The urgent need for change in Radiology has been raised by multiple stakeholders, national reports, and academic studies. The Royal College of Radiologists (RCR) and others are calling for more Radiology funding, but money alone is not a magic bullet, it is only part of the solution.

Regional Imaging Networks have been set up to deliver commitments as set out in the NHS Long Term Plan and bring together clinical expertise and deliver financial efficiencies.

Investment has also been made to replace ageing imaging equipment and in expanding the workforce. In 2020 £206 million has been spent on additional staffing capacity, more than triple the spend in 2014. However, year on year increases in staff spending perpetuate and exacerbate staff shortages rather than solving them, as outsourcing draws staff out of permanent roles in the NHS, and increases financial pressure on services, which is unsustainable.

Recent initiatives and reports have provided the transformational and strategic vision (see table) but large-scale reforms and top-down initiatives alone will not deliver the transformational and sustainable change needed. National reports and guidance also highlight quality improvement as playing a key role in the future of both Radiology Departments and Imaging Network development but practical tools and support are also needed to make changes happen.

Recent Radiology reports and references to Quality Improvement

NHS Long Term Plan (2019)

Key headlines

10 year plan for the NHS.

• Capacity has not kept pace with demand.
• Investment in new equipment & staff required, underpinned by formation of Imaging Networks.
  
• Objectives: Early diagnosis of 75% of cancers by 2028 & efficiency savings of at least 1.1% over next 5 years.
  

Quality Improvement (QI)

• Recommends investing in QI to ensure staff have the skills & methodology to improve care & reduce costs.
• Argues care & performance are directly affected by leadership & improvement culture created.
  

Transforming Imaging Services in England (2019)

Key headlines

National Imaging Network Case & Strategy.

Quality Improvement (QI)

• Recommends QI Lead and approach across imaging networks.

Getting It Right First Time (GIRFT) Radiology (2020)

Key headlines

National Report on Improvement Opportunities.

Recommendations, based on Department visits, focus on 6 key areas:

• delivering a patient-centred service
• maximising capacity
• making data work harder
• managing increasing demand
• procurement
• reducing the impact of litigation

Quality Improvement (QI)

• Supports continuous quality improvement for the benefit of patients.
  
• Highlights substantial improvement opportunities in Radiology & across treatment pathways.
  
• Recommends identifying improvement opportunities within the existing resource envelope.
  
• Suggests services need to evolve and innovate to increase capacity & effectiveness to provide foundations for sustainable services.
  

Diagnostics: Recovery & Renewal (2020)

Key headlines

Independent Review of NHS Diagnostic Capacity

Recommendations focus on 5 key areas:

• new delivery models (including Community Diagnostic Hubs)
• equipment & facilities
• workforce
• digitisation & connectivity
• enablers for change

Quality Improvement (QI)

• States ‘Expansion of the imaging workforce & productivity improvements vital to meet increasing demand.’
  

RCR Radiology Workforce Census 2020 (2021)

Key headlines

Annual UK report on Radiology consultant workforce.

Quality Improvement (QI)

• Argues ‘[QI] activities vital to improving radiology services & better outcomes for patients.’