It has been a frustrating 2 months for anyone trying to run any of the phase 1 PET services. There have been multiple production issues with the one company who supplies FDG under the contract. I know it will never happen but it would be good if a senior manager from that company could talk to one of our patients who is not well, has to travel a significant distance and finds fasting difficult after his PET was cancelled 3 times. I think as doctors we find it difficult to explain to non-medical commercial people the various ways the actions (or non-actions) of their company causes distress and suffering. Our medical director was forced to issue a letter stating only the most urgent patients such as lymphoma review and those needing FDG for immediate surgery should be referred. However the real blame lies with NHS England in the way they set up the contract and run it without having an understanding of production resilience and contingency planning. Finally giving 45% of the UK provision in a monopoly to a simple company was always going to end badly. At least the government has learnt some lessons and not awarded any post Brexit ferry deals to companies with no ferries using ports too small for current ferries.

A different tack, after 35 years’ service in the NHS I have entered the world of being a patient. I now know what it is like to wait 4 weeks for a 10 minute GP referral. Then you head off with your signed bit of paper to Boots, everyone waits 15 minutes though that can be an 8 minute, 15 minutes (yippee) or a foot hurting 40 minutes, 15 minutes. It is a good thing I am semi-retired there would be no way I could do all this waiting if I actually had a job or a life. Now I am waiting for the hospital appointment letter day after day I get bills but no letter. Surely in the days of email and texts for most patients this could be done more efficiently but then we could not be called patients anymore because we would not have to spend endless hours waiting.

The other message is, if a patient or carer comes to nuclear medicine and is a bit grumpy, they have probably had real problems getting to you through this convoluted referral system.  Remember the old adage of nuclear medicine, Be nice. Be kind.

See you all in a few weeks in Oxford

Dr John Buscombe

BNMS President

I am writing this here in a very hot Germany, the nuclear medicine community is meeting at the EANM congress. The meeting has been a huge success over 6000 attendees but in other ways it has become very impersonal the rooms can be so large you can often feel lost. Especially in a very good session on radiopharmaceutical development and authorisation there were 100 of us and 5900 empty chairs which was sad as it was a very good session.

My main problem is the conference centre is just vast it may take 20 minutes to get between two different rooms. There was a very good exhibition where you could look at mock ups of very expensive looking PET/CTs and PET/MRs all seemed to be bathed in blue light. I am not sure they will have blue light in reality, though one manufacturer will let you have mood lighting. Of course the highlight of the exhibition was the BNMS stand where Charlotte Weston our CEO talked to lots of nuclear medicine staff from around the world including many really keen young nuclear medicine people.

Our celebration of European Nuclear Medicine has been tinged with sadness. The same meeting brought confirmation of the closure of the Grove centre by GE Healthcare. There are specific issues about the loss of Cr-51 EDTA and we will need to work on this over the next few months. There is a wider story. The centre was set up 78 years ago to provide thorium needed for the luminescent dials of military aircraft. Then as the Radiochemical Centre during the 1950s and 1960s the Radiochemical Centre was the great innovator in world nuclear medicine. In the 1970s and 1980s it became a world leader in world nuclear medicine. It did not matter if it was the UK, Israel or Cuba nuclear medicine departments all had Amersham generators and Amertech kits. In the 1980s, under its new name Amersham, it was privatised, the first privatisation of Mrs Thatcher’s government. It continued to be the great world leader but more recently other companies seem to have taken on that leadership role. When the Grove Centre closes so will end 78 years of radionuclide production on the Amersham site. We will be 100% dependent on imported Mo-99/Tc-99m generators. We must hope our politicians do not mess up Brexit. We also must feel for those dedicated scientists and engineers whose jobs are at risk, some of whom are members of the BNMS

We must look on the bright side though so we are looking forward to seeing you all in Dublin and you can start to submit those abstracts for the Spring meeting in Oxford.

Dr John Buscombe

BNMS President

I must have a whinge more often.  At least some of the phase 2 PET procurement has been settled to the pleasure of some local providers and some not. Time will tell if this works well but always we must be aware the prime requirement is delivery of a high quality and safe service to our patients. There remain deep concerns that the phase 1 and 2 contracts stifle innovation in PET-CT. Maybe we will have to find new ways of expanding services despite these constraints. Also in July Lutathera treatments for gastro-intestinal and pancreatic neuroendocrine tumours was funded by NICE and NHS England. Again there must now be some equity in delivery with patients hopefully receiving treatment not too far from their homes. Locally in Cambridge today we did our first blueteq funded patient so after a 3 year gap we can treat again. By the way I am not claiming any credit for these 2 events but maybe if it works I should whinge about a few more items we need fixing like technologist training.

I am sure like me when you are on your holidays sitting on the beach sipping a pina colada your mind thinks about what work can I present at the BNMS. If you have something ready to go, the abstract submission for our November meeting in Dublin shared with the Irish Nuclear Medicine Association is open. If you still need to do some more work or maybe not yet started this is a good time to prepare what you will present at the Spring BNMS.  September is a better time to think about these things than the first week of January.

Can I also send a big thank you to all of those who filled in the BNMS membership survey, I know it takes time but it really helps us focus on what concerns us all as members of the BNMS. Some things we cannot fix but we will always try if we can. One example was moving the spring meeting away from a weekend as this was particularly difficult for many technologists and radiographers. Concerning the Spring meeting for those thinking of coming and joining us in Oxford we have some accommodation arranged at Worcester College 10 minutes’ walk from the venue and more affordable than a hotel. It may not be the Ritz but you can relive those glory days as a student and we hope the bar (i.e. cheap beer) will be open till late to get a great authentic  Uni feeling back again.

Dr John Buscombe

BNMS President