March in Focus: Progress, Recognition, and the Power of Collaboration

Honouring Scientific Heritage: 126 Years Since the Birth of Frédéric Joliot Curie

On 19 March, we marked 126 years since the birth of Frédéric Joliot Curie, whose discovery of artificial radioactivity with Irène Joliot Curie in 1934 transformed the future of science and medicine.

Their work made it possible to create medical radionuclides, laying the foundations for the diagnostic tracers and targeted therapies at the heart of modern nuclear medicine. A remarkable legacy that continues to shape our field every day.

Prostate Cancer Awareness Month

March is also Prostate Cancer Awareness Month, an important opportunity to highlight the most common cancer affecting men in many countries.
It reinforces the importance of early detection, equitable access to diagnostic pathways, and the central role nuclear medicine plays in prostate cancer management, including advanced PSMA imaging and radiopharmaceutical therapies.

This month has also brought significant regulatory discussion. The new MHRA guidance risks maintaining Qualified Person (QP) oversight for many diagnostic PET radiopharmaceuticals used in clinical trials, a position that does not align with the intent of Regulation 37A, which was designed to create a more proportionate and enabling framework.

We advocate that diagnostic radiopharmaceuticals used in clinical trials should be permitted to be manufactured under Manufacturer’s Specials (MS) licences, consistent with current practice for unlicensed diagnostic radiopharmaceuticals, without the requirement for routine QP certification, while maintaining all existing regulatory safeguards.

BNMS will continue to engage constructively with MHRA and partners to ensure a regulatory environment that protects patients while enabling innovation.

Alongside this, we continue our strong advocacy for Technology Registration, a critical step in ensuring appropriate recognition, professional identity, and career pathways for our nuclear medicine technologists and radiographers.

The joint letter, signed by IPEM, BNMS, RCR, RCP and SoR, has been sent again to the relevant stakeholders to reinforce the urgency and importance of this issue.

We remain fully committed to this work. We are not giving up, and we will continue to advocate until a fair and sustainable solution is achieved.

We were delighted to celebrate Sarah Allen, awarded an Honorary Fellowship by the Academy for Healthcare Science, a well deserved recognition of her leadership and contributions to nuclear medicine and Healthcare Science.

Council Meeting: Progress and Purpose

Our March Council meeting was productive and forward looking, strengthening governance processes and refining our strategic priorities for the year ahead. I remain grateful for the thoughtful engagement of every Council member.

A Heartfelt Thank You to Jilly Croasdale

This month we also acknowledged Jilly Croasdale’s remarkable 16 years of service on Council.

From UKRG Chair, to Treasurer, to President (2023–2025), Jilly has shaped our Society with integrity, wisdom, and unwavering dedication. Her leadership of the MRT Consortium has been visionary, and her contribution to BNMS will continue to resonate for years to come.

Ian will be greatly missed on the SEC, and I have no doubt that his skills, knowledge, and enthusiasm will continue to benefit BNMS for many years to come.
Since joining the SEC in 2016 and serving as Chair/Co Chair since 2022 Ian has made an exceptional contribution. He introduced the multi-professional co chair and deputy structure, a forward thinking model that has strengthened representation, collaboration, and shared leadership across the Society. His commitment to inclusivity and professional excellence has left a lasting and meaningful legacy.

We organised an excellent webinar featuring Prof Alan Perkins, Dr Alp Notghi, and our Treasurer, Charnie Kalirai. Their contributions brought clarity, depth, and a truly multi-professional perspective to complex topics, a perfect illustration of the collaborative spirit that defines BNMS.

The session offered a rich overview of current developments in Nuclear Medicine, from innovative intraoperative probe technologies to practical and effective strategies for managing clinical incidents.

Prof Alan Perkins, the first clinical scientist, non medical BNMS President, delivered an outstanding and deeply engaging talk, “A personal journey from the first surgical gamma probes to intraoperative hybrid imaging.” He traced decades of innovation with his characteristic insight and humility.
Dr Alp Notghi, our 50th Anniversary BNMS President, brought a wealth of clinical knowledge from his 32 years as an NHS consultant, offering a compelling vision for the digital future of Nuclear Medicine and the evolution of clinical practice.

14 April 2026 at 6 p.m. — Next Live Webinar in the Past Presidents Series
This session will feature Prof Michael Maisey, Prof Richard Graham, and Dr Amy Eccles, Honorary Secretary of the BNMS.

It promises to be an exceptional event celebrating the rich history and pioneering work of Prof Michael Maisey, whose vision and determination brought clinical PET to fruition in the UK. Together with Prof Graham and Dr Eccles, we will explore the remarkable journey of PET — from its earliest conceptual foundations to its transformation into a cornerstone of modern clinical practice.

A story of scientific courage, technological ingenuity, and the people who believed in PET long before the world understood its potential.

19 April — Manchester Membership Reception

A warm opportunity to connect with colleagues, welcome new members, and celebrate our vibrant community.

20–22 April — BNMS Spring Annual Meeting, Manchester

Join us for our 60th Anniversary Celebration, a landmark gathering honouring six decades of innovation, leadership, and multi-professional excellence in UK Nuclear Medicine.

‘Carpe Diem’: ‘Seize the day’. Embrace the moment. Recognise opportunity even in challenge

February was another “flying” month. Although shorter, it was full: events, deadlines, clinical work, and the constant ‘rhythm of Nuclear Medicine’. One thing is certain, life in our field is never boring. I am finalising this blog on the train back to Brighton from London after an excellent BNMS Molecular Therapy Consortium meeting in London, finally with a moment to pause and reflect.

Molecular Radiotherapy Consortium

The MRT Consortium meeting in London was one of the highlights of the month. It brought together our multiprofessional community, NIHR, RCR, cancer charities including Prostate Cancer UK and Neuroendocrine Cancer UK, patient advocates, and industry partners, all working tirelessly to advance molecular radiotherapy in the UK. What struck me most was the shared determination to push boundaries while keeping patients at the heart of every decision. 

Over the past year, we have seen a remarkable shift in national focus. The publication of the Cancer Plan, the results of the system wide NIHR review, and the renewed emphasis on clinical research delivery all point to the same conclusion: molecular imaging and therapy must be strengthened, expanded, and properly supported. This is not a niche ambition; it is a national priority.

A System Ready for Change

The Cancer Plan sets out a vision for earlier diagnosis, equitable access, and a research active NHS. The NIHR review reinforces this direction, highlighting the need for stronger translational pathways, faster study set up times, and sustained investment in workforce and infrastructure. These themes align directly with the work of this Consortium, and they signal that the system is ready for meaningful change. This is our moment to lead with clarity and ambition.

We heard about progress in preclinical research, radiobiology, the development of novel radiopharmaceuticals and emphasis on dosimetry. These scientific advances are essential, but they must be supported by a home grown supply chain that is resilient and future proof. The fragility of current provision is well recognised, and we cannot build a world class therapy service on a foundation that remains vulnerable to disruption.

That is why BNMS continues to advocate with regulators and government for strengthened UK radiopharmaceutical production capacity, improved logistics, streamlined regulation, and a coherent national strategy that supports both diagnostics and therapy. This is not optional; it is fundamental to the future of our field.

This month we celebrated the remarkable women who have shaped our specialty. Our webinar with past female BNMS Presidents was truly special. We even witnessed the dawn in Sydney through Gill’s window, who joined us from Australia - clearly, dedication to Nuclear Medicine keeps its own clock!  

We had fantastic attendance and lively interaction with our fabulous four:
• Dr Sue Clarke: Sue was a trailblazer in every sense. As the first female President of the BNMS, she opened doors that others could walk through. Her leadership helped define the professional standards and collaborative spirit that still underpin our specialty today. 

• Dr Mary Prescott: Mary strengthened the very foundations of Nuclear Medicine in the UK. She championed training, education, and the professional identity of our specialty. Her work on curricula and workforce development shaped generations of clinicians. Her legacy is one of generosity and transformative influence.

• Dr Gillian (Gill) Vivian: Gill guided the Society through some of its most challenging years. Her presidency coincided with financial pressures and organisational uncertainty, yet she steered the BNMS with calm resolve. Her role in securing the Society’s charitable incorporation was pivotal, safeguarding its future.

• Ms Jilly Croasdale: Jilly made history as the first female scientist to lead the BNMS. Her presidency was marked by decisive action during the molybdenum 99 shortage, when she brought the community together to protect patient access. Her energy, clarity, and commitment to collaboration strengthened our multiprofessional Society at a critical moment. 

Jilly’s talk on overcoming radiopharmaceutical production challenges highlighted the power of collaboration and resilience across our community.
Their stories, reflections, and humour created a genuine time machine moment, reminding us how far we have come and how much we owe to their leadership.

In Memory of Dr Muriel Buxton Thomas

No celebration of women in BNMS leadership would be complete without honouring the late Dr Muriel Buxton Thomas. Muriel was a pioneer of exceptional calibre, a clinician of rare insight, a friend, a mentor of immense generosity, and a leader whose influence shaped the trajectory of Nuclear Medicine in the UK. We remember her with deep respect, affection, and gratitude.

A Reflection on “Carpe Diem”

When I asked Gill what advice she would give to future generations, she smiled and offered two simple words: “Carpe diem.” There was something profoundly grounding about the way she said it, not as a cliché, but as a lived truth, an invitation: ‘Seize the day’ while it is here, while it is full, while it is yours to shape.

In Nuclear Medicine, where the landscape is constantly shifting, her message felt like a reminder to be courageous and present. To act with intention. To savour moments of progress, connection, and discovery. And to remember that the future of our specialty is built one decisive, purposeful day at a time.

On the International Stage 

EANM Member Societies Council (MSC)
I attended my first online meeting as a member of MSC, led by Professor Andor Glaudemans (The Netherlands), together with European colleagues Dr Donia Piciu, Dr Ziv Bar-Sever, Agata Pietrzak, Annalee Sekulic , and Isabela Estrada. Our discussions centred on planning for the National Assembly programme as requested by EANM Board, and shaping our priorities for the year ahead. I will be delivering a talk on our fifth pillar, Collaboration, at the upcoming EANM National Assembly in Vienna on 28 March 2026. In this first year, our aim for this pillar is to analyse and strengthen links between National Delegates and National Societies. I will share further updates at our AGM in Manchester following the National Assembly meeting.

SNMMI: Continued Education Sessions
A major focus this month has been planning our educational programme for SNMMI in Los Angeles. BNMS will be organising three sessions, and I look forward to sharing more details once they receive final approval from the SNMMI Scientific Committee.

A personal highlight this month was meeting Prof Ralph McCready at the Prince Alfred Pub, the birthplace of the BNMS. We are preparing a special surprise for you all: a celebratory video that will feature in our Opening Session at 60th BNMS Anniversary in Manchester and Opening Ceremony at SNMMI in LA, along with an accompanying article for the BNMS that reflects on our past, celebrates our present, and looks ahead to the future.

New year, new beginnings

I hope you all had a lovely holiday season and were able to enjoy some well-deserved time with your families and friends, and that you’re feeling refreshed and recharged as we begin our celebratory year of 2026.

January has flown by, marked by the launch of our first Past Presidents’ Webinar. Dr David Keeling, Prof John Buscombe and Prof Sobhan Vinjamuri were all exceptional. We received wonderful feedback and it was my honour and pleasure to speak with them.

Thank you to everyone who attended. For those who were unable to join us, the recording is available free of charge to all BNMS members on our website, and it is well worth watching when you have a moment.

Dr David Keeling, one of the pioneers of our specialty and a founding member of what became the British Nuclear Medicine Society, served as BNMS President from 1994 to 1996.

Our Society was founded in 1966 in the friendly, vibrant atmosphere of the Prince Alfred Pub in London. Among those present with David were Prof Ralph McCready, Dr Steve Garnett and Dr Edward Williams, who together went on to establish the Society that would become the British Nuclear Medicine Society. 

At that time, long before ultrasound, CT or MRI, Nuclear Medicine already offered a remarkably broad range of clinical applications and operated with far fewer regulatory constraints than today. David shared fascinating stories from his training and consultancy years, when radiopharmaceuticals were made on the bench and staff could volunteer in research without a need for ethical approval.

Prof Sobhan Vinjamuri gave a talk titled “Towards High Specificity”, bringing together cutting edge hybrid imaging, advanced diagnostics and theragnostic technologies, alongside reflections on his personal journey and the innovations that have shaped our field.

Professor John Buscombe shared truly insightful stories from his experiences during the COVID pandemic and his successful career! John has been a leader on international education in nuclear medicine for decades and has become a well renowned NM physician. He delivered an inspiring talk, “Molecular Radiotherapy: To Infinity and Beyond,” highlighting the future of molecular radiotherapy and its expanding role within modern Nuclear Medicine.

I am now very much looking forward to our next event!

Female Past Presidents’ Webinar: 10th February

This webinar will explore the challenges faced by our four female past BNMS Presidents, the inspirations that shaped their leadership, and the key achievements of their terms. It will also highlight their perspectives on gender equality in medicine and the evolving role of women in our specialty.

The panel will feature our first female President and my dear consultant colleague who first guided me into the world of nuclear medicine therapy during my early consultant years at Guy’s Hospital, Dr Sue Clarke. She will be joined by two iconic nuclear medicine physicians and past Presidents, Dr Mary Prescott and Dr Gill Vivian, as well as our outstanding Immediate Past President, Ms Jilly Croasdale. Together, they will share their stories, experiences, and visions for the future of our specialty.

Jilly will also deliver a dedicated talk on the molybdenum shortages and how BNMS helped navigate this challenge, offering valuable insights into resilience, advocacy, and the power of a coordinated national response.

Radiopharmaceutical Production- towards home-grown production in the UK

A major focus this month has been on fruitful discussions with industry and academic partners on the current state of radiopharmaceutical production in the UK. We are working together to advocate for a sustainable, home grown production pathway.

From the Arthur reactor to radioactive waste recycling and emerging long life fusion reactor technologies such as the Astral system, there are many avenues to explore as we work towards securing a resilient UK radiopharmaceutical supply.

On the International Stage: EANM Member Societies Council (MSC)

I am delighted to have been nominated as a member of the newly established EANM Member Societies Council (MSC) in January 2026. The core mission of the MSC is to facilitate transparent information exchange, foster deeper engagement, and promote meaningful involvement of National Delegates and National Societies within the EANM framework. The MSC serves as an intermediary advisory body designed to enhance engagement and communication between the EANM Board, National Delegates, and National Member Societies. Its purpose is to ensure that national perspectives are heard, valued, and fully integrated into the wider European strategy for Nuclear Medicine.

