Recruitment freezes in cancer and diagnostic departments risk patient care and waste NHS resources

The Royal College of Radiologists is raising urgent concerns about widespread recruitment freezes in cancer and diagnostic services across the NHS, undermining critical efforts to reduce delays for patients and improve early cancer diagnosis.

New analysis shows more than a fifth of NHS trusts have implemented recruitment freezes, across every English region and every UK nation. This halts workforce growth at a time of rising patient demand and persistent care backlogs. 

This calls into question the feasibility of the Government’s commitments to reform elective care, established earlier this week – including bringing down diagnostic delays and delivering same-day results. Recruitment freezes put these ambitions at risk: to build diagnostic capacity, we must build the diagnostic workforce.

Care at risk due to staff shortfalls 

This comes as the UK faces a severe shortfall of specialists, with 1,962 fewer consultant radiologists and 185 fewer clinical oncologists than needed. These shortfalls are the main factor behind persistent failure to meet targets for cancer waiting times and delays in the reporting of scans.

And with more than 80% of patient pathways in the NHS reliant on radiology, staff shortfalls can create a wider domino effect, as delays in scan reporting result in delayed treatment. A swift diagnosis is especially important for cancer, where a month’s delay in starting treatment can raise the risk of death by 10%.
The NHS sets itself a target that every scan should be reported within a month – but in the first half of 2024 alone, over 420,000 scans took more than a month to report. 

Financial pressures lead to short-term thinking 

The cause of these freezes is mixed. Some trusts are freezing or cutting posts in an effort to balance local budgets. Others have been placed under freezes by national NHS bodies, preventing them from hiring new trainees, consultants, or specialty and specialist (SAS) doctors.  

Shortfalls mean consultants already face heavy workloads and burnout, which exacerbates early retirement (average age of retirement is 54) and compromise non-clinical responsibilities like training and service improvement. 

Shortfalls drive higher costs for the NHS, by meaning demand must be managed through locums and outsourcing to private companies. Outsourcing is already widespread in radiology, with 99% of trusts unable to meet their reporting requirements on their own in 2023, resulting in a national outsourcing bill of £276 million. This amount could pay the salaries of 2,690 consultants. 

While outsourcing can temporarily ease demand, it is inefficient for the NHS – resulting in higher costs, greater likelihood that scans need to be reported multiple times and missed opportunities for training. Some outsourcing companies are already overwhelmed, so there is a limit to how much extra capacity can be found. 

The East Midlands and the East of England are particularly affected, with 40% and 27% of trusts in these regions experiencing recruitment freezes. These areas already faced radiology workforce shortfalls of 36% and 33% in 2023, compounding the risk to patient outcomes. While training posts are distributed around the country based on areas of most need, the benefit will be limited if those doctors must leave to find consultant jobs elsewhere.

Newly trained consultants could struggle to find jobs 

In 2024, funded vacancies for consultant radiologists dropped from 518 to 152 because of financial pressures. Doctors coming to the end of training could be unable to find work, with 264 radiologists completing their training last year. This would be a failure for those hard-working doctors, for patients and for the NHS, given the cost and time it takes to train specialist doctors.

Newly trained radiologists and oncologists without a consultant post would be forced to apply for locum jobs, move abroad or leave healthcare altogether.

Commenting on this analysis, Dr Katharine Halliday, President of the Royal College of Radiologists said:

“Recruitment freezes are a false economy, and it is patients who will pay the price. We are facing severe workforce shortfalls and rising demand, so all these freezes will achieve is to force departments to spend more on costly alternatives. We urge the Government to make sure our cancer and diagnostics services can recruit the staff they need.”

Notes to editors 

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• Preliminary data from The Royal College of Radiologists’ 2024 Workforce Census reveals that 24% of cancer centre Heads of Service said that consultant recruitment freezes were happening in their NHS trust, and 19% of radiology department Clinical Directors said the same.  
• This is based on a 94% response rate from Radiology Clinical Directors and 92% response rate of Cancer Centre Heads of Service. Full data from the Workforce Census will be published in June 2025. 
• The same preliminary census data found that, when scaled up to represent a 100% return rate, there are 152 radiology consultant vacancies and 59 clinical oncology consultant vacancies across the UK. 
• This compares to 519 radiology consultant vacancies in 2023 and 84 clinical oncology vacancies. 
• Meanwhile RCR training data shows that in 2024, 264 radiologists and 54 oncologists completed their specialist training. 
• This shows that there may not be enough consultant posts for newly qualified radiologists and oncologists in 2024, creating a surplus of qualified doctors despite clear need for more consultants.  
• Total shortfall figures show that we are 1,962 radiologists and 185 clinical oncologists short of what is needed to deliver effective and timely patient care. This data has been calculated from the published 2023 RCR workforce census. 
• To effectively meet patient demand and to meet national targets, sustainable and long-term investment in the workforce is required. 
• Currently, every ICB in England is failing to meet its cancer and diagnostics waiting times.