Guide · checked October 2026
Radiology QA metrics: what to measure
The core radiology QA metrics are reporting turnaround against target, acknowledgement of critical and urgent alerts, peer review completion and discrepancy rates, REALM attendance and contribution, and image quality and dose audits, each tied to a standard you can point to.
Measures with a published standard behind them
- Reporting turnaround: NHS England's 2023 guidance sets targets by urgency and says no verified report should take longer than four weeks after image acquisition.
- Alerts: the 2022 Academy of Medical Royal Colleges recommendations expect a fail-safe system that finds reports not read, acknowledged and acted on, with escalation of unacknowledged alerts.
- REALM participation: the RCR's 2020 standards ask for at least six meetings a year, at least 50% attendance and one case contributed per radiologist per year.
- Image quality and dose: the Quality Standard for Imaging 2026 (XR-604) expects image quality and dose audits, monitoring of reject analysis, and regular local diagnostic reference level audits.
- Clinical audit: IR(ME)R 2017 requires employer's procedures for clinical audit and, since October 2024, for acting on the results.
Measures you set locally
Peer review completion against plan, the share of reviews with a discrepancy, the share judged clinically significant, and time to review are useful, but the targets are local. The same goes for report QA findings such as missing follow-up recommendations or template text left in a report.
Always show the denominator and the period. A discrepancy rate without the number of reviews is hard to interpret.
Presenting them
Show trends over time rather than single months, split by modality and urgency, and keep individual-level figures to the people who need them for appraisal and learning. Pair each metric with an owner and the action it should trigger.
Common traps
- A low discrepancy rate can mean few reviews, not good reporting.
- Mean turnaround hides the long tail; look at breaches against target too.
- Counting alerts sent is not the same as counting alerts acknowledged.
Where RadQA fits
RadQA's analytics show case volume, mean QA score, median turnaround, SLA breach rate (with routine, urgent and stat targets you set), the critical-communication gap, discrepancy rate, reviews submitted and pending, RADPEER-style score distribution, findings by check and severity, and the noisiest checks, filterable by modality and connector. Reports export as CSV, JSON or HTML.
Per-radiologist figures are shown only to users allowed to see them. RadQA is a pilot. It is a quality-assurance assistant, not a diagnostic device, and it does not replace radiologist reporting or clinical judgement.
Questions
What is the maximum reporting turnaround in NHS England guidance?
NHS England's 2023 guidance says no verified report should take longer than four weeks after image acquisition.
Is reject analysis expected?
The Quality Standard for Imaging 2026 expects services to monitor reject analysis as part of image quality and dose audits.
Sources
Official pages, checked October 2026. Guidance changes, so check the current version before you rely on it.
- NHS England: Diagnostic imaging reporting turnaround times (August 2023)
- AoMRC / RCR: Alerts and notification of imaging reports (October 2022)
- RCR: Standards for radiology events and learning meetings (January 2020)
- CoR and RCR: Quality Standard for Imaging 2026, version 1.0
- legislation.gov.uk: IR(ME)R 2017 regulation 7, clinical audit
General information for healthcare managers and clinical teams, checked October 2026. It is not legal, regulatory or clinical advice; follow the current official guidance and your organisation's own policies. No patient data is used in these examples. RadQA is a quality-assurance assistant for imaging departments. It is not a diagnostic device and does not replace radiologist reporting or clinical judgement. Validate against your own systems and local governance before production use.