025
Updated: 25 March 2025

It’s all about patients…
Unbelievable as it seems to me, this is the second to last monthly message I will be writing as your President. I was thinking about what to write for this one and I have to bring it back to patients. 

Over the last couple of years, I have had my own experiences as a patient and as the close relative of a patient, as you know. It’s really focused my mind on what’s important and what as a patient, we should be able to expect from all the healthcare professionals we come into contact with. 

Today I’ve been a patient and it’s been a good experience. I had to have an urgent mammogram after finding a small lump in my breast. When I first went to get it checked out, I did think it was probably nothing – it was so small - but I didn’t think I should ignore it, and the nurse at my G.P surgery agreed with me. My referral said I was being investigated for suspected cancer. That’s a scary sentence! Two of my close friends have been diagnosed with cancer in the last year – it’s not something that only happens to other people. 

Happily, for me today it turned out to be nothing to worry about, but it is something that I think we are too hesitant to talk about. All women should be examining their breasts regularly and it should not be something that we are too embarrassed to talk about. I wasn’t nervous about the breast screening process – although I know some people are and I understand that. What I was anxious about was that they would find something after all. I’m quite a practical person, so it wasn’t something I dwelled on overmuch beforehand, or particularly talked to anyone else about. The only thing that was going to help was finding out one way or another. 

The Radiographers were excellent. They asked me what I would prefer to be called (you all know by now my aversion to being called ‘sweetheart’) and were friendly, reassuring and professional. I was given clear directions on where to go and what to do and didn’t end up waiting long for the mammogram or the ultrasound. It was very slick. The appointment ended up with an advanced nurse practitioner who took time to talk everything through with me. I very much felt like my concerns were taken seriously, were looked into thoroughly and that I was treated respectfully and kindly. To me, this was the NHS at its best, and I’m very glad I went. 

So, before I move on from Jilly the patient, please can I say to all you other women out there – get into the habit of examining your breasts every month so you know what is normal and can pick up any changes early. It’s one of the cancers that is more detectable and is more treatable. And men – please also check yourself regularly for any lumps and bumps – you know where I mean!

Back to Nuclear Medicine. Going back to one of my first blogs, no-one can overstate how important good communication is. Some people will be anxious about radiation. Some will struggle to understand what’s happening. Some will be nervous about simple things like parking or finding the Nuclear Medicine department. Almost all of them will be nervous about whatever has brought them to us, and we need to do everything we can not to add to that. As a Radiopharmacist, I don’t personally see the patients very often, but I do know that being kept waiting because the radiopharmaceutical isn’t available can cause anxiety, and where there are delays, it’s important to communicate well. You know yourself if you’re waiting for something and it’s late, if no-one is telling you anything, it can wind you up, or make you feel more anxious. But if someone comes to say they’re sorry you’re waiting, but that there has been a delay, and you should be seen in around 20 minutes, for example, it does help. 

We all impact the patient’s experience – either directly or indirectly. We need to make sure we get the science right. The tests or treatments we carry out need to achieve what they are meant to. I think our system of authorising exposures really helps with this – although it would help to get a bit more clinical information sometimes. Our equipment needs to do what it’s meant to. It all needs to be working to optimal state.

So, as I’ve said before, everyone in the team is important. But when you think of it, who in the Nuclear Medicine department has the most impact from the patient’s point of view on the day? It is likely to be the person who carries out their scan. Who helps them to feel at ease. The role of our Technologists and Radiographers is so important. That’s why we’ve removed any reference to the term ‘craft group’ from our website. I find the term so condescending; no-one is turning up for work as a hobby, as this term implies. That’s why if anyone talks about craft groups, I’ll ask them to use the term ‘professional groups’. We’re not here to do arts and crafts. We’re all professionals. It’s a weird and outdated term, so please let’s stop using it.

So, back to the patient. I don’t know how you feel, but whenever I am the patient, I find it a little weird being on the ‘other side’. When you’re the patient, the healthcare appointment will almost certainly be the only one of the day. It will certainly be the focus of your day. That was certainly how I felt this morning. I tried to do some work before I set off, but I just couldn’t concentrate. So, when we talk about Getting It Right First Time (GIRFT) this is not just about getting the diagnosis or treatment right first time. It’s about getting the patient experience right first and every time and that was certainly my experience today. 
Finding out how people have found their time with us is important, so going into our conference, I could think of nothing more appropriate to start the proceedings off that to hear from one of our patients. After the success of our Members’ event last year in Belfast, we are going to organising a similar event the evening before the conference kicks off. Although I’ve referred to this as a ‘Members Event’, anyone can register to go to it. It is free for members, and non-members need to be accompanied by a member. The evening will involve some food and a drink for everyone and provides a great opportunity to catch up with old friends or to make new ones before the busyness of the meeting. We will then be hearing from a lady who is currently undergoing Lu-177 Dota therapy and from her clinician. A lot of the conference will be about celebrating excellence in Nuclear Medicine, but I think it’s really important that we start with something that is outward looking. The talks won’t be long, but I for one, am always interested in listening to what a patient has to tell me about their experience of Nuclear Medicine. 

