Dear Medway NHS Foundation Trust,
Prostate Cancer UK undertook a Freedom of Information Act (FOI) request of all Trusts, Health Boards and Health and Social Care Trusts in 2016, and again in 2018, with the aim of achieving a state of the nation overview of the use of mpMRI before biopsy.

We gained an in-depth understanding of the current status of mpMRI before prostate biopsy across the UK. We have used the data to make the case to National Commissioners for implementation support. It has also guided our funding and development of resources that respond to some of the challenges and barriers to implementation that centres told us they faced.

This third and final round of questions is our means of understanding what progress has been made and to identify where we can target our resources and National Commissioners’ support to have maximum impact.

We really appreciate your help with this. Please pass the below on to your urology department for them to complete. If this is not possible we would really appreciate your help to provide as much information as you can.

Yours faithfully,

Lizzie Ellis

1. Do you routinely conduct prostate MRI (bpMRI/mpMRI) scans before first prostate biopsy as part of the initial diagnostic process? (please tick all that apply):

a. Yes, using T2-weighted, diffusion-weighted (multi-b ADC and high/long b) and dynamic contrast enhanced (DCE) sequences
b. Yes, using T2-weighted, diffusion-weighted (multi-b ADC and high/long b) sequences but not DCE
c. No but we refer to another provider (please provide details)
d. No (please provide details)

2. If yes, to 1a: What percentage of men with suspected prostate cancer receive mpMRI before biopsy as part of the initial diagnostic process?

3. If yes, to 1b: What percentage of men with suspected prostate cancer receive bpMRI before biopsy as part of the initial diagnostic process?

4. What are your eligibility criteria/exclusion criteria for prostate MRI? (please tick all that apply):
a. Age (please provide details)
b. Symptoms (please provide details)
c. Life expectancy (please provide details)
d. Contra-indications (please provide details)
e. Other (please provide details)

5. Are you using results from the prostate MRI before biopsy to rule some men out of biopsy as part of the initial diagnostic process? (yes/no)

6. Do you biopsy all PI-RADS or LIKERT 3 scores?
a. Yes
b. No
c. Dependent on patient histology

7. What threshold do you mostly use for ruling men out of biopsy?
a. PI-RADs 3 and above
b. LIKERT 3 and above
c. PI-RADs 4 and above
d. LIKERT 4 and above
e. Varies depending on age (Please provide detail)
f. Varies depending on other factors (Please provide detail)

8. What percentage of men do you estimate are ruled out of biopsy?

9. Have there been any changes to your prostate MRI capacity in the last year? (please choose all that apply):
a. An additional or new MRI scanner
b. Increased MRI scanner slots for prostate
c. Agreement to use Dynamic Contrast Enhancement
d. No longer using Dynamic Contrast Enhancement
e. A scanner/magnet upgrade
f. other (free text)

10. Has the number of radiologists at your trust/health board who report prostate MRI scans changed in the last year?
a. Increased
b. Decreased
c. Stayed the same

11. How many radiologists at your trust/health board report at least 250 prostate MRI scans per year?

12. Which of the following processes do you follow to manage men ruled out of an immediate biopsy, but with a raised PSA?
a. NICE Guidelines: prostate cancer diagnosis and management (NG131)
b. A local protocol (please provide details)
c. Other (please provide details)

Freedomofinformation (MEDWAY NHS FOUNDATION TRUST), Medway NHS Foundation Trust

4 Attachments

Dear Ms Ellis

 

Freedom of Information Request: reference 5662

 

Thank you for your email requesting information regarding Medway NHS
Foundation Trust. Your request is being dealt with under the terms of the
Freedom of Information Act 2000 and will be responded to within the
statutory 20 working day deadline.

 

Yours sincerely

 

Freedom of Information Team

[1][email address]

 

Medway NHS Foundation Trust
Windmill Road
Gillingham
Kent
ME7 5NY

Website: [2]www.medway.nhs.uk 

[3][IMG]    [4][IMG]    [5][IMG] 

 

 

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Dear Freedomofinformation (MEDWAY NHS FOUNDATION TRUST),

Further to our Freedom of Information request of 20th Aug 2019, we have received a large number of responses, however, we are still awaiting a response from your Trust. Please provide a response as soon as possible as the deadline has passed.
Please let me know if you are having any problems completing the request.

Yours sincerely,

Lizzie Ellis

Freedomofinformation (MEDWAY NHS FOUNDATION TRUST), Medway NHS Foundation Trust

4 Attachments

Dear Ms Ellis

 

Freedom of Information Request: reference 5662

 

Thank you for your email and please accept our apologies for the delay in
responding.  I have today chased for an urgent response and will get back
to you as soon as possible.

