Elsevier

Clinical Radiology

Volume 77, Issue 12, December 2022, Pages 913-919
Clinical Radiology

Commentary
Current pressure on the UK imaging workforce deters imaging research in the NHS and requires urgent attention

https://doi.org/10.1016/j.crad.2022.07.015Get rights and content

Medical imaging is a multidisciplinary specialty, combining clinical expertise from medical physics, radiography, and radiology, and plays a key role in patient care. Research is vital to ensure the care delivered to patients is evidence-based, and is a core component of clinical governance; however, there are pressures on the imaging workforce, which are significantly impeding imaging research. This commentary presents a research gap analysis pertaining to the multidisciplinary imaging workforce on behalf of the National Institute for Health Research (NIHR) Imaging Workforce Group. Data were summarised from membership surveys of the Royal College of Radiologists, Society and College of Radiographers, and Institute of Physics and Engineering in Medicine; national reports; and feedback from NIHR Clinical Research Network Imaging Champions meeting in 2020/2021. Common barriers to delivering research were found across the multidisciplinary workforce. The key issues were lack of staff, lack of time, and lack of funding to backfill clinical services. Given the ongoing workforce shortages and increasing clinical demands on radiologists, diagnostic radiographers, and medical physicists, these issues must be tackled with a high priority to ensure the future of clinical research within the NHS.

Introduction

Research is one of the seven pillars of clinical governance (clinical effectiveness and research) for multidisciplinary care in the National Health Service (NHS).1 For healthcare organisations across the UK, there are expectations with respect to research-active staff, set out by the Care Quality Commission, Care Inspectorate, Regulation and Quality Improvement Authority, or Care Inspectorate Wales, alongside specific quality standards for Imaging requirements for research.2 Imaging is a crosscutting, multidisciplinary field, of critical importance to patient care, with a key role in the majority of patient pathways. Imaging is also a crucial component of many clinical trials of new therapeutics and interventions, and the UK plays a leading role globally in developing new imaging techniques. Imaging is also at the forefront of scientific developments in rapidly developing areas such as artificial intelligence, with multiple established academic–industry partnerships.

The National Institute for Health Research (NIHR) is a key UK organisation working with patients, health and care professionals, researchers, and industry to accelerate the development, evaluation, and clinical translation of novel imaging science, ensuring that innovations in imaging bring benefits to patients.3 Between 2017 and 2018, over 250 studies involving imaging were supported by NIHR Biomedical Research Centres and Clinical Research Facilities. Each year, the NIHR Clinical Research Network supports more than 2,000 studies in which imaging plays a crucial role. Since 2016, the NIHR Academy has awarded 54 fellowships involving imaging research from a range of disciplines and fellowship programmes. In the same period, multiple NIHR programmes funded over 90 primary imaging research studies or studies where imaging was a key research component (£17.5m through Efficacy and Mechanism Evaluation; £9.3m through i4i; £41.8m through Health Technology Assessment; and £2m through Research for Patient Benefit Programmes).

Yet, despite this, there are significant barriers facing the imaging work force in delivering research on the ground. In order to tackle these issues, the NIHR Imaging Group was formed in 2020. Overseen by a steering committee, the group consists of three working groups: imaging science, research delivery, and workforce, supported by patient and public representation.4 With respect to the imaging workforce, the NIHR Imaging Group's aims are to:

  • Support the development of the imaging research workforce, with a particular focus on those working in the NHS;

  • Work with NIHR-funded imaging researchers, patients and key stakeholders to develop a strong NIHR multidisciplinary community of practice for imaging research; and

  • Collaborate with key national partners, including UK research and innovation (UKRI), the major medical research charities and patient groups.

The aim of this commentary is to describe a gap analysis for the multidisciplinary imaging workforce including radiologists, radiographers, and medical physicists, performed by the NIHR imaging workforce group. Having defined the gaps facing the workforce, potential remedies to bridge these gaps are discussed.

Section snippets

Defining the barriers to research in medical imaging

Data for this gap analysis were collated from existing membership surveys of the Royal College of Radiologists (RCR), Society and College of Radiographers (SCoR) and Institute of Physics and Engineering in Medicine (IPEM); national reports including the “2020 Diagnostics: Recovery and Renewal (Richards) report”5 and “2020 Getting It Right First Time national specialty report in Radiology”6; as well as feedback from attendees of a national NIHR Clinical Research Network Imaging Champions meeting

Conclusion

Imaging is crucial to many aspects of patient care in modern medicine. Conducting research is a key component of clinical governance. It is important to ensure that we are delivering the best care to our patients and conducting research activity in populations who need it most. In this gap analysis, the NIHR imaging workforce group has found a number of common issues across the multidisciplinary workforce, contributing to lack of research delivery within the NHS. The key issues are lack of

Conflict of interest

The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Jonathan Rodrigues reports a relationship with Sanofi that includes: speaking and lecture fees. Jonathan Rodrigues reports a relationship with NHSX that includes: consulting or advisory. Jonathan Rodrigues reports a relationship with Heart and Lung Health that includes: equity or stocks. Jonathan Rodrigues reports a relationship with HeartFlow Inc that includes:

Acknowledgements

Workforce Group (in alphabetical order): Prof. Vicky Goh (Chair), Dr Anna Barnes, Dr Angela Darekar, Prof. Margaret Hall-Craggs, Ms Jo Mearhart, Mr Robert Milner, Dr Anu Obaro, Dr Tracy O'Regan, Dr William Ramsden, Ms Julie Solomon, Prof. Stuart Taylor, Dr Tom Turmezei Imaging Steering Group (in alphabetical order): Prof. Stuart Taylor (Chair), Dr Angela Darekar, Prof. Vicky Goh, Dr Kate Holmes, Prof. Stefan Neubauer, Prof. Andrea Rockall, Dr Penny Wilson NIHR Clinical Research Network Imaging

References (23)

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    • Clinical audit and research in radiography practice: An exploration of the English landscape

      2023, Radiography
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      The lack of participation in research by radiographers may be attributed to lack of research skills and knowledge, as pointed out by Upton and Upton.35 Of note, current pressure on the imaging and radiotherapy workforce which has been escalated by the COVID-19 pandemic has further reduced capacity for radiographer-led research and/or audit activities and requires urgent attention.36–38 Involvement in research and research processes were not associated with gender, working hours or years of experience.

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