Dr Giles Maskell is a consultant radiologist in Truro, and President of the Royal College of Radiologists. Here, he shares his reaction to our new report on medical imaging services, published today.
Cancer Research UK’s new report on medical imaging services in England has shown precisely what those of us in radiology departments have long known: the NHS is not coping with the increasing number of scans we’re required to carry out each year.
We don’t have enough people, and we don’t have enough machines.
Medical images – x-rays and scans – are now absolutely key to diagnosing and directing treatment for patients with the great majority of serious conditions – including cancer.
But while demand for the most complex scans – CT and MRI – is rising by at least 10 per cent each year, the resources we have in the NHS have not kept pace.
Radiologists play a vital role – they’re the experts who diagnose cancer and other serious diseases from x-rays and scans. But with fewer than half as many radiologists per person as the rest of the developed world, it is no wonder that we’re struggling to diagnose cancer early enough.
I know from having friends and relatives with cancer that, when the time comes to have a scan, their life goes on hold until the result arrives. Will it mean more treatment? Or different treatment? Or are they now beyond treatment at all? So the fact that some patients are waiting a month or longer to find this out, as the Royal College of Radiologists discovered in a survey earlier this year, is frankly shocking.
How would it look for patients if we got things right?
They could have their scan at their local hospital, clinic or health centre, without having to travel long distances, hunt for a parking place or navigate the corridors of a large hospital, searching for the right department.
An expert could interpret their scan right away, without having to come back for another appointment days or weeks later. And although the result would be the same – good or bad – we could remove that awful uncertainty, and get patients the right treatment more quickly.
And ultimately, getting the answer quicker – and treatment sooner – could make the vital difference in diagnosing cancer before it has spread, leading to better outcomes and a greater chance of complete cure.
So how do we get from here to there?
The good news is that we have a new cancer strategy which was published in July. The strategy sets out a number of steps that can be taken to ensure patients with cancer are diagnosed earlier, so it’s vital the strategy is implemented as soon as possible. There are some key steps we can take to improve imaging services specifically:
First, we desperately need to train more radiologists to bring us closer to the numbers found in other European countries. We only have around 48 radiologists per million people in the UK, compared with 92 in Germany, 112 in Spain and 130 in France.
We also need more radiographers – the technologists who operate the machines.
And, almost as important, we need more of the machines themselves, in a wider range of accessible locations, so that they are not all sited in large hospitals.
So why should the NHS spend its precious resource on imaging, rather than on the many other areas which demand investment?
Imaging leads to diagnosis – and until we can diagnose cancer earlier, our chances of beating it are very slim. And there’s an economic argument too: just as prevention is better than cure, studies have shown that investing in early diagnosis will reduce the costs associated with treating advanced disease.
This is why the Royal College of Radiologists supports Cancer Research UK’s new campaign Test Cancer Sooner, which is calling on the Chancellor, George Osborne, to commit the investment needed to improve diagnostic services in the upcoming Spending Review. This will help to make sure everyone who needs a test – not just people being tested for cancer – will receive the care they deserve.
Results from the International Cancer Benchmarking Partnership show outcomes from cancer in the UK lagging behind those in other similar nations. It is no coincidence that those countries have invested much more than us in medical imaging.
It is time for us to catch up.