• Sources involved in regional cancer services say diagnostic departments may not cope with increased referrals from screening pilot
  • Vice president of Royal College of Radiologists says she is “worried” about rollout
  • Radiology and pathology workforces already struggling to cope with imaging workloads

NHS England has “questions to answer” about its lung cancer scanning pilots, as concerns have been raised over whether there will be enough diagnostic capacity to cope with the expected increase in referrals.

The national body announced in February that 10 clinical commissioning groups will share £70m of national funding to operate lung cancer scanning trucks from supermarket car parks. The scheme is intended to improve early cancer diagnosis, one of the key aims of the NHS long-term plan.

However, various senior sources have told HSJ that local providers will struggle to manage the knock-on effects of the pilot.

A Cancer Research UK spokeswoman said there were “lots of questions the NHS needs to answer about how the lung health check programme will be rolled out… [as it will result in] thousands of extra CT scans carried out each year across the chosen [pilot] areas”.

Two senior cancer nurses who work in district general hospitals, and spoke to HSJ on the condition of anonymity, said their diagnostic departments had raised significant concerns about how their radiology and pathology workforces would cope with increased referrals resulting from the pilots.

Another senior source who works in regional cancer services told HSJ the new screening vans “could wipe out the [diagnostic] workforce” if rolled out nationally.

The first lung scanning vans were first tested in Greater Manchester in 2017. This project found demand for the service was “higher than anticipated” and the number of appointments available had to be increased.

All three sources were supportive of the early diagnosis aim but said additional money was not being sufficiently offered to the trusts to increase the diagnostic workforce and that recruiting to current vacancies was already challenging.

Meanwhile, Caroline Rubin, vice president at the Royal College of Radiologists, told an event recently: “With my diagnostic hat on, I am worried. We have the opportunity to quite rapidly skill up the skills that the radiologists will need but we just need a few more people quite honestly in order to [do that] across the patch.”

An RCR spokeswoman also stressed trusts must have the capacity to properly staff the pilots, alongside normal imaging workloads.

The college’s 2018 radiology workforce census, released this month, found only 2 per cent of UK trusts were able to report on their scans without having to rely on outsourcing or overtime. There was also a 9 per cent vacancy rate in consultant clinical radiologist posts in England.

A recent workforce census by the Royal College of Pathologists raised similar concerns. It showed that only 3 per cent of NHS histopathology departments, which deal with cancer biopsies, have enough staff to meet clinical demand.

Some CCGs involved in the trial told HSJ the funding they have received from NHS England will pay for nurses, radiographers and radiologists to provide lung health check appointments and low dose CT scans in the mobile vans. It is not clear if this funding will cover further diagnostic tests in trusts.

An NHSE spokeswoman said: “The benefits of lung health checks have already been field tested in Greater Manchester and elsewhere to ensure their practical impacts, including on workforce, can be fully taken into account as the model is extended.”