RCR welcomes calls for major expansion of diagnostic imaging capacity in England

Friday 2 October 2020
The RCR has issued an enthusiastic welcome to a new report from the NHS’ top cancer and screening advisor, which urges “major expansion and reform” of diagnostic services to enable the health service to recover from COVID-19 and improve care. 
Last year, Professor Sir Mike Richards presented a report into overhauling screening services in England, which was set to be followed by a review of NHS England’s (NHSE) diagnostic capacity. 
Presented at yesterday’s NHSE board meeting, Sir Mike’s anticipated report, Diagnostics: Recovery and Renewal, outlines the constraints facing NHS imaging, pathology and genomics services before and after the arrival of coronavirus, and makes a series of long-term recommendations to usher in new delivery models, improve clinical networking and connectivity and, fundamentally, increase NHS staff numbers. 
The RCR engaged with Sir Mike and his team during the drafting of the review and we are hugely supportive of the report’s proposals for imaging, many of which were also highlighted in our recent Comprehensive Spending Review representation to the Treasury
Primary recommendations for imaging from the review include:
  • The creation of new pathways to streamline diagnosis and separate emergency and elective patients, with a key mechanism being the creation of new community-based diagnostic services
  • A doubling of CT scanner capacity over the next five years, other machine capacity to be increased in line with patient demand, and the upgrade of all imaging equipment over ten years old
  • Training places for an extra 2,000 radiologists and 4,000 radiographers, as well imaging support staff
  • Rapid development and regional leadership of imaging networks, enabled by improved hospital IT and home reporting facilities for radiology staff
  • A review of the commissioning arrangements for imaging, including tariff incentives and service specifications
  • Clarity around the regulatory landscape for imaging artificial intelligence and rapid evaluation of useful programmes in development 
Welcoming the report, RCR President Dr Jeanette Dickson said:
“We cannot applaud Sir Mike enough for his accurate assessment of England’s NHS imaging services, their urgent need for increased resourcing and connectivity and, most crucially, more staff. 
“Alongside other diagnostic disciplines, imaging has been clearly identified as being at ‘tipping point’ before the advent of COVID-19, and now at increased need of ‘major expansion’ to support the ambitions outlined in the NHSE Long Term Plan (LTP). 
“The RCR made these points before and during the course of the pandemic, and we are hugely pleased to see them amplified in Sir Mike’s review. 
“We welcome all of his recommendations to fund increased imaging capacity and accelerate new delivery models, which are urgently needed for services to recover and clear imaging backlogs, as well as diagnose and treat new patients during the endemic phase of coronavirus. 
“Only a fully-funded, sustainable service will improve patient outcomes, reduce waits for diagnosis and treatment and enable rapid rollout of improvements, such as those promised in the LTP.
“Properly implemented and resourced, new patient pathways, including triaging to separate urgent and elective patient care – facilitated by the widespread creation of COVID-secure community-based diagnostic hubs – will improve time to diagnosis and give acute providers the breathing space they need to manage elective and emergency care simultaneously.
“Welcome moves have been made over the past year to upgrade and expand scanning capacity, but swathes of the existing NHS equipment base remains outdated. The recommendations to double CT scanning capacity and upscale other machines in line with increasing demand are pivotal, as both new community diagnostic hubs and existing hospital imaging services need equipping with machines fit to deliver 21st century care.   
“We need better networking and innovation, but these measures, in addition to new machines, will be ineffective without an increase in staffing. We are elated by the report’s clear calls for expansion of radiologist and radiographer numbers – and this must be a priority for Health Education England and NHSE. Radiology teams are stretched after years of chronic under-investment, and an extra 2,000 consultant radiologists in practice would plug the existing shortfall in England and give a long-awaited, meaningful boost to the workforce.    
“If they are implemented with commitment and speed these proposals have the power and potential to bring about real improvements to patient outcomes and cut waiting times. 
“However, Sir Mike is clear that his recommendations will only be realised with effective clinical leadership – what we need to see, along with urgent momentum from NHSE, is strong leadership in the imaging community to implement these proposals, alongside parallel improvements in the devolved nations.”