Prior to this, I had the privilege of serving on the Member Societies Council Piloting Group (PG), established in May 2025. Working alongside eminent European colleagues and under the leadership of Professor Andor Glaudemans (The Netherlands), we defined the scope of the MSC, developed recommendations, and proposed strategic actions to the EANM Board. Together, we produced a comprehensive 2026–2028 roadmap, outlining clear interactions, missions, responsibilities, timelines, and expected outcomes.

‘This strengthened collaboration will support a more unified European voice in advancing Nuclear Medicine, shaping policy, and driving innovation across our specialty.’

From strength to strength- abstracts for the 60th Anniversary Annual Meeting

We are delighted to announce that we have received a record 285 abstracts for the BNMS 60th Anniversary Annual Meeting, a true testament to the strength, commitment, and creativity of our community. Thank you to everyone who submitted their work. We very much look forward to seeing you all present your outstanding research, audits, quality improvement projects, and to learning together through inspiring and educational clinical cases.

We promise this will be a truly special meeting as we celebrate 60 years of excellence in Nuclear Medicine and we look forward to welcoming you to what will be our best meeting yet.

Research Champions Network Meeting

One of the highlights of January was witnessing the remarkable progress of our Research Network and receiving updates from our Research Champions leading both single centre and multi centre projects.

We have grown into a powerful collaborative community where basic scientists, translational researchers, and clinical academics exchange ideas and are already delivering meaningful results aligned with our Research Strategy. Plans for new collaborations and upcoming grant applications are well underway.

If you are interested in joining one of the projects or sharing your own research, please contact the Chair of the Network and R&I Committee, Prof Jane Sosabowski, the Deputy Chair, Prof Vineet Prakash, or any of the Research Champions listed on our website.

Looking Ahead: Dates for Your Diary - Highlights

BNMS 60th Anniversary Celebratory Event Calendar: A series of live webinars with Past BNMS Presidents: Celebrating our Past and Present, Shaping the Future: Webinar with Female Past Presidents - 10th February 2026, 6pm

Academic–Industry Forum- online event -29th January, 2pm

MRT Consortium meeting – face to face - 26th February

Event calendar – refer to BNMS website

Prof Sabina Dizdarevic
BNMS President

What a year this has been.  

Since taking on the role of BNMS President, the journey has been dynamic and at times a roller coaster, marked by both achievements and challenges. A year marked by weddings and, sadly, funerals; by highs and lows, meaningful milestones and networking, that have kept me moving forward. So much has happened in just the past seven months.

At BNMS, we have achieved a great deal. Education and research remain the key pillars of our Society. Yet the time has come and perhaps is overdue to add advocacy alongside our educational and scientific priorities.

I therefore propose that advocacy becomes a formal aim of BNMS: ensuring that our voice is heard, our specialty is represented, and our patients benefit from the collective strength of our community. This proposal will be brought to the Officers and BNMS Council next year for consultation and approval. Many of you also highlighted this in our recent membership survey./span>

Membership Survey

Thank you to all who responded! I am delighted that you are, overall, happy with BNMS direction and achievements. Of course, there is always room for improvement, but I was encouraged to hear that you feel BNMS remains closely connected to the real‑life needs of nuclear medicine staff at all levels.

However, our multi-professional workforce continues to be our greatest challenge, while patient‑centred care remains our greatest source of pride.

During Jilly’s presidency, we made a strong case for statutory technologist registration. IPEM, SoR, and BNMS have worked together on this, but without success so far. We must not give up, and we will continue to pursue this goal.

There are also significant concerns regarding training for resident doctors. We urgently need more doctors, yet there are simply no sufficient training posts available. With resident doctors again on strike, this is a difficult situation for both current and future generations of young professionals.

You told us where we are doing well, and we will continue to build on that while striving to improve further. We have also been reminded of the need to develop a strategic plan, and the membership will be consulted on this in due course.

Education, Education, Education

December began with our CME event, the second in our series of Multidisciplinary Reporting webinars, co chaired by Mr Tristan Barnden, Advanced Clinical Practitioner from Maidstone Hospital/Tunbridge Wells Hospital at Pembury and me.

Dr Emma Owens (Eastbourne District General Hospital) and Dr David Little (Royal United Hospital, Bath, NHS FT), delivered exceptional talks, offering deep insight into the implementation of REALM in Nuclear Medicine and its value in strengthening multidisciplinary learning.

Together, we reflected on the benefits of reviewing learning events in a truly multiprofessional environment. Several interesting cases were presented, and the underlying causes of discrepancies were explored to help prevent similar issues in the future.

Molecular Radiotherapy (MRT) – A Game Changer in Cancer Treatment

One of the highlights of December was the parliamentary panel event “From Research to Reality: Scaling Innovation in Cancer Treatment,” organised and funded by Novartis in partnership with Medicines Discovery Catapult and hosted by Dr Peter Prinsley MP in the historic surroundings of the House of Commons.

Expert speakers highlighted three major breakthroughs in cancer treatment: cancer vaccines, molecular radiotherapy (MRT) and immuno oncology. They shared their perspectives on how the adoption and scale up of new cancer innovations can be accelerated.

Prof Jonathan Wadsley, our BNMS MRT Lead, Clinical Oncologist, and NIHR Specialty Lead for Cancer Radiotherapy and Imaging Research, emphasised the vital role of MRT in targeted precision cancer treatment and theranostics, engaging both attendees and parliamentarians in this important discussion.

Preparations for the BNMS Annual Celebratory 60th Anniversary Meeting

The Scientific Education Committee, led by Co chairs Dr Ian Armstrong and Dr Simon Hughes, together with our newly appointed RTN SEC Deputy Chair, Miss Hannah Chandler, is working extremely hard to prepare what promises to be our most exceptional meeting yet.

They have curated a fantastic programme of speakers, leaders in the field, both nationally and internationally, ensuring there will be something for everyone across our diverse nuclear medicine community. The full programme is expected to be published in January 2026. Please watch this space.

Regional Recognition

The importance of regional recognition was highlighted at our recent meeting with regional leads as we prepare the timeline for the BNMS 60th Anniversary celebrations. We want to hear from all regions about their milestones. Please contact the BNMS office with your regional achievements so we can complete our journey of 60 years together, including all devolved nations and showcase national progress through regional milestones.

For example, I felt extremely proud of our department this month: we delivered the first ¹⁷⁷Lu PSMA treatment in Sussex as part of the national STAMPEDE 2 trial, a true milestone for our patients and our research community.

This month has also been full of departmental celebrations: our Christmas dinner, Santa sharing presents, and plans for a lunch together on Christmas Eve. It is always wonderful to celebrate as a team. We even reviewed nearly 400 photos from previous parties, collected by our lead nurse, Ms Angela Clarke. Work with heart, party with spirit. Not a bad motto to live by.

This reminds me to invite you to upload your departmental photos at https://bubbleit.workplace.datto.com/filelink/79aef-29e01281-8eb4ad4bcc-2, so we can feature them at the BNMS Annual Meeting during our 60th Anniversary celebrations.

Congratulations

Our amazing CEO, Charlotte Weston, has celebrated her 20th anniversary of service and leadership to BNMS this year. I would like to take this opportunity to thank her for her outstanding work, her unwavering dedication, and everything she does for our community!

Looking Ahead 

Dates for Your Diary

• BNMS 60th Anniversary Celebratory Event Calendar  
  

A series of four live webinars– Celebrating our Past and Present, Shaping the Future featuring interviews with past presidents, inspiring lectures, and Q&A sessions.

• First Webinar with Past BNMS Presidents, Tuesday, 13th January 2026, 6pm  

Featuring Prof Buscombe, Prof Vinjamuri, and Dr David Keeling (one of the four BNMS founders in 1966)

• Abstract Submission Deadline: 16th January 2026  

Please submit your work and join us in Manchester to network, learn from one another, and celebrate the achievements of BNMS members across our wonderful nuclear medicine community.

Season’s Greetings

Wishing all BNMS members joy, peace, and rest during this festive season. Thank you for everything you do for our patients, colleagues, and the wider nuclear medicine community. Your dedication and commitment continue to inspire.

Merry Christmas to those celebrating, and my very best wishes for the New Year. Here’s to a happy and successful 2026!

Prof Sabina Dizdarevic
BNMS President

BNMS November Legacy 

“Concordia res parvae crescunt, discordia magnae dilabuntur”

“In unity little things flourish, in discord great things fall to pieces.” – Dr William Harvey 

Harveian Lecture at Liverpool RCP

I was fortunate to be invited to the Harveian Oration, a tradition that reminds us, that medicine flourishes through unity, respect, and the pursuit of discovery. It was inspiring to hear Professor Feehally’s reflections on nephrology’s journey. Nuclear medicine too is maturing into a discipline of global impact. 

The Harveian Oration, established in 1656 by Dr William Harvey, remains one of the most prestigious platforms in UK medicine. Harvey gifted his patrimonial estate of Burmash in Kent to the Royal College of Physicians, directing that an annual feast and Latin oration should exhort fellows to “search and study out the secrets of nature by way of experiment.” 

He urged mutual respect and collegiality. Harvey’s words remind us that collaboration sustains growth. We in the BNMS community know this well: it is not “I” who matters, but “We/Us”- the team. 

Continued Education for BNMS Members: Free monthly and on-demand webinars

Once again, our BNMS educational schedule proved to be very busy. I would like to extend my sincere thanks to our speakers, audience, and sponsors, Novartis, Siemens Healthineers, and Curium, for supporting this month’s webinars.

Multidisciplinary Reporting Webinar Series 

The Multidisciplinary Reporting webinar was a true success, sparking fruitful discussion on the importance of appropriate training, audit, and multiprofessional working. 

Excellent talks were delivered by our radiographer colleagues Mrs Sarah Stace and Miss Amy Bishop from Withybush General Hospital, and Mrs Rose Hazell-Evans from West Suffolk Hospital, highlighting both expertise and collaborative practice. 

This was the first in a new series of joint BNMS/SoR webinars, chaired by Miss Hannah Chandler (Radiographer, LNWH NHS Trust), together with me and Dr Amy Eccles as expert panel members, providing medical perspectives and insights on complex cases.

Webinar – Cardiology & Women’s Health (3rd in Series)

Free on demand for BNMS members! 

What a fabulous series this has been! Our colleague Dr Stefan Vöö and the UCLH team did an outstanding job in creating the programme, with distinguished contributions from honorary guest lecturer Prof Angela Mass (Radboud, Netherlands), Prof Michelle Williams (University of Edinburgh), and esteemed colleagues from UCLH including Dr Deena Neriman, Dr Irfan Kayani, Dr Karen Desouza, Dr Dalila Ludwic, and Dr Arjun Ghosh. The session was co-chaired by Dr Kshama Wechalekar. This third Women’s Health webinar focused on cardiovascular health in women, spotlighting major differences between men’s and women’s hearts. The speakers were impressive, delivering insightful talks that stimulated discussion and highlighted the importance of advancing women’s cardiovascular health.

Colleagues Legends 

While preparing my DXA reporting lecture for Nuclear Medicine Classics: Pitfalls, Patterns and Pearls on 28 October 2025, masterminded by Dr Gopinath Gnanasegaran and the UCLH team, I found myself reflecting on the legendary colleagues I have been fortunate to work with. 

I first learned DXA reporting and the management of patients with osteoporosis from the late Prof Fogelman during my first consultant post at Guy’s and St Thomas’ Hospital. He played a pivotal role in introducing DXA into UK clinical practice and was rightly crowned the “father of radionuclide bone imaging.” His vision and dedication left an indelible mark on our field.

It was equally inspiring to work alongside two past BNMS Presidents: Prof Maisey, who appointed me to my first academic post as Lecturer in PET at KCL and honorary consultant, and Dr Sue Clarke, the legendary first female BNMS President. Wise, supportive, and an extraordinary physician colleague, she shared with me a deep love and enthusiasm for radionuclide therapy. Their example reinforced the importance of teamwork and instilled in me the drive to strive beyond and above every single day. Progress in nuclear medicine has always been, and will always remain, a collective achievement.

Prof John Buscombe retirement 

Another colleague legend, Prof John Buscombe, also a past BNMS President, has now retired from clinical work and from his role as module lead for the MRT/Theragnostics module at the MSc/PGDip/PgCert programme. Brighton and Sussex Medical School marked his retirement last week.

We wish him a long and happy retirement, knowing he will remain active in our community. Indeed, he will feature in the very first of our Past Presidents’ webinars on 13 January 2026. 

Research Highlight – AlphaBet 

This month’s standout publication is AlphaBet, a compelling study from the Hoffman team exploring the therapeutic potential of combining the alpha emitter 223Ra with the beta emitter 177Lu radiopharmaceuticals. 

We have recognised this topic as a priority in our BNMS Research Strategy. AlphaBet reminds us of the power of translational research to reshape clinical paradigms. As we move toward more personalised and potent treatments, it exemplifies the kind of innovation that will define the next era of nuclear medicine. 

I-131 mIBG Delivered for Children’s Care 

I was delighted to learn that the Royal Hospital for Children, Glasgow received I-131 mIBG from Izotop in Hungary on schedule and without any issues, enabling timely treatment for their young patient. 

Receiving an email from Dr Michael Bradnam, thanking Charlotte, Jilly, myself, and BNMS for helping to expedite the supply of I-131 mIBG last month, truly made my day. Thank you, Michael, for finding time in your busy schedule to write to us. It meant a great deal!

Looking Ahead 

Dates for your diary: 

• Next free BNMS webinar: 2nd December 2025, 6–7 p.m. – the second in our joint SoR/BNMS webinar series, featuring Dr David Little and Dr Emma Owens on 
  Implementation of REALM in Nuclear Medicine, chaired by Mr Tristan Barnden and myself. 
  
  
• 60th Anniversary celebratory event calendar: to be published in early December, featuring exciting highlights including a special series of live webinars and pre-recorded videos with past BNMS Presidents: Celebrating our past and present, shaping the future. These sessions will reflect on key milestones, share wisdom, and inspire the next generation of nuclear medicine professionals. 

We look forward to virtually seeing you on 2nd December!

Warm Regards

Prof Sabina Dizdarevic
BNMS President

From London to Barcelona: A Month of Milestones

The last month has been an exceptionally busy and rewarding month for BNMS, one marked by connection, celebration, and strategic momentum across our nuclear medicine community.

