By Angus Thomson and Kate Aubusson
A radiology department under siege at a hospital in Sydney’s west is struggling to keep up with a backlog of more than 17,000 MRIs and other scans, leaving trainees to work unsupervised and placing patients at risk of delayed diagnoses for cancer and other serious diseases.
A confidential report by the specialist college responsible for overseeing the training of radiology registrars said there had been a “significant deterioration” in trainee supervision at Nepean Hospital.
The radiology department at Nepean hospital is dealing with a backlog of 17,000 unreported scans dating as far back as April. Credit: James Brickwood
On Friday, 17,725 MRI, CT, ultrasound scans and X-rays were waiting to be assessed by a consultant radiologist. Some 4003 examinations were listed as “preliminary”, meaning they had only been assessed by a trainee and not checked by a fully qualified consultant.
Some scans dated back to April.
“Each scan represents a patient and their doctors waiting to know what’s going on,” said a radiologist not authorised to speak publicly. “We don’t know how many more scans are sitting there showing signs of disease that haven’t been reported yet.”
Four doctors, who spoke on condition of anonymity to protect their employment, described a toxic work environment at Nepean Hospital and accused the administration of bullying and harassment as the backlog piled up.
One doctor said staff had raised concerns the backlog of unreported scans was affecting patient care, mainly through delayed decision-making, especially in cancer patients.
Another said there had been no backlog before 2024 and the “total breakdown” of the relationship between the department and hospital administration.
“You need goodwill to run the department … that’s all gone,” the doctor said. “We are now known as a toxic department, which makes it even more difficult to attract radiologists.”
A spokesperson for the Nepean Blue Mountains Local Health District said bullying and harassment were not tolerated.
“The safety and wellbeing of all our workforce is of paramount importance,” they said in a statement.
In a confidential training accreditation review, the Royal Australian and New Zealand College of Radiologists (RANZCR) reported a shortage of consultants had left trainees working unsupervised on at least three emergency department reporting shifts per week, leaving thousands of reports waiting months to be signed off by a senior radiologist.
The report said this issue arose “almost immediately” after the head of department and several senior radiologists left the unit.
The hospital has hired contractors to provide off-site teleradiology services to “help process scans and provide urgent out-of-hours reporting”, the spokesperson confirmed.
But the college’s report warned this would not address the backlog of preliminary reports, which a supervising radiologist must review.
A spokeswoman for RANZCR declined to comment on the confidential report.
The health district spokesperson said management would work closely with staff to address feedback from the assessor’s report.
A statewide staff specialist recruitment and retention crisis is affecting multiple healthcare workers, including radiologists, psychiatrists and nurses, who are paid significantly less than their interstate counterparts.
A radiologist staff specialist has a base salary of roughly $186,241 in NSW compared to $210,332 in Queensland.
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