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6th December 2011

Questions asked about the quality of radiology reports

Four separate reports have raised concerns over reporting by some overseas doctors on NHS patients.

The reports point to various patient safety implications as a result of doctors and some overseas-based teleradiologists:

• Being unable to consult quickly with the referring clinician
• Having poor language skills
• Not having access to patient’s previous medical history
• Having no experience of working within the NHS culture and its reporting models
• Being consulted with no reference to the patient

The four reports and their main findings are:

The European Society of Radiology¹ COVER survey (Clinicians' Opinions, Views, and Expectations Concerning Radiology) which shows that physicians want radiologists to have good report-writing skills, an understanding of the patient’s clinical history and to be able to telephone them when required.

A report² by the General Medical Council (GMC), which says that newly-qualified and overseas doctors should have to complete a basic induction course prior to starting work in the UK.

A poll conducted by the teleradiology company Medica at this year’s UKRC in which 81% of respondents felt it important that radiologists providing teleradiology reports for the NHS should have worked in the NHS.

A report by the House of Lords Social Policies and Consumer Protection EU Sub-Committee which says that the EU strikes the wrong balance between allowing healthcare professionals to work in other EU countries and ensuring the safety of patients.

“Looking at these reports in a quietly objective way, it is hard to escape the conclusion that legislators, radiologists and referring clinicians have growing concerns about the patient safety implications of sending images outside national borders for reporting”, said John Graham, Medica CEO.

“When reports are not prepared to an accepted NHS format, or the radiologist cannot quickly get in touch with the referring physician, then it can lead to uncertainties and imprecisions.

“Also, not having access to the patient’s clinical history means that the teleradiology service is not only failing to offer clinical and service level equivalence with a locally-provided service but also, frankly, creating the potential for misdiagnosis”.

Mr Graham observed that optimum patient safety conditions were more likely when both the radiologist and referring physician were working in the same national health provision culture and in the same time zone – even though lower cost alternatives may be available overseas.

The survey at UKRC, conducted with more than 350 consultant radiologists, radiographers, radiology managers and registrars found that some 89% of respondents said that it was either ‘unacceptable’ or ‘totally unacceptable’ for a teleradiologist to routinely issue reports without access to the patient’s previous images and reports.

Also, 79% of the respondents said that patients would either be ‘unhappy’ or ‘extremely unhappy’ if they knew that an NHS Trust was sending their images outside the EU for reporting.

“These figures, and the other three independent reports from respected organisations, must give NHS Trusts pause for thought when commissioning teleradiology services”, he said.

The President of the Royal College of Radiologists, Dr. Jane Barrett – commenting on the House of Lords report – was quoted in RAD magazine as saying: “We support the conclusion that the current directive puts patients at potential risk of harm”.

1. How do referring clinicians want radiologists to report? Suggestions from the COVER survey - Jan M. L. Bosmans, Lieve Peremans, Arthur M. De Schepper, Philippe O. Duyck and Paul M. Parizel. Published in partnership with the European Society of Radiology.
2. The first ‘State of Medical Education and Practice’ report was published by the General Medical Council in September.

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For further information contact John V. Wright, Blue Planet Communications, 07710 454214

NOTES FOR EDITORS

MEDICA operates the largest remote radiology reporting network in the UK and is part of Nuffield Health, the UK’s leading health charity.

Its objective is to provide high value radiology reporting services that are demonstrably of at least the same high clinical standard as those produced by radiologists working in the nation’s hospitals.

Its 80 radiologists - all UK-based and UK-trained FRCR consultant radiologists
- report on patient scans derived from X-Ray, MRI, CT, Ultrasound and other medical technologies.

Each consultant is equipped at home with a state-of-the-art PACS (Picture Archiving and Communications System) workstation. Connecting directly into the secure RIS (Radiology Information System) at the hospital where the patient was scanned, consultants provide both verbal and detailed written reports on the scans they have received. These essential reports enable doctors at the hospital to determine the best course of treatment for their patients.

For further information on our remote Reporting Service, please telephone 0845 0569 750 and ask for the Business Development Team,
or email us: info@medicagroup.co.uk