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Provisional Monthly Diagnostic Imaging Dataset Statistics

April 2012 to April 2013, England

Experimental Official Statistics

Frequently Used Acronyms

Acronym / Full name
DID / Diagnostic Imaging Dataset
HSCIC / Health and Social Care Information Centre
RIS / Radiology Information System

In this publication, imaging activity for the latest month of data is based on submissions up to and including the last working day of the month before the publication.

Almost 35 million imaging tests were reported in England between April 2012 and April 2013. Plain Radiography (X-ray) was most common, followed by Ultrasound, CT Scan, MRI and Fluoroscopy. The following tables give an England count of imaging activity by modality for each month April 2012 to April 2013.

For the first time, figures for Medical Photography, Nuclear Medicine, PET Scans and SPECT Scans are included in the monthly report.Please see the definitions section for further information on those tests included.

Table 1.1: Count of imaging activity in England, on NHS patients, for April 2012 – April 2013

CT Scan
(Computerised Axial Tomography) / Ultrasound
(Diagnostic Ultrasonography) / Fluoroscopy / MRI
(Magnetic Resonance Imaging) / X-ray
(Plain Radiography) / Total1 / % of organisations included
Apr / 230,495 / 503,700 / 69,385 / 159,745 / 1,567,800 / 2,531,125 / 96.3%
May / 264,605 / 592,260 / 83,335 / 181,580 / 1,832,855 / 2,954,635 / 96.8%
Jun / 225,730 / 485,530 / 66,795 / 161,365 / 1,564,395 / 2,503,815 / 93.6%
Jul / 248,015 / 546,560 / 76,530 / 178,010 / 1,677,735 / 2,726,850 / 93.1%
Aug / 258,840 / 555,120 / 76,325 / 184,095 / 1,647,305 / 2,721,690 / 93.6%
Sep / 242,430 / 515,520 / 68,460 / 173,050 / 1,596,935 / 2,596,400 / 93.6%
Oct / 252,360 / 564,640 / 74,065 / 175,775 / 1,631,065 / 2,697,905 / 89.9%
Nov / 244,010 / 501,215 / 69,655 / 161,400 / 1,587,215 / 2,563,495 / 90.5%
Dec / 222,980 / 419,820 / 57,430 / 144,770 / 1,408,320 / 2,253,320 / 91.1%
Jan / 278,720 / 562,510 / 75,310 / 181,110 / 1,780,900 / 2,878,550 / 98.4%
Feb / 256,110 / 571,130 / 75,395 / 185,450 / 1,593,690 / 2,681,775 / 94.7%
Mar / 271,365 / 597,385 / 77,120 / 190,875 / 1,651,245 / 2,787,990 / 92.1%
Apr / 268,770 / 617,105 / 76,925 / 187,390 / 1,652,385 / 2,802,575 / 87.3%

1This total only includes those imaging scans counted in this table; other imaging scans such as nuclear medicine, medical photography and PET scans are not counted in this total.

Table 1.2: Count of imaging activity in England, on NHS patients, for April 2013

Medical Photography / Nuclear Medicine / PET Scans
(Position Emission Tomography) / SPECT Scans
(Single Photon Emission Computerized Tomography) / Total2 / % of organisations included
Apr / 550 / 33,780 / 5,705 / 855 / 2,843,465 / 87.3%

2 This total includes all imaging scans counted in both this table and table 1.1

These tables include the percentage of organisations for which data have been included for each month. Data submitted for some organisations have not been included in the data tables owing to data quality issues, and not all organisations have submitted data each month.

Graph 1: Graph of imaging activity in England, on NHS patients, for April 2012 – April 2013

Please see Additional Table 1a (separate Excel file) for a break-down of imaging by modality and by provider.

Patient Test Times

The DID collects data on four dates associated with each imaging event:

- Date of test request (request made by health care professional)

- Date of test request received (by the organisation providing the imaging)

- Date of test

- Date of test report issued (by health care professional interpreting the imaging output)

The Date of Test determines the month an imaging event is reported under in the DID monthly publications.

The median period between the request being made and the test being performed varied greatly for the different tests, from the same day for X-ray, Fluoroscopy and Medical Photography, to 20 days for SPECT scans and 23 days for MRI.

The following table gives the median number of days between the ‘date of test request’and the ‘date of test’, split by the test modality for each month from April2012 to April 2013.

In the following table, median values of 0 occur where atleast 50% of activity has a 'date of test request' and 'date of test' which is recorded as the same day. Records where either of these dates is missing are not used to calculate median values.

