CQC reports on safe use of radiation in healthcare settings

We have published our latest annual report on our work to enforce the Ionising Radiation (Medical Exposure) Regulations in England.

The regulations aim to protect people against the dangers from being accidentally or unintentionally exposed to ionising radiation in a healthcare setting.

A small proportion of errors happen when healthcare providers are using ionising radiation when diagnosing or treating people. Our report focuses on what we found from our inspections of healthcare providers and from reviewing the errors they notified us about between 1 April 2020 and 31 March 2021.

Our work focuses on finding out the causes of errors so that we can share this information and help all providers to learn from them and improve their safety.

The report also provides data on the number and type of statutory notifications of errors. There was less activity across all types of imaging in 2020/21 because of the impact of the coronavirus (COVID-19) pandemic. Nevertheless, over 34 million diagnostic imaging examinations were carried out on NHS patients in England, and of these, 23 million used ionising radiation.

During 2020/21, we received 499 notifications of errors, which is a small proportion of the total activity. Of all notifications received, 329 (66%) were from diagnostic radiology departments, 35 (7%) were from nuclear medicine and 135 (27%) were from radiotherapy departments.

A key source of errors continued to be when referrers requested imaging for the wrong patient. We also found that inadequate checks about the patient’s identity or mistakes by the operator were causes of errors. Although notifications relate to incidents where there is risk of harm, the majority do not result in harm to patients.

We paused our routine scheduled inspections during the pandemic and focused our resources on monitoring and inspecting in response to risk and concerns. In 2020/21, our IR(ME)R team carried out 18 inspections.

For some of these inspections, we made recommendations for improvement or took enforcement action. Areas identified for improvement included the need to ensure that procedures, protocols and guidance for staff were up-to-date and effective, and to strengthen training and supervision arrangements. In some cases, we found insufficient support for staff from medical physics experts.

Inspectors also saw how COVID-19 had exacerbated pre-existing staffing problems. Staff shortages and recruitment difficulties were affecting the ability of departments to maintain their regulatory compliance.

The report includes practical actions for IR(ME)R employers to improve compliance with the regulations. It also shares examples of the steps some providers have taken in response to errors to improve quality and safety. It is important that healthcare professionals learn from these examples and identify where they can make improvements in their own services.