• Review will look back to 2012
  • Some X-rays were not seen by radiologists at the time
  • Trust does not expect patients to have been harmed

A Sussex trust is reviewing thousands of X-rays taken over the last six years which were not examined by radiologists at the time.

East Sussex Healthcare Trust said its decision to investigate X-rays taken between 2012 and 2017 was not prompted by any national concern – despite a recent national Care Quality Commission review highlighting radiology issues and harm being caused to patients in Portsmouth when X-rays were not reviewed

Since 2014 X-rays taken for inpatients and those attending clinics at ESHT have only been reviewed by a radiologist if the doctor who asked for the film specifically requested it once they had reviewed the image themselves.

The trust is now revising that policy but concerns that something may have been missed has meant it needs to look at unreported X-rays. In a statement the trust said it had chosen to look at the 2012-17 period “as this was felt to be a safe timeframe to review.”

Around 4,000 X-rays of abdomens and chests which were not seen by radiologists – but had been reviewed by the doctors who ordered them – are now to be re-examined. The trust says that “no significant clinical risk is anticipated.”

However, the trust has yet to decide what to do with 30,000 to 40,000 X-rays of limbs which had not been reviewed by a radiologist between 2013 and 2017. It says the risk of “undetected pathology” in these is minimal and it is determining which of these needs to be reviewed.

Some of the reporting work is having to be outsourced as the trust does not have the capacity to do the work itself. 

The policy of radiologists not reviewing X-rays did not apply to those requested by GPs or through accident and emergency which should all have been seen by a radiologist. However, the trust found that around 600 films from A&E and GPs appeared not to have been reported but has now reviewed those with no issues found.

The trust has also looked at some CT and MRI scans from 2012-13 which initially could not be found on its picture archiving and communication systems. These turned out to have been stored on another system. However, review of the non-reported CTs revealed one case where a patient had a slow growing adenocarcinoma which has been reported as a serious incident. The trust said there had been no other serious incidents and the patient in this case had been followed up before the missed report was found.    

The CQC has warned that in cases where a radiologist does not examine images “there is a potential risk of harm to patients…this is especially a risk for chest and abdomen X-rays where general medical training does not constitute adequate training.”