CQC reports on radiation incidents

Our annual report on activity relating to our enforcement of the Ionising Radiation (Medical Exposure) Regulations in England has been published.

The report gives a breakdown of the number and type of notifications we received from healthcare providers when patients were exposed to radiation either when it was unintended or when they received a higher dose than intended during the 2017 calendar year and the first quarter of 2018.

In this reporting period, we received 1,226 notifications of incidents. This is in the context of around 40 million procedures carried out on patients during the 2017/18 financial year. Although notifications relate to errors and incidents where there is risk of harm to patients, the majority of over-exposures do not result in harm.

In 2017, the number of notifications decreased by 28% compared with the number received during 2016. However, this is not thought to be due to improving practice, but is a result of changes introduced in January 2017 to the guidance about the type of incidents that need to be notified to CQC.

Of all the notifications we received, 975 (80% of the total) were from diagnostic radiology departments, 94 were from nuclear medicine and 157 notifications were from radiotherapy departments.

The report also presents the key findings from our inspections of departments, either reactive to a notification or concern or as part of our programme of planned inspections, alongside details of our enforcement activity in this area.

In 2017, we issued improvement notices to two hospital trusts following concerns identified on our IR(ME)R inspections. Further information can be found on our IR(ME)R enforcement page.

Professor Ted Baker, CQC’s Chief Inspector of Hospitals, said:

"It is important that organisations learn from incidents and take action to mitigate the risks of repeating errors to protect patients from risks when they are exposed to radiation from x-rays, radiotherapy or radiopharmaceuticals as part of their diagnosis or treatment.

"Many errors happen simply because of poor communication and unclear responsibilities. We want this report to remind clinical departments of the importance of a strong safety culture in including carrying out essential safety checks. I hope that they will learn from the examples in this report to ensure they provide safe services to patients.”

The report also provides early feedback on the implementation of the new regulations that came into force in February 2018, and shares examples of the actions that some providers have taken to improve, to help leaders and healthcare professionals identify where they can make improvements in their own services.

Further information

• CQC is the enforcement authority for the IR(ME)R regulations in England.
• In February 2018, the new Ionising Radiation (Medical Exposure) Regulations 2017 replaced the 2000 regulations (including amendments made in 2006 and 2011).
• Incidents can be reported here.
• Further information about ionising radiation and how we enforce the regulations is also available here.