I’m really excited to see those of you who are going to be able to join me in Glasgow, my last meeting as BNMS President. I’m really excited to celebrate Nuclear Medicine and I’m really excited to learn more about how what we do helps the people who matter most. Our patients – and that sometimes includes ourselves. Until next time.

Ms Jilly Croasdale

BNMS President 

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BNMS President's blog - February 2025

Posted By Caroline Oxley, 21 February 2025
Updated: 17 February 2025

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 26th 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

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BNMS President's blog - January 2025

Posted By On behalf of Jilly Croasdale, 24 January 2025
Updated: 21 January 2025

Molecular Radiotherapy: Looking forward to a bright future 
Like some of you, I’m doing dry January (bear with me – I’ll get to MRT eventually!) and have gone on a diet after the indulgences of December - Christmas AND my birthday was not good for the waistline! But rather than being the house that fun forgot, me and my partner both feel a sense of renewed motivation - although he may disagree. The living room may even get decorated as a result. Don’t get me wrong – I will enjoy having a beer with my curry when my sister comes to visit in February (she thinks I’m too boring to visit in January, so maybe we are less fun) but I’m really enjoying the positives for now. 

I know many of us don’t like January that much, but I think it’s a bit of a misunderstood month. But although outside it’s cold and dark, I think this month presents a good opportunity to reset and refocus. 

So, what will 2025 hold for us in Nuclear Medicine? Among the many things which lie ahead, I want to focus here on MRT. See, I got there in the end!

MRT, along with the associated diagnostic imaging really does have the potential to change a lot of people’s lives and certainly could change the landscape of Nuclear Medicine in the future. As more treatments are approved for use, the demand will naturally increase and we are not ready for it. 

As you probably know by now, the UK MRT Consortium merged with the BNMS MRT Group partway through 2023 and over the last 18 months the new BNMS MRT Consortium has made definite progress. The Consortium is now fully established, with representation from all professional groups, the major centres and stakeholders such as ARSAC, IPEM and IDUG. We continue to try to engage key players, including government ministers, to lobby for equitable access to services across the OK. As part of this, I have written to the Secretary of State for Health. I am hoping that Wes Streeting can provide us with some much-needed help and support. 

We have gathered information about surveys being undertaken across the country with a view to providing a single survey to measure and track gaps in service provision. 

Clearly workforce is an important factor in any service provision, and we have made progress in developing training for clinicians which will lead the way to training for other staff groups. 

We have set up an MRT page on the BNMS website where we have signposted existing guidance which could be of use to those of you working in MRT, more recently have started to look at the information being given to patients post-therapy with a view to providing more consistency in this area. 

However, there is still much to be done and in recent weeks, I’ve started to feel we’re not being quite clear enough about what we want and need. 

I chaired a meeting at the House of Lords in December, organised by Novartis and hosted by Baroness Ritchie of Downpatrick (I was so glad when she said ‘call me Margaret!) This was a very useful meeting where I came away with a bit more clarity. MRT services are clearly more advanced in some areas than others and I feel a hub and spoke approach is the right way to go. Like the recently published Welsh strategy, government involvement and support is critical. I would like to see a central ‘hub’ providing leadership and consistency for services across the UK, but with implementation being done regionally by the people who know the local landscape. 

So, in my letter to Wes Streeting, I asked for support in establishing this hub and spoke model. I also asked for help with our infrastructure, our workforce and our Radiopharmacy supply chains. 

I am now on a train heading back to the Midlands from London, where BNMS have hosted an event at the Royal College of Radiologists to review the plan for MRT. As I said, January seems like a good time to review, reset and re-energise. 

These are the headlines: We need a new focus on lobbying, and there were some good suggestions on how we could do this more effectively. We need to consider how we communicate and how we could best ‘market’ the concept of MRT, which is easier said than done. Infrastructure and workforce remain an important factor for development of services, as does ensuring a robust and consistent supply of therapeutic radiopharmaceuticals. Certainly, data collection to foster equitable provision of services remains a high priority. 