BNMS Autumn Meeting: “Are You Okay?”: Compassion at the Heart of Innovation

Our Autumn Meeting at the Kia Oval brought together patients, multidisciplinary colleagues, and nuclear medicine professionals from across the UK for a programme rich in clinical insight and collaborative spirit. From sessions on PRRT, SIRT and paediatric MRT to discussions on Total Body PET, multi professional working, innovation in nuclear medicine and radiopharmacy, the meeting reaffirmed our commitment to compassionate care and
advancements.

I am deeply grateful to our patients, speakers, sponsors, and the King’s College Hospital team – Dr Saira Reynolds, Mrs Marisa Botelho Cruz and Mr Matt Aldridge, for curating such a thoughtful and inclusive event.

One of the most powerful takeaways came directly from our patients. Amid the science and strategy, they reminded us of something profoundly simple yet often overlooked: the importance of asking, “Are you okay?” This gentle question acknowledges the emotional landscape of illness. As nuclear medicine professionals, we must continue to pair technical and clinical excellence with emotional presence. Listening deeply and honouring the whole
person, these are the foundations of compassionate care.

EANM Barcelona: Global Vision, Local Pride

The EANM Congress in Barcelona marked 40 years of the European Association of Nuclear Medicine, welcoming a record 9,431 participants from across the globe. It was a privilege to represent BNMS and engage with international colleagues on theragnostic developments, molecular diagnostics, and the future of our field. A particular highlight was the dosimetry paper winning the prestigious Marie Curie Award, a testament to the
scientific excellence driving our community forward.

The UK’s clinical, scientific, and technological contributions were widely recognised throughout the congress. I was especially inspired by emerging work on combination therapies and newly described targets for prostate cancer, signposts of the innovation ahead.

BNMS meets international leadership: UK Nuclear Medicine Takes Centre Stage

A standout moment during EANM was meeting with international presidents of multiple national societies from all over the world. Our discussions with the Society of Nuclear Medicine and Molecular Imaging (SNMMI) President, Dr Jean-Luc Urbain and SNMMI officers have been centred on transatlantic collaboration, shared educational goals, and the evolving landscape of our speciality. It was a pleasure to exchange ideas and reaffirm our mutual commitment to advancing nuclear medicine globally.

UK Highlight Country at SNMMI 2026: Honouring Our Legacy

Looking ahead, I am thrilled to share that the UK will be the Highlight Country at SNMMI in Los Angeles, taking place 30th May to 2nd June 2026. This is a moment of immense pride and responsibility. Preparations are already underway for a celebratory segment during the opening ceremony, featuring the UK flag and showcasing our rich cultural, scientific, and clinical heritage. Adding to the excitement, we have also been invited to provide a taste of British food at our stand in the exhibition hall!

This tribute will honour the UK’s history, culture and contributions to nuclear medicine and beyond, reflecting our history while spotlighting the diversity, innovation, and humanity that define our present and future. I warmly invite any ideas from across the BNMS community, to help shape this transatlantic cultural and scientific celebration.

Strategic Dialogue and the Future of Tracers in the UK

Recent weeks have seen pivotal conversations around the introduction of new tracers in the UK- conversations that could reshape access, innovation, and clinical outcomes.

A meeting between BNMS and GE Healthcare, led by Professor Richard Underwood and Dr Kshama Wechalekar, brought together clinical leads in nuclear cardiology and cardiologists, to explore the potential rollout of ¹⁸F-Flurpiridaz for cardiac imaging. In parallel, another expert group is advancing dialogue around ¹⁸F-FET for brain tumours, underscoring the growing need for its clinical utility and broader accessibility.

These developments arrive at a critical juncture. The proposed procurement approach to procure PET-CT services to replace the current phase 1 contracts remains an important consideration for our community, sparking widespread engagement and reflecting both urgency and ongoing challenges. BNMS remains firmly committed to working with NHS England to ensure equitable access to PET-CT services for all patients. We hope NHSE will recognise nuclear medicine not only as a cornerstone of modern medicine, but as a field defined by precision, compassion, and transformative potential. The time to ensure its delivery and growth is now.

Exciting News from Wales: Advancing Access to PET-CT

On 26 September 2025, a ceremonial ground-breaking marked the start of a major extension to the Cancer Centre in Swansea, which will host the new static PET-CT scanner for South West Wales. This development led by Prof Neil Hartman and his team, represents a significant step forward in regional access to advanced imaging.

The building phase is expected to take 56 weeks, culminating in the installation of a state-of-the-art digital PET-CT scanner. The expanded centre will feature six uptake rooms, including dedicated facilities for general anaesthesia and radiotherapy planning—ensuring comprehensive, patient-centred care.

This milestone reflects the growing commitment to equitable, high-quality nuclear medicine services across the UK.

Looking Ahead to November

November is shaping up to be a vibrant month for education and collaboration, with nine upcoming events across the BNMS calendar. Be sure to visit the BNMS Event Calendar to explore what’s on - November is no longer the quiet month it used to be!

Highlights include: PET-CT Fundamentals, led by Dr Randeep Kulshrestha; AI in Nuclear Medicine and PET-CT, masterminded by Dr Daniel McGowan, BNMS Research Champion in AI; and the ever-popular Nuclear Medicine Classics: Pitfalls, Patterns and Pearls, orchestrated by Dr Gopinath Gnanasegaran. In addition, several international meetings will provide rich opportunities to learn, share, and connect with colleagues worldwide.

Especially, we are delighted to invite you to two standout BNMS webinars this November:

• 4th November 2026 at 6:00 p.m.
The first joint BNMS/SoR webinar on multi professional reporting, featuring Hannah Chandler and the SoR team - a timely dialogue on collaborative practice and shared expertise.

• 19th November 2026 at 1:00 p.m.
The 3rd Women’s Health webinar, curated by Stefan Voo and the UCL team, spotlighting innovation, equity, and excellence in women’s care.

Both sessions promise rich insights, collaborative dialogue, and practical takeaways. Please join us and help spread the word across your networks.

Warmest wishes
Prof Sabina Dizdarevic
BNMS President

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

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

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

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

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.

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 

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

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.  

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

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

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 13^th 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 19^th – 21^st 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

What do you want from your BNMS membership? 

Since becoming BNMS President, I have been giving a lot of thought to what it means to be a BNMS member. Our society belongs to all of us, and it is my sincere hope that my being President has really emphasised that for each of you, whatever your role. All our voices should be heard and every one of us is important. As you all know, I love the BNMS and have been a member for ages, but I have been thinking a lot recently about how we make it even better for everyone. There are three main areas I’d like to highlight for us to think about:
1. Representation
BNMS is a charity run by a central Council. We have three hard working salaried members of staff, who I’m sure you will agree, are a huge asset to us (and irreplaceable in my opinion). The rest of Council is then made up of a number of Trustees and co-opted members, with ratios which roughly reflect the number of members working in the different areas. By the way, I’d like to say here that I’m not keen on the term ‘craft group’ – what does that even mean? I just think we’re all members of the various different groups. So here goes: we have three medical practitioners, at least two clinical scientists, at least one radiopharmacist, at least two RTNG representatives, including one nurse, and one trainee, with the latter currently being reviewed to make sure they represent all trainees, not just medical trainees as is currently the case. 
We are all volunteers who do it because we care passionately about Nuclear Medicine generally and what BNMS represents specifically. There are a number of subgroups reporting into Council: we have a group for Radiographers, Technologists and Nurses (the RTNG Group), there is the BNMS Radiopharmaceutical Sciences Group, which is headed by a member of the UK Radiopharmacy Group committee who is able to appraise Council of matters relating to Radiopharmacy. We also have a Royal College of Radiologists radionuclide adviser, a British Nuclear Cardiology Society representative and a patient representative. More recently, we have established our Research and Molecular Radiotherapy Consortium Groups which report into the main Council. 
There is no specific doctors, radiologists or physicians, or clinical scientists Group, but this was discussed with the Council when I first took over and it was felt there was sufficient representation of and networking by those members who fall into these categories already within Council. 
So question 1: Are you happy with your representation within the BNMS Council and do you think it is effective? If not, how could it be improved? 
2. Communication and Engagement
Communication with members who fall into each of the different groups varies – there are meetings and newsletters, for example, but it would be helpful to know if you have ideas on how this could be improved upon without putting too much on people who are volunteering their time. 
Something I really want us to look at together is how we have better 2-way communication. I think the BNMS Council does pretty well with communicating outwards – the newsletter and website are pretty good - but I am concerned that Council could be perceived as ‘central government’ where I’d perhaps like to see a bit more ‘local council’. 
I hadn’t realised before I took over as President that BNMS do have regional representatives. I recently met with them, and they are all very approachable and helpful. However, many of them are quite senior with a lot on their plate. I do also suspect a degree of arm twisting may have taken place. However it happened, they are clearly doing it to help the BNMS, but most don’t have the capacity to do much more than pass communication on to local members. It was very useful to talk to them as I do feel this could potentially be another way of having better involvement with our members. 
Maybe rather than looking at local connections of the various different groups, we look at supporting local or regional Nuclear Medicine networks. This might seem ambitious, but there are already links and networks out there, albeit quite variable depending on where you are. So maybe that is something we could build on. Maybe if you would like to be more involved with BNMS, this would be a good place to start? So, if you’d like to get involved at a more regional level, then let me know. It’s just an idea at the moment which needs to be worked out, so I’d really appreciate your thoughts, ideas and most of all, help. 
So question 2: How do you think we can improve our communication, both outwards from Council and 2-way?
3. Member Benefits
This is something else I feel strongly about. What are we all getting out of being a BNMS member? The cheaper conference rates are a definite bonus, and we do get increased membership around conference season. But often our organisation pays for this, so what more can we do to benefit people individually? 
Members all get their NMC, which is great. We are looking at options for this going digital to be more environmentally friendly, but it is complex, and people will have different preferences for this. But however it is delivered, this is a benefit. But often there is someone in the department who has a spare NMC lying around, so is this enough? I’m not sure. 
The BNMS lobbies on our behalf on many things. We engaged extensively to try and minimise the impact Brexit could have had on our services. We develop useful guidance on an ongoing basis and give other specific advice as needed, for example, during Covid. We are currently working with IPEM to encourage Government to look at Technologist registration to recognise the important work being done by Technologists across the country, and the potential risks that go with it. 
That seems like quite a lot to me, but yet, could there be more? I think so. 
So more recently, we introduced a members event the evening before the start of our annual Spring conference. This was something we did for the first time this year in Belfast, and it went really well. We had a great talk by Professor Joe O’Sullivan in a really nice place called The Dark Horse Restaurant, followed by a buffet and a drink for everyone. Non members could attend, but there was a charge and they had to be accompanied by a member. I did worry that people may not want to spend their Sunday evening listening to a talk, but it was absolutely brilliant, and everyone enjoyed the chance to catch up with people before the start of the meeting proper. We are intending to do the same the evening before the start of the Glasgow conference, so please come along if you can. 
Our latest idea for member benefits came from a thought I had about putting on some free live webinars for members. These are going to take place monthly from November onwards and will cover different aspects of research. When I put the idea out there, I had no idea that what was going to come back would be so brilliant! Honestly, the people who are giving their time to share their expertise with you are all so renowned and downright clever, not to mention all lovely, you are in for an absolute treat. Once I saw the titles of the talks and who was going to be speaking, I decided this couldn’t just be a members benefit – they are too good not to share more widely. But although non-members can all join the live events, what we are doing for our members is making them available afterwards in the members area to view at your leisure (although it you want to ask questions you’ll need to join them live). However you view them, I hope you enjoy them – I know I’m going to. The titles and speakers can be seen below - I’ll be hosting them all so look forward to welcoming you.
So third and final question: Can you suggest any other member benefits? 
I hope you feel you are getting good value for your membership – I pay by monthly direct debit, and it adds up to less than the price of a takeaway, or a decent box of chocolates. Definitely worth it (and so are the chocolates!) We may not be able to do everything you suggest, but we can certainly have a think about it and let you know. 

Please send your responses and ideas to me at President@bnms.org.uk preferably by the end of October so we can review these at our next Council meeting, but you can reach me anytime with queries or suggestions at President@bnms.org.uk.
And while we’re asking questions, I’d be really grateful if someone from your department could complete the BNMS survey. I know it’s difficult to find time, but the information we get from it is really vital for understanding, and hopefully developing, our services. Until next time. Jilly
Monthly Research Webinars:
• 12th November Prof Gary Cook Professor of Molecular Imaging King's College London Navigating the Regulatory Requirements to Imaging Research
• 10th December Dr Maggie Cooper PET Chemistry Operations manager for the Positron Emitting Radiopharmaceutical Laboratory (PERL) at King's College London The challenges of producing RP for research trials
• 14th January Prof Jane Sosabowski Professor of Radionuclide Imaging and Therapy, Barts Cancer Institute Implementation of new radionuclides in clinical trials in the UK
• 11th February Dr Ian Newington Assistant Director, Innovations,  NIHR Coordinating Centre NIHR Funding for Clinical Trials and Studies in MRT
• 11th March Dr Juliana Maynard PET Director and Head of Translational Imaging Working Strategically across research councils to ensure collaboration at a national level
• 8th April Dr Jennifer Young Postdoctoral Researcher at King's College London The journey of radiopharmaceuticals from clinical trials to NHS commissioning.
• 13th May Prof Jon Wadsley Consultant Clinical Oncologist, Sheffield Teaching Hospitals Experience of leading a multi-centre MRT trial

Ms Jilly Croasdale

BNMS President

Hope and our Nuclear Medicine community

Following on from the statement I made earlier this month on the effects the riots in this country may be having on some of our colleagues, I wanted to say how gratifying it was to receive messages of support from so many of you across the country. Not support for me, but support for each other. It reminded me again of one of the things I love about working in Nuclear Medicine: our community. We support each other, and we are a team.

I want to say to anyone directly affected by what happened that I hope you’re OK. I’m not going to talk too much more about the riots – I think those people have had enough of our attention. Instead in this month’s blog I want to focus on hope and on our Nuclear Medicine community.

After the riots a couple of things in particular made me feel hopeful. One was a story about members of a Mosque who, after waiting inside for things to ease off, went out and offered food to the rioters. They had conversations with them and came to the conclusion that the people who were rioting had never spoken properly themselves with a person of the Muslim faith. In the end, they felt there was more understanding and the violence dissipated. This may not have permanently changed these people minds, or fundamentally made them feel differently – I suspect that once they are among other people with a similar mindset again or interacting on social media with all those poisonous influences, those people may well have reverted to type. Old habits die hard. But it did make me think about education and talking to other people, and the part this could play in changing things in the future. It gave me a tiny bit of hope.

