To determine the cost awareness of common radiological investigations among referrers in a major London acute trust. To quantify the extent by which referrers under- or over-estimate imaging tariffs. To identify variations and potential differences between staff groups and specialities.

A randomised survey was conducted amongst clinical staff at the Royal Free Hospital (N = 1,126). The sample (n=104) was selected from Workforce databases and stratified by specialty and staff group; namely consultants, specialist registrars GP trainees / clinical fellows, foundation trainees, and non-medical referrers (NMRs). A 43.7% response rate was achieved. Respondents were asked to estimate the 2012-13 NHS tariff (Department of Health, 2013) for eight common radiological investigations: - Chest XR - Abdominal XR - CT head - CT chest - USS abdomen...

Respondents’ answers were divided by the official 2012-13 tariff and expressed as a percentage of the actual tariff. Respondents generally overestimated costs significantly. On average and across all investigations, respondents assumed costs to be 248% (95% CI 216 - 279) the actual costs. Figure 1 gives the breakdown by radiological investigation. No relationship found between overestimated costs and actual procedure cost. Most overestimated investigation was Barium swallow (£79) by 281%. Least over-estimated investigation was CXR (£25) by 158 %. The sample provided insufficient power to...

Radiology departments face increasing financial and workload pressures due to a rise in demand from an ageing population and the advance of expensive imaging technology. Over-investigation is also likely to contribute to rising healthcare expenditure. Many hospitals have introduced measures such as service-line reporting to tackle this issue. One would expect non-radiology staff to under-appreciate the cost of investigations and therefore perhaps under-estimate the cost. This research demonstrates the overall poor knowledge of the cost of radiological investigations amongst the sampled groups. However the groups...

Dr Yasmin Khaleghi is a Radiology trainee and Dr Anmol Malhotra and Dr Dylan Tsukagoshi are consultant radiologists at the Royal Free Hospital, London. Peter Dutey-Magni is based in the Public Health Department at the Royal Free London NHS Foundation Trust, as well as the department of social statistics and demography at the University of Southampton.

Department of Health. (2013). Payment by Results in the NHS: Tariff for 2012 to 2013. London: Department of Health. Retrieved from https://www.gov.uk/government/publications/confirmation-of-payment-by-results-pbr-arrangements-for-2012-13