Leaked NHS documents reveal a large backlog of unreported scans

Hospitals have reported a surge in the number of patients waiting for the results of X-rays and scans, leaked documents show.

On average, there were 2,800 ‘unreported’ scans per NHS trust at the end of the 2016-17 year, an increase of 130 per cent. 

But experts warn the true situation could be ‘very much worse’ as many radiologists are too busy to review scans – leading to a rise in ‘auto-reporting’. 

The NHS Benchmarking report, leaked to the Health Service Journal, looked at data from 95 anonymised NHS trusts.

The report found that two medium sized trusts had backlogs of over 30,000 and one large trust had just under 25,000 reports unread.

Wrong diagnosis: The Quality Care Commission are investigating radiology at a national level admin reports of scans going unreported and following several mistakes where junior doctors missed cancer signs in X-ray scans

For many trusts, the backlog was less than 100, showing large differences between the levels of unreported scans at NHS trusts.

Unreported scans simply mean the number of scans such as MRI and X-rays that have not been reported by a radiologist, for at least 10 days since examination.

At some trusts there were very long delays in reporting scans. Some X-rays took as long as 45 days to report, and MRIs 46.

Substantial concern about failures in radiology reporting across the whole country has led to the Care Quality Commission carrying out a national review.

This comes after the CQC released a report about Portsmouth Hospitals Trust where junior doctors had missed fatal lung cancers after the radiology department agreed not to review most chest X-rays.

As well as unreported scans, the Royal College of Radiologists raised concerns over indications in the report that the share of scans being ‘auto-reported’ was increasing.

Dr Nicola Strickland, president of the Royal College of Radiologists, said auto-reporting is happening because there are not enough radiologists to cope with demand.  

Magnetic resonance imaging, or MRI scans, are used to produce images of  inside the body. According to the NHS Benchmarking report, some MRI scans are going unreviewed by a specialist for up to 46 days.

Magnetic resonance imaging, or MRI scans, are used to produce images of  inside the body. According to the NHS Benchmarking report, some MRI scans are going unreviewed by a specialist for up to 46 days.

She said: ‘It widely known that auto reporting is occurring throughout the whole of the UK because there aren’t enough radiologists to cope with the reporting work but it is difficult to trace [scans] that have been not been reviewed by a radiologist.

‘[These reports] are generally not officially classed as a backlog. The bottom line is the situation is very much worse than it appears if all those auto reports are not included in the figures.’

Why are the CQC carrying out a review of radiology? 

In December 2017, the Care Quality Commission found that more than 20,000 X-rays had not been reviewed by a radiologist or an appropriately trained clinician at the Queen Alexandra Hospital hospital in Portsmouth.

Junior doctors were left to interpret X-rays, including chest those in which cancer was suspected.

In two incidents, junior doctors found no abnormalities in chest X-rays, and the cancer was only discovered a year later when the patient returned to their GP- clinicians with more experience felt that the abnormalities were present in the first scan.

 Interpreting scans is considered a ‘specialist skill’ by the CQC, which should not be left to junior or untrained doctors.

Auto-reporting means that some scans are directly sent to clinicians without first being reviewed by the radiologist. 

Although this is sometimes the right course of action, HSJ report being told auto-reporting indicates that even more scans are being entirely unreported, or even reviewed by staff without the appropriate skills.

 Waiting Times 

The report details lengthening wait times faced by both urgent and non-urgent patients.

Wait times for an x-ray for patients with symptoms of cancer were five weeks, while it took six weeks to get a CT scan and seven weeks for an MRI.

Patients needing a non-urgent ultrasound faced wait times of six months, or three months for a non-urgent x-ray.

With regards to the six week target for diagnosing patients, the report said: ‘broadly stable in the last year [but] many organisations demonstrate difficulty in consistently meeting the… target.’

‘Trusts are still struggling to optimally report requests for a routine inpatient scan.’

In some NHS trusts inpatients were left waiting up to six days to receive results of CT scans that were medically requested to be reported the same day, although the overall average turnaround for a scan result was two days. 

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