The other thing which brought me hope was when the anti-fascist demonstrators took to the streets in those places where they had heard the far right were intending to riot and literally outnumbered them. There is power in numbers, and that so many felt brave enough to do it and that it seemed to work, is a beautiful thing. It was a community standing together.

In stark contrast to all that was going on at home, the Olympics were taking place in Paris. I love the Olympics – I think it represents the best of us. Effort, pride, rewards, striving to be the best you can, supporting each other and working as a team and representing your country. It couldn’t get any different, right? Keeping tally of our medals and seeing our heroes pushing themselves to be world beaters is inspiring. As was the grace we saw in defeat where athletes would congratulate the winners, despite their own disappointment. But behind every medal winner is a team. They don’t achieve any of this on their own and this is where I would make comparisons with us all in our everyday life (see - I got there in the end!)

In Nuclear Medicine, we strive as a team to do the best we can for our patients every day. These are our gold medals and for everyone we see we want to get it exactly right. I’ve talked before about Harm free Care and GIRFT – Getting It Right First Time. The right diagnosis, for sure. But also, the right experience in every way. I’ve said before how important each and every member of our teams are and it is so true. Many of our roles are flexible, I know, but generally speaking.

Without our doctors, whether Nuclear Medicine Physician or Radiologist, our patients wouldn’t have their report and therefore their diagnosis. Those referred for it would not receive the treatment they need. These are often our clinical leaders, and without them we may not be developing our clinical services. We also may not have the same connections with the rest of the hospital. We need our doctors, for sure.

But without our nurses, or where we don’t have them, our support workers, Radiographers and Technologists, our patients would not be as well cared for while they are with us and as a result, may not be confident we’re in good hands.

Without our Radiographers or Technologists, no patient scans would happen. There is that and often Radiographers and Technologists fulfil multiple roles - there are too many to list here. Again, without them these things could not happen.

Without our Physicists, we could not image our patients satisfactorily, we would not be maintaining our cameras in optimum condition to help patients, dosimetry definitely would not happen (I always find it amusing to see the dreamy look some of them get in their eyes when you get them started on dosimetry. You know who you are!) and we would not be protecting our staff so well from potentially harmful radiation. Again, they have their fingers in many many pies!

Without the Radiopharmacy team, nothing would happen. I’m not saying that Radiopharmacists are the most important (honestly, I’m not – even though I am one, as you know). But you all also know how it feels when there are problems with supply – it’s pretty fundamental to our services to our patients to have the good stuff to give to them!

Without our receptionist and administrative staff, the appointments would not get made, so no patients would turn up and then we’d all be out of a job. See what I’m saying?

The most important member of our team? Our patients. Let’s never forget that.

So please let us focus on hope. On staying positive. On our wonderful Nuclear Medicine community, where everyone, irrespective of the colour of their skin or their faith, has an equally important and valued role to play. On looking out for each other and on pride in ourselves of the good variety. Pride that celebrates the best of us all, rather than excludes people.

In Nuclear Medicine, we have a lot to be proud of. I feel proud to represent all of you, in whatever way I can. I think you’re all amazing, so thank you to each of you for everything you do.

So, let’s continue to do what we do best: working together to get on with the job in hand, being there for our patients and for each other. Until next time.

Ms Jilly Croasdale

BNMS President

Football, leadership and Nuclear Medicine

You may or may not know this about me, but I am a massive football fan. My youngest son and I are avid Liverpool supporters and we love nothing more than the excitement of looking forward to and watching the game. We also enjoy watching international football and in particular, watching our national team play. This can often be a less than gratifying experience, however, as was evidenced recently by the Euros. 

Whatever you think of Southgate (and I think he is great in many ways), he clearly inspired a lot of love and loyalty from the players. They definitely seem to have grown as a team over recent years and I think most people acknowledge that they are in a much better place as he steps down than when he took the job on. 

I don’t think anyone could argue the extent of the talent on the field – we have some world class players in our squad. So why wasn’t this enough to win us some silverware? Regardless of the final result, and the style of football played under Gareth Southgate (yes, it is a bit dull to watch), it is interesting to think about the lessons that can be learned and applied to everyday life.

For example, what makes a good leader and why is it important?  Leaders are needed to help teams achieve thing and the national team has achieved a lot, albeit not the ultimate prize. Applying this to Nuclear Medicine, without good leadership, we probably would still be able to run our departments, so long as we had good managers who helped us do what needs to be done to scan and treat our patients. But would we develop and grow? Would we improve our services to get better? Or would we still be doing things the way they were done 10 years ago? The difference between management and leadership is a subject often discussed and I’m not going to go into a lot of detail about it here, other than to say that, put simply, I think management is about making sure the things that need to be done get done. Leadership, however, is about vision, growth and inspiration which ultimately leads to greater levels of satisfaction, better performance and constantly improving services. 

I remember once doing a leadership course where we were shown a video of an experiment conducted some years ago (I think it was carried out in the 70s, or at least, that is what the brown suits people were wearing would suggest!)  In this, the performance and subsequent outputs of three teams was compared.  In a nutshell, the first team was told to work to their job description, the second team was sold the vision of what they were trying to achieve and in the third team it was all about making people happy at work. It was assumed at the time that the happier team would be the highest performing (yes, definitely the 70s!) However, this was very much not the case. Feeling happy and valued was not enough. In fact, the team who understood the vision of what needed to be achieved knew their role within it and felt part of making it happen outperformed the others by a significant margin. 

When it comes to successful teams there are many elements at play.  Certainly, considering the Southgate analogy, tactics and strategy are crucial ultimately.  You can have the best people in the world on your team, but if you are asking them to do things which aren’t their strength, if you don’t train them properly or if your approach to achieving the goal is flawed, then you will limit your achievements. 

While I think it’s true to say that being happy at work is a big factor within successful teams, I think it’s actually more about relationships. I remember hearing a discussion on the radio about the approach to team building in the military, where good teamwork and performance can literally be the difference between life and death. Teams in the military are like family to each other, and this does make a difference.  Basically, you can’t lead people you don’t care about and I 100% agree. 

This brings me to whether or not you can teach someone to be a good leader or is it just that some people are born with it. You can certainly learn about leadership styles and how to put the mechanics of good leadership in place, but I don’t think you can really maximise your potential as a leader unless you build relationships and really care about the people you are leading. You can try and fake this if you can, but most people can spot a fake a mile off and they can also tell if you’re being authentic. So yes, you can learn to be a leader, but to do this you have to learn to genuinely care about the people you are leading and you need to take time to build and communicate, or support (depending on your role) the vision of what you are trying to achieve as a team together. Inspiring people to believe in the vision, knowing their strengths and playing to them and helping people take ownership of what you are trying to achieve as a team is what makes the difference. 

Achievements should be shared, something you’ve all achieved together, not just you as the leader. I remember a friend of mine saying to me, tongue in cheek, that she tells her team that their job is to make her look good. It made me laugh, and I do sometimes say this jokingly to my deputy, but actually I think that, as a leader, it’s part of my job to make my team look good. Believe me, this makes you look good too. When you hear someone running other people down, think about what impression that gives you of the person talking. Then think about how people who talk positively about their teams or workmates make you feel. I think you’ll agree - no-one ever looks bad by building other people up. 

Make a start today and you don’t necessarily have to be the manager to be a leader. Anyone can be a leader and we need all of you. Whatever your role, you can inspire other people. You can help achieve the vision and make other people feel included and part of it.  

I’m sure you’ve all got a million things to do and may feel this isn’t something you have time for. I often look back on my NHS career and feel that we don’t seem to have as much time to be friendly anymore. I think this is a shame and to be honest, counterproductive, as a small investment in building relationships with the rest of your team really can reap rewards which are tangible. 

So, try to make some time today to start to get to know your teammates a bit better. Really talk to them and build relationships with each one – not just the outgoing ones, or the people you’re already friendly with, but the quieter people who don’t always speak up. Or maybe those you find a little more difficult to get on with. Maybe take time to really talk to those who can always be relied upon to make everyone laugh. Talk to them properly and really find out what’s below the surface – you may be surprised. 

Be part of building a happy AND successful workplace. Build your relationships but always remember to keep your eye on the prize! Until next time.

Ms Jilly Croasdale

BNMS President

Nuclear Medicine and Regulation: Friend or Foe?

Hello to all of you. I hope you are enjoying some nice June weather and dare I say, even a holiday or two! Enjoy it while it lasts, my friend. Unbelievably at the time of writing we have had almost a week of good weather, and its even looking like a welly-free Glastonbury is coming up. Although I may just have jinxed it for everyone!

And what better subject to consider while you’re pottering around the garden, relaxing on a beach, or (more likely) driving through sweltering rush hour traffic to work than regulation?

Working in Radiopharmacy and Nuclear Medicine, we are used to regulation. We have a lot of it to comply with! And it can be stressful. Do I wish I worked in a less highly regulated area? Sometimes. But generally, I like my job, and this is part and parcel of it. It’s easy to say that you should be inspection ready at all times, but when the reality is facing busy day after busy day with limited resource, particularly if you’re working in an older facility, this is often easier said than done.

And don’t we all slightly dread that e-mail announcing the imminent arrival of an inspector? I’ve worked in Radiopharmacy for over 30 years, and I’ve experienced inspection by some very pragmatic and helpful inspectors, and also some that have felt very punitive. However, I do honestly feel that the expression ‘no pain no gain’ does often apply. I wanted to share a few of my inspection experiences with you. One was about 20 years ago, and it didn’t go well. I was not long in a new job and was still finding my feet in my new role. I knew things weren’t perfect, but I was still learning who was who and trying to work with what I’d got and then I got the e-mail. The inspector was coming, and although he was someone I still think was reasonable and pragmatic, he identified some significant shortcomings with our Quality Management System and like many of you, I’m sure, none of it came as a surprise. I felt quite depressed sitting there listening to the feedback, but the next day I came back to work determined to change things. The inspection report actually gave me the ammunition to make the changes I needed. I put together a business case for a new member of staff specialising in Quality Management and over the next couple of years, we worked hard to overhaul our processes and do you know what, the next inspection not only went well, but we also have no real significant shortfalls identified and my staff were happier. They were working with someone who really knew what they were doing. They began to feel proud of how good the new systems were and took ownership of them. This lasted long after the new member of staff moved on, and not only did the culture change, but the other staff had developed to the extent that one of them was successfully appointed into the job.

The second experience I wanted to share was from a different regulator. It was of an area that I would say forms a small part of my process, so as a result, at that time probably wasn’t getting the focus it needed. Most of my systems were good, but it came to light during the inspection that I was lacking a certain radiological risk assessment. It was one of those situations where I thought the Head of Nuclear Medicine had done it, and he thought I had, so it fell down the cracks. I was quite a lot more experienced by then and have always prided myself on doing the best job I can. So not to have this in place was quite mortifying, as I felt I should have done better and to my intense embarrassment, I got quite upset during the inspection. Yes, in front of the inspector. Not a high point in my professional career, I can tell you. But to her credit, the inspector realised I was upset because I wanted to do a good job, and actually was very supportive in helping me address the shortfall. What followed was 6 months of hard graft and as a result, the systems which I previously thought were good ended up all changing as well, but by the end of it, I honestly felt like a bit of an expert. That was a nice feeling, I can tell you. We had an inspection last year from the same regulator (different inspector), and they actually had no non-compliances to report. That was an even nicer feeling. The hard work in the short term was painful, but the gain further down the line was extremely gratifying.

Fast forward to today, and I’m reflecting on what regulation and inspectors are for. Should they be punitive to ‘catch us out’ and punish us, as can sometimes seem to be the case. Surely the aim of both parties is ultimately regulatory compliance and safety for our staff and patients? Huge factors in our levels of regulatory compliance are lack of workforce and ageing infrastructure. These cannot be addressed overnight, and are not excuses, they are fact. No-one comes to work wanting to do a bad job. Well, none of the people I’ve ever worked with do. They also don’t usually lack expertise or understanding. But they are often working in stressful environments with limited time and resources.

So, does an overly punitive approach actually work? I honestly don’t think so. In both these examples, the inspector did report the non-compliances; they didn’t pull their punches at all, but both of them were ultimately pragmatic and helpful. And in both cases, it resulted in huge service improvements and a movement towards compliance. Surely that has to be the goal. They also helped me learn how to build a strong business case, how important it is to use your risk register and local governance frameworks and how to lobby (engage with, nag?) the right people. All valuable skills.

I’ve previously attended a stakeholder event with the Office for Nuclear Regulation, and they stated their aim is to aid compliance. What a refreshing thing that was to hear.

I also attended an encouraging MHRA event recently and they are clearly coming to understand that the punitive approach doesn’t work. The number of units under special measures has not dropped at all, in fact it’s probably increasing. This is likely because the facilities are getting older, money for investment is getting tighter and staff recruitment ever more difficult. So, they want to work with NHS stakeholders to become more enabling. I’m sure many will view this cynically, but I think to have the desire to change things that aren’t working and to state this, is admirable. And I can’t help but think of that poor teacher who committed suicide after an OFSTED inspection. I think everyone needs to be mindful or this and approach these stressful situations with care.

So, although something which may seem glib, my aim is to be inspection ready. I may not be quite there yet. There have been recent changes to regulation, and I have just moved departments so need to fully get to grips with things. Inspection ready is not a constant – you do have to keep working at it. And I know it’s hard when you feel you do not have time. But it’s a damn nice feeling if you can get there.

Anyway, back to the sunshine – I hope. Until next time.

Ms Jilly Croasdale

BNMS President

Impressions of Belfast

As most of you will be aware (and if not, we didn’t shout about it loudly enough!) the BNMS held it’s Spring meeting this year in Belfast. We originally booked this venue back in 2019, with a view to holding our 2021 meeting there, but COVID struck, and life changed in many ways for us all.

Happily, we were able to reschedule, and so fast track to 2024, and here we are. I was a bit worried at the time of booking that people may not want to go to Belfast; it involves arranging a flight, for a start. And it would be disingenuous not to acknowledge its difficult history, which I did wonder may put some people off. But it certainly didn’t, and for good reason, as Belfast really is a wonderful city. It has such a friendly vibe, and in many ways does feel like a more compact Dublin. But in my opinion, Belfast is very much a great city in its own right, so although I love Dublin, my comparisons will stop there.

