Coronavirus: Imaging equipment ‘woefully underfunded’

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Radiologists say they are “very concerned” patients may not be cured of serious illnesses when demand for services increases, due to a lack of imaging equipment in the UK.

The president of the Royal College of Radiologists has warned the service had been “woefully underfunded”.

She said cleaning requirements because of coronavirus would reduce capacity.

The Department of Health and Social Care in England said it was investing £200m on imaging equipment.

“Radiology is one of those services that people use all the time, but don’t really often think about, it’s not sexy like surgery”, said Dr Jeanette Dickson, president of the Royal College of Radiologists.

“Imaging touches on virtually every patient who comes into a hospital.

“If you look at us on a European-wide average, we are certainly one of the countries that have the fewest number of scanners a head of the population.”

A comparison by the OECD, the Organisation for Economic Co-operation and Development, in 2014 – the last set of comparable figures – showed there were just 9.5 scanners per million head of the population, far below figures for Spain, Germany, France and Italy.

The BBC has been told some trusts just had a single CT scanner in operation in the UK.

Dr Dickson said normal service before the outbreak was “woefully underfunded and under-resourced” and that they were “coping but barely”.

She said the whole of imaging was very much understaffed prior to the Covid-19 crisis. The latest figures form the Royal College of Radiologists show 11% of funded posts for radiologists across the UK were vacant.

‘Breaking point’

In April, Cancer Research said a drop-off in screening and referrals meant roughly 2,700 fewer people were being diagnosed every week.

Sara Hiom, Cancer Research UK’s director of early diagnosis said CT scanners for diagnosing cancer “were already at breaking point before the pandemic”.

The BBC understands that more than 30 CT scanners have been obtained from the independent sector during the coronavirus crisis, with at least 35 more ordered.

“Capacity will be much, much less than demand” even with the equipment that has been ordered, Dr Dickson said.

She warned even when all imaging resumes, and the NHS gets back to operating fully, it would take “at least 30-45 minutes” to deep clean scanners after Covid-19 patients and “more attention” was being paid to cleaning equipment between all patients. Patients have to socially distance in the waiting room.

“I am very concerned that we may find that patients are suffering unnecessary treatments or unnecessarily damaging treatments and losing the opportunity for a cure of cancer or another serious illness, because of the lack of imaging,” Dr Dickson said.

Sara Hiom added: “The government needs to invest in the necessary equipment, employing and training more staff to enable the NHS to cope with the backlog of patients waiting for cancer care.

“Prompt diagnosis and treatment remain crucial to give patients the greatest chances of survival.”

The Department of Health and Social Care in England said in a statement it is “committed to increasing our capacity for earlier cancer diagnosis and have provided £200m for new state of the art diagnostic machines to improve the quality and speed of diagnosis and replace any outdated machines”.

It added that cancer services would be “among the first of many NHS services to be returning to normal” during the coronavirus outbreak.

A spokesperson for NHS England said: “Increased cleaning of CT scanners and additional infection control measures are in place throughout the pandemic to protect staff and patients.

“The NHS is making full use of the additional scanning capacity in the independent sector as well as buying additional scanners so that tests can go ahead as normal.”

The Welsh government said it was “increasing diagnostic capacity in radiology, including a new National Imaging Academy, and doubling the radiology training programme”.

Meanwhile, the Scottish government said it expected all health boards to “continue to prioritise radiology capacity for those patients referred with an urgent suspicion of cancer throughout and beyond the Covid-19 outbreak”.

“The majority of cancer radiology diagnostics and treatments have continued, however some patient’s treatment plans will change to minimise their individual risk,” it added.

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