 

Yours sincerely

 

Freedom of Information Team

[1][email address]

 

Medway NHS Foundation Trust
Windmill Road
Gillingham
Kent
ME7 5NY

Website: [2]www.medway.nhs.uk 

[3][IMG]    [4][IMG]    [5][IMG] 

 

For future reference, please note that the Trust’s FOI email address is: 
[6][email address]

 

 

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Freedomofinformation (MEDWAY NHS FOUNDATION TRUST), Medway NHS Foundation Trust

4 Attachments

Dear Ms Ellis,

 

Freedom of Information Request: reference 5662

 

Thank you for your request under the Freedom of Information Act 2000 and
please accept our sincere apologies for the delay in responding.

 

The information you have requested is as follows:

 

1.            Do you routinely conduct prostate MRI (bpMRI/mpMRI) scans
before first prostate biopsy as part of the initial diagnostic process?
(please tick all that apply):

a.            Yes, using T2-weighted, diffusion-weighted (multi-b ADC and
high/long b) and dynamic contrast enhanced (DCE) sequences yes

b.            Yes, using T2-weighted, diffusion-weighted (multi-b ADC and
high/long b) sequences but not DCE-  N/A

c.             No but we refer to another provider (please provide
details)- N/A

d.            No (please provide details)- N/A

 

2.            If yes, to 1a: What percentage of men with suspected
prostate cancer receive mpMRI before biopsy as part of the initial
diagnostic process?- 100%

 

3.            If yes, to 1b: What percentage of men with suspected
prostate cancer receive bpMRI before biopsy as part of the initial
diagnostic process?- N/A

 

4.            What are your eligibility criteria/exclusion criteria for
prostate MRI? (please tick all that apply):

a.            Age (please provide details) yes

b.            Symptoms (please provide details) yes

c.             Life expectancy (please provide details) yes

d.            Contra-indications (please provide details) yes

e.            Other (please provide details) PSA levels

 

5.            Are you using results from the prostate MRI before biopsy to
rule some men out of biopsy as part of the initial diagnostic process?
(yes/no) yes

 

6.            Do you biopsy all PI-RADS or LIKERT 3 scores? no

a.            Yes

b.            No

c.             Dependent on patient histology can only have histology
after biopsy

 

7.            What threshold do you mostly use for ruling men out of
biopsy?

a.            PI-RADs 3 and above

b.            LIKERT 3 and above

c.             PI-RADs 4 and above

d.            LIKERT 4 and above

e.            Varies depending on age (Please provide detail)

f.             Varies depending on other factors (Please provide detail)
varies depending on age, PSA, DRE findings, family history & patient
choice

 

8.            What percentage of men do you estimate are ruled out of
biopsy? 5-10% (estimation)

 

9.            Have there been any changes to your prostate MRI capacity in
the last year? (please choose all that apply):

a.            An additional or new MRI scanner

b.            Increased MRI scanner slots for prostate

c.             Agreement to use Dynamic Contrast Enhancement- yes

d.            No longer using Dynamic Contrast Enhancement

e.            A scanner/magnet upgrade

f.             other (free text) -Hire  mobile scanner

 

10.          Has the number of radiologists at your trust/health board who
report prostate MRI scans changed in the last year? no

a.            Increased

b.            Decreased

c.            Stayed the same - Yes

 

11.          How many radiologists at your trust/health board report at
least 250 prostate MRI scans per year? Only 1 out of the 2 has reported
250 or more prostate examinations within the last year

 

12. Which of the following processes do you follow to manage men ruled out
of an immediate biopsy, but with a raised PSA?

a. NICE Guidelines: prostate cancer diagnosis and management (NG131)  -
Yes

b. A local protocol (please provide details)

c. Other (please provide details)

 

Once again, please accept our apologies but I hope that this gives you the
answer you need.  If you are dissatisfied with the handling of your
request, you have the right to ask for an internal review. Internal review
requests should be submitted within two months of the date of receipt of
this email and should be addressed to:

 

Rachel Adams

Interim Information Governance Manager and Acting Data Protection Officer

Medway NHS Foundation Trust

Windmill Road

Gillingham

Kent

ME7 5NY

 

Please remember to quote the reference number in any future
communications.

 

In line with our obligations under the Freedom of Information Act the
Trust publishes responses to Freedom of Information Act Requests on the
Trust’s Disclosure Log which can be accessed via our website at:
[1]https://www.medway.nhs.uk/patients-and-p...

 

Yours sincerely

 

Freedom of Information Team

[2][email address]

 

 

Medway NHS Foundation Trust
Windmill Road
Gillingham
Kent
ME7 5NY

Website: [3]www.medway.nhs.uk 

[4][IMG]    [5][IMG]    [6][IMG] 

 

           

 

 

 

  

 

 

 

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