Radiology departments failing to cope with demand is nothing new – it's been documented since the 1970's, says Professor Nigel Thomas, a consultant radiologist from the University of Salford.

The solution, he says, is to train radiographers to take on more of radiologists' reporting work.

Thomas says: “Radiographers have been helping doctors with reporting for years. Even when radiography did not require a degree, junior doctors were informally asking radiographers for their opinions of X-Rays.”

Then this was formalised: radiographers stuck a red dot on images they felt raised questions. “This was by no means diagnosis, but some junior doctors realised that some radiographers were particularly skilled at recognising abnormal images and to some extent relied on them,” says Thomas.

In the mid-1990s, postgraduate courses for radiographers (who by then needed a degree) were initiated to train them in reporting on plain film X-Rays taken in A&E. “Radiologists were directly involved in setting up the courses and setting course contents, and within hospitals, radiologists advised and mentored the reporting radiographers,” says Thomas.

Later the courses were expanded to include reporting on plain films outside of A&E, such as chest and abdomen X-Rays, and there are now courses on reporting some types of CT and MRI scans.

“We now have 50-60 consultant radiographers in the UK. Those who specialise in breast imaging can carry out the mammogram, interpret it, if necessary do an ultrasound scan, interpret that, and if required do a biopsy, as well as providing counselling to the woman,” says Thomas.

Safeguards are built in to radiographer reporting to ensure high standards are maintained.

There is a prescribed scheme of work, signed off by the boards of NHS trusts, that sets out what kind of reports that reporting radiographers can do, how many reports they can produce and the time allowed.

There is also an audit mechanism in place. Around 10% of their reports are reviewed by consultant radiologists and their peers, and there are meetings to look at trends in the reporting of individual radiographers.

Thomas says: “It takes at least five years to train a consultant radiologist and whilst we should campaign for more trainees, in the meantime we need to use the resources we already have more efficiently.”

He suggests more training for assistant radiographers, so they could reduce the work pressure on radiographers, and in turn reporting radiographers and radiologists. “This would mean reporting radiographers could help reduce the reporting backlog and the number of unreported images and auto-reported images – those which are informally reported by other medical staff.” Thomas says.

“Many radiologists have been involved in training reporting radiographers and they know it works, but some have opposed radiographer reporting,” says Thomas. “It is essential that everyone realises that radiographers and radiologists complement each other.”