The conference centre is located on the banks of the River Lagan, a short walk from the city centre. There are many lovely restaurants – the people of Belfast enjoy good food – and a lot of interesting things to do. I went over on the Friday evening, and amazingly, enjoyed beautiful weather for the weekend (this doesn’t happen that often, believe me – Northern Ireland colleagues will agree.)

Some of the film locations for Game of Thrones can be found across Northern Ireland. This is, in my opinion one of the best TV series of all time - although I swear, if they’d killed off Tyrion I would have stopped watching. (Spoiler alert – no-one was safe from getting the chop!) Belfast has celebrated its connection with GoT by installing huge stained glass murals depicting different moments from the series, so I had a nice walk along the river finding them all. This was followed up by a couple of pints of Guinness in a sunny beer garden in the City Centre. And the Guinness tasted great, especially after a couple of hours walking in the hot sunshine working up a thirst!

There is also the Titanic Museum, which was very interesting. Although the Titanic maiden voyage resulted in awful tragedy, the museum didn’t just focus on that. It also looked more widely at ship building and other related industries for which Belfast was then well known. This was followed by another Guinness (the sharp eyed among you may have spotted a theme here!) in the Drawing Room of the Titanic Hotel. This is where plans were drawn up for ships built in the Belfast shipyard. Unlike the unskilled workers, these employees enjoyed good working conditions, and this room is beautiful, flooded with natural light and certainly a nice place to while away an hour, contemplating everything we had seen in the museum.

On Sunday evening we launched a new BNMS initiative for our members. If you read last month’s blog, you’ll know that the BNMS does a lot of great work, but I did feel that, as well as cheaper conference registration and a copy of the NMC, it would be nice to give something a bit more personal and tangible to those of us who are BNMS members. To this end, we hosted a welcome event on the Sunday evening which was free for members. Non-members were still able to come, but they had to be accompanied by a member, and there was a £10 charge for them. The event took place in a venue in the Belfast cathedral quarter called The Dark Horse, and we provided food and a drink for everyone. As well as that, we had a couple of talks organised. I did wonder what people would think of listening to a ‘talk’ on a Sunday evening, but it was so much more than that. Joe O’Sulllivan is an academic clinical oncologist and Clinical Director of the Northern Ireland Cancer Centre, and has a clear passion for prostate cancer treatment. Joe is a brilliant, charismatic speaker and gave us an absolutely fantastic overview of the work being done in Belfast and elsewhere on Radium therapy. Honestly, I think we were all mesmerised – we were all literally hanging off his every word. The evening was a great success, so is definitely something we will be repeating next year.

On to the conference itself. Opening the meeting was fairly terrifying, and of course, a little bit of the old Imposter Syndrome reared its head, but I pushed it firmly back down. It’s always a bit scary at the beginning, but as the meeting went on, confidence grew, and so many of you were so kind! When you’re speaking to a large group of people it’s easy to feel like everyone is going to be a critic, but my experience of our BNMS family is that everyone is, in fact, a cheerleader. Thank you all so much for your support.

Following on from the conference opening address, this year we decided to present the highlights lectures at the start of the meeting. The idea was that this would help you navigate the programme. We had separate Clinical, Scientific and RTN highlight presentations. It was a new thing for us, and it will be interesting to hear the feedback on it. From my own point of view, I thought it was more useful, although we can probably refine it a bit further. I also feel the people putting together the highlights lectures put such a lot of work into it, it was nice for them to present to a full room, rather than at the end, when some people have had to leave.

I then realised I had to speak at the President’s Reception. It should have been fairly obvious I’d need to speak, but it hadn’t registered! Mild panic ensued – I’d used all my best material in the morning opening speech! But it went OK, and we proceeded to enjoy a lovely couple of hours in the exhibition hall networking, meeting up with old friends and hopefully making new ones. I include our Industry partners in this – the exhibition was great, and several people commented on this. Furthermore, the food throughout the three days was really very good. If you’ve ever been involved in organising events, you’ll know the food is difficult to get right, but the feedback at the meeting was overwhelmingly positive and speaking of food, I really do have to mention the Conference Dinner at this point. It was held at Belfast City Hall and what an amazing venue. I had the privilege of presenting the President’s Medal to Dr. John Buscombe, who needs no introduction. I’ve known John for about 25 years, having worked with him at the Royal Free so many years ago, so it was really special to be able to recognise all he has done over the years for Nuclear Medicine and for the Society. He’s been a brilliant advocate for British Nuclear Medicine across the world. I also presented the Roll of Honour to Dr. Beverly Ellis. This is a recently established award for outstanding contribution to Nuclear Medicine and Radiopharmacy, and Bev has definitely done that, working diligently behind the scenes to provide support and guidance to Radiopharmacy and Nuclear Medicine. A big shout out has to go the inimitable Dr. Glen Flux, recipient of the Norman Veall Medal who has done so much for Radionuclide therapy and associated dosimetry in the UK and the worthy winner of the RTN award was Prof. Peter Hogg, who has been a great ambassador for Nuclear Medicine in the wider world of Radiology and advanced practice. All four of them are utterly brilliant. I know that being recognised by their peers meant a lot to all of them, so it is definitely one of the perks of being President that you are able to be part of that. I must also mention the honorary membership award, which was presented by Sue Hatchard to Steve Anderson, previously of Bright Technologies. This was pretty special for a couple of reasons. Firstly, as many of you will remember, as Charlotte’s predecessor, Sue was an integral part of the BNMS for many years, and I would argue has achieved legendary status for many of us. And secondly, because this is the first time such an award has been made to someone from Industry. Over the last few years, the relationship between the BNMS and Industry has definitely become a partnership, and it was nice to recognise that – and I know from speaking to Industry colleagues the day after the dinner that recognition of Steve’s contribution to the BNMS felt like a recognition of them all.

The content of the meeting was fantastic, and huge thanks need to go to the SEC chairs and committee members, and to our wonderful BNMS staff, who make all this possible. They’ve all worked incredibly hard, and it showed. We had so many great papers and posters to choose from. Please take some time to review the abstracts in NMC. And this year, rather than having the educational talks all front loaded into a bootcamp, they were spread throughout the meeting, something I thought worked well. There were so many brilliant invited talks too, I can’t talk about them all here, but I do have to mention a few. The first was our Annual Lecture, this year given by Prof. Ian Law from Copenhagen University Hospital, who gave us a great insight into state of the art neuro PET imaging. He was another great speaker, and the allotted hour flew by. I also really enjoyed a talk given by Dr. Samantha Terry from Kings College London on Auger Electron Therapy and the updates from Dr. Jennifer Young on new work being done by Radionuclides for Health with Iodine 124 and Astatine-211. We also had a talk on considerations for trans and non-binary patients with cancer as well as one on improving the experience of gender non-conforming patients. Both were well attended, and it makes me so proud that we are an inclusive society who want to support and provide compassionate care to all our patients. There was plenty on MRT and theranostics, and some brilliant talks on Total Body PET. This is definitely going to be a big talking point going forward. But what was also really good was there were also plenty of interesting general Nuclear Medicine talks and I think the balance between everything was pretty much perfect. What exciting times we have ahead of us - I feel so fortunate to be working in Nuclear Medicine now, despite the challenges we all face around resources and staffing.

I do also have to mention one poster which struck a real cord with me personally, and this was one about how to make our services more dementia friendly. As you know, this is a subject close to my heart and there are simple things which we can do to better support people who are unfortunate enough to suffer from this awful disease. For example, not booking appointments towards the end of the day, when people living with dementia may experience heightened confusion, something called ‘sundowning’, which can start in late afternoon.

You probably know about the still very recent loss of my mum. She was my confidant, the person I told about all the highs and lows of my life and this was most definitely a high. All of you who have lost people you love dearly will know it is a journey and I did feel sad that I couldn’t call her after the conference to tell her all about it. She would have been so proud and pleased for me. But the BNMS is not just about sharing learning and experience; in Nuclear Medicine we support each other. So sharing my impressions of Belfast with all of you is what I’m doing instead. To all of you who attended it gave me a much needed lift to share the experience with you, so thank you. I hope you enjoyed the conference as much as me, and that you also found lots of things in it to further improve the already great services being provided by you across the country.

If you weren’t able to attend this time, please do think about joining us in Glasgow next year from 19th – 21st May. If you are struggling to get funding for this, and are a Radiographer, Technologist or Nurse, have a look at the Ros Breen fund – you can find information on it on our website. Ros was a Superintendent Radiographer at Southampton General Hospital who made a great contribution to the field on Nuclear Medicine Technology and this fund was set up in memory of her to support RTN colleagues to come to the conference. I’m not sure if people know about it, as we don’t get lots of applications, so have a look to see if it might help you.

The conference offers us a great opportunity to reflect on what we have learnt in the last year, and to make plans for the next. Let’s make it amazing. Until the next time.

Ms Jilly Croasdale
BNMS President

Back to Nuclear Medicine Business

After a turbulent time for me personally since losing mammy in February, this month I’m getting back to Nuclear Medicine business, and to be honest, it feels good. I would like to say thank you to everyone who took the time to send me a message after my last blog. Hearing your stories of similar experiences and reading your condolences made me feel less alone and really helped a lot. So thanks – it was a lovely example of what a close community we are fortunate to be part of within the BNMS.

Something else that highlighted the unique strength of our organisation to me came from an invitation from the Dutch Embassy to speak at an event they were organising in London. Excitingly, this was called ‘Innovation Mission to London, United Kingdom’ and was organised by the Netherlands Enterprise Agency. It sounded like something straight out of Star Trek, which I love, so immediately felt right up my street. (I was raised on a solid diet of Sci-Fi by my dad, with a healthy dollop of John Wayne / Clint Eastwood westerns thrown into the mix and a side order or Rogers and Hammerstein. It was an eclectic mix.)

The event took place at the London Institute of Healthcare Engineering, which is located right next to the Thames. After a short introduction we were served lunch on the 3rd floor which led onto outside tables overlooking Westminster Palace and Big Ben. Happily, the sun came out and gave a welcoming impression for our visitors and for the first time in several weeks, brought a smile to my face.

The afternoon talks were designed to promote knowledge exchange and discussion, and as part of this I was asked to give a presentation on the BNMS. At first, I wasn’t quite sure how to pitch it, but once I started talking about what BNMS does, I realised afresh how much our Society actually does.

Whilst we have good links with the European Association of Nuclear Medicine, we also have a very strong individual identity and community of our own. The BNMS provides guidance and leadership, and I’ll give you a couple of good examples. I try not to mention the B-work (Brexit – there, I said it), but we worked hard with our Industry colleagues and the Royal College of Radiologists to successfully engage the government in the lead up to the change in our border controls. This minimised the disruption to patients that Brexit could have caused. And although it wasn’t perfect, and there were financial implications, we didn’t see the chaos that was definitely possible. Moving to flights for shipment of radioisotopes from abroad has its challenges but was definitely preferable to deliveries being stuck in a queue for the channel tunnel or the short straits ferry crossings.

I hope you found the guidance we wrote during covid useful, which was another good example of the benefits of having a national Society providing helpful leadership and of how engaged, proactive and helpful our members are. This was a collaborative piece of work put together by colleagues at Birmingham City Hospital and Liverpool Royal along with BNMS Council members.

The BNMS has important links to other partners organisations, which we utilise to take forward the Nuclear Medicine agenda. Hopefully these links have benefitted you, even if you’ve not been aware of the work being done behind the scenes. In both the above examples, they were vitally important. Currently we are trying our best to take forward registration for technologists and to maintain standards for PET CT commissioning, amongst other things.

As well as our main Council, we also have a number of special interest groups. These include the Professional Standards Committee, which brings you our guidelines, amongst other things. Although we do cross-reference EANM guidelines, we also write our own BNMS guidelines, tapping into experts practicing within the UK and they’re really good.

We have our Scientific and Education Committee which as well as overseeing a year-round programme of regional educational meetings and webinars, they bring you your brilliant national meetings. These give us a valuable opportunity to share good practice and develop our own networks, as well as being interesting and generally good fun. Many other countries in Europe don’t have this. Of course, they have the EANM conference, which is amazing, but there’s a lot to be said for something that is smaller and more focused on local practice and issues.

We have our Research and Innovation Committee which aims to bring together new and experienced researchers from different departments across the UK, establishing research champions and linking in with other bodies who promote research. This important group provides support to researchers, who may otherwise be a little isolated as well as encouraging trainees and leading on registries. They are looking at setting up a database of Nuclear Medicine clinical trials, which will provide a valuable overview on work taking place in our country.

And last but definitely not least, we have our recently established BNMS UK MRT Consortium, which was formed after a merger of the BNMS Molecular Radiotherapy Group and the UK MRT Consortium. This new group is working to engage stakeholders to improve equity of access to MRT across the country, to provide a space for knowledge exchange, shared learning and collaboration, including development of MRT guidance, to monitor MRT services across the country, to help with expansion and training of the workforce and to link in with research groups to promote MRT research. This is an ambitious ask, and we are only at the beginning of what needs to be done. To take this forward, we have established a number of workstreams, each led by a passionate MRT advocate, with the aspiration that this country will be a world leader in MRT in the future.

We try to ensure we have good links with all our craft groups, and although I think this is something that could be improved even further, the links we have with the Radiographers, Technologists and Nurses through the BNMS RTN Group, with the Clinical Scientists and Clinical trainees, and with the UK Radiopharmacy Group are very good. I would like us to improve on our 2-way communication, so it is a little less top down and makes better provision for listening to members. Nuclear Medicine is a team sport and within the BNMS we all get to play an equally important and recognised part. As a Radiopharmacist I’ve always felt valued within the society, and I hope all of you feel the same. If not, please let us know how we could do this better.

We have our BNMS website, which provides a platform for us to share guidance and news with our members, as well as being a good vehicle for administering our scientific and educational agenda. And unlike many other countries, we have our own official journal, Nuclear Medicine Communications. I must give a huge thank you to all our contributors, editors and our wonderful editor-in-chief.

I have to conclude with a mention for our brilliant permanent staff, without whom none of the above would be possible. Our CEO, Charlotte Weston, our BNMS Committees Secretary, Caroline Oxley and our newest staff member, Angelica Spina who is providing valuable admin support. They are all fantastic and work so hard on behalf of all of us.

Please don’t underestimate how good this all is. If you can remember my first ever blog, I made reference to BNMS being good for your health. This is because I’m grateful to our society for so many things, and being grateful is good for your wellbeing. After the events of recent weeks, reminding myself of this has given me a welcome lift. I hope it does the same for you. And talking about positive things, our Spring conference is just round the corner. Please do try to join me in Belfast next month and be part of the BNMS Community!

