Radiology workloads and manpower

Diagnostic Radiology workloads continue to increase due to a number of factors:

• Increased requests from clinicians: There has been an increase in awareness amongst clinicians of the value of imaging in diagnosis and treatment planning.
  
  
• Increased complexity of imaging: Particularly in cross-sectional imaging with ultrasound, Computed Tomography (CT) and especially Magnetic Resonance Imaging (MRI).
  
  
• Increased interventional procedures: In addition to the expansion in number of minimally invasive radiologically-guided procedures, the complexity of these procedures has also increased.
  
  
• Increase in imaging through primary care: There has been a rise in demand for investigations from primary care users, including demand for cross-sectional imaging such as ultrasound, CT and MRI.
  
  
• Increasing role of radiologists in management: There is increasing demand for radiologists to become directly involved in the management of radiology departments, which in turn affects the time available for routine reporting.

The number of examinations reported per consultant radiologist has risen steadily over the last 20 years, and radiologists report and / or perform between 25-50% more examinations per annum than the maximum limit recommended by the Royal College of Radiologists (1).

The increased pressure to ‘get through’ large piles of reporting leads to a reduced review time per examination, and increased risk of radiologists missing significant lesions. This has implications from both a medicolegal and clinical governance perspective.

Many radiologists are working significantly more fixed sessions than are recommended by the Royal College of Radiologists, and invariably work many more hours than they are contracted for. There have been recommendations for increased radiology consultant numbers above existing levels throughout the UK. For instance, in Scotland, an increase of 25% has been recommended to cover existing reporting requirements(2), even without taking into account projected increases in imaging demand.

The increase in number of consultant radiologists has not kept pace with the demand. Though new posts are being created, there are currently insufficient radiology graduates to fill vacated posts. In fact, in a recent survey of District General Hospitals (DGHs) only 50% of new and replacement posts were filled, and a quarter received no applicants at all. The relative unpopularity of DGH posts (compared to teaching hospitals) is at least partly due to increased expectations and excessive workloads in these hospitals.

Increases in out-of-hours imaging
In addition to increased pressure on radiologists during normal working hours, the demand for out-of-hours imaging (particularly CT) has risen even more steeply. The requirement to implement the European Community Maximum Working Directive at consultant level by the year 2003 will make the provision of an out-of-hours CT service untenable in many DGHs.

The solution
A solution to local problems of radiology reporting is to recruit the available expertise of radiologists from other sites. By using teleradiology, or a dedicated courier service, a rapid turnaround of reporting can be achieved for many routine examinations without the need for increased on-site radiology support.

Expert eye provides an efficient radiology reporting service tailored to the needs of District General Hospital radiologists and radiology departments. Expert eye services are designed to complement existing radiology services, helping to improve efficiency, and reduce the stress of radiologists and support staff. If you think you would be interested in our teleradiology reporting services contact us now.