Patients waiting too long for test results

Thursday 13 November 2014

The Royal College of Radiologists (RCR) today releases the results of a snapshot survey undertaken to find out how long patients in England are waiting for the results of X-rays and scans.

  • A sample representing about a quarter of English NHS radiology departments was surveyed on 16 October, asking them how many imaging examinations (X-rays, CT scans and MRI scans) had waited more than 30 days for interpretation by a radiologist.The survey included a mix of all types of institution from large urban teaching hospitals to small rural hospitals.

  • The results show a wide variation. A small number of the departments surveyed have no problem with reporting delays, but others have major issues.

  • The survey identified 81137 X-rays, and 1697 CT and MRI scans which had waited more than 30 days for a radiologist’s report.

  • If this reflects the national picture, about 300,000 patients are currently waiting more than a month for their X-rays to be analysed and about 6000 patients have waited more than a month for the results of CT and MRI scans.

What are the implications?

  • Potential to cause delays in diagnosing cancer and other serious illnesses

  • anxiety for patients waiting for test results

  • wasted journeys for patients expecting test results

  • waste of time and other resources, not just in radiology but throughout the healthcare system

What should be done about it?

1. Identify and assess the problem

The RCR has only taken a snapshot: work is urgently needed to understand the full extent of reporting delays across the country.  We welcome the recent decision by the Care Quality Commission (CQC) to include diagnostic imaging as a core service to be reviewed in all its hospital inspections. We call on the CQC to investigate the extent of reporting delays across the country to assess the size of the problem and for NHS England to publish timely and meaningful data on the delays patients are experiencing. 

2. Train more radiologists

There is a chronic shortage of radiologists in the UK. We have around 48 trained radiologists per million population, a figure which has increased only slowly over the past five years. The equivalent figures are 92 in Germany, 112 in Spain and 130 in France.  The number of scans performed in the UK remains significantly below those in other countries for most tests. Further growth is inevitable. The situation revealed by our snapshot will only improve if a commitment is made now by NHS England and Health Education England to train more radiologists.

3. Make the best of the current radiologist workforce

We could make better use of the radiologists we already have. Networks allowing groups of radiologists to provide services to a population greater than that traditionally served by a single hospital could help to offer timely and equitable access to imaging for patients.  This proposal would help to reduce delays and is explained further in our paper: Radiology in the UK: the case for a new service model.  The barriers that prevent this from happening must be removed. 

Dr Giles Maskell, RCR President, said:

“This snapshot survey raises serious concerns for patient safety. Although most of these X-Rays and scans will not show serious abnormalities, some will show findings which would allow an expert to diagnose cancer or another serious condition at a stage at which it could be cured. The RCR is wholly committed to improving the quality of services for patients and is keen to work with NHS England and others to find the solutions.”

Professor Mary Evans, lay member of the RCR Council said:

"If the RCR's survey is representative of what is happening around the country, then this is unacceptable for patients.  The stress and worry patients suffer while waiting for radiology test results is considerable and the NHS should not be allowing that to happen.  I hope NHS England and the CQC will take effective action without delay."

Harpal Kumar, Chief Executive of Cancer Research UK, said:

“Reporting delays of this magnitude are unacceptable for patients and urgent action must be taken. We know that in some other countries in Europe, scans are reported in as little as 24 hours. Timely diagnosis and prompt access to treatment for cancer, and other diseases, can make all the difference in improving survival. Patients need the assurance that suspected cancer is taken seriously and is prioritised by the NHS. A plan needs to be put in place urgently to train many more radiologists to deliver an improved service. We won't successfully tackle this problem unless we deal with workforce constraints head on.”