A report from the UK Audit Commission shows that around half a million people are waiting for scans at NHS hospitals, including MRI and CT scans used to diagnose epilepsy.
These delays, the report says, in radiology services are creating a bottleneck which can slow treatment of patients.
These delays are caused, in part, by large increases in demand for complex treatments. However, the report identifies a number of potential improvements. Departments with long waits for specific examinations need to:
- develop guidelines for referrers on appropriateness of examinations
- screen more requests to ensure that they are justified
- examine whether low utilisation of equipment is acting as a bottleneck (for instance, where there are long waits, MRI scanners are in some cases being used for nine hours or less per day on weekdays)
Usage of different items of equipment varies by a factor of two or more across similar departments. For example, some MRI scanners are used for 4,000 examinations a year, but others are used for fewer than 2,000 examinations.
The Audit Commission recommends that trusts also need to:
- Investigate opportunities to extend operating hours, improve work scheduling, and have robust long-term plans for replacement of old equipment
- Compare their productivity to similar departments with high productivity and take opportunities to adopt improved working practices. Productivity of similar departments can vary by a factor of over three, for both the workload of radiologists per clinical session and for each radiographer;
- Extend the roles of radiographers to help overcome radiologist shortages quickly, supported by the delegation of more straightforward tasks to helpers
The Audit Commission report also identifies some concerns about the age of radiology equipment used in NHS hospitals. Only 59 per cent of radiology equipment is less than seven years old, within the recommended maximum age set by the Royal College of Radiologists, and new NHS investment is expected to improve this figure.
High staff vacancies in some departments raise concerns about delivering the service, with shortages occurring in some regions. Vacancy rates are highest in the north of England for radiologists (for example, 11 per cent in the north west), but in London and the south east for radiographers (for example, 15 per cent in London). These shortages potentially slow the service provided to patients. At a national level better information needs to be gathered on vacancies and strategies developed for recruitment, training and retention.