CQC IR(ME)R inspections of specialist paediatric radiology services

Published: 18 July 2019 Page last updated: 12 May 2022
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We have published a report bringing together the findings from our proactive inspection programme of specialist paediatric radiology services in 12 NHS children’s hospitals in England.

The inspections, between April 2017 and March 2019, assessed compliance with the Ionising Radiation (Medical Exposure) Regulations (IR(ME)R). Medical ionising radiation is fundamental to help diagnose and treat conditions. The regulations aim to make sure that it is used safely and to protect patients from the risk of harm. They also require providers to pay particular attention to medical exposures of children.

As well as paediatric radiology services, the inspections also included the wider services for adults where we had trust wide concerns, or where children’s and adult services were not distinct.

We found some examples of good practice but also identified some common themes and areas for improvement.

  • In some cases, we found a lack of up to date or incomplete written procedures or procedures that did not always align with clinical practice.
  • Most services had detailed training records for radiographers that clearly described how they had been assessed as competent to use each piece of imaging equipment. However, this was not always the case for some other staff groups that may be required to operate imaging equipment.
  • Compliance with equipment quality assurance requirements varied, with a failure to perform regular equipment testing at some trusts.
  • Guidelines for referring patients were not always in place or made available to all referrers who used their services.
  • Many radiology staff felt they had limited opportunity to share areas of good practice with other departments to help improve radiation protection across the hospital.

Where we found specific concerns that regulations were not being met, we have told those hospital trusts to make improvements, using our enforcement powers where necessary.

See the full details of our findings and the recommendations we have made to help hospital trusts ensure they provide safe services to patients.


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