2024 workforce census reports lay bare the challenges facing radiology and clinical oncology

Today, the RCR publishes our 2024 clinical radiology and clinical oncology workforce census reports. These reports offer a detailed snapshot of both specialties as they stood in September (CR) and October (CO) last year.  

The reports are invaluable resources for our professions. They enable us to understand in granular detail the pressures on radiology and oncology, and to quantify these at the local, regional and national levels. They are central to all the RCR’s efforts to advocate for change on your behalf. 

Thanks to a 100% response rate – for which we are incredibly grateful to all Clinical Directors and Heads of Service – the census provides the most comprehensive and authoritative view of the state of our workforce across the UK. 

Unfortunately, but unsurprisingly, the census confirms that the NHS is continuing to struggle to train, recruit and retain enough radiologists and oncologists.  

• The shortfalls in both workforces now stand at 29% and 15%, respectively. These are each set to rise to 39% and 19% by 2029, should no action be taken.  
• These deficits are the product of chronic under-investment in staff, which coincides with spiking demand for our expertise. The 4.2% growth in the radiology consultant workforce in 2024 was dwarfed by an 8% increase in the number of CT and MRI scans performed. 
• Problems with recruitment and retention are a major risk for patient safety moving forward. Indeed, 9 in 10 cancer centre Heads of Service told us that patients are experiencing delays to begin radiotherapy or SACT due to staffing shortages. If nothing is done, delays to patients will only worsen. 

Expanding the radiology and oncology workforces is essential and non-negotiable. The message of the census is clear: we need more staff.   

But it is also true that, given demand trends and the financial and practical constraints facing the NHS, we are unlikely to train enough people to plug the workforce shortfall. So, we must focus not only on workforce growth but on making best use of the expertise of our consultant radiologists and oncologists. 

This includes looking carefully at the way we spend our time at work and understanding where we add most value. For instance, are multidisciplinary team meetings the most productive way to ensure good outcomes for patients? Should we spend as much time of them as we do?

If you have any views on this matter, please do complete and circulate our survey. 

Other changes we urgently need to explore include the use of technology and digitisation.  

• We should explore adopting new technologies and ways of working, such as artificial intelligence tools (AI).  
• These could augment our capacity to deliver care and free up time to do what we do best: directing patients’ care and making tough clinical decisions.  
• But we also need to acknowledge that digital tools do not necessarily always save us time – as this year’s data on the use of AI in radiology shows. 
• Deployments need to be backed by proper investment – both financial and in terms of staff time. 
• It’s also important to note that the productivity gains provided by digital solutions may ameliorate the effects of workforce shortages for patients and staff, but they will not resolve them altogether. 

All these factors merit serious consideration.  

The census underpins huge amounts of the RCR’s work. It enables us to support Fellows and members locally, and advocate for change nationally. 

• Every cancer centre and radiology department around the country receives a suite of data about their local staffing situation, combining quantitative and qualitative insights into team size and sentiment.  
• Last year, 9 in 10 Heads of Service and 8 in 10 Clinical Directors told us they used this data to develop business cases in their trust/health board, many times successfully unlocking funds for additional training places.  
• We also supply data worksheets and site specialty dashboards, which provide further data on regional trends and inter-specialty expertise. 
• On the national stage, we deploy the census data to advocate for policies that would deliver meaningful change for you, including sustained investment in the workforce, rational incentives for recruiting and retaining staff, and funding for vital infrastructure, such as IT systems, that would empower you to do the jobs for which you trained.  
• The pace of change is certainly slow. But in every meeting we have with senior politicians and decision-makers, we use our census data. Every time we have seen a “win” for our specialties, such as recent years’ maintenance of expansion specialty training places, it has been the census data that has provided the bedrock for the arguments that succeeded in securing those changes.  

I would encourage you to explore this year’s census reports. You may also find the supplementary data worksheets and site specialty dashboards to be useful resources for use in your area.  

If you have any questions on the census data, or how it is used, please contact the team at [email protected].  

Huge thanks once again to all those who responded to the census, as well as to every RCR Fellow and member for your ongoing support. This is your College. We are here to support and champion you. We would welcome all feedback on how we can strengthen the census so it works for you.