More patient scans sent outside NHS for diagnosis

A shortage of radiologists has led to the NHS sending an increasing number of patient scans, to outside firms for reporting, according to the Financial Times.

About 14% of scans, including MRI scans, CT scans and X-rays, are being outsourced to radiologists outside the NHS for reporting, the FT says, compared to only 5% six years ago.

That figure rises to 80% for out-of-hours scans, according to data from LEK Consulting, a firm advising teleradiology providers. Some are sent to radiologists in Australia and New Zealand for overnight reporting – the time difference proving helpful when a radiologist is needed to report on X-rays for patients attending NHS accident and emergency departments late at night.

The cost to the NHS is substantial. According to the Royal College of Radiologists (RCR), in 2020, trusts and health boards spent £206m in outsourcing scan reporting. The government could save £190m a year, the RCR argues, by investing in training and overseas recruitment.

The decision to outsource scans is being driven by a shortage of radiologists. The RCR estimates that 1,939 full-time consultant clinical radiologist posts across the UK are vacant, a shortfall of 33%.

This shortage has led to longer waiting lists for many patients. Even before the pandemic, 10% waited more than six weeks for an MRI, but by December 2020, that had increased to 21%. As a consequence of staff shortages, the RCR told the FT, 115,000 cancer patients are “diagnosed too late to give them the best chance of survival.”

Radiologists do more than just read scans

Dr William Ramsden, vice-president for clinical radiology at the RCR, told the FT that although private-sector involvement was vital to managing immediate demand “more and more outsourcing to external suppliers is not the cure for insufficient radiologists on the ground”.

Ramsden pointed out that in-house hospital radiologists did far more than just read scans on computers. They worked with other doctors to manage cases and run clinics, “as well as performing life-saving interventions using real-time scans”.

Eilert Hinrichs, partner at LEK Consulting, said teleradiology could help address the capacity shortfall and provide more specialised expertise because patients and radiologists no longer needed to be in the same location: “It provides speed and quality and could address the capacity shortage.”

There are about 10 teleradiology providers in the UK, most of whom use trained radiologists who work part-time for the NHS or have retired. They are sent the scans and provided with the technology to carry out the reporting from home.