Ms Jilly Croasdale

BNMS President

Seeing the person behind the dementia diagnosis

If you read my January blog, you will realise I am speaking from some personal experience on this. My mum was formally diagnosed with dementia last year. Everyone's journey is different, and hers was a real eye opener for me. Firstly, the way it started was quite insidious. She didn’t start by forgetting anyone’s name. She just started to randomly, every now and again, forget to take her tablets. She had a medidose system (one of those cases with different little boxes for morning and evening for each day), which my sister filled up every week and we started seeing that on the occasional day, she’d just forgotten to take them. Not very often – at first. But it got more and more frequent. We changed the medidose system for one with an alarm to remind her. It didn’t make any difference. She complained she had too many to take, and didn’t like ‘those big ones’. It seems so ridiculous now, but we actually thought at the time she was doing it on purpose to make a stand in her own way – a bit of a ‘you’re not going to control me’ sort of stance and that was the only thing for some time. Then she stopped doing her jigsaws. She almost always had a 1000 piece one on the go and she was good at it. I realise now this was because she couldn’t concentrate – later on, she would enjoy doing simpler jigsaws - but at the time, she didn’t know what to do, so just stopped. She stopped reading books, but everything else seemed normal - she still read her magazines, so it wasn’t so noticeable. Again, books took more concentration. 

But on Boxing Day 2022 when I saw her at my sisters, she seemed not quite right. I couldn’t put my finger on it, but she had a rabbit in the headlights sort of look about her. And in the months following that, it started to quickly become clearer that something was wrong. She couldn’t remember what she’d had to eat. She stopped showering without a reminder. She had to have dressings on her legs and couldn’t remember why, so would remove them quickly after the nurse had gone. She started wondering off up the street and a couple of times fell over. She tried to give her house keys to the window cleaner. She stopped watching TV. She lost track of time and stopped going to bed. 

But she always knew who we all were. She always knew who I was, who my sister was. She always remembered her hospital consultant (he was apparently a ‘bit of alright’). People who she had long-standing relationships with, she remembered, even if she hadn’t seen them for a long time. Her new GP was always a surprise to her though, as she was transferred to him more recently.  

My mum was always very compliant, and I would say she ‘did dementia’ well. I put that partly down to her personality; she was a lovely and gentle person and partly down to my amazing sister, Sally, who was so reassuring to her, always. Think what it’s like when you lose the thread of what you’re talking about. It’s on the tip of your tongue, but you can’t quire remember it. Or you walk through a door to get something and then can’t remember why you’re there. This does occasionally happen to me (I’m a woman of a ‘certain age’ - I’m sure some of you who understand what this is like). It’s frustrating. But eventually I find a way of remembering. Imagine this happens more and more to you. It would start to make you anxious and eventually frightened. A lot of the behaviour exhibited by people living with dementia stems from anxiety, so they need a lot of reassurance, rather than being reminded that what they are talking about isn’t right. So, for example, a lady living with dementia at the hospital we were at with Mammy a few weeks ago was accusing the staff of taking her things. We saw one Healthcare assistant respond harshly to demand ‘why would I take your things?’ But actually the lady just couldn’t remember where she’d put anything, didn’t really understand why she was there in this unfamiliar environment and was simply anxious. My sister suggested to her that maybe her son, who had visited that afternoon, had got them put away safe, and that she didn’t need to worry and do you know what? She calmed down. It was a reassuring suggestion she accepted. My mum was the same when she couldn’t find her purse, for example. I’d say to her, Sally has that safe, don’t worry, and she was reassured. So correcting someone living with dementia can make them anxious. Going along with it or providing a reassuring reason for things does help.  

We all see patients living with dementia in our Nuclear Medicine departments. Notice that I call them patients living with dementia, not dementia patients. I strongly feel we should not label people or let things like their dementia define them. My mum was what I would call an extraordinary ordinary woman. She was a teacher, although she never moved very far away from where she was born - as is the case for a lot of people who live in the Yorkshire mining town where I grew up. She would often bump into people when she was pottering to the shops who would say she’d taught them. She used to say how old it made her feel as these people stopped being young mothers and became older women with grey hair and grandchildren themselves. But they all remembered Mrs Hepplewhite fondly. She made a difference to them. And to me she was the best mum anyone could have wished for. She was kind, she was generous and she was funny – even when she developed dementia. She called it ‘The Forgettery’. See, funny. Another thing I loved about her was that she was totally partisan. Always completely on my side, my cheerleader. And don’t we all need one of those? She was just the best sort of person. If you had her as a friend, as so many did, your life was richer for it and you were lucky.  

She was 86 and frail, and living with dementia – but my goodness, she was brave about it. No-one else’s face will ever light up like hers did whenever she saw me. That never changed. I remember when I told her I was President of BNMS, how impressed she was. Then she asked me to write it down so she got it right when she rang round all her friends to show off her bragging rights. 

So it sounds obvious, and I’m sure most of you do this, but when a person who is living with dementia comes to our departments, we need to remember that they are a person first and foremost. They will have lived their own extraordinary ordinary life. We need to respect them, to understand and reassure them, but not be condescending (don’t let me get started again on being called ‘sweetheart’ by strangers in hospitals). We need to be kind. 

You might have already guessed from the past tense references. Mammy succumbed to Sepsis and died on the 26th February. So this is my tribute to her. I couldn’t write a blog this month on anything else – it’s too much of a life-changing event for me. I’m so sad she’s gone, but so grateful to have had her for so long. Life will never be quite the same again, but a life having had her in it will be forever enriched.  

R.I.P. Barbara Hepplewhite, an extraordinary ordinary woman. 27.6.1937 – 26.2.2024

Ms Jilly Croasdale

BNMS President

Nuclear Medicine and the LGBTQ+ Community

The title of this month’s blog may raise a few eyebrows, as many of you may not realise that we in Nuclear Medicine have much of a link with the LGBTQ+ community. But we do. An important part of our job in Nuclear Medicine is to make sure we abide by good radiation protection practices and that we maximise the benefits of radiation exposure to our patients. And that applies to all our patients. This includes those whose gender identity does not fit into what is considered societal norms of ‘male’ and ‘female’. 

When I first started thinking about writing a blog on this subject, I was going to say that you may have an opinion on the subject, but that your opinion really doesn’t matter. I was going to say that what matters is that we don’t irradiate any unborn babies unnecessarily, that we don’t have any babies fed breast milk which may contain radiation, and that we are able to ensure we report our scans accurately, without confusion about unusual uptake arising from the unexpected presence of organs aligned to a patient’s sex at birth. 

However, I’ve changed my mind about that, for a number of reasons. I feel like we are reaching a point in our society where neutrality isn’t an option any more. The brutal murder of Brianna Ghey has deeply upset me, as I’m sure it has many of you. There is an ongoing commentary in some parts of our national media on the Trans community particularly which I find divisive and upsetting. Language is important, and I feel to have our NHS Constitution changed to remove more inclusive wording is wrong. 

We should be providing compassionate care to our patients. To all our patients. We should be striving to be compassionate leaders. And compassion should mean without judgement. It should mean making everyone feel included. It should be about provision of not only the best care, but also support, acceptance and understanding. If we in the caring professions cannot do that, then who will?   

I’m putting my head above the parapet on this. My son is at University, and is part of the LGBTQ+ community. That I was unsure about whether to share this with you, rather than saying instead that he knows many people in the LGBTQ+ community says a lot. I shouldn’t be giving it a second thought. It’s not something to be ashamed of; I am proud of my son. He is smart – currently in his 2nd year of a 4-year Physics Masters. He’s kind, thoughtful, loyal, loving and empathic – and great if you want someone to talk things over with. And more, I’m proud of him for living an unapologetically authentic life. And I’m proud of myself for helping to give him the confidence to do so. Apart from his incredible level of untidiness – it genuinely stresses me out to be in his room – he is a pretty all-round wonderful person.  I honestly think that how someone identifies, what their sexuality is, is an irrelevance. To me it’s just part of the spectrum of what is normal. Of what is human. Everyone sits somewhere on a normal distribution curve, so what does it matter whereabouts that is?

I know at least 4 young people who are Trans. They are all dealing with their own struggles around this, and most of that is not because their peers don’t accept them; however much of it is because of our wider society. But the world is changing, whatever some of the headlines may lead us to believe. Especially with younger people, who are generally so much more open about and accepting of variety and individuality.

I know that if you wear the wrong trainers to school then your life can still be made a misery. In my school days, my parents made me wear polyvelt shoes - do you remember them? My dad once cut my hair (how wonky and short can one fringe get?), and my mum made me have a perm. I was a bridesmaid at her cousin’s wedding. It was BAD. So you can imagine what my secondary school years were like. That hasn’t changed all that much really. I have to buy my youngest expensive Nike Air Force One trainers in black as he was getting bullied for his well-fitting but much less cool Clarkes shoes. 

But in terms of sexuality and gender, my experience is that more younger people do accept that for many, this is more fluid and less rigidly defined. And with around 4.5% of the UK population identifying as Trans or Non-Binary, we will see an increase in people attending our departments to whom this applies as time goes on, and we need to be prepared.

To help with this and to hopefully make a small step towards helping all our patients feel included, the BNMS has written some guidance on how to interact with our patients in an inclusive way. This applies particularly when checking for possibility of pregnancy, or the potential for unexpected uptake of a tracer. It’s not about randomly asking granddad John Smith whether he could be pregnant as soon as he walks into the department. I’m sure none of us would do this. It’s about tactfully finding out for whom further enquiries and conversations are needed. We have already done our first pregnancy test on a non-binary patient in the Nuclear Medicine department here, so there is a need to have a process in place sensitively identify and support those individuals who are transgender or non-binary, as well as those with diversity in their sex characteristics whilst at the same time providing compassionate and respectful care for all patients. 

As you may realise, this is a subject I feel passionately about. I saw Miriam Margolyes on the Graham Norton Show a few weeks ago. There’s something about someone who sounds so proper saying such naughty things which really makes me laugh, but during this interview she was talking earnestly about how she became a Trans ally. She said ‘I was very keen on grammar, and so when people started talking about pronouns, and that they wanted ‘them’, and not ‘he’, ‘she’, I thought, what are they talking about? It’s clear, it’s grammar, the structure of language. But I met a wonderful actress in Australia, and she’s Trans, and she had a discussion with me about it. She said, what does it matter to you? If you can make somebody happy by calling them ‘they’ instead of ‘he’ or ‘she’, why not do it? And I thought, that’s right. It doesn’t matter about grammar. If you can make someone happy and give them a sense of themselves, then do it.’ 

You can probably tell I feel exactly the same. I am a bit nervous about how some may perceive what I’ve written this month, but I strongly feel that, as an ally myself, the time has come to stand up and be counted, especially in light of the BNMS guidance soon to be published. I hope that when it comes out in March, you find the document helpful. And thank you for your support. 

Ms Jilly Croasdale

BNMS President

Happy New Year! So how can we make the most of 2024?

I hope you all had a lovely break over the festive season. It does already seem a long time ago, but I’m not full of the January blues. I had a busy but very enjoyable break, and a lovely New Year’s Eve. I try not to be sad when good times are over, just grateful that they happened in the first place.  

However, I understand that for many of us, the festive season is hard. There have been challenges for me this Christmas too. My mum was formally diagnosed with dementia this year which rapidly deteriorated, and as a result she moved to a nursing home. It’s been a tough year for us all. This was the first Christmas I wasn’t going home to visit her. As in home to the place my mum and dad bought when they got married and where my sister and I were brought up. I went to the nursing home to see her, and whilst is was still lovely, it did feel strange. I had to remind myself that she is well and definitely safer. And she’s been lonely since my dad passed away and now she has company all the time she’s so much happier.  

So reflecting on all of this, I feel we need to make the most of every day, month and year. I heard something on the radio recently which really resonated with me. Giving things up for January can feel quite negative, although don’t get me wrong, I’m certainly back in the gym after all the Christmas indulgences. But much more positive than giving things up is starting to make plans. Don’t put things off – either in your personal life or at work. I love planning things to do with my loved ones, but I also get a lot of satisfaction out of being productive at work. I know things can go wrong and you can be hit by varying degrees of curveballs. This could happen at any time, but we need to make the plans despite this. Something I certainly do is overestimate what I can get done in a day, and then feel disappointed when I don’t achieve it. But apparently people overestimate what they can achieve in a day but underestimate what they can achieve in a year.  

The important thing is to make some plans and this brings me nicely round to Nuclear Medicine and more specifically to my area, Radiopharmacy. At the beginning of January this year we implemented a significant organisational change. In a nutshell, my Radiopharmacy service moved to another Trust. It is something we have been planning for some years, so to have realised it is both scary and exciting in pretty much equal measure. I’ll miss seeing the people in my old Nuclear Medicine department, whom I’ve worked alongside for so many years and if they are reading this, I want them all to know how grateful I am to them all for everything. They are a fantastic group of people.

It has been a long road to get to where we are now, and like all big plans, there were a lot of individual components which had to be realised to bring it to fruition. But now we have made the move, any idea that we had reached the end of the journey has very quickly gone out of the window. There is still a lot to do. For the first week I felt quite overwhelmed and didn’t know where to start. My to-do list looked out of control!

It was then that I heard about a technique called ‘Time boxing’ on the radio. It is a technique which essentially involves ‘calendaring’ your to-do list. Sounds nice and simple and it is. But it’s also been proven to be effective. It’s not just about what you’re going to do, but when. It’s like scheduling a meeting with yourself in your calendar, and as such, you should treat it like a meeting. No rescheduling, unless it’s urgent. No distractions. It requires you to block out a period of time to work on something, something Psychologists call ‘setting an implementation intention’, which is just a fancy way of saying ‘planning out what you are going to do and when you are going to do it. And for bigger tasks, you can reserve several blocks of time in advance. It gives you control over your schedule, even if there are things you can’t control within it. 

I read an article on it in the Harvard Business Review, published about 5 years ago. In this article it described 5 problems with the to-do list: 

1. They overwhelm us with too many choices. This is certainly true. Mine is massive, and doesn’t help nearly as much as just selecting a few things I’m going to do that day and putting them in my calendar.

2. We are naturally drawn to simpler tasks which are more easily accomplished. For sure – who doesn’t love a quick win? But to do this means other, more complex tasks, can end up being left.

