Written evidence submitted by The Royal College of Radiologists (DHS0025)
About the RCR
- The Royal College of Radiologists (RCR) is the professional membership body for doctors specialising in the fields of clinical radiology (including interventional radiology) and clinical oncology. We provide leadership to improve the standard of medical practice and training across both disciplines.
- We engage with our Fellows, members and multiple clinical partners, combining the latest research to improve training and the development of guidelines to support clinical radiology and clinical oncology patient care. This enables us to effectively educate and support doctors throughout their career by providing practical guidance and supporting individuals and their clinical services to facilitate better patient outcomes.
- Across the four policy areas under consideration by the Expert Panel, we have chosen to submit comments for the two commitments under the fourth policy area: “Workforce literacy and the digital workforce”. As we have no specific comments on existing strategies pertaining to these two commitments, or on the roll out of training for social care services, our comments relate to the remaining three categories of “evidence required” detailed on p. 5 of the Planning Grid.
- Three of our Officers attended the Digitisation roundtable events prior to this written stage of the consultation.
- The qualitative elements discussed below have come from feedback received from Officers of the College, as well as our Insight Panel. The Insight Panel is a group of doctors, made up of RCR Fellows and members, both practising and retired, from across the world, who have agreed to respond to surveys from the RCR. We recently ran an Insight Panel survey on equipment needs and digital connectivity, in which we received valuable anonymous qualitative feedback and quantitative responses.
- The current state of the IT and digital workforce presents significant challenges. Our specialties experience a chronic lack of IT support staff and oftentimes, the same people who are responding to everyday queries are also often expected to be doing the strategy work.
- Discussions of IT and digital workforce requirements should ideally consider the broader context of the infrastructure in which they operate. The Insight Panel survey revealed that in England, 49% of clinical radiologists (CRs) and 21% of clinical oncologists (COs) said they do not have the equipment they need to deliver a safe and effective service for patients in their department or cancer centre. Furthermore, only 32% of CRs and 54% COs said their equipment is fit for purpose with the rest saying it is substandard or only acceptable to some extent.
Impacts of limited workforce (I)
- The result of this is that:
- Digital strategy is often rushed and poorly thought through, and that project work is extremely slow.
- Frontline health workers waste huge amounts of time with poorly functioning systems and suboptimal interoperability.
- Systems are not used to their full advantage because there is not enough on the ground training capacity.
- It is very hard to implement any new solutions, such as artificial intelligence (AI), because IT staff don’t have the time or head space to do this. AI is developing very rapidly and has a great deal to offer in terms of saving staff time and patient safety.
- When a lack of dedicated IT support is coupled with known infrastructure challenges, such as those described by our Panel, the severity of IT failures can have impacts for the hospital (e.g. capacity), patients (e.g. being diverted elsewhere) and staff (e.g. added stress).
Impacts of limited workforce (II): IT support
- Significant time is wasted waiting for basic IT support. A lack of available and/or immediate technical support can often lead to long delays in getting minor hardware/software faults fixed and requests to be resolved. This can be difficult particularly in busy clinics.
- Some respondents to the Insight Panel reported finding it difficult to access on-site in hours IT support and on-site/off-site IT support out of hours. Having more reliable and continued IT support for in house and remote delivery of service would be beneficial, including for radiology teams, which some respondents claimed needed more technology support than general IT support teams could manage.
- Data is also important and currently it is difficult to compare centres and identify best practice, because the codes we use are not comparable in radiology. One area where data is particularly poor is in the field of interventional radiology (minimally invasive, image guided procedures). These interventions do not map through to the Hospital episode statistics (HES data) and therefore vital information about mortality and morbidity is not available in this large and rapidly expanding field.
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