Table 2.1: Median number of days between ‘date of test request’ and ‘date of test’ for imaging activity, April 2012 –April 2013

CT Scan
(Computerised Axial Tomography) / Ultrasound
(Diagnostic Ultrasonography) / Fluoroscopy / MRI
(Magnetic Resonance Imaging) / X-ray
(Plain Radiography)
Apr / 2 / 13 / 0 / 26 / 0
May / 2 / 13 / 0 / 24 / 0
Jun / 2 / 13 / 0 / 25 / 0
Jul / 2 / 12 / 0 / 22 / 0
Aug / 2 / 13 / 0 / 23 / 0
Sep / 1 / 13 / 0 / 23 / 0
Oct / 2 / 12 / 0 / 21 / 0
Nov / 2 / 14 / 0 / 22 / 0
Dec / 1 / 14 / 0 / 23 / 0
Jan / 1 / 15 / 0 / 26 / 0
Feb / 2 / 12 / 0 / 21 / 0
Mar / 1 / 13 / 0 / 21 / 0
Apr / 2 / 14 / 0 / 23 / 0

Table 2.2: Median number of days between ‘date of test request’ and ‘date of test’ for imaging activity, April 2013

Medical Photography / Nuclear Medicine / PET Scans
(Position Emission Tomography) / SPECT Scans
(Single Photon Emission Computerized Tomography)
Apr / 0 / 15 / 7 / 20

Please see Additional Tables 2a (separate Excel file)for the median number of days between ‘date of test request’ and ‘date of test’ for imaging activityby modality and by provider.

These figures should notbe compared to “waiting time” statistics that measure how long patients are on a waiting list, since these figures include both planned and unplanned imaging activity. In addition, these figures may not have been adjusted for any cancelled or missed appointments and they count the period for each individual test not each patient appointment.

The median period for the report to be issued after the test was the same day for CT scan, Ultrasound and Fluoroscopy, within a day or two for X-ray, and up to three days for MRI. The following table gives the median number of days between ‘date of test’ and ‘date of test report issued’, split by the test modality for each month April2012 to April 2013.

In the following table, median values of 0 occur where atleast 50% of activity has the same day for both 'date of test' and 'date of test report issued date'. Records where either of these dates is missing are excluded from the calculation of median values.

Table 3.1: Median number of days between ‘date of test’ and ‘date of test report issued’ for imaging activity and percentage of records where date of test report issued equals date of test, split by modality, for April 2012 – April2013

England / CT Scan
(Computerised Axial Tomography) / Ultrasound
(Diagnostic Ultrasonography) / Fluoroscopy / MRI
(Magnetic Resonance Imaging) / X-ray
(Plain Radiography)
Measure / Median / % same day / Median / % same day / Median / % same day / Median / % same day / Median / % same day
Apr / 0 / 56% / 0 / 84% / 0 / 61% / 3 / 25% / 2 / 29%
May / 0 / 55% / 0 / 84% / 0 / 61% / 2 / 26% / 1 / 29%
Jun / 0 / 56% / 0 / 84% / 0 / 62% / 3 / 25% / 2 / 27%
Jul / 0 / 55% / 0 / 84% / 0 / 62% / 3 / 26% / 2 / 28%
Aug / 0 / 56% / 0 / 85% / 0 / 63% / 3 / 27% / 2 / 29%
Sep / 0 / 57% / 0 / 86% / 0 / 62% / 3 / 26% / 2 / 28%
Oct / 0 / 58% / 0 / 86% / 0 / 63% / 2 / 28% / 1 / 32%
Nov / 0 / 58% / 0 / 85% / 0 / 63% / 2 / 28% / 1 / 32%
Dec / 0 / 60% / 0 / 86% / 0 / 66% / 2 / 29% / 1 / 33%
Jan / 0 / 60% / 0 / 86% / 0 / 66% / 2 / 29% / 1 / 35%
Feb / 0 / 58% / 0 / 87% / 0 / 66% / 2 / 28% / 1 / 34%
Mar / 0 / 59% / 0 / 87% / 0 / 66% / 2 / 27% / 1 / 32%
Apr / 0 / 58% / 0 / 87% / 0 / 65% / 2 / 28% / 1 / 31%

Table 3.2: Median number of days between ‘date of test’ and ‘date of test report issued’ for imaging activity and percentage of records where date of test report issued equals date of test, split by modality, for April 2013

England / Medical Photography / Nuclear Medicine / PET Scans
(Position Emission Tomography) / SPECT Scans
(Single Photon Emission Computerized Tomography)
Measure / Median / % same day / Median / % same day / Median / % same day / Median / % same day
Apr / 1 / 16% / 1 / 29% / 2 / 5% / 1 / 37%

Please see Additional Tables 3a(separate Excel file) for mediannumber of days between ‘date of test’ and ‘date of test report issued’ for imaging activity by modality and by provider.