3. We are rarely drawn to important but not urgent tasks, like setting aside time for learning.

4. To-do lists on their own lack the essential context of what time you have available. Time boxing allows you to factor in things you already have committed time to. For example, meetings, that manufacturing or reporting session. 

5. They lack a commitment device, to keep us honest. Because we haven’t committed to when we are going to do a task, we don’t hold ourselves to it. 

It’s not about timetabling your whole day – that would be impossible and doomed to failure. It’s about looking at your schedule at the start of each day / week, and looking at your to-do list, and then blocking out time in your diary to work on specific things. Today my calendar looked like this:

7am – approx. 9.30am: Manufacturing session in the Radiopharmacy (already in schedule). 

10 – 11am: QA meeting (already in schedule)

11.30am – 12.30pm: Radiopharmacy move close-out document (time boxed work – first of 2 for this)

1.30 – 2.30pm: Complete ARSAC paperwork (time boxed work)

I’ve not tried this before, so if I’m going to stick to it, I’ll need to embed it into my routine. With 10 minutes planning at the start of the day / week it might even work. The evidence and my experience today certainly indicate it may be helpful.  

If you found this interesting, maybe give it a try? And if you are able to attend the BNMS Spring meeting in Belfast this May, perhaps we can compare notes to see how we’re all doing? 2024 could be a productive year for us all!

Ms Jilly Croasdale

BNMS President

Christmas Challenges and Some Cheer (at last)

As we approach Christmas, it is generally seen as a time of celebration for many. And I sincerely hope this will be the case for you.

However, it would be disingenuous not to acknowledge that many in our Nuclear Medicine community have had a very tough time over the last few months which has inevitably had a negative impact on some of our patients.

Most of you will be aware that there has been a significant and widespread shortage of Technetium-99m radiopharmaceuticals since October, and unlike other shortages, this has not been related to reactor problems or difficulties getting any materials into the country. It has been as a result of a perfect storm of a number of Radiopharmacy closures, for various reasons. And to complicate things even more, some of them were acting as a contingency supplier themselves before closing.

The upshot of this has not just been delayed or limited supplies. For some Nuclear Medicine departments, it has meant NO supplies. And not just for the occasional day. For some, it has been for several days, running over the weeks and months since the beginning of October.

There was a similar problem a few years ago in 2019, but to a lesser extent because it involved just one large Radiopharmacy. And that was bad enough. After that the BNMS and the UK Radiopharmacy Group highlighted the clear problems we have nationally in the UK with spare capacity to supply and the lack of good contingencies in place for our patients. Whilst some Radiopharmacies around the country have provided some contingency supplies, this has been limited by a number of factors. For example:

• Staffing capacity within individual Radiopharmacy units to supply – Radiopharmacies have a regulatory responsibility to work within defined capacity limits

• Isotope capacity within the limitations of local Permit

• Impact of increased workload on individual radiation exposure

• Availability of trained and approved drivers

The problems experienced in 2019 led to the 2021 national review in England of Radiopharmacy services, which was based on similar principles to a review which had previously been conducted on Pharmacy aseptic services. Unfortunately, there hasn’t been much progress for a number of reasons. Many of the things which need to change or improve need time - for example, improving ageing infrastructures, increasing availability of a suitably trained workforce.

And then we ended up in the position we have seen this year, and I don’t feel it is an exaggeration to say it has come to crisis point for many of us, and it is now very clear that these things, and others, need to be addressed as a matter of urgency.

So to move towards more positive news. We are now finally starting to see light at the end of the tunnel for many of us. One of the large units is starting to resume services from the 27th December onwards, so many of us can look forward to a happier and more plentiful (from a Technetium-99m supply point of view) New Year. This is not the case for all, but for the units who remain affected by other closures, hopefully this will release some capacity for ongoing supplies to them.

Recent months have made it clear that there is a significant risk to patients when the Radiopharmacy itself cannot operate. And because of this, BNMS and the UKRG will continue to work hard behind the scenes with our partners at NHS England and within the devolved nations to try to improve things for our patients and for our community.

So I would like to end this month’s blog by saying thank you to all of you who have kept your services running through such a difficult time. To those of you who have reassured worried patients. Who have had to deliver bad news to surgeons about not being able to support their lists. Who have borne the brunt of disappointed patients when having to deliver the news their scan has had to be delayed.

I’d also like to thank those Radiopharmacy colleagues who have stepped in to try to support services where they can. You’ve been amazing. And to the Radiopharmacy staff at the affected centre who have worked hard to re-open their unit, I know it’s been a tough few months, but I know you’re looking forward to being able to do what you do best – providing a reliable and effective Radiopharmacy service.

I’d like to finish by quoting American writer and artist, Agnes M Pharo, who gave us this definition of Christmas: ‘What is Christmas? It is tenderness for the past, courage for the present and hope for the future. It is a wish that every cup may overflow with blessings rich and eternal and that every path may lead to peace.’ Whether you celebrate Christmas or not, that sounds like a pretty decent aspiration.

Or alternatively, this quote by Maya Angelou, American memoirist, poet and civil rights activist: ‘I’ve learned that you can tell a lot about a person by the way he/she handles these three things: a rainy day, lost luggage, and tangled Christmas tree lights’. And maybe we should add to that ‘Technetium-99m shortages’!

I do hope you manage to have a break to enjoy some time with your friends and family. And please join me in wishing us all a very happy, healthy and successful 2024 (Let’s aim high and hope for the best, as Agnes says!)

Ms Jilly Croasdale

BNMS President

BNMS Autumn Meeting: More than a conference

I have to say, you may say I’m biased, but I really think BNMS do put on a good meeting. For those of you who were able to join us in London for our Autumn meeting, thank you so much for coming, and I hope you enjoyed the day. I would also like to take this opportunity to once more thank Dr. Ranju Dhawan and her team from the hybrid Imaging and Therapy unit at the Wellington Hospital for organising such a fantastic meeting for us all. 

If you weren’t one of the 300-or so people who were there, let me tell you, you really missed a fantastic event. And honestly, I’m not just saying that because I’m BNMS President. There was so much that was good about it. For a start, content. You always need to have good content. Interesting talks that people want to hear. For this meeting, Ranju arranged talks around the general theme ‘Choosing Wisely’, and for me, the standout session was around the opportunities and challenges within Nuclear Medicine for Artificial Intelligence, which I thought was super informative and engaging. As a Radiopharmacist, I also enjoyed hearing about the journey of the radiotracer from lab to patient, and about new radiopharmaceuticals in the pipeline, but I have to say, the quality of the talks throughout was excellent, and there was certainly something for everyone. 

Another innovation introduced by Ranju and her colleagues, e-posters, which went down very well, and I must also mention the BNMS Manifesto for PET CT Commissioning that was released at the meeting. This was pulled together by our immediate Past-President, Prof. Richard Graham after extensive collaboration and consultation with experts in the field. I look forward to hearing what you all think of it, so please have a look at it when you get a moment.

As is always the case with us at BNMS, there was a lot of interesting debate throughout the meeting, and I was pleased to see so many people following in the footsteps of the late Dr. Keith Harding and asking plenty of questions (see October blog for more context on that if you didn’t read it!)

Another really lovely touch was the tour the afternoon before of Lords cricket ground with a reception at The Lord’s Tavern afterwards. We had a talk from Prof. Nick Pierce, Chief Medical Officer for the England Cricket Board. Oh, and refreshments – this is always a good thing. I found Nick’s talk incredibly interesting. Prior to working for the Cricket Board, he had worked with the UK Olympic team, who as elite athletes, took their training, health and lifestyle very seriously and had high performance equipment, sports clothing and footwear. By comparison, the cricket players had a different, shall I say, outlook on life and sport and certainly weren’t even wearing specialist footwear when he started, although the latter has changed. They do sound fun though. 

I’d never considered that cricket players were at higher risk of skin cancer, although once you think about it, it’s obvious – as Nick said, they follow the sun. And because of the higher risk of that, they use a lot of sun cream, which in turn leads to a lot of vitamin D deficiency. I also have this – as do many Brits. You probably do too – go get it checked if you haven’t already. The half an hour of sun we get on that afternoon in July when we’re all crowded on Scarborough / Bournemouth (delete or amend as appropriate) beach just isn’t enough to last us the rest of the year! 

Anyway, I wasn’t a cricket fan, but I learnt a lot about cricket and there’s clearly more to it than the opportunity to have a nice picnic (probably under an umbrella unless you happen upon that nice weekend in July). 

Other things essential for a good meeting are nice food, a good, accessible venue and a friendly atmosphere. I have to say, we had all that in spades at this meeting. Food especially – although there was nowhere really to sit, so sorry to those that struggled to balance their plates and drinks. But it did make for good mingling though!

Finally, I have to say that this was my first experience of a BNMS meeting as BNMS President. For those of you who are aware of my tendency towards Imposter Syndrome, this did rear its head a bit when I had to open the meeting. I was nervous. There were a lot of people in the room, and I was sure I’d be rubbish and wouldn’t sound as good as previous Presidents. However, something quite lovely happened through the meeting. Maybe it was the nice friendly atmosphere (see above). Maybe it was because I got my head around the fact I was actually doing it. You know, being BNMS President at a BNMS meeting. And it was going OK. But by the time I came to hand out the poster awards and close the meeting, it really felt like I was in a room with friends. The nerves had melted away throughout the day. 

So, I’d like to finish this blog by saying thank you. Thank you for supporting the BNMS and thank you for supporting me. 

And please think seriously about coming to the next meeting in Belfast next Spring if you possibly can. It’s already shaping up to be another good one….

We can all strive to be an Icon of Nuclear Medicine!
I’m in a very reflective mood today. I’m thinking about the legacy we all leave behind us. As a number of you will have heard, sadly Dr. Keith Harding, or ‘LKH’ as he was affectionately known, passed away recently. He was an absolute giant of Nuclear Medicine (and I don’t just mean because he was very tall, which he was) and had huge influence on the practice of Nuclear Medicine in the UK and beyond. 

The first time I met LKH, I must admit, I was a bit scared of him. I was in my first job as a trainee Radiopharmacist at City Hospital, Dudley Road. I was very green and wet behind the ears. He was very tall (as I said!) and I really was a bit intimidated by his no-nonsense manner. He always asked questions – as many of you will remember from BNMS conferences, if you were there. Not always easy ones. He challenged things and had an expectation that you would do the same. So ever so slightly terrifying at first!

As I got to know him, however, I realised what a kind and supportive man he was. He would invite the Nuclear Medicine team to BBQs at his house in the summer. He made sure we all had the chance to go to conferences. He was generous with his time and encouraged us all to be better. He raised the standard – in fact, he often set the standard. After finding out he had passed away, so many people responded to say they owed him their entire careers. He was that sort of man.  

He did so many things over the years. He was instrumental in starting up our Nuclear Medicine department, and worked there for his entire career. He was the first chair of ARSAC, and indeed, was instrumental in setting that organisation up. He also led in establishing the carer and comforter regulations, without which treating our benign radioiodine patients on an out-patient basis would have been much more difficult. He had an influence beyond the UK, from sitting on a European Commission to look at early radiation protection law to being instrumental in setting up the IRMER regulations. And I’m sure many other things I don’t know about. 

He was a BNMS Treasurer, and BNMS President – same as me. I don’t think I would have been so involved in the BNMS if it weren’t for him, and my career would have definitely been the worse for that (I love the BNMS, in case you hadn’t already realised!)

There have been many other people who have been role models for me, but he was the first, and he made one hell of an impression. 

Maybe we won’t all go on to be as influential as LKH. We shouldn’t be comparing ourselves with other people anyway. But we can all aim to be the best we can be, within the roles we occupy. We can all challenge the status quo. We can all aim to raise the standard. We can all create our own legacy.

Every single time you go the extra mile for a patient, for another service or for a colleague, you are making a difference. You probably don’t think of it very often, but every day that we come into work we are in a position to encourage or discourage someone else, to be a role model - whatever our job is in the department. How we treat other people can have a huge impact, so if there is a kind way to do something, I think we should be kind. That doesn’t mean to say you shouldn’t challenge poor behaviour or performance, if appropriate, or discuss difficult subjects. It’s hard to say some things, but if messages are delivered with honesty and kindness, they can be something which helps people grow, not knocks them down. Honestly, you don’t ever make yourself look any better by belittling anyone else. But if you support your team, then everybody wins. 

We all have the potential to be an icon of Nuclear Medicine, and I think this is the greatest compliment we can pay to those who have influenced and encouraged us. So my thoughts today are that I want to be more like LKH, and I would highly recommend you try to be too. Ask the questions, challenge the status quo, raise the standards, create your legacy. But above all, be kind. 

So go be iconic!

If you would like to practice some LKH-style BNMS conference questioning, please join me at the Autumn BNMS meeting on Tuesday 31st October. I’d love to see you there!

Ms Jilly Croasdale
BNMS President

What does quality look like? 
Part 2: Fundamental Care

Following on from last month’s blog about how communication and the interface between departments and organisations can impact on the quality of our services, I’d like to delve a little bit further into the subject of quality and the things that can affect it. 

In my organisation we have launched a programme called ‘Fundamentals of Care’. This is something that I think is both fantastic and sad. It’s fantastic because it is successfully improving how we care for our patients by taking things back to basics, but sad at the same time that it’s necessary and because it started out with some distressing feedback from patients about their poor experiences in hospital. Patients at end of life whose relatives were poorly communicated with. Stories from relatives whose loved ones did not have their basic hygiene needs met and who were greeted with soiled bedding when they came to visit. Patients who weren’t eating because no-one was giving them the sort of food they could eat. Whilst advances in the technical aspects of care are wonderful, it is important not to forget the fundamental principles of how to look after our patients. 

The fundamental care principles identified are: 
• Harm Free Care
• Promoting independence
• Nutrition and Hydration
• Communication
• Symptom Management
• Sleep and Rest
• Personalised care 

At first glance, much of this does feel very ward-based, and it is easy when you work in Imaging to think this doesn’t apply to us. But as I said in last month’s blog, it’s often not until you have an experience yourself that you start to consider the sort of seemingly small things that can make a huge difference. I remember visiting my dad in hospital the week before he passed away and he was sat in a chair with no trousers on. My dad was the type of man who wore a shirt and tie (and trousers!) every day of his life. Apart from warm days on holiday when the shirt and tie were exchanged for a polo shirt. Never anything without a collar. He had other visitors that day and they had put a blanket over his legs, but this kept falling off. He was a big man, and I think the staff had just given up trying to get the trousers on him, but to this day, this is one of my stand-out memories of his final days in hospital. Making sure someone is properly dressed and retains their dignity is pretty damn fundamental. And yes, I’m still mad about it. 

