RCR submission to the 2025 Spending Review

The window for submitting evidence to the 2025 Spending Review closed on Sunday 9 February. The RCR took this important opportunity to put forward specific, costed policy solutions to the chronic problems facing the NHS and our specialties of clinical radiology and oncology. The submission reflects some of your top priorities, and will be considered by the Treasury and the Department of Health and Social Care (DHSC) as part of their healthcare plans over the coming years. 

The Spending Review is the process by which government allocates funds to each of its departments, according to its priorities. This Spending Review covers the period 2026-29 and extends to 2031 for capital funding. The decisions made by the Treasury and DHSC will have significant impacts on clinicians’ working lives and patients’ experiences. Intelligent, judicious decisions could have a transformative impact. 

The RCR submission majored on three main ‘asks’, each linked explicitly to a government priority. First, we made the case for additional specialty training posts in both radiology and oncology. Workforce expansion, regardless of what other policies are pursued, is essential; without it, there is simply no possibility for the NHS to meet its performance targets or for all patients to receive safe and effective care. Analysis shows that investment in training and growing the workforce is a cost saving policy in the medium to long term. 

Second, the submission argued that the government should complete the renewal of the NHS’s linac fleet. Additional funding is required to ensure that all linacs in service are under 10 years of age, and to enable patients regardless of their postcode to have access to radiotherapy. As a highly effective treatment, radiotherapy can also help patients to spend less time in hospital and more time at home, especially when modern machines capable of optimising doses are used.  

Thirdly, the submission called for additional investment in iRefer, in order that demand for imaging examinations is optimised and the gap between demand and capacity is reduced. iRefer is effective in reducing the volume of unnecessary or repeat tests, and thereby helps to reduce diagnostic waiting times and radiation exposure. It needs to be rolled out to all primary care settings and all A&E departments. There is a strong case to be made that iRefer will help the NHS to capitalise on recent years’ investments in digitisation and IT system upgrades.