Significant backlogs in radiology reporting

WIDE national variation in timescales for radiology results – with significant backlogs – have been reported in a new Care Quality Commission (CQC) review.

The CQC also found varying arrangements in place to monitor and manage backlogs of unreported images at NHS hospital trusts across England – with scans at one trust left unreviewed for eight months and other scans having never been seen by a radiologist. This leads to delays in X-ray results being shared with clinicians responsible for patient care, or X-rays being examined by clinicians without the necessary specialist training.

The regulator has also raised concerns about the lack of agreed best practice and is calling for the development of national standards for reporting turnaround times and improved guidance to support trusts in monitoring their own performance in order to protect patients from the potential risk of delayed or missed diagnoses.

The review was initiated after CQC inspections identified serious concerns around radiology reporting in three NHS trusts: Worcester Royal Hospital, Kettering General Hospital and Queen Alexandra Hospital, Portsmouth. This resulted in the CQC taking immediate action to protect patients at these trusts but also flagged wider concerns about delays in reporting across all NHS trusts.

Data from a sample group of 30 trusts revealed wide variation in set timescales for reporting radiological examinations referred from emergency departments – from an hour at one trust to two working days at another. Expected timescales for outpatient referrals ranged from five to 21 days – evidencing a lack of agreement among trusts on how quickly examinations should be reported on.

A shortage of radiologists was also found to be a contributing factor to delays and backlogs in reporting, with the average vacancy rate across all non-specialist acute trusts being 14 per cent. This supports evidence from the Royal College of Radiologists regarding the difficulties in recruiting and retaining radiologists.

Professor Ted Baker, CQC’s Chief Inspector of Hospitals, said: "While our review found some examples of good practice it also revealed a major disparity in timescales for interpreting and reporting on examinations, meaning that some patients are waiting far longer than others for their results.

"We are calling for agreed national standards to ensure consistent, timely reporting of radiological examinations. This will allow trusts to monitor and benchmark their own performance – and ensure that, for example patients are not put at risk by delays in their X-ray results being reported to the clinician responsible for their care."

Sara Bainbridge, policy manager at Cancer Research UK, commented: "Radiology scans are crucial in diagnosing many cancer types, so it’s vital that results are reported quickly. It's extremely worrying that this inquiry found that patients were not having their scan interpreted by a specialist at all, or had to wait a long time."