Diversity and representation within the NHS medical imaging workforce

Thursday 23 February 2023

Earlier this month, I was delighted to speak at the recent British Institute of Radiology (BIR) event on the theme ‘women in imaging 2023’. My talk tackled diversity in the NHS more broadly. As members may know, this is an issue I care deeply about, which, despite the excellent progress made in recent years, requires our ongoing attention. The UK radiology workforce has become increasingly diverse in recent years, but we have much further to go to make sure all radiologists feel accepted and valued. 

Our changing medical workforce

Currently, 25% of the consultant radiology workforce gained their primary medical qualification in non-EEA countries. This reflects an increasing reliance on international recruitment as we attempt to meet rising demand. International doctors are invaluable to healthcare in the UK and we are very fortunate that in spite of the many challenges they face, such as the lengthy process for General Medical Council (GMC) registration, we are still able to attract excellent doctors from across the world. However, the data shows that many non-EEA doctors leave the NHS after a relatively short period, and a sustainable solution to the workforce crisis must necessarily involve training and retaining many more doctors here in the UK.  We can only benefit from a workforce that draws on the diversity of experience and expertise of doctors from both the UK and abroad, but we must understand what lies behind these data if we are to support staff and make a realistic plan for the future.

I also highlighted the NHS Medical Workforce Race Equality Standard report (MWRES), which demonstrates the challenges NHS staff from underrepresented backgrounds still face. For instance, it is still the case that white applicants are 1.61 times more likely to be appointed from shortlisting than BME candidates. In common with the other Royal Colleges, we now receive data from the GMC about ethnicity and a variety of outcomes such as Annual Review Competency Progressions (ARCP) and exams. We will be looking at this very carefully from now on to understand how we can support all staff to achieve their potential. One problem we have is that many people do not complete the EDI questions. Good data is essential if we are to understand and support our workforce, so please can I urge you to fill this section in in future?

Women in radiology

The number of women now working as consultants in radiology has grown in recent years, with the headcount up by 338 since 2017. However, as a proportion, we have seen little change in the number of women working in radiology over the last five years. Figures from our 2021 census show that only 37% of clinical radiology consultants in the UK are women – up by just 1% from 2017.

There is some limited data showing that women are underrepresented at conferences and editorial boards and are less likely to speak up in meetings. In my own institution it is striking that a very low proportion of women apply for national awards. There are numerous possible reasons for this, many of which are cultural, but it can only benefit our professions if we ensure that everyone places appropriate value on their expertise and feels supported to speak up.  

Diversity and representation at the RCR

Diversity and representation are recognised to be vitally important in any workforce and particularly in healthcare. The RCR is committed to equality, diversity and inclusion (EDI). In October 2021, we formed the EDI Committee to provide high-level oversight and a regular review of practices, processes, and progress. Last spring, we also appointed six fairer training Fellows – two from clinical oncology and four from clinical radiology – with a shared interest in promoting fair training outcomes.

When it comes to effecting change the only intervention for which there is supportive evidence is mentoring. The innovative RadReach mentoring scheme is aimed at encouraging under-represented groups to choose a career in clinical oncology or clinical radiology. It has been popular and the numbers are increasing. Our plan is to develop the RCR mentoring scheme to include other groups and indeed anyone who may find it helpful over the coming months. Watch out for news of this on the website and do consider taking part. Whether as mentor or mentee most people enjoy the experience and benefit from it.

Dr Katharine Halliday, RCR President