February has been cold. Most of the country has been in the grip of storm Darcey. Temperatures have fallen to -23 centigrade in some parts of the UK. Walking to work I have found a surgical mask is an excellent way to keep your nose warm. It is much easier to use than a scarf and can be used if you are walking or cycling. The best thing is everyone thinks you are just being a good citizen and that I am wearing the mask to protect my fellow citizens. Of course, this is just how I appear and our perception of appearances can change. Just a year ago a woman wearing a face mask would be considered a likely terrorist by many, now such a woman would be considered a good example for all to follow.

12 years ago there was a general view that hybrid imaging would be a threat to nuclear medicine physicians and there was a shift in training to ensure the nuclear medicine physician of the future would be equipped to work in the department of the future. The appearance was that training was now right for the nuclear medicine practice as it would evolve in the 21^st century. However, the rise of theragnostics have shown that we need to look again at how we train doctors in nuclear medicine as they will need to both scan and treat patients with radionuclides. So on the outside nuclear medicine clinicians would appear to be like other imaging consultants. Theragnostics mean they will need to attend MDTs, out-patients clinics and treat patients. Also, as theragnostics expand some radionuclide radiologists might like to dust off their old clinical skills and treat patients as well. The profession will have to work through has this can be achieved.

I try not to mention the “B” word again but that thorny topic of Brexit just will not go away. If you live in Northern Ireland you can get hold of any drug used in Europe as long as its imported via the Republic and not the UK. Of course, food is another matter. I am sure someone will have the bright idea of saying the Irish are good at growing potatoes. Well that worked out well last time! We are starting to get reports of delayed deliveries of some therapeutic radiopharmaceuticals and mysterious extra charges for delivery. In England the Department of Health and Social Care seems to have gone for the radio-silence approach. Those civil servants who were keen to talk to us in December all seemed to have switched off their email accounts. Very frustrating.

Clearly, the DHSC has been working on the new white paper on delivery of integrated Health and Social Care. Those of us who are old enough to get a COVID vaccination remember this was how it was before Kenneth Clark’s great ideas in the NHS reforms of 1987. This brings up the old joke “What is the definition of an NHS reform? Answer: The longest distance between point A and point A” Though the white paper does not mention extending registration to health professionals such as nuclear medicine technologists there are vague concepts about safety and accountability (in fact the white paper is just vague terms) so we will have to wait for the actual bill to be published in a couple of months to see what is proposed. Then it will be action stations for all of us.

Keep warm and keep safe.

Dr John Buscombe

BNMS President