AXREM Response to The Guardian Article and the Royal College of Radiologists Workforce Report

28 May 2026

AXREM acknowledges the concerns raised in The Guardian article and the Royal College of Radiologists’ (RCR) latest workforce report. However, it is essential to provide balance and clarity on the vital role that teleradiology companies, many of whom AXREM represents, play in supporting NHS diagnostic services.

The UK is facing a long‑standing and well‑documented shortage of radiologists, with demand for diagnostic imaging increasing at a pace that far outstrips available NHS reporting capacity. This reality has direct consequences for patients: longer waits for scan results, delays in diagnosis and slower access to treatment. In this context, teleradiology is not an optional extra, it is an essential component of a safe, functioning diagnostic pathway.

AXREM members provide high‑quality, regulated and clinically robust reporting services delivered by appropriately qualified, GMC‑registered radiologists working to the same professional standards expected within NHS radiology departments. Importantly, the vast majority of radiologists undertaking outsourced reporting are the very same clinicians who also work within NHS hospitals, in fact some teleradiology companies exclusively work with UK based radiologists working with the NHS. Teleradiology does not draw staff away from the NHS; it enables NHS radiologists to contribute additional reporting capacity, often outside core hours, helping to keep services safe and timely. These services are subject to stringent governance, audit and quality assurance processes and they operate to the same professional standards expected within NHS radiology departments. Far from compromising quality, teleradiology companies help maintain it by ensuring that patients receive timely, accurate reports when NHS teams are under immense pressure.

It is also important to recognise that the value of teleradiology is not limited to additional reporting capacity. One of its greatest clinical advantages is the ability to allocate each scan to the subspecialist best qualified to interpret that specific examination, regardless of geography. Modern imaging is increasingly subspecialised and no individual NHS trust can realistically maintain comprehensive in‑house expertise across every discipline, every hour of the week, whether musculoskeletal oncology, neuroradiology, cardiac CT, paediatric imaging or complex emergency reporting. This subspecialist matching matters not only for speed but for diagnostic accuracy and pathway efficiency. A subtle lesion that may be missed in a general reporting environment but recognised by an appropriate subspecialist can prevent months of repeat appointments, additional imaging, prolonged symptoms and delayed treatment. In such cases, the most expensive scan is often the one that was not interpreted correctly the first time. As such, the relevant quality question is not whether a report was produced inside or outside an NHS hospital, but whether it was produced by the clinician with the right expertise for that examination.

Teleradiology is already proving its value at national scale. It underpins the NHS England Targeted Lung Health Check (TLHC) programme, which has now diagnosed more than 10,000 lung cancers, over 70% at an early and highly treatable stage. This programme simply could not have been delivered at pace or scale without teleradiology. The subspecialist reporting provided by teleradiology services is widely regarded as offering quality, sustainability and turnaround times that exceed what is achievable through traditional in‑house models alone. In addition, many teleradiology providers operate rigorous quality assurance frameworks, including systematic double‑reading, which are not routinely embedded across NHS radiology departments. These enhanced governance processes further strengthen diagnostic accuracy and patient safety, demonstrating that teleradiology is not only a capacity solution but a quality‑driven one.

While AXREM fully supports the RCR’s call for long‑term investment in radiology training and workforce expansion, it is important to recognise that training new radiologists takes many years. Patients need timely diagnoses today. Until the workforce gap is resolved, teleradiology provides essential capacity that helps the NHS manage backlogs, deliver seven‑day services and maintain safe turnaround times for critical imaging. Even then, teleradiology will always have a place in the NHS as long as patients and referring clinicians need access prompt and high-quality diagnoses.

Although outsourcing demand reflects the significant and well-recognised pressures within the system, it should not be characterised as a failure of it. Instead, it is a necessary and effective response to current pressures, one that ensures patients are not left waiting for the diagnoses that underpin their care. AXREM members work collaboratively with NHS trusts, providing flexible, scalable support that protects patient safety and upholds diagnostic standards.”

The priority for all of us: NHS leaders, government, professional bodies and industry, must be ensuring that patients receive the best possible care. Teleradiology plays a vital role in achieving that and AXREM will continue to champion high‑quality, patient‑centred diagnostic services across the UK.