You may be reading this and thinking that’s all very interesting, Jilly, but what does it have to do with Nuclear Medicine? But we do have in-patients in our departments, who may well be in their nightwear. Do we make sure their dignity is preserved at all times? And are they warm enough, for example? 
Many of our patients are only with us for a short while, and a lot are out-patients. However, some people can be with us for quite extended periods. Sometimes planned, and sometime unplanned – for example, waiting for transport. Do we make sure they have enough food and water? Maybe they are diabetic – do we make sure they eat when they should? Do we check they are able to take any medication they may be on if their transport is delayed? You may feel this is going beyond our remit, but I feel that every single department in the hospital should be actively thinking about how this applies to them. 

You’ll see there’s reference to ‘Harm Free Care’ on the list. So what does Harm Free Care mean for Nuclear Medicine? My thoughts are that for us this means ensuring the patient has the right test and gets the report at the right time. The GIRFT (Get It Right First time) principle is particularly apt here. And certainly, no-one could argue this is beyond our remit. 

Again, my experience of Nuclear Medicine departments is that we do look after our patients well, but it never does any harm to look beyond the doors to the Nuclear Medicine department and have a think how initiatives within your organisation can be applied to your area. Have a think about how someone’s dignity is being preserved, whether they have enough food and water and what happens when transport doesn’t turn up before the department closes, for example. And have a think about how we can assure ourselves that we are providing Harm Free Care 100% of the time. 

I hope you’ve found this interesting! Find me on X (formerly known as Twitter) @PresBnms

Please look out for our Autumn meeting, coming up on 31st October in London – it would be great to see you there if you can make it!

What does quality look like? 
Part 1: Communication

I must start by saying that my experience of Nuclear Medicine departments is that we generally look after our patients beautifully while they are in our departments. And if you don’t think that’s true for your department, then you should make your feelings known, whatever your role.

However, I have recently been thinking a lot about how good our patients’ overall experience is. What do they consider to be a quality service? Is there anything that we can do better?

I think it can be easy to forget, when we talk about our patients, that sometimes WE are the patients.  Like many of you, I’ve had this experience. Not in Nuclear Medicine, but in other areas. And in most aspects, our wonderful NHS has been brilliant. But there were some opportunities to improve – for example in communication and the interface between different services and organisations. I’d like to share some of these experiences, as some of it may give some food for thought:

1. I like to think I’m a fairly intelligent woman, and I really don’t like being called sweetheart by someone I don’t know. In fact, I’m not that keen when it’s someone I do know. My brother-in-law, who I like very much, occasionally gets away with it. I’d rather someone used my name – and gave me theirs. This irritates me a lot, and I know I’m not the only one. 

2. I don’t like things being done ‘to me’. One example of this was when my 3 year old son was in traction for 4 weeks and had to stay in hospital. He was well looked after, and the nursing and medical care was good, but looking after a young child and keeping him occupied in hospital for that length of time was a challenge. We ended up with quite a lot of ‘stuff’ in the bed bay. I kept it very organised and for that time, it essentially became home. However, one day the nurses, without anyone saying anything to me, started moving everything. Suddenly having someone start to handle all our things without knowing why was alarming and upsetting. We were being moved to another bay, which was fine, but a simple conversation beforehand would have alleviated the upset. Letting patients know what is happening to them and why is important.

3. Another thing I really don’t like is when things have to repeated for what seems no good reason – what a waste of resource. My mum has recently been unwell and saw her respiratory consultant at her local hospital. He ran some blood tests and contacted us to say she needed to go to A & E that day. He wanted her put on a drip for severe dehydration and dangerously low potassium levels. We took her in to the emergency department (at the same Trust) and had to wait for hours to be seen, after which time, all the blood tests had to be repeated before anything could be done. My poor little mammy – 86 and confused, waiting all that time, and not going to the toilet even once because she’s so dehydrated (she’s normally a very habitual user of the facilities). She went to A & E at teatime, and it was past midnight before she was put on a drip. Why did it take so long, considering a consultant at the same organisation had said for her to go in, and why did we have to repeat blood tests? I know this isn’t directly relatable to Nuclear Medicine, but the communication between departments within our hospitals and the interface between different organisation is definitely something that can be improved in my experience. And it may be that the poor communication comes from other departments, but as far as the patient is concerned, they don’t see where it arises. It’s worth a review to see if we can affect any improvements. How educated are the ward and medical staff about Nuclear Medicine tests? Could we improve this, and by doing so, improve the experience of our patients? 

I consider the visit to our Nuclear Medicine departments as the meat in the referral sandwich. There is a slice of bread before they arrive, and this is the part where we communicate the details of the test or treatment they are being invited to have. How good is that communication? How many of us are communicating the appointment information in the patient’s own first language, for example? In the area where my Trust is located, for a large proportion of the population we serve, this isn’t English. Wouldn’t it be more reassuring and welcoming if some of our direct communication with them also provided some information in their own language? You may think this is too difficult, or maybe even disagree, but have you asked your patients about it? 

The final slice of the sandwich is what happens after the patient has been for their appointment. If I have a test for something at the hospital and don’t get the result for 5 months, do I really view this as a quality service, even if the people were lovely? If the result is likely to take a long time, are we giving the patient realistic time frames? And if a result slips through the net and for some reason, is late being reported, are we being open about it and apologising?
So going back to the question about whether you have asked your patients – many of us do gather feedback, but it can be quite passive. We sometimes get lovely thank you letters (and occasionally even sweet treats). We may have a box for suggestions, and we respond to any complaints received. But do we actively ask them for feedback? I know it takes time to process when it is returned, so it may not be something we’re able to do continuously, but could you consider how to do this in some way, if you’re not already?

If you’re wondering where to start with this, the BNMS can help. We have a patient advocate named Adrian Hardy on the BNMS Council, and who better to help us gather feedback from patients. He has put together some questions he feels would give us a better overview of how patients feel about their experiences. He has made this available on our website for you to give to your patients. Patients need only answer the questions that they see as relevant to their experience. Adrian would like to co-ordinate the feedback on a national level, so please ask your patients to send their answers to Adrian at apaulhardy@aol.com or if they’d like to speak with Adrian send him a text on 07707 901953 and he will get back to them.  

You can find the information at: 
https://cdn.ymaws.com/www.bnms.org.uk/resource/resmgr/patient_information_leaflets/v2_patient_experience_feedba.pdf

I hope you’ve found this interesting! Find me on X (formerly known as Twitter) @PresBnms

Ms Jilly Croasdale
BNMS President

Do you suffer from The Imposter Syndrome?

If the answer to this question is yes, you won’t be the only one. It’s something I have struggled with for years. I’ve always felt I got to where I am today by sheer luck, and that any day people will find out I’m not good enough really. I compare myself to my Radiopharmacist peers and find myself lacking. And when I became President of our wonderful society, it went into overdrive. “I’m not a doctor. I’m not clever enough. I won’t be able to give you in-depth clinical guidance on all the areas of Nuclear Medicine outside of Radiopharmacy.” These are the things which were going round my head and giving me some real anxiety. And guess what – many other people you will have heard of suffer from the same self-doubt, with celebrities such as Kate Winslet, Meryl Streep and Tom Hanks all feeling they have made their careers out of luck. Whilst I wouldn’t argue that luck can play a part, it’s a small part. The wonderful Tom says he wonders ‘How did I get here? When are they going to discover that I am, in fact, a fraud and take everything away from me?’ The incredible Michelle Obama often feels self-doubt. Even Albert Einstein is quoted as saying “The exaggerated esteem in which my lifework is held makes me ill at ease. I feel compelled to think of myself as an involuntary swindler”. 

Well for me all this has changed. I was very fortunate to be able to attend this year’s SNMMI in Chicago. I had planned to do a blog telling you about all the many interesting clinical talks I attended – and I was worrying that what I wrote wouldn’t be good enough. However, the session which really struck a chord with me was called ‘Imposter No More Workshop: Practical Strategies to Step into Full Authenticity and Confidence, led by a MD called Gail Gazelle (great name!) and I sat there in a room full of amazing people, both men and women, all of whom felt the same as I did. I’d like to share some of the main points which have really stuck with me, in the hope that any of you who have similar feelings find it helpful too. 

Firstly, we are not our thoughts. The things we say to ourselves in our heads can be mean. Some of the things I say to myself I would never think of saying of another person. But just because we think them doesn’t make them true. We are our own worst critics and need to be kinder to the one person that will always be with us. Ourselves. 

Secondly, we have learnt to be extremely intolerant of our own mistakes. We expect ourselves to be perfect, and when we’re not, we are much harder on ourselves than other people are. What is the ratio of positive to negative thoughts you have about yourself? Many of us focus too much on our deficits and not enough on the things we do well. 

We did an exercise during the session when we discussed with another person a time we felt we had dealt with something well, and the other person identified our strengths, before swapping over. My strengths include humour, leadership, relationships, problem-solving, courage, positivity, big picture perspective and fairness. Wow – that doesn’t sound too shabby! My partner’s strengths included love of learning, patience, critical thinking, perseverance and curiosity. Notice how our strengths are completely different? We also had to write down our number one negative thought. Mine was that I had felt inferior to my peers. However, the very bright research scientist next to wrote that all her life she had felt unworthy and undeserving of anything positive which came her way. I was appalled that she had written something so unkind about herself. I had heard her speak and she was articulate and bright. However, her moment of clarity came when she realised that no-one else knows as much about her research as she does. And she’s right. 

So I know it may sound crazy. Maybe being in America has affected me (I’m certainly allowing myself to be ‘vulnerable’ at the moment, which feels quite Oprah), but I actually do feel different. I’ve stopped comparing myself to all the other Presidents you’ve had and I don’t feel like a fake. I’ve actually realised that everyone has their strengths and comparing yourself is a fool’s game. I think I’ve actually made quite a good start (I’m resisting being very English and adding a disclaimer here!)

I’m 100% positive I’m not alone in this, and I hope that this blog helps one or two of you out there who have felt the same. Maybe by writing this, I’m demonstrating some courage, hopefully mixed in with a drop of humour (see earlier strengths references). 

I’d like to finish by sharing a quote Gail Gazelle brought to my attention from American science author, Adam Grant: ‘Imposter syndrome is a paradox: others believe in you; you don’t believe in yourself; yet you believe yourself instead of them. If you doubt yourself, shouldn’t you doubt your judgement of yourself? When multiple people believe in you, it might be time to believe them.’

Hopefully see you in London on 31st October for the Autumn meeting. Please come along – all of you are what makes our meetings. And we all bring something equally important to the party!

The BNMS could be good for your health!

Countless psychology studies have investigated the underlying factors which support happiness and wellbeing. One such factor is gratitude. Gratitude is defined in the Cambridge dictionary as ‘a strong feeling of appreciation to someone or something for what the person has done to help you’, and that sums up how I feel about the part the BNMS and the people I have through it have played in my life and career. 

I first attended a BNMS conference in the early 90s, when I worked as a trainee Radiopharmacist at what was then Dudley Road Hospital in Birmingham. The conference was held at Imperial College, London – and was in fact, the last of a number of meetings held there. I remember sitting in the various sessions in awe of everyone – not just the presenters, but also the audience. The interactions, questions and debate coming from the audience totally impressed, and slightly terrified me. I so wanted to put my hand up and comment but was too shy in those early days. However, BNMS is full of people like Dr. Keith Harding, past BNMS President and my first Consultant back at Dudley Road - innovative, questioning, clever but also down-to earth and encouraging. I continued to be involved in BNMS through the rest of my time in Birmingham, whilst at Leicester Royal Infirmary and at the Royal Free Hospital, and then when back in Birmingham once more. I was so lucky to work with some wonderful people in each of these places. I grew in confidence and with the help of the BNMS, enjoyed not only learning about the wider world of Nuclear Medicine, but also making useful contacts both with other Nuclear Medicine professionals and with Industry colleagues. 

The BNMS is about a lot more that the conferences it puts on – although these are great, as anyone who managed to join us in Harrogate will hopefully attest to. It is about a unique community of professionals, all working together to achieve the same goals and all respecting the part they all play in the care of patients. It’s about all those Technologists and Radiographers who put the patient at ease, ensure the scans are of suitable diagnostic quality and much much more. It’s about the Radiopharmacy staff who work to ensure safe, effective and high quality Radiopharmacy services are provided. The Physicists who ensure our cameras are working to their optimum capability and that we are working safely within the boundaries of good radiation protection, for example. It’s the nurses and support workers who care for our patients whilst they are in our departments, and our doctors who ensure the test the patient receives is suitable as well as providing that important final report. Of course, all the people I mentioned do many other things, but the point I’m trying to make is that everyone plays an equally important part in the care, diagnosis and ultimately treatment of the patient. And I think that’s pretty unique, and to be frank, pretty fantastic. 

BNMS does many things behind the scenes to help and support our community. Elected council members, co-opted experts and our wonderful BNMS staff help provide guidance and leadership - you may have read some of our guidance documents and I hope you have found them useful. One which springs to mind is the guidance developed during the first COVID lockdown. BNMS worked with colleagues from all our different disciplines to pull together practical advice for how to manage our services during that challenging time. We represent the interests of our Nuclear Medicine community to government – for example, in trying to mitigate the potential impact of Brexit on our services.  More recently we have been working to put together a manifesto for PET CT commissioning, and going forward, I hope that we will play a key role in further developing Molecular Radiotherapy (MRT) services in the UK. We really are living in exciting times, and I feel we are on the cusp of something potentially game changing for many of our patients. There has never been a better time to work in Nuclear Medicine. 

So, I’d like to end my first newsletter article as BNMS President by bring this back to gratitude and the impact it has on health. I would like to say thank you to the BNMS for the opportunities it has afforded me. I’d like to say thank you to all the Radiopharmacists, Physicists, Nurses, Support Workers, Technologists, Radiographers and Doctors I have met, not only in the various departments I’ve worked but also through the BNMS, for their help, encouragement and friendship. 

Thank you. Two small words, but a very big meaning. 

As I said when I had the President’s baton handed over to me in Harrogate, I feel very grateful and very healthy! I sincerely hope that reading this prompts you to reflect on your BNMS experiences, and that you go home tonight feeling the same. Please consider joining us at the Autumn meeting at the Royal Society of Medicine (Wimpole Street, London) on Tuesday 31st October  for another dose of health and happiness!