Intended for healthcare professionals


Radiology in Scotland is at breaking point, royal college warns

BMJ 2017; 356 doi: (Published 17 February 2017) Cite this as: BMJ 2017;356:j866
  1. Abi Rimmer
  1. BMJ Careers
  1. arimmer{at}

The Royal College of Radiologists has warned that radiology services in Scotland are at breaking point because of a lack of radiologists. Grant Baxter, chairman of the college’s Standing Scottish Committee, said that radiology in Scotland was in a desperate place.1

“There has been a huge increase, year on year, in demand for our services, both diagnostic and interventional, and that has clearly not been matched by any increase in radiology numbers,” he said. “We’re really at a point in time when we are teetering on a precipice; we’re almost at the point of collapse. Radiologists up and down the country are on their knees trying to hold a failing service together. It really is desperate, and I can’t make that point strongly enough.”

Baxter warned that there were serious implications for the safety of patients if radiology departments remained understaffed. “We’re so integral to patient care, whether it’s primary care or hospital based care, that if we don’t have [enough] radiologists then we simply are not going to have a properly functioning health service.”

An increase in the radiology workload, Baxter said, had not been met by an increase in staff. “There’s been a 55% increase in workload in five years, while the number of consultant radiologists in Scotland in the same time period has increased by 3%. And to be frank, our numbers fell last year by 1%. There’s a huge mismatch there,” he said.

The specialty has also been hit by a reduction in training numbers in 2011, Baxter said, with any increases since just making up for the shortfall. He added, “The frustrating thing is that we are one of the few specialties that actually have excess applications for training posts, so for every post we have appointed in the last three or four years we have turned down four people.”

In addition, many consultant radiologists are due to retire in the next few years, Baxter said. “We have a tsunami of retirements coming in the next three years. We estimate that 60 consultant radiologists will be retiring; that’s a fifth of our workforce, and we have unfilled posts.”

The college is urging the Scottish government to resolve the problem through a two pronged approach.“The mid to long term [plan] is to get in more trainees, and we’ve asked for 20 to 25 extra trainees each year for the next five years,” Baxter said. “In the shorter term, [the plan is] to encourage more overseas doctors to come to this country to fill a number of the gaps that exist.”

He added, “We just feel we’re on a ticking timebomb. The process can’t start next year, or in six months’ time, or in two years—it really has to start now.”

Responding to the college’s concerns, Scotland’s health secretary, Shona Robison, said, “Under this government the number of consultant clinical radiologists working in Scotland’s NHS has increased by 46%, and the number of radiography staff has risen by over 24%.”

Robison said that the Scottish government had published its five year £100m cancer strategy last year, which included a £50m investment in radiotherapy equipment, and training and recruiting specialists with an interest in radiotherapy.2

“We’re committed to working closely with the NHS, including staff representatives like the Royal College of Radiologists, to ensure this investment sees the expected increase in the number of specialist radiotherapists working in our health service,” she said. “We are also currently developing a new National Health and Social Care Workforce Plan—the first of its kind for Scotland—which will identify future workforce needs and training requirements to prepare our NHS for the future.”