It will probably not surprise you to hear there was a fair bit of talk about dosimetry. Not being a physicist, this isn’t something I have previously spent an awful lot of time thinking about (sorry, Physicists!) However, today was a real eye opener for me. It links so clearly, not just with health economics, but with ethical delivery of treatment. I learnt today that some patients show really good tumour uptake after their first treatment, but that the second may be significantly less, with sometimes hardly any by the third treatment. People are individuals and will often respond differently. When you hear of patients re-mortgaging their house to pay for a course of treatments, surely, we need to be absolutely sure they are benefitting from all the doses being given to them? The same goes if they are having a treatment funded by the NHS. I’m sure we all want the money we pay in taxes to be used as effectively as possible. So, we need to make sure that when research shows dosimetry is necessary, that it happens. I think we need to re-write the narrative. It shouldn’t be about limiting access; rather it is about focusing access to the people who need it. For that to happen, dosimetry needs to be included in patient pathways where appropriate and properly resourced.  

To bring this back to our patients - please have a look at our patient stories on the MRT Consortium section of the BNMS website.  These are very powerful and really help focus the mind on what we were trying to achieve. We need more of them to help us lobby for services in the future, so if you know of anyone who could talk to us, please e-mail our patient representative, Adrian Hardy, at apaulhardy@aol.com

I am travelling home now with a renewed enthusiasm. For me, the January MRT reset has worked. There is real potential here to make a difference to people. And we need just a little help. Oh, and a few million, but what’s that between friends? 

If you feel you can help us achieve our goals for MRT, please get in touch. Until next time.  

Ms Jilly Croasdale

BNMS President

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BNMS President's blog - December 2024

Posted By Caroline Oxley, 20 December 2024
Updated: 18 December 2024

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

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BNMS President's blog - November 2024

Posted By Caroline Oxley, 29 November 2024
Updated: 22 November 2024

Can we build more resilience into our Nuclear Medicine services?

What a difference a day makes. Who would have predicted that, as I wrote my last blog on the train out of Norwich that, less than 24 hours later, I would get the news that the reactors which supply Curium would be offline for a period of around 4 weeks. My first response was that I wasn’t overly worried. I’ve been a Radiopharmacist for three decades, and during that time I have seen my fair share of shortages – one in particular back in 2009 when the Chalk River reactor in Canada was out of action was much longer than this one and each time, I’d managed to keep my service going.

However, this time was different and this was in the main because of the significant gap that there now is market share between the generator suppliers. Another factor was that those GE generators which remained were not evenly spread across the country, with quite a few in areas such as Yorkshire and the Northeast, a few down in Devon and Exeter, but none at all in many other areas. If you read the letters I wrote through the shortage, you will already know that this meant no generators going into Scotland, Northern Ireland, Central London, the South Coast and South Wales at all and not a lot in great swathes of the rest of the country.

So, the lack of Curium generators, even for a short time had the potential to cause a real problem for patients in many areas of the country.

What followed was unprecedented. This was because, instead of it being a first come first served situation, where some Nuclear Medicines got supply and others had none, we worked together to put in place a plan for Mutual Aid to try and make sure everyone had access to something for their most urgent patients.

I was completely bowled over by the response of you all. Our Nuclear Medicine community really pulled together to put our patients first. I am very very grateful to everyone who shared their generator activity and postponed their non-urgent patients, even though they actually had a generator delivery. Thank you.

In the end, Curium were able to sweat the Safari reactor and managed to secure some extra supplies. The Maria reactor came back online a little earlier than planned and the HFR reactor repair was completed not long afterward. This all helped a lot. However, do not be deceived, the Mutual Aid arrangements we put in place made a huge difference. We didn’t end up seeing increased waiting times for those more urgently needed tests and surgeries and that means the plans worked.

Going forward, it’s important to consider what we can learn from this. These are my thoughts.

Clearly, the schedule of reactor maintenance and how repairs are handled need to be looked at to reduce vulnerabilities. This is outside of our control, but I know that the companies involved are looking at this and the schedule for next year is better.

In terms of the things we can control, perhaps we could work better as regions and have a more resilient procurement strategy. How this can be funded is to be discussed, but we could make sure that in each region there are some generators from each of the two suppliers. This is certainly what I did in the West Midlands after the 2009 Chalk River problem. I ran a big unit and had 2 generator deliveries a week, so although it cost a little more to use two difference suppliers, it wasn’t significant and essentially, I badged this the cost of having a resilient service. Clearly this is more difficult for smaller units who only have one delivery a week, but it could work on a regional level if we are all working together. This is something that is being looked at in Scotland, whereby one Radiopharmacy will use both suppliers, and the others could then contribute to any increased costs.

