New figures reveal the continuing shortage of radiologists in the U.K. is putting patients at risk and driving massive rises in outsourcing costs for the National Health Service (NHS). The NHS does not have enough radiologists to keep patients safe, according to 75% of hospital imaging bosses.
The annual radiology workforce report of the Royal College of Radiologists (RCR) collected data and comments from imaging managers from all 172 health boards and trusts/hospital groups that employ radiologists. The main findings included the following:
- NHS hospitals spent 165 million pounds (187.5 million euros) last year on outsourcing, overtime, and locums to cover radiologist scan reporting -- 49 million pounds (57.5 million euros) more than in 2017 and three times what was spent in 2014.
- The amount spent on outsourcing would pay for 1,887 full-time radiologists, which would more than pay to cover the current shortfall of 1,104 consultants.
- Only one in five trusts and health boards has enough interventional radiologists to run a safe 24/7 service to perform urgent procedures.
The report shows the number of NHS radiologists is falling well short of demand, and respondents confirmed that staff shortages are leading to delayed cancer diagnoses and inadequate emergency diagnostic and interventional services, the RCR stated.
The number of consultant radiologists is going up each year, but the growth is predominantly in England, according to the report. Between 2014 and 2018, the number of full-time consultants in England rose by 535, but in that same period Scotland gained only 15 extra full-time consultants, with 12 additional consultants entering the workforce in both Wales and Northern Ireland (see table).
| Full-time consultant radiologists, outsourcing/overtime/locum costs, and vacancy rate per region | |||||
| Region | No. of whole-time equivalent consultant radiologists | Estimated NHS scan outsourcing/overtime/ locum costs |
Vacancy rate of NHS consultant radiologist posts | ||
| 2014 | 2018 | 2017 | 2018 | 2018 | |
| U.K. | 3,048 | 3,622 | 116 million pounds | 165 million pounds | 9% |
| England | 2,503 | 3,038 | 99.3 million pounds | 136.9 million pounds | 9% |
| Scotland | 288 | 303 | 4 million pounds | 10.4 million pounds | 8% |
| Wales | 143 | 155 | 4.9 million pounds | 8.8 million pounds | 10% |
| Northern Ireland | 114 | 126 | 7.7 million pounds | 9.2 million pounds | 18% |
Hospitals reported there were 379 unfilled consultant radiologist posts across the U.K. in 2018, 61% of which were vacant for at least a year.
To cope with rising demand, outsourcing costs shot up across all U.K. nations, with the biggest escalations in Scotland, where costs more than doubled from 2017 to 2018, and Wales, where expenditures went up by 80% from year to year.
Prof. Mark Callaway, lead author of the workforce report."Service leaders are now telling us loud and clear that staff shortages are putting patients at risk, with three-quarters saying they cannot guarantee a safe service," noted Prof. Mark Callaway, lead author of the workforce report and the RCR's medical director of professional practice for clinical radiology.
"Trusts and health boards desperately need to recruit, but our report shows that new consultant numbers and overseas and locum appointments are just not enough to plug staffing gaps. As a result, our radiologists are exhausted and the NHS bill for outsourcing scan reporting continues to climb," he added in a statement from the RCR.
The RCR has been working to enhance training for clinicians in key shortage areas, including breast imaging and emergency stroke treatment, but there is still an urgent need for more central funding to train thousands of new consultant radiologists, said Callaway, who is a consultant radiologist at the Bristol Royal Infirmary, lead cancer radiologist for the local trust, and a professor of radiology.
