One year on from a damning review into its operations, it’s emerged that the radiology department is under pressure again – with staff shortages forcing a reliance on external specialists.

Costs to the Health Department for teleradiology are expected to reach £130,000 by the end of this year.

What is teleradiology?

Teleradiology is the electronic transmission of medical images, such as X-rays, CT scans, and MRIs, from one location to another for interpretation by a radiologist. 

It allows radiologists to provide services remotely, enabling access to specialised expertise regardless of the patient’s location. 

Teleradiology was initially introduced in Jersey to provide coverage during evenings to improve compliance with national guidance regarding the management of head injuries.

It has since been expanded to include elective reporting, which increases overall reporting capacity and allows the Health Department to “utilise clinical expertise of our radiologists for completion of diagnostic tests that require physical presence rather than reporting”, according to a recent report presented to the Health Advisory Board.

However, a shortage of in-house radiology staff has created a “greater reliance” on teleradiology.

This service cost Jersey’s Health Department £90,000 last year – a figure which is expected to rise by 55% to £130,000 this year.

Teleradiology also results in slower service delivery than internal reporting, according to the report.

A department under scrutiny

The Royal College of Physicians’ review of radiology, which was published last year, found that “aggression” and “gatekeeping” had destroyed diagnosis opportunities.

Junior doctors reported facing difficulties when requesting imaging, and at times felt the behaviour from radiologists to be so unpleasant that they were discouraged from seeking scans from them.

Amidst these concerns, 20 women had to be recalled for a breast cancer screening over fears of a possible misdiagnosis by a radiologist, while a further 14 were told that their diagnosis was initially missed – in some cases delaying their treatment for up to a year.

At the time, Health Minister Tom Binet admitted there were “other issues in radiology under scrutiny at the moment”.

At “full capacity”

One year on, the recent report presented to the Health Advisory Board revealed that MRI is at “full capacity on both scanners and workforce”.

There are “limited options for expansion” of MRI scans without further funding, it added.

The CT scanner is available but “staffing constraints” is a “limiting factor”, and concerns were raised about “annual leave coverage gaps”.

“Service capacity drops significantly during periods of annual leave,” the report said.

Meanwhile, an increase in activity in the Emergency Department drove an increase in diagnostic requirements – with a 400% increase in CT head scans last year impacting the ability to deliver elective CT activity.

The report also raised concerns that the National Institute for Health and Care Excellence (NICE) “frequently changes its guidelines, such as adjusting scan frequencies for cancer follow-up or the threshold for trauma imaging, which impacts on capacity with no additional resource”.