The Mutual Aid arrangements enabled us to prioritise more clinically urgent patients with all Nuclear Medicine departments postponing their non-urgent patients, regardless of whether they had a GE generator supply themselves. This was mandated through the National Patient Safety Alert put out by NHS England. I think this gives us a model to work to in the future which is better for our patients.

It could also work if we see problems with supply because of more domestic problems, such as we had last year when two large Radiopharmacies were closed at the same time. Although we cannot mandate the Mutual Aid on a regional level without the Patient Safety Alert, maybe we could agree a regional contingency plan between ourselves which all Trusts sign up to.

Another important consideration is the possibility of the UK having its own reactor for medical isotopes. You will probably have heard of the Arthur project, as we have had updates on this at our conference. A domestic supply of Molybdenum would help, although there are considerations, as the Molybdenum needs to be processed and generators made. We would also need to work with our neighbours to support the supply chain. We may live on an Island, but no-one is an Island (as they say).

Resilience is not just about how to respond to emergencies or about procurement strategies. It is about ensuring we have properly resourced services. I don’t think we do at the moment. Many of our Radiopharmacies are ageing or have other problems with their infrastructure. Our workforce in Radiopharmacy and in Nuclear Medicine is vulnerable. It is hard to recruit to our specialist areas, and lack of staff means lack of capacity. We need investment in our greatest asset – our people and this doesn’t just need money (although it does need money), it needs a plan.

All of this is much bigger than one blog. But if after reading this, you decide to look into having a regional contingency plan, then we will have taken the first steps to better resilience and have a think about that plan – let me know if you have any ideas which could help. Until next time.

Ms Jilly Croasdale

BNMS President

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BNMS President's blog - October 2024

Posted By On behalf of Jilly Croasdale, 24 October 2024
Updated: 16 October 2024
Jilly Croasdale

Norwich – well worth the trip!

I’m writing this blog sitting on a train in Norwich train station, having just attended the BNMS Autumn Meeting. I’ve never been here before – it’s quite a long way from the Midlands, where I live and work. However, one of the nice things about the Autumn meetings is that it offers the opportunity to visit somewhere new, and I’m so glad I’ve had this chance to visit. Before I tell you about the fantastic meeting we’ve just had, I’d like to pass on a few facts about Norwich which I found interesting. Firstly, back in medieval times, Norwich was actually the second biggest city in the country, second only to London. Immigrants came from all over the place to work in the city’s wool and weaving industries. And it still remains the only English city to be located in a national park – for those of you who haven’t been, the Norfolk Broads is designated an Area of Outstanding Beauty. 125 miles of navigable lock-free waterways wind their way through beautiful countryside and pretty towns and villages. It’s also mentioned in David Bowie’s ‘Life on Mars’, just FYI. And who can resist anything with a link to him? (not me!)

Other claims to fame – Norwich was the first town to have a pedestrianised street (this happened back in July 1967) and was the first place to have postcodes. Another interesting fact for some may be that Norwich at one time had a pub for every day of the year x (almost) 2, so you could literally go to a different one every night for quite a long time, if you so wished. However, many were closed in the 1960s, which saw King Street go from a staggering 58 pubs to just one. This pub remains today – aptly called the Last Pub Standing.

Famous people from Norwich include Alan Partridge (OK, he’s not a real person, but bear with me), Jeremiah James Colman (better known for making a famous brand of mustard), and who can forget the great Delia Smith whose now famous half time  ‘Let’s be havin’ you’ speech in the 2005 Premier League clash against Manchester City surely had them quaking in their boots, and at the very least helped put Norwich football club on the map (although another interesting Norwich fact - Norwich FC has the oldest football song, written in 1890) . But in my book, her recipes probably outshine the football – especially the Christmas ones!

Anyway, back to the BNMS. Our meeting was held at the beautiful Norwich Assembly Rooms and was jointly organised by Cambridge and Norfolk and Norwich University Hospitals. The venue is one of the most glorious examples of Georgian assembly rooms architecture in the country. It is a grade 1 listed building, originally the site of a 13th century hospital and secular college and church for priests. In 1544 the college closed when Henry VIII ran rampage through the country’s monasteries and the building were subsequently surrendered to the crown. Following that, much demolishing took place (he was a destructive lad, was Henry), but eventually the house was renovated and converted to ultimately become the Assembly House we were lucky enough to spend today in.

