Seconds that matter: the hidden burden of vetting times on radiology workflow

Vetting is an essential but often overlooked step in radiology workflow. No published data exist on time spent vetting in National Health Service radiology departments. This study aims to quantify vetting times, examine variation by professional role, outcome, modality and referral source and explores the relationship of vetting outcome to professional role and referral source.

Between April and August 2025, 344 vetting episodes in two tertiary hospitals in the North East and North Cumbria Imaging Network were prospectively observed. Time taken to vet, professional role of the vetter, outcome, referral source, and modality were recorded.

The median vetting time was 31 seconds (IQR: 44.5; range: 4-347). Residents spent the longest time per request (61s, IQR: 79). Vetting times were similar for radiographers/sonographers (30s, IQR: 36) and consultant radiologists (28.5s, IQR: 39). Approved requests were processed fastest (median: 33s) and cancelled requests took longest (71s). Vetting times differed across modalities (H = 91.50, df (5), P<.001), longest for computed tomography (42s) and nuclear medicine (39s), and shortest for ultrasound (11s). Referral source influenced vetting time: musculoskeletal interface clinic were quickest (14s), whereas hospital referral was slowest (44s). Vetting outcomes differed by role (X²(4, N=344) = 34.15, P<.001), with residents approving most requests. Outcomes were similar between consultants and radiographers/sonographers (X²(2, N=278) = 4.46, P=.11). Approval rates varied by referrals source (X²(8, N=344) = 106.93, P<.001)-lowest for general practice (GP) (62 %) and highest for accident and emergency (100 %).

Vetting consumes a substantial amount of time and resources. Quantifying and understanding vetting time are vital for workforce planning and optimising departmental efficiency.