Imaging Tests that could contribute to Early Diagnosis of Cancer

A main driver for the creation of the DID is to assess use of diagnostic imaging that could contribute tothe early diagnosis of cancer, and in particular,General Practitioner (GP) direct access to these tests. To enable this analysis a subset of procedures particularly used to identify or discount a diagnosis of cancer have been identified:

Brain (MRI)

  • This may diagnose brain cancer, this includes – MRI of brain (often with contrast);

Kidney or bladder (Ultrasound)

  • This may diagnose kidney or bladder cancer, this includes – ultrasound of kidney, ultrasound scan of bladder or ultrasound and doppler scan of kidney;

Chest and/or abdomen (CT)

  • CTs which may diagnose lung cancer, this includes- Chest + Abdominal CT, CT of chest (high resolution or other), CT thorax + abdomen with contrast, CT thorax with contrast or CT chest + abdomen;

Chest (X-ray)

  • This may diagnose lung cancer, this includes– Plain chest X-ray only;

Abdomen and/or pelvis (Ultrasound)

  • This may diagnose ovarian cancer, this includes – Ultrasonography of pelvis, Ultrasonography of abdomen (upper, lower or other) or abdomen + pelvis.

Note, brain MRI, chest x-ray, and ultrasounds of the abdomen and pelvis to diagnose Ovarian Cancer are three of the key tests which are outlined in Improving Outcomes: a Strategy for Cancer.

Although these tests are used to diagnose cancer, many of the tests also have wider clinical uses. Within thisdata, it is not possible to distinguish between the different uses of these tests.

Over a quarter of thetests that may have been used to diagnose or discount cancer were requested by GPs under direct access arrangements. Of these, the most common test requested by GPs was Chest X-ray, followed by diagnostic tests that may have been used to diagnose ovarian cancer (48% of which were requested by GPs). The following table gives a count of tests carried out on NHS patients that may have been used to make an early diagnosis of cancer. It includes the total number of these tests carried out, regardless of patient source setting, and a subset of this total; where the patient source setting was recorded as “GP Direct Access”.

Table 4: Graph of imaging activity, using groups of tests suitable for diagnosing cancer,labelled by body site, for all patients referred and those directly referred by a GP, April2012 – April 2013

Brain (MRI) / Kidney or bladder (Ultrasound) / Chest and/or abdomen
(CT) / Chest (X-ray) / Abdomen and/or pelvis (Ultrasound) / % of organi-sations included
All / GP / All / GP / All / GP / All / GP / All / GP
Apr / 32,805 / 1,970 / 15,740 / 4,905 / 26,305 / 1,905 / 581,625 / 137,210 / 83,695 / 38,360 / 96.3%
May / 36,995 / 2,340 / 17,910 / 5,510 / 31,265 / 2,435 / 669,585 / 191,820 / 97,865 / 44,875 / 96.8%
Jun / 33,025 / 2,215 / 14,630 / 4,280 / 25,905 / 1,945 / 585,680 / 163,590 / 80,100 / 35,960 / 93.6%
Jul / 36,015 / 2,350 / 16,510 / 5,040 / 28,955 / 2,415 / 608,865 / 164,950 / 89,930 / 41,190 / 93.1%
Aug / 37,400 / 2,535 / 17,205 / 5,085 / 29,545 / 2,560 / 579,720 / 150,360 / 91,810 / 42,905 / 93.6%
Sep / 35,100 / 2,325 / 16,350 / 4,895 / 27,245 / 2,105 / 550,940 / 130,260 / 87,045 / 40,720 / 93.6%
Oct / 35,755 / 2,535 / 17,900 / 5,740 / 29,010 / 2,375 / 576,350 / 145,760 / 90,970 / 42,980 / 89.9%
Nov / 37,510 / 2,500 / 17,850 / 5,745 / 29,915 / 2,510 / 587,510 / 145,545 / 91,415 / 43,050 / 90.5%
Dec / 33,930 / 2,410 / 15,140 / 4,690 / 26,515 / 2,195 / 568,130 / 118,725 / 75,525 / 34,055 / 91.1%
Jan / 42,460 / 2,650 / 19,775 / 5,925 / 34,900 / 2,760 / 696,995 / 183,600 / 101,325 / 46,255 / 98.4%
Feb / 38,290 / 2,525 / 16,975 / 5,110 / 30,625 / 2,615 / 602,755 / 158,935 / 88,490 / 40,340 / 94.7%
Mar / 38,865 / 2,640 / 16,720 / 5,175 / 30,940 / 2,755 / 627,375 / 157,030 / 87,975 / 39,990 / 92.1%
Apr / 38,925 / 2,640 / 16,230 / 4,895 / 31,515 / 2,940 / 600,385 / 158,975 / 93,350 / 44,880 / 87.3%

