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Improving PIR services in the UK

The Royal College of Radiologists has published an important report on paediatric interventional radiology (PIR). This specialty provides minimally invasive, high-quality treatment for cancer and many other diseases, vastly improving the range, efficiency and quality of paediatric care.

Published: April 2023


Widespread adoption of PIR has so far failed in the UK, and there has been little progress since the Department of Health’s 2010 report on interventional radiology, which highlighted the variability in this service. The UK is woefully under-resourced in PIR and there are huge inequalities in access to this specialist care across the country, with only 12 consultant posts, which are concentrated in Birmingham and London. We are calling for an increased focus on this vital service, and action to ensure good PIR provision for all children who need it.

Key findings:

  • Paediatric interventional radiology (PIR) delivers clear benefits: a significant reduction in risk for many life-saving procedures, shorter hospital stays, quicker recovery times, and financial savings for the NHS.
  • There are just 12 consultant posts across the UK in which PIR forms a major component of the job plan; 7 of these are in London, which means children across all four nations are missing out on vital care.
  • Provision of interventional radiology across the UK should be comprehensive and equitable for all age groups, including very young children.
  • PIR service specification in paediatric and adult/paediatric mixed Major Trauma Centre contracts needs to be clearly delivered and audited.
  • Comprehensive PIR investment in all tertiary paediatric centres is imperative to provide specialist care for children with rare or more complex diseases and to develop national PIR expertise.
  • Cross-skilling of a range of other clinical specialists to deliver certain PIR procedures is essential to provide more generalised IR care or a baseline range of IR interventions for children across all four nations to close the service gap.
  • Raising awareness of the benefits of PIR among the wider health community is key to driving PIR referrals and service development.
  • Accurate outcome data to evidence the extent of improved paediatric care outcomes from IR investment is vital to its success; and needs a central registry.
  • Interdependency with anaesthetic and paediatric surgical services is essential and should be part of ongoing workforce planning. 


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