RCR's annual workforce report highlights UK's radiologist shortfall and escalating millions spent on scan outsourcing

Wednesday 5 September 2018

Released today, The Royal College of Radiologists’ (RCR) annual radiologist workforce report highlights the UK’s current and predicted future shortage of imaging doctors and urgently calls for more funding for trainees and better NHS retention and recruitment.

Key findings from the Clinical Radiology UK Workforce Census 2017 report include:

  • The UK currently needs another 1,004 full-time diagnostic radiologists – by 2022 the shortfall will be at least 1,610, a third of the number of doctors needed to keep up with scanning workload1

  • NHS hospitals across the UK spent an estimated £116m on outsourcing scans and related overtime last year2, nearly £30m more than in 2016 (£88m) and double the amount spent in 2014 (£58m) – enough to cover the shortfall and pay for approximately 1,300 full-time consultant radiologists3

  • Full-time radiologist numbers in the devolved nations have flat lined between 2012-2017

  • Although England has seen a 15 per cent increase in full-time radiologist numbers between 2012-2017, scan workload has risen by 30 per cent4

The report shows that 10.3 per cent of UK radiologist jobs remained empty in 2017, with nearly a fifth of posts (18.4 per cent) in Northern Ireland unfilled. More than two-thirds (69 per cent) of unfilled NHS radiologist posts have been vacant for a year or more. 

To keep up with ever-growing demand for patient scans, the amount hospitals spend on outsourcing and overtime has spiralled to £116m UK-wide, double the amount spent in 2014.

For the first time, the RCR has forecast the minimum number of radiologists needed to keep up with patient scans.

Between 2012-2017 the scan workload of UK radiologists went up by at least 30 per cent – this does not include other work done by imaging consultants, such as determining patient  management at multidisciplinary team meetings, taking biopsies and performing life-saving interventional radiology.

To enable hospitals to keep up with scanning demand – and not have to outsource work or pay expensive locums – the UK currently needs at least 1,004 extra diagnostic radiologists. If nothing is done to address the staffing crisis, the shortfall is predicted to rise to 1,610 by 2022. 

The report also reveals that full-time radiologist numbers in the devolved nations have flat lined between 2012-2017, with the number of Scottish whole-time equivalent radiologists actually declining over that five year period (see end table).

Meanwhile, outsourcing costs in every country have risen to meet demand, with English outsourcing and overtime more than doubling over three years, from £47m in 2014 to £99.3m last year. Welsh radiology has seen outsourcing and overtime boom by 157 per cent in that same period, hitting £4.9m in 2017, compared with £1.9m in 2014. 

RCR President Dr Nicola Strickland said:

“The scale of the crisis in radiologist staffing cannot be overstated. Diagnostic and interventional radiology is fundamental to so much of the NHS – from getting a proper diagnosis to planning surgery to cancer care and trauma management. The fabric of medical and surgical care will collapse unless more is done to increase the number of home-grown radiologists.

“The NHS bill for outsourcing scans continues to soar because imaging departments are run ragged, without enough trained radiologists to handle the spiralling workload. The irony is that the amount spent on overtime scan reporting and contracting scans out last year would pay for more than enough fully qualified, in-house radiologists, if only the money were allocated to train them.

“Scan outsourcing is not sustainable, and while we rely on radiologists from overseas to help keep NHS imaging departments afloat, and the RCR wants the shortage occupation list to be broadened to help support services, international recruitment is not the answer either.

“Retention strategies are also important. Our workforce census report recommends employers concentrate on working conditions and flexibility and it has been encouraging to hear the new health secretary’s vocal commitments to helping the NHS keep its best people.

“However, the obvious long-term, sustainable solution to our staffing crisis is to fund more trainee radiologists to become our future consultant workforce.

“Radiology is a very popular medical specialty for young doctors – we have four applications for every trainee post. We know many hospital imaging departments desperately want to train up more radiologists but they need health bosses to stump up the money needed to fund those trainees.”    

To download the full report and supporting infographic, please visit the RCR census webpage

Whole-time radiologists, outsourcing/overtime costs and vacancy rate per region
 

Region

Number of whole-time equivalent consultant radiologists in 2012

Number of whole-time equivalent consultant  radiologists in 2017

Vacancy rate of NHS consultant radiologist posts 2017

Estimated NHS scan outsourcing/
overtime
cost  in 2014

Estimated NHS scan outsourcing/
overtime
cost  in 2017

UK

2997

3390

10.3%

£58m

£116m

England

2444

2828

10%

£47m

£99.3m

Scotland

302

298

10.7%

£3.5m

£4m

Wales

142

149

7.2%

£1.9m

£4.9m

Northern Ireland

109

115

18.4%

£5.2m

£7.7m