Objectives and Background Clinical Audit provides a powerful tool for quality improvement against aspirational standards and is an integral part of the Euratom BSS Directive [1] separate to regulatory inspection for compliance. Better justification for benefit-risk considerations provides value both for patients and the UK National Health Service. This audit takes the novel approach of a collaborative effort between multi-disciplinary professionals working together locally and multiple national organisations with external guidance addressing a common objective in radiation quality and safety. Radiation safety is the responsibility...

Methods In 2020 the UK Royal College of Radiologists (RCR) chaired a work group together with representatives of the British Institute of Radiology (BIR), the UK Institute of Physics and Engineering in Medicine (IPEM) and the UK Society of Radiographers (SoR). This group was tasked with scoping, discussing and devising a clinical audit of professional practices related to radiation protection (RP) and good RP practices in line with UK RP regulations, IR(ME)R. The work group met several times and consulted with their parent organisations, making...

Results Responses from 97 departments provided analysis of approximately 3000 CT and 3000 MR examinations. Responses were received from departments representing 59% of substantive UK radiologists. Availability of Guidelines was reported at 71% (cf 2014, 68%) overall, but good practices with distribution through national coordinated initiatives in Wales and Northern Ireland show 100% availability (Fig. 2)[Fig 2]. Evidence of justification was high with authorisation shown in a median of 100% exams and a mean of 98% (Fig.3)[Fig 3]. CT and MRI exams were retrospectively judged...

Discussion and Conclusions Availability of Referral Guidelines is below standard and reflects difficulties with distribution encountered by employers particularly in England which is already being addressed by innovative technology linked to diagnostic/imaging referral information systems. Clinical Decision Support for appropriate imaging (CDS) [9] is now being piloted in 2 UK Nations with ambition for national provision for all. When guidelines are freely available to referrers, there is a lesser burden for radiology practitioners to provide such guidance both for individual cases and for nudging referral...

References Council Directive 2013/59/Euratom of 5 December 2013 laying down basic safety standards for protection against the dangers arising from exposure to ionising radiation. OJ EU L13; 57:1–73 https://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=OJ:L:2014:013:0001:0073:EN:PDF (Accessed on 11.1.22) The Ionising Radiation (Medical Exposure) Regulations 2017 https://www.legislation.gov.uk/uksi/2017/1322/contents/made (Accessed on 11.1.22) The Ionising Radiation (Medical Exposure) Regulations (Northern Ireland) 2018 https://www.legislation.gov.uk/nisr/2018/17/contents/made (Accessed on 11.1.22) Committee on Medical Aspects of Radiation in the Environment (COMARE) SIXTEENTH REPORT. Patient radiation dose issues resulting from the use of CT in the UK. 2014. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/343836/COMARE_16th_Report.pdf (Accessed on...

D. Remedios: Nothing to disclose K. Drinkwater: Nothing to disclose S. Ebdon-Jackson: Nothing to disclose