As we have started to do in recent years, we held a welcome event the evening before the meeting. This is something I really like – it is just so nice to have that little bit of extra time to spend with people who you may not have seen for a while as well as to meet new people. It also helps if you are travelling a bit further. We had a couple of speakers before dinner on a subject close to my heart – sustainability. Erika Denton, who I’m sure many of you will know of, gave an excellent talk in her capacity as National Medical Director for Transformation at NHS England and lead for The Greener NHS. She was followed by Gerry Lowe, of East and North Hertfordshire and Mark Cracknell of the Paul Strickland Scanner Centre, who gave a thought provoking talk about the carbon footprint of PET. All highlighted travel as the biggest contributor to the size of our carbon footprint, not surprisingly, but it was also interesting to hear the part played by our equipment, including when it is idle. It’s definitely worth checking whether your piece of kit needs to be on all the time - it’s not always the case. As someone working in Radiopharmacy, I do find the number of single use items a cause of concern. Of course, many things must be single use, but not everything needs to be. There are a lot of unseen factors – often upstream - which influence our overall carbon footprint.

That was followed by a lovely meal and even nicer company. Not a bad way to spend a Monday evening.

The next day was the meeting proper and there really was a great varied menu to choose from. For our first Plenary session, we had what can only be described as a stunning talk from an esteemed Professor of Medical Oncology at the University of Groningen in the Netherlands, Elisabeth De Vries. Elisabeth spoke about the role that molecular imaging can play in supporting drug development and patient selection for cancer medicines. One of the slides in particular was very thought provoking – it was around breast cancers which may not be visualised using the usual imaging routes, but which can be seen with some types of PET imaging (non FDG).

As many of you will be aware, a subject close to my heart is dementia and we had a wonderful talk about PET amyloid imaging in Alzheimer’s. This highlighted how key early diagnosis is, although currently not all treatments have approval. I know first-hand how challenging it can be to get any investigations at all for a loved one who you suspect may be developing dementia. My sister was asked what we hoped to achieve by getting a dementia diagnosis by my mum’s GP, for goodness sake. Needless to say, he didn’t remain her GP for much longer. So anything which helps people early on in their journey, especially if it leads to something which could slow down the progression of their disease is important.

Another aspect I enjoyed were the talks from healthcare professionals outside of the immediate world of Nuclear Medicine, such as the talk from a Medical Oncologist about radionuclide therapy which added another perspective to this important subject.

I never cease to be impressed by the problem-solving brains of our physicists and the talk on Pituitary Phantom and Optimisation of PET by Daniel Gillet from Cambridge was no exception. Unfortunately, this clashed with the presentation by Rita Pereira and Deborah Burgess on their Technologist-led Stress service, which is a shame as extended roles for Technologists and Radiographers is something I am a keen advocate of.  I also have to mention Busola Ade-Ojo’s talk on challenges in Radiopharmacy. As a Radiopharmacist myself, I was pleased to see this given a focus in the meeting.

Our final Plenary session was delivered by our very own John Buscombe as he took us with him on a Theranostics journey from Saul Hertz to PSMA like no-one else can. He is a great story teller, and really brought the subject to life. He ended with a slide showing photos of a number of pioneers of Theranostics. I noticed that his picture was not included (something commented on by someone else too, and why he typically brushed aside), but having worked with John many years ago, I know for a fact that many Nuclear Medicine departments and their patients across the world owe a lot to him as a supporter and advocate for Theranostics and Molecular Radiotherapy as he helped them set up their services.

So, as you can hopefully see, there was a little something for everyone and it’s been an absolutely great day. If you can, please try to join us in Glasgow for the Spring meeting from 19th – 21st May next year, or the next Autumn meeting, which will be held in London (details to be confirmed).

I have to finish by saying a few words of thanks. The local organising committees always put so much into making this a great day for all, and we owe our sincere appreciation to Clare Beadsmoore, Luigi Aloj, Ferdia Gallagher and Matthew Gray and the rest of the organising committee below for all the hard work they have put into this event.  Until next time.

Ms Jilly Croasdale

BNMS President

Organising Committee:

Norfolk and Norwich University Hospitals NHS Foundation Trust:

Clare Beadsmoore, Radiologist

Matthew Gray, Clinical Scientist

 

Cambridge University Hospitals NHs Foundation Trust:

Luigi Aloj, Physician

HK Cheow, Physician

Ferdia Gallagher, Radiologist

Daniel Gillett, Clinical Scientist

Ines Harper, Radiologist

Sarah Heard, Clinical Scientist

Helen Mason, Radiographer

Iosif Mendichovszky, Radiologist

Busola Ade-Ojo, Radiopharmacist

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