The NHS is paying private firms record sums to analyse diagnostic scans, with spending doubling in five years as hospitals struggle to cope with a severe shortage of radiologists, new data reveals.
The Royal College of Radiologists (RCR) has calculated that NHS trusts and health boards across the UK handed £241 million to private companies to interpret CT and MRI scans in the latest financial year. That figure has risen from £120 million in 2021 and has tripled since 2018, when it stood at £81 million. The year-on-year increase alone was 12 per cent, up from £216 million in the previous period.
The RCR described the expenditure as “ballooning” and said it reflected a health service that was “haemorrhaging” cash to independent firms because it lacked the in-house capacity to read all scans. The college’s annual workforce census, which collated the figures, warned that the reliance on outsourcing was not sustainable.
Shortage of radiologists at the heart of the crisis
The core driver of the soaring outsourcing bill is a critical shortage of consultant radiologists. As of 2023, the NHS faced a 30 per cent shortfall – the equivalent of 1,962 fewer radiologists than needed. Projections suggest that if current trends continue, that deficit could reach 40 per cent by 2028, leaving a gap of 3,670 doctors.
Demand for diagnostic imaging, particularly CT and MRI scans, is rising far faster than the workforce can absorb. The volume of scans requiring reporting grew by 11 per cent in the latest period, while the radiologist workforce expanded by just 6 per cent. That imbalance is leading to significant delays and backlogs, forcing hospitals to turn to private teleradiology companies to get results back in a timely manner.
The RCR has raised concerns that the outsourcing itself may be contributing to a vicious cycle. As more work is sent to private firms, NHS radiology departments are weakened, and experienced NHS radiologists are drawn to higher-paid private work. Meanwhile, recruitment freezes within the NHS are exacerbating the shortage: 36 per cent of radiology departments reported hiring freezes in 2025, almost double the figure from the previous year.
Training capacity is also under scrutiny. Although the RCR noted there are currently 11 applicants for every training post, the number of available training places may not be sufficient to meet future demand. The college’s president, Dr Stephen Harden, criticised what he called a “short-sighted failure to train enough doctors”.
The financial impact of the workforce gap is stark. The £241 million spent on outsourced scan analysis in the latest year could have funded the salaries of an estimated 2,690 consultant radiologists. Projections indicate that if current trends persist, outsourcing costs could exceed £400 million annually by 2028 – a sum that could otherwise support more than 3,000 full-time consultant radiologists.
Concerns over quality and the risk of permanent reliance
Beyond the cost, there are serious questions about the quality of work being done by private firms. The RCR warned that the analysis provided is sometimes so poor that NHS radiologists have to re-read the scans. In its census, 86 per cent of NHS radiology department heads said they had serious concerns that privatisation results in lower-quality reports, and 90 per cent reported that NHS radiologists needed to double-check outsourced reports.
“Increasing NHS reliance on outsourcing in radiology is not sustainable and the costs of this are spiralling out of control,” said Dr Harden. “In the short term, outsourcing can help to manage diagnostic backlogs, but it cannot be a long-term solution to workforce shortages. Clinical radiologists play an essential role in making most diagnoses, but rising demand for scans is outstripping our capacity.”
The Centre for Health and the Public Interest (CHPI) thinktank warned that the NHS risks becoming permanently dependent on private companies for this critical function. Its director, David Rowland, said: “The use of private teleradiology companies to read NHS scans is growing rapidly. History shows that once the government hands these roles over to the private sector, they remain in private hands, taking income and revenue away from NHS hospitals and removing the opportunity to train the next generation of NHS staff. The risk is that the NHS becomes wholly dependent on private companies for this critical function, whose sole focus is on the bottom line.”
Patients are feeling the impact. In 2024, a record 976,000 scans in England breached the one-month target for reporting – a 28 per cent increase from the previous year. That included more than 74,000 CT and MRI scans that took longer than six weeks to be read. By early 2025, approximately 1.67 million people in England were waiting for a diagnostic test.
Government plans and criticism
The Department of Health and Social Care (DHSC) acknowledged that radiology services were under growing pressure. A spokesperson said: “We recognise the pressures facing radiology services, and that demand for diagnostic imaging has risen significantly in recent years. Despite this, the NHS carried out 30 million diagnostic tests in the last year alone, and compared with the previous 12 months, 95,000 more patients were diagnosed with cancer or given the all-clear within 28 days. But we know there is more to do, which is why this government will publish a 10-year workforce plan to help deliver a transformed health service in England. This will make sure we have the right staff in the right places, with the right skills to care for patients, when they need it.”
Critics, however, argue that continued heavy spending on outsourcing without addressing the underlying workforce shortage is short-sighted. Dr Harden urged ministers and NHS chiefs to boost the radiology workforce by creating more training roles. “To ignore this call and continue to spend heavily on outsourcing would be short-sighted, would not be the best use of NHS funds and would not be in patients’ best interests,” he said. The RCR also warned that the £241 million outsourcing bill was a “false economy” and that without immediate action, the annual cost could surpass £400 million by 2028 – a sum that could otherwise support more than 3,000 full-time consultant radiologists.
