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Keeping pace with the demand for imaging

Diagnostic imaging has come a long way since the discovery of x-rays in 1895 by Wilhelm Rontgen, a German professor of physics. Indeed, the new discovery was put to diagnostic use very early on, before the need for protection against the dangers of ionizing radiation were realized.

Diagnostic imaging has transformed healthcare enabling patients to be diagnosed earlier, leading to better outcomes. Such has been its success that the demand for diagnosis imaging is greater than ever, placing huge pressures on the NHS which is struggling to meet this demand. According to imaging activity statistics last reported by NHS England, there were over 13 million more diagnostic images conducted between the years 2015-2016, than 20 years previous. An increase of some 52%. Clearly as our population demographics continue to change this demand is only going to get greater.

The NHS’s struggle to cope is evident within patient waiting times. According to the Quarterly Diagnostics Census, figures released in September 2016 show more patients than in any other diagnostic test category are waiting greater than 6 weeks for an imaging diagnostic test. However, the problem is not just about the increased numbers of patients requiring diagnostic imaging, but also a shortage in workforce. Currently 9% of UK consultant radiologist posts are unfulfilled and 41% have been vacant for over a year. Radiologists are in even shorter supply with 15% of situations vacant within the UK. This has led to an increase in the number of patients who have to wait over a month for their imaging test results. According to statistics by the Royal College of Radiologists this number stands at over 230,000.

Evidently, Trusts will need to look at new ways of working to cope with the increase in demand and the shortages in specialist staff. NHS Glasgow and Clyde is one such Trust. Their solution has been to look at partnerships to deal with the pressures and the introduction of a what’s known as a teleradiology service. This means that the reporting of diagnostic imaging is shared across hospitals, with CT and MRI scans sent electronically to off-site specialists, who can view and discuss the image at the same. This approach enables a faster and more accurate diagnosis. And more innovative ways of working are planned. Aileen MacLennan, Director of Diagnostics, NHS Greater Glasgow and Clyde comments “we plan to start using virtual hubs, enabling radiologists to work from home – in the next few years we will be working in a different way than in the past.”

As well as new ways of working, new technologies are being developed which have the potential to transform diagnostic imaging as we know it today. One such technology is the development of molecular imaging which could lead to far greater personalised care for cancer patients. Molecular imaging reveals the biology of the cells themselves, allowing doctors to investigate whether cells are growing, dying or are less susceptible to radiation treatment. This type of imaging has the potential to lead to more informed diagnostic decisions.

Imaging technology using high frequency radiowaves is also being developed by a Bristol based company Micrima. The technology, which was initially pioneered at the University of Bristol, hopes to improve the early diagnosis of breast cancer by offering a faster and more accurate diagnosis.

Andy Rogers, President, The British Institute of Radiology believes “the future of imaging is a bright one” although like most areas in the NHS today, it appears there are a number of challenges it will have to overcome.