No / Radiographer abnormality detection schemes (RADS) were first introduced in the United Kingdom (UK) in the mid 1980s with the development of the ‘red dot scheme’. This article establishes the current position of UK RADS practice and provides insight into specific areas for development. Method: A postal questionnaire was distributed to 456 sites, including 270 emergency departments and 186 minor injuries units (MIU). Information was sought relating to: the type of emergency department and radiography service provided; details of RADS operated including any education and audit to support radiographer participation; and the mandatory/voluntary nature of the system adopted. Results: A total of 306 (n = 306/456; 74%) responses were received. The large majority of respondents (n = 284/306; 92.8%) indicated that a RADS was in operation. Of these, 221 sites operated a red dot scheme, 7 sites operated a radiographer comment system, and a further 54 sites operated both a red dot and comment scheme. Two sites indicated that a RADS other than red dot or radiographer commenting was operated. Twenty-one different methods of highlighting abnormal images were identified and eight different commenting methods. The RADS was considered mandatory at 25% of sites. Conclusion: This study confirms the continued widespread contribution of radiographers to the trauma diagnostic process through the use of RADS. The informal nature of the systems, inconsistent approaches to audit and education, and variations in the methods employed are issues which require national guidance.

No / Errors in the interpretation of diagnostic images in the emergency department are a persistent problem internationally. To address this issue, a number of risk reduction strategies have been suggested but only radiographer abnormality detection schemes (RADS) have been widely implemented in the UK. This study considers the variation in RADS operation and communication in light of technological advances and changes in service operation. A postal survey of all NHS hospitals operating either an Emergency Department or Minor Injury Unit and a diagnostic imaging (radiology) department (n = 510) was undertaken between July and August 2011. The questionnaire was designed to elicit information on emergency service provision and details of RADS. 325 questionnaires were returned (n = 325/510; 63.7%). The majority of sites (n = 288/325; 88.6%) operated a RADS with the majority (n = 227/288; 78.8%) employing a visual ‘flagging’ system as the only method of communication although symbols used were inconsistent and contradictory across sites. 61 sites communicated radiographer findings through a written proforma (paper or electronic) but this was run in conjunction with a flagging system at 50 sites. The majority of sites did not have guidance on the scope or operation of the ‘flagging’ or written communication system in use. RADS is an established clinical intervention to reduce errors in diagnostic image interpretation within the emergency setting. The lack of standardisation in communication processes and practices alongside the rapid adoption of technology has increased the potential for error and miscommunication.