Graph 2.1: Graph of imaging activity, using groups of tests suitable for diagnosing chest cancer, for patients directly referred by a GP, April2012 – April 2013

Graph 2.2: Graph of imaging activity, using groups of tests suitable for diagnosing abdomen and/or pelvis cancer, for patients directly referred by a GP, April2012 – April 2013

Graph 2.3 : Graph of imaging activity, using groups of tests suitable for diagnosing other listed cancers,labelled by body site, for patients directly referred by a GP, April2012 – April 2013

Graph 3: Graph of the percentage of referrals made by General Practitioners by modality, for April 2013

Please see Additional Tables 4a (separate Excel file)for a count of imaging activity, using tests suitable for diagnosing Cancer, by body site, for all patients referred and those directly referred by a GP, by provider for April 2012 –April 2013

In the following table, median values of 0 occur where atleast 50% of activity has the same day for both 'date of test request' and 'date of test'. Records where either of these dates is missing are not used to calculate median values.

Table 5: Median number of days between ‘date of test request’ and ‘date of test’ for imaging activity using groups of tests suitable for diagnosing cancer,labelled by body site,split by

patient source setting “GP Direct Access”, for April 2012 – April 2013

Brain (MRI) / Kidney or bladder (Ultrasound) / Chest and/or abdomen
(CT) / Chest (X-ray) / Abdomen and/or pelvis (Ultrasound)
All / GP / All / GP / All / GP / All / GP / All / GP
Apr / 24 / 26 / 14 / 26 / 13 / 17 / 0 / 0 / 17 / 26
May / 21 / 25 / 13 / 23 / 12 / 15 / 0 / 0 / 15 / 23
Jun / 23 / 28 / 14 / 25 / 13 / 17 / 0 / 0 / 16 / 26
Jul / 21 / 24 / 13 / 25 / 12 / 16 / 0 / 0 / 15 / 23
Aug / 21 / 26 / 13 / 26 / 12 / 16 / 0 / 0 / 15 / 24
Sep / 21 / 25 / 14 / 26 / 12 / 15 / 0 / 0 / 15 / 23
Oct / 19 / 25 / 13 / 22 / 12 / 15 / 0 / 0 / 13 / 21
Nov / 20 / 25 / 13 / 23 / 12 / 16 / 0 / 0 / 14 / 21
Dec / 21 / 26 / 13 / 22 / 12 / 17 / 0 / 0 / 14 / 21
Jan / 24 / 27 / 14 / 24 / 14 / 20 / 0 / 0 / 14 / 23
Feb / 19 / 22 / 12 / 19 / 13 / 17 / 0 / 0 / 14 / 20
Mar / 20 / 23 / 12 / 21 / 12 / 17 / 0 / 0 / 14 / 22
Apr / 22 / 26 / 14 / 25 / 13 / 17 / 0 / 0 / 18 / 27

Graph 4.1: Graph of themedian number of days between ‘date of test request’ and ‘date of test’for imaging activity using groups of tests suitable for diagnosing kidney or bladder cancer, split by patient source setting “GP Direct Access”, for April 2012 – April 2013

Graph 4.2: Graph of themedian number of days between ‘date of test request’ and ‘date of test’for imaging activity using groups of tests suitable for diagnosing abdomen and/or pelvis cancer,split by patient source setting “GP Direct Access”, for April 2012 – April 2013.

With the exception of Chest X-ray, for the key tests that may be used to diagnose or discount cancer, the median period from a test being requested to being performed is longer for GP direct access compared with all referrals. The main reason for this difference is that‘all referrals’ includes tests on emergency admissions and inpatients, which have shorter waits.

