As the latest Royal College of Radiologists census highlights the need for almost 2,000 more radiology consultants to meet clinical demand, Dr Mary Wilson outlines how the multidisciplinary approach to workforce development and retention pioneered by the National Breast Imaging Academy could help alleviate some of the workforce issues.
The RCR 2020 census shows that while overall UK radiologist numbers are rising, they are not keeping up with patient demand and consultant shortfalls range from 24-38% across the UK. Without more consultants in training, investment in new models of care and better staff retention and recruitment, the UK’s radiologist shortfall is forecast to hit 44% (3,613 consultants) by 2025.
It’s a familiar picture to those of us in the breast radiology field, and one we have been working to address over the past four years.
The number of trained staff entering the breast imaging workforce has not kept up with the increasing clinical demands. This has been further exacerbated by an increased retirement rate amongst senior breast radiologists and radiographers. The shortage of staff has led to several breast units closing, which directly impacts on patients by causing delays in diagnosis and treatment. And of course further pressure has been put on stretched resources by the impact of the pandemic on the National Breast Screening Programme and the need to tackle a screening backlog.
Working with partner organisations and funded by Health Education England, the NBIA was established in 2017 to tackle imaging workforce issues on a national basis. By providing and developing new courses to attract a more diverse workforce into breast imaging, we are committed to improving sustainability of breast services. Our remit also includes increasing the profile of breast imaging careers to attract new entrants, ultimately ensuring that patients receive the best care possible.
The NBIA Radiology Group was tasked with improving recruitment and training for the multidisciplinary heath care professionals delivering breast imaging. The one-year Radiology Fellowship scheme they developed has been very successful in attracting high calibre post-CCT candidates, who undergo practical training in breast units supplemented by bespoke study blocks and training courses. Five radiologists have completed their fellowship and are continuing to build their careers within the NHS imaging workforce, with a further 11 fellows set to take up their training posts by autumn 2021.
Although the RCR census highlights workforce shortages at radiology consultant level, within breast imaging we have taken a multidisciplinary approach to workforce training and career development. A collaborative national Trailblazer Group developed the Mammography Associate Level 4 apprenticeship programme, which is delivered on a partnership basis by four training sites across England. The first 36 apprentices have completed their training and joined the mammography workforce.
The NBIA also joined the Association of Breast Clinicians, the Royal College of Radiologists and Health Education England to develop a new credential in breast disease management. Launched in 2019, the three-year programme aims to standardise and recognise the training for breast clinicians, and increase the breast clinician workforce to support breast screening and symptomatic services. The pilot cohort of ten trainees has given excellent feedback on the curriculum and quality of training, and a second cohort is due to begin training later this year and in 2022.
All these interconnected workstreams will increase the breast imaging workforce, and help to mitigate the very severe shortage of imaging specialists seen across the country.
Dr Mary Wilson is the NBIA Programme Lead and a Consultant Breast Radiologist at the Nightingale Centre, Wythenshawe Hospital, part of Manchester University NHS Foundation Trust.