European Radiology

, Volume 29, Issue 4, pp 1649–1654 | Cite as

Clinicians’ perceptions of the quality of outsourced radiology and actions taken around perceived imaging errors in practice

  • Yitka GrahamEmail author
  • Catherine Hayes
  • Pallavi Mehrotra
  • Jonathan Spratt
  • Kathryn Siddle
  • Julie Cox
Radiological Education



Outsourcing of radiological reporting services has fundamentally altered communication between radiologists and clinicians in clinical decision making, which relies heavily on diagnostic imaging. The aim of this study was to understand clinicians’ perspectives and experiences of interpretation of outsourced reports in clinical practice, if the author of imaging reports matters to clinicians, and actions taken to deal with perceived errors.


A printed survey was distributed to a purposive sample of 50 of the 250 senior medical and surgical staff of a large National Health Service hospital in the UK who regularly engaged with the Radiology Department between May and October 2017, representing 20% of this hospital workforce. The survey consisted of ten questions examining clinicians’ opinions on radiology reporting, with comment options to encourage respondents to give further detail. Participants were requested to return the survey to the study investigators.


The survey elicited a 100% response rate (n = 50). A constant comparative framework was used to guide analysis, revealing themes relevant to the ongoing inter-professional relationship between clinicians and radiologists. The disparity between in-house and externally sourced radiology reports and underlying issues of trust surrounding outsourced reports were the most significant themes identified.


This study found outsourcing of radiology reporting needs multi-disciplinary team availability regarding the interpretation and discussions around capacity for effective communication. It raises important issues around often under-acknowledged additional workloads imposed on in-house radiologists. There are financial and pragmatic clinical aspects in pathways of radiology practice which require further research and examination.

Key Points

Utilisation of outsourcing is increasing in practice in response to imaging demands.

Outsourcing increases departmental primary reporting capacity but may increase the workload of the local radiologist.

The development of strategies for outsourcing examinations may lessen demands on the in-house workforce.


Outsourcing Workload Clinical decision making 



The authors state that this work has not received any funding.

Compliance with ethical standards


The scientific guarantor of this publication is Dr. Julie Cox.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was not required for this study because the participants were hospital staff, and written informed consent was waived by the Institutional Review Board.

Ethical approval

Institutional Review Board approval was obtained.


• retrospective


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Copyright information

© European Society of Radiology 2018

Authors and Affiliations

  1. 1.Department of RadiologyCity Hospitals Sunderland NHS Foundation TrustSunderlandUK
  2. 2.Faculty of Health Sciences and WellbeingUniversity of Sunderland, Sciences ComplexSunderlandUK

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