New figures show the NHS needs thousands more radiologists to keep patients safe, with a post-COVID consultant exodus also looming

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NHSMore than half (58%) of radiology leaders say they do not have enough diagnostic and interventional radiologists to keep patients safe, new data from National Health Service (NHS) trusts and health boards across the UK show. The data, recently published in a Royal College of Radiologists (RCR) report, also show that, despite many imaging doctors staying in the NHS last year to help the coronavirus effort, the NHS radiologist workforce is now short-staffed by 33% and needs at least another 1,939 consultants to meet safe staffing levels and pre-coronavirus levels of demand for scans.

Furthermore, half of trusts and health boards (47%) do not have the staff or transfer arrangements needed to run safe 24/7 interventional radiology services, meaning patients are potentially missing out on life-saving procedures. Without more consultants in training, investment in new models of care and better staff retention and recruitment, by 2025 the UK’s radiologist shortfall will hit 44% (3,613 consultants short of real terms demand).

Mark Callaway, radiology workforce lead at The Royal College of Radiologists (RCR), comments: “Our new report has found the NHS needs thousands more radiologists to ensure patients get the safe and effective treatment they deserve, amplified by the first-hand experience of frontline doctors who witness the impact of consultant shortages on patient care on a daily basis.

“The staffing forecast for 2025 makes grim reading, but, even more worryingly, swathes of demoralised radiologists are imminently looking to work less or leave the NHS.”

The RCR’s latest workforce census reveals the NHS needs nearly 2,000 extra radiologists to clear scan backlogs, meet safe staffing quotas, and keep up with demand.

Meanwhile, a recent poll to gauge radiologists’ morale found half intend to cut their hours, and three times as many consultants than normal plan to leave the NHS in the next year.

Waiting lists for hospital treatment have now hit record highs in England and tens of thousands of patients currently face long waits for scans3.

Understaffed radiology departments across the UK are working hard to bring down backlogs caused by last year’s pause in non-urgent hospital work, while having to scan at a slower rate because of infection control and social distancing measures.

The census shows radiologist staffing has reached a tipping point, with imaging leaders warning that shortages pose a serious threat to NHS recovery and that patients facing “long, anxious and inevitable” waits for diagnoses and surgery as a result.

Hospital leaders completing the RCR’s census said radiologist shortages now continually jeopardise patient safety, reporting: “We cannot deliver adequate services for our patients” and “we can no longer provide cancer and acute care safely”.

The report shows the UK now has 4,277 radiology consultants, equating to 3,902 doctors working full-time, an increase of 170 full-time consultants compared to 2019.

Consultant numbers are increasing, but not fast enough to keep up with patient demand. RCR shortfall calculations, which use rota and service demand figures to give a realistic estimate of NHS requirements, show radiologist shortfalls range from 24–38% across the UK.

England now has 146 more full-time imaging experts than it did in 2019. However, it still needs another 1,675 consultants to keep up with NHS demand.

Radiologist numbers in other home nations have barely risen

Northern Ireland gained 19 extra full-time radiology consultants in 2020. Scotland gained five. Wales’ radiologist workforce has stalled and the country has incurred huge patient backlogs for scans during the pandemic. Wales also has the most severe radiologist shortage of any UK nation.

If nothing improves, the RCR predicts the UK’s 33% actual radiologist shortfall will hit 44% by 2025.

Closing the forecast gap between consultant supply and demand would require the number of new radiologists in training across the UK to treble, from 300 to 900 training places per year.

However, shortages could deepen even more quickly than forecast if findings from a recent RCR member survey are realised.

A poll of 1,089 UK radiology consultants at the start of April 20217 found:

  • 41% are moderately or severely demoralised in their jobs post-pandemic
  • Nearly half (48%) are planning on working less after the past year
  • A fifth (22%) are now considering leaving the NHS
  • 12% are considering leaving in the next 12 months—three times as many radiologists than would normally leave the NHS each year, equating to potentially losing 735 consultants and trainees across the whole workforce.

Last year, NHS England’s top diagnostics adviser Mike Richards called for a major increase in hospital scanners and radiology staff in England.

On the back of these “stark” staffing data, the RCR is calling for these measures to be urgently realised across the whole of the UK.

The RCR’s radiology workforce lead Mark Callaway says: “The coronavirus pandemic has bluntly contrasted the every-day heroism of NHS teams with the chronic under-funding of services, and the cracks in radiology, as elsewhere, are becoming undeniable.

“Our new report has found the NHS needs thousands more radiologists to ensure patients get the safe and effective treatment they deserve, amplified by the first-hand experience of frontline doctors who witness the impact of consultant shortages on patient care on a daily basis.

“The staffing forecast for 2025 makes grim reading, but, even more worryingly, swathes of demoralised radiologists are imminently looking to work less or leave the NHS.

“Unless hospital imaging capacity is massively improved, the UK will continue to lag behind other countries on cancer survival rates and patients will face worse outcomes for trauma care and all kinds of conditions. The need for investment is urgent.

“The UK’s political leaders have made encouraging pledges around catching up with scan backlogs and implementing new diagnostic pathways and community-based scanning away from hospitals.

“The NHS also came through last year with emergency funding for scanners and private provider support, and we strongly support emerging plans to introduce diagnostic hubs to speed up access to scans, but the vital issue remains—we need more staff.

“Without thousands more radiologists—as well as radiographers, nurses and support staff—patients will inevitably continue to face long, anxious waits for radiology services, missing out on crucial early diagnoses and life-saving image-guided surgery.”


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