NHS Lanarkshire swapped children's X-rays for a £400 handheld metal detector

Children who swallow coins or other metal objects typically get one or more X-rays to find them — and absorb the radiation that comes with imaging. At NHS Lanarkshire, a pilot at Monklands Hospital replaced that with a handheld metal detector waved over the child. 'We just run the detector over them and, if it bleeps and the light flashes, we know they have swallowed something metallic,' said Dr Nicola Moultrie, who ran the project — named Hunting for Swallowed Treasure — as part of her studies to become a consultant.

Depending on where the object is in the body, some patients can go home without any radiological imaging at all, said consultant Dr Fiona Hunter, who oversaw the project. As well as being safer, it is cheaper: X-rays run around £55 each, the detector cost less than £400, 'so it has quickly paid for itself.' After the pilot, the initiative was set to spread to NHS Lanarkshire's two other emergency departments — Hairmyres Hospital in East Kilbride and Wishaw General Hospital — with the whole emergency department team trained to use the detector where appropriate.

It replaces an imaging procedure with a bleep: the detector answers the only question that matters — is there metal, and where — for £400 once instead of £55 a scan.

It removes radiation from a paediatric pathway where the patients are the most radiosensitive people in the hospital.

The pilot came from a trainee's consultant project, showing a big system can adopt a tool-level innovation from the shop floor.

Training the whole emergency department team, rather than a specialist few, made the substitute genuinely available at the front door.

A cheap tool from another walk of life can delete a procedure: match the instrument to the question being asked, not to the machine the department already owns.

As of March 2017 the detector was in use after the Monklands pilot, being introduced at Hairmyres Hospital and Wishaw General Hospital, with NHS Lanarkshire considering a rollout to all A&E departments.