Please see Additional Table 5a (separate Excel file) for median number of days between ‘date of test request’and ‘date of test’for imaging activityusing tests suitable for diagnosing Cancer, by body site, split by patient source setting (GP Direct Access) and by provider for April 2012 – April 2013.

In the following table, median values of 0 occur where atleast 50% of activity has a 'date of test' and 'date of test report issued date' which is recorded as the same day. Records where either of these dates is missing are excluded from the calculation of median values.

Table 6: Median number of days between date of test and date of test report issued for imaging activity and percentage of records where date of test report issued equals date of test, using groups of tests suitable for diagnosing cancer,labelled by body site, split by patient source setting “GP Direct Access”, for April 2012 –April 2013

Month / Measure / Apr / May / Jun / Jul / Aug / Sep / Oct / Nov / Dec / Jan / Feb / Mar / Apr
Brain (MRI) / All Median / 2 / 2 / 2 / 2 / 2 / 2 / 1 / 2 / 2 / 1 / 1 / 2 / 1
All % Same Day / 30% / 31% / 29% / 30% / 30% / 31% / 33% / 33% / 34% / 35% / 34% / 33% / 34%
GP Median / 4 / 3 / 3 / 3 / 4 / 3 / 2 / 2 / 3 / 2 / 2 / 3 / 3
GP % Same Day / 14% / 16% / 17% / 15% / 14% / 16% / 18% / 19% / 18% / 20% / 17% / 17% / 18%
Kidney or bladder (Ultrasound) / All Median / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0
All % Same Day / 84% / 84% / 86% / 86% / 86% / 85% / 86% / 85% / 86% / 86% / 86% / 87% / 87%
GP Median / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0
GP % Same Day / 79% / 80% / 81% / 81% / 80% / 79% / 81% / 79% / 79% / 82% / 81% / 82% / 83%
Chest and/or abdomen
(CT) / All Median / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1
All % Same Day / 41% / 43% / 41% / 41% / 41% / 41% / 43% / 42% / 44% / 44% / 42% / 41% / 41%
GP Median / 2 / 1 / 2 / 2 / 2 / 1 / 1 / 1 / 2 / 1 / 2 / 2 / 2
GP % Same Day / 33% / 37% / 31% / 31% / 30% / 35% / 36% / 34% / 32% / 33% / 32% / 29% / 28%
Chest
(X-ray) / All Median / 2 / 2 / 3 / 2 / 2 / 2 / 2 / 2 / 2 / 1 / 2 / 2 / 2
All % Same Day / 24% / 25% / 22% / 23% / 24% / 23% / 26% / 26% / 27% / 29% / 28% / 26% / 25%
GP Median / 2 / 2 / 2 / 2 / 2 / 2 / 1 / 1 / 1 / 1 / 1 / 2 / 2
GP % Same Day / 28% / 28% / 24% / 25% / 27% / 28% / 31% / 31% / 35% / 34% / 29% / 28% / 28%
Abdomen and/or pelvis (Ultrasound) / All Median / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0
All % Same Day / 85% / 85% / 85% / 85% / 86% / 86% / 87% / 87% / 88% / 87% / 88% / 88% / 88%
GP Median / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0
GP % Same Day / 82% / 83% / 83% / 83% / 85% / 85% / 86% / 85% / 85% / 85% / 87% / 87% / 86%

Please see Additional Table 6a(separate Excel file) for median number of days between date of test and date of test report issued for imaging activityspecific to the early diagnosis of cancer, split by patient source setting “GP Direct Access” and by provider for April 2012 – April 2013.


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iView

The HSCIC will be allowing health sector colleagues to access DID information through their web-based reporting tool, iView. Registered users will be able to access annonymised data at aggregate level in a consistent and flexible format:

Access Information – choose from a variety of data areas.

Build Reports – select data to suit your needs.

Generate Charts – customise report tables and graphs.

Export Data – copy to Excel and manipulate data your way.

Save Reports – store your favourite views for future use.

If you would like to register to use iView for DID, please email (subject: DID iView Access). For more information, please visit the iView website

Website

The DID website can be found here:

The DID Additional Tables and Technical Report can be found here:

Additional Information

For press enquiries contact the Department of Health Media Centre. Please refer to theDepartment of Health’s website for the relevant contact details:

The Government Statistical Service (GSS) statistician responsible for producing thesedata is:

Mark Svenson

Analytical Service (Operations)

NHS England

Room 8E28, Quarry House, Quarry Hill, Leeds LS2 7UE

Email: