In light of the current COVID – 19 pandemic POAC would like to take the opportunity to reinforce the POAC funding policy for CXR in Community Acquired Pneumonia (CAP).
In accordance with the Auckland Regional HealthPathway for Community Acquired Pneumonia in Adults
Chest X ray is not usually needed in CAP unless it will change management.
Acute CXR under POAC is not indicated unless it has the potential to avoid same-day hospital presentation or change immediate management.
In most cases of Lower Respiratory Tract infection presenting to primary care the diagnosis is made clinically and the patient can be manged on the basis of their clinical presentation. Chest X ray does not normally add anything to the immediate primary decision-making process, which is between admission or initial trial of management in primary care.
In order to avoid sending symptomatic patients to community radiology providers unnecessarily your co-operation is respectfully requested: please consider very carefully whether a POAC CXR is indicated for patients presenting with LRTI, especially if there is a possibility that the patient may have COVID – 19. This will help reduce the need for community radiology providers to execute PPE procedures (with the resultant disruption to services) and reduce potential exposure of other patients in radiology waiting rooms (elderly, pregnant women etc.).
(Note also that some private providers are declining to see people who should be self-isolating, even if they are well.)
If you believe a patient with LRTI, especially if a potential COVID-19 case, is unwell enough to require chest X ray to guide immediate management they are likely to require hospital admission. Please discuss with your local General Medicine Specialist