Without a doubt, the digital revolution has created the greatest transformation in radiology
Over the last 30 years, radiology in the UK has undergone monumental transformation and growth. I am fortunate to have worked through this, as a consultant radiologist in a single NHS trust, one that has existed in many guises, with serial mergers and changing status. Now in its strongest position, I remain proud to be employed at Mid Yorkshire Teaching NHS Trust. Over this period, we have seen extraordinary technological advancements and huge growth in demand, alongside the evolving healthcare needs of an ageing population and increasing patient expectations.
At the beginning of my consultant career, an on-call duty lasted a whole week, 24/7, as radiology did not have the powerful diagnostic tools like CT and MRI available out of hours, if at all. In 2025 in my institution, like many the world over, outsourcing of emergency scans takes place overnight because it is so intensive and central to urgent care, and would be hugely disruptive to daytime rotas if delivered entirely in-house. Radiology is also now central to all diagnostic and therapeutic pathways. Multidisciplinary team (MDT) working is fully established alongside subspecialisation in radiology.
My career highlights include significant involvement in the design and commissioning of new hospitals (2000-11); delivery of the first MRI unit to our institution (2000); and my first trips to UKRC (now UKIO), RSNA and ECR. All of those were memorable for a range of reasons. I am also proud of being involved with the creation of one of the first haematology MDTs in a district general hospital, way back in the late 1990s. I have been privileged to work with many great people and in some fantastic teams, especially the working parties at UKIO, where I contributed for almost a decade. That included helping the conference ‘survive’ the pandemic, with two fallow years, and learning how to deliver virtual conferences.
Undoubtedly, however, the digital revolution has created the greatest transformation in radiology. PACS was widely adopted in the NHS in 2006. It changed radiology overnight from film based to an entirely digital speciality, providing instant access to all imaging, and making it viewable across enterprise boundaries, including on mobile devices. With the advent of PACS came further digitalisation in radiography. The emergence of multislice or spiral CT, and then MRI too, have been the main drivers truly making radiology mainstream. And of course, these modalities have grown beyond comprehension over the last 20 years.
As we enter the era of AI, radiology is at the forefront of healthcare. This will be the main driver towards personalised care, and others hope for both prediction and prevention of disease in future. We now offer a much more patient-centred service, which continues to improve, people are much better informed and experience much shorter waiting times and improved communication of results. Multidisciplinary working has improved standards and led to consistent and better care.
Now in the twilight of my career, I recognise that radiology is a highly technological and digitally-driven speciality, which plays a vital role in modern healthcare. It is difficult to predict the next 30 years, but I am sure this will incorporate AI and other novel and emerging technologies. I am also confident that compassionate care, alongside human experience and expertise, will remain firmly at the heart of future healthcare.
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