Differential practice of peer review and peer feedback between National Health Service (NHS) imaging departments and teleradiology companies; how big is the gap?

Abstract

Aim: Assessing the performance of peer review (PR) and peer feedback (PF) within National Health Service (NHS) imaging departments (NIDs) and teleradiology companies (TRCs) within the United Kingdom.

Material and methods: All NHS providers with a clinical radiology audit lead registered with the Royal College of Radiologists and the major TRCs that provided services within the UK were invited to participate via a questionnaire.

Results: All 6 TRCs (6/6) and 73% (146/200) of NIDs responded. All 6 TRCs performed formal PR and apportioned time for the role. Only 14/146 (10%) NIDs undertook formal PR, of which 4/14 (29%) received no remuneration for the work. In comparison, most NIDs 120/146 (82%) performed informal PR, using methods like multidisciplinary team meetings (MDTM) which occurred in 113/146 (77%). Peer feedback was practised by 104/146 (71%) NIDs and 5/6 (83%) TRCs, but only 30% to 49% of NIDs and 33% of TRCs used the content for reflective notes or incorporated it within appraisal. Electronic PF was possible in 36/146 (25%) NIDs and 3/6 (50%) TRCs. A peer moderator was present in 35% of NIDs and 50% of TRCs.

Conclusion: Formal PR was performed by all TRCs but underutilised within NIDs, where it was poorly remunerated. NHS imaging departments relied more on informal methods of PR, such as MDTM. The majority of NIDs and TRCs performed PF; however, the educational benefits of integrating PF within reflection and appraisal were often not implemented. Information technology systems to provide contemporaneous PF and a peer moderator could improve engagement but weren't present in most departments.