All public radiology departments are under pressure as they are neither staffed nor resourced adequately to meet demand, according to the Faculty of Radiologists.
The faculty, the professional and academic body for radiologists, was responding to the publication on Wednesday of a report which found a cancer diagnosis had either been delayed or missed in 14 patients attending University Hospital Kerry (UHK), four of whom have died. The diagnosis of one patient with lung cancer was delayed by 76 weeks.
The report, a review of more than 46,000 medical images involving more than 26,700 patients, examined the work of one locum consultant radiologist who no longer works at UHK. The report says concerns had been raised regarding “the level of activity the individual was undertaking” and a “small number of doctors” had expressed concerns about the quality of some of the [radiological] reports.
Faculty dean Niall Sheehy said yesterday that problems of understaffing and under-resourcing of radiology departments “are most acute in small departments such as University Hospital Kerry where burdens such as on-call duty are spread between a small number of consultants”.
Dr Sheehy said these departments “frequently have difficulty in recruiting consultant radiologists and may be over-reliant on locum support and outsourcing”.
“The faculty calls for greater support for these smaller departments and for the HSE to examine how the hospital groups and the National Integrated Imaging System can assist with this,” he said.
Dr Sheehy said more than 2m radiologic examinations are performed in HSE-run Irish hospitals every year and that the “vast majority” performed “to a high standard and reported promptly and accurately”.
However, he said no test is 100% accurate and errors may occur both in the technical performance and in the reporting of a radiologic examination.
“Examinations are reported by humans and humans make errors,” said Dr Sheehy.
“Whilst individual errors are regrettable with potentially profound implications for the patient, errors do not always imply negligence or malpractice.”
Dr Sheehy said the faculty extends “sincere sympathy to all of the patients and their relatives affected by this review”.
“We also acknowledge the distress caused to University Hospital Kerry staff by this review,” he said.
The review of X-rays by the radiologist who was the subject of the review at UHK was found to be “in the upper limits of norms” although the report concedes there are “no national or international guidelines indicating the volume of work to be performed by individual radiologists”. It says there was an element of “doctor discretion”.
The faculty welcomed the report’s recommendations which include that the HSE and the faculty “need to define acceptable volumes of work for individual radiologists” and that the faculty should examine how Quality Improvement Programme guidelines can be modified to support smaller hospitals with a reliance on locum radiologists.
Dr Sheehy said the recommendations, “if implemented, will lead to more robust internal processes within UHK and other hospitals… which it is hoped will obviate the need for extensive reviews in the future”.