What is the problem...?


Medical procedures involving Diagnostic X-rays are by far the most significant source of human-made radiation exposure to the general public.


Staff training to perform these procedures can currently only train to perform these procedures on real equipment and on real patients, exposing both themselves and the patient to unnecessary radiation.


At the same time, staff who are already trained to use fluoroscopic equipment but who may wish to fine tune and refine their knowledge of anatomy can only do this through performing repeated clinical procedures, learning largely through trial and error.


On top of all this, there is a relentless growth in diagnostic and interventional imaging procedures fuelled by population demographics, various national strategies and initiatives (for example, the 18 week wait, cancer and cardiac reform strategy, etc).


This in turn puts enormous pressure on the NHS to train and educate staff to get them to a stage where they are not only qualified to carry out these procedures, but to a stage where they can do them with confidence.


There is scope for reducing the radiological risks involved to both patients and staff which are inherent in these procedures, without reducing the medical benefits.


What is the solution...?


The virtual cath lab is a fully interactive computer simulation of the clinical fluoroscopy environment and uses a real time 3d games engine which will run on any windows PC.


It will allow users to train to use equipment that delivers ionising radiation in a completely safe yet realistic way, either at home or in hospital.

In addition, through the use of 3D anatomical models, staff who are already trained in fluoroscopy can fine tune their anatomical knowledge (by experimenting with new radiographic projections (for example), also in a completely safe and radiation free environment).


In summary, the virtual cath lab delivers a safe, realistic and radiation free learning environment which is both affordable and accessible to all Healthcare Providers.

The Business Case

Here is an extract from the VCL Business Case, you can download the PDF here: VCL_Business_Case_v1.pdf

3.0       Business Case- fitness for purpose checklist:


  • Is the business need clearly stated?


There is an ongoing requirement for the NHS to facilitate high quality patient care and increased productivity (e.g. 18 Week Wait, Payment by Results, PCT Quality based Commissioning initiatives) whilst simultaneously optimizing and protecting resources (e.g. staff via the EWTD).


The Department of Health has identified NHS-led healthcare innovation (and procedure simulation in particular) as a key component to address the above requirement.



(In particular this section of the report: “Safer medical practice: Machines, manikins and Polo mints”).


  • Have the benefits been clearly identified & are they consistent with the organisations strategy?


Radiology procedure simulation has been shown to reduce patient & staff radiation dose by up to 48% (see link below) and is therefore justifiably good practise from a clinical safety perspective alone. Additionally, simulation should decrease clinical procedure times and correspondingly improve clinical procedure outcomes & efficiency.


Cash releasing benefits can be formally mapped to staffing (less mentoring of trainees & decreased ramp up time), increased procedure throughput (influencing Payment by Results), PCT quality-based commissioning, 18 Week Wait initiative and will address training challenges resulting from the EWTD legislation.


The VCL will ‘fit in’ at any stage of NHS healthcare delivery (medical / radiography school, independent sector, postgraduate education & Acute NHS Trust) and will additionally (via home-based learning) allow learning outcomes to be achieved outside the healthcare environment’s clinical staffing and IM&T infrastructure, thereby enabling reduction of possible maintenance costs to the Trust.


  • Is it clear what will define a successful outcome?


-       Clinical Safety: substantial reduction (up to 48%) of radiation dose to patients and staff.


-       Conformance with Ionising Radiation (Medical Exposure) Regulations 2000 (IRMER) training recommendations (Section 2).

-       Decreased ramp-up time for trainees and less mentoring of trainees by trained staff- cash releasing benefit.

-       Increased productivity (via increased knowledge of spatial awareness leading to more efficient radiographic technique) of trained staff, leading to increased patient throughput.


  • Is it clear what the preferred option is?


The “established” option (training using real equipment and patients with a staff mentor) remained unchallenged until the recent advent of computer based simulation technology. However corporate application of much of this technology still suffers from the drawbacks of the established option (dedicated and costly custom training environments, staff needing to be released to attend training at a remote location, etc).


The VCL is a viable alternative to the high-end manikin based dedicated simulation products on the market today and is capable of delivering most of the benefits of these high end products in an efficient, affordable, accessible and cost-effective manner.


  • Is it clear why this is the preferred option?


-       Vycaria’s due diligence had indicated that the VCL is the only UK-based fluoroscopy simulator on the market today.

-       The VCL does not require custom hardware / software / training environment.

-       The VCL does not put a maintenance burden on Trust’s IM&T department / Catheterisation Laboratory infrastructure or staffing.

-       The VCL is very favourably priced & there are a variety of licensing options.

-       The ongoing VCL product roadmap has been heavily influenced by and can quickly respond to the specialised requirements of the UK cardiology community and has previously incorporated input from specialist user groups (e.g. Cardiac Radiographers Advisory Group).


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