More than half of patients in England referred for imaging are waiting for six weeks or more, and that number increased from fewer than 20,000 in May 2019 to nearly 327,000 in May 2020, according to a report posted on 14 July by the Guardian. It's the perfect storm, admits the Royal College of Radiologists (RCR).
Hospital trusts urgently need more equipment, staff, and space to deal with a huge backlog of scans for cancer and other conditions, as more than 600,000 patients await CT, MRI, and other scans amid the coronavirus crisis, the report noted.
"It's sort of a perfect storm in terms of delivering capacity," said Dr. Caroline Rubin, vice president of clinical radiology at the RCR. "It was not good before COVID-19, and now it has reduced as a result of it. I have no idea how long it will take to clear the backlog, we are doing all we can in terms of trying to get patients through."
She said there was a "significant block capacity gap in terms of the number of scanners," with the U.K. having one of the lowest number when compared with other countries. The most recent data from the Organization for Economic Co-operation and Development show the U.K. has 9.4 CT scanners per million population; France has twice as many, and Germany four times.
There also need to be more staff to run them, including nuclear medicine specialists, she continued. RCR stats show at the end of 2019 that the U.K. needed another 1900 radiologists (33% of the workforce again) to keep up with (pre-COVID-19) demand. "So not just radiologists but radiographers, it is a whole-team approach that we need to get right," she explained.
The regional picture
According to The Guardian report, Croydon health service, in south London, has revealed that within six weeks, it will need one CT, one MRI, and two ultrasound scanners to address the shortfall. Leeds Teaching Hospitals National Health Service (NHS) Trust needs two MRI and two CT scanners, as well as extra staff to operate them and more space for patient waiting areas. Great Western Hospitals NHS Foundation Trust needs two CT scanners, but it will also need qualified staff and for other scanners to operate at full capacity. Oxford University Hospitals NHS Foundation Trust said it needed two static CT scanners, three static MRI scanners, and four ultrasound units.
"Much of the existing stock is faulty and unreliable, causing delay, disruption, and added anxiety for patients," said Saffron Cordery, deputy chief executive of NHS Providers. "The pressures are likely to intensify in the coming months as more people are referred for scans, reflecting pent-up demand that didn't surface during the initial surge of COVID-19 cases."
At the Royal Free Hospital in London, 34,769 patients were waiting in June -- up from 30,242 a year ago. Addenbrooke's in Cambridge had 39,009 patients awaiting imaging studies -- 632 of these were cancer patients -- as of 10 June 2020, up from 28,684 at the same time last year, stated The Guardian.
"The challenge is one of creating safe patient access to imaging facilities in a manner that respects the social distancing and other infection prevention rules set out nationally," said Dr. Ashley Shaw, Cambridge University Hospitals NHS Foundation Trust medical director, who is a radiologist. "We have for some time been utilising private sector hospitals and are establishing other additional resources, including mobile facilities, to increase volumes."