Xray Urgent Response Team (XURT)

Welsh Ambulance Services NHS Trust

James Gough, Head of Quality Improvement

Chris Evans, Research, Innovation and Improvement lead

Ben Scott, Quality and Improvement – Falls

Andrew Carter, Radiology Services Manager, Professional Head of Radiography

The urgent and emergency care system has witnessed significant increase in demand spanning several decades. Less than 10% of emergency service users experience life-threatening conditions however but consist primarily of frail and elderly fallers with long-term sequelae of complex co-morbidities. These patients now experience significant delays in ambulance response and, once ‘in the system’, may face lengthy delays in secondary care before returning to community living.


As much as two in every five patients accessing Emergency Department services receive an imaging examination. Accordingly, the aim of this project is to evaluate the feasibility and impact of an X-ray Urgent Response Team, delivered to Welsh communities by the Welsh Ambulance Services NHS Trust.


The project objectives include:

  • Evaluating suitability of equipment and quality of x-ray films in the pre-hospital setting.
  • Determining risk and governance implications, from a medical physics perspective, that reflect safety and suitability of mobile x-ray imaging within Ambulance Service and community contexts.
  • Developing a portable x-ray deployment model that details staff skills and competency requirements; booking system processes; ICT infrastructure and integration with local healthcare systems.


Evaluating the impact of portable x-ray provision on:


  • Patient transport requests
  • Project cost-benefit parameters
  • Patient safety and quality of care
  • ED referral rates for x-ray diagnostics
  • Elective/outpatient services
  • Added value and the patient experience
  • Added value and staff experience

Anticipated outcomes include:

  • Realised cost savings
  • Enhanced safety and quality of service
  • A reduction in the number of patients requiring ED transport for x-ray diagnostics
  • A reduction in demand for elective/outpatient services from increasing referrals to frailty rapid response teams
  • Improved patient and staff experience