IR(ME)R annual report 2024/25

We continue to build capacity within our annual inspection programme and carried out 78% more inspections in 2024/25 (71 inspections) compared with the previous year (40 inspections).

Our proactive annual inspection programme uses a risk-based graded approach, with the majority completed as planned proactive inspections.

We completed 3 reactive inspections in response to information of concern reported to us.

Figure 2: Total inspections carried out in 2024/25 and 2023/24, by modality

We issue an Improvement Notice when we have identified a significant compliance gap with the regulations on an inspection that could have serious consequences for patient safety. This involves:

• considering the extent of the compliance gap, and the level of potential risk associated with the non-compliance in relation to patient safety at a formal decision-making meeting
• applying our enforcement decision making policy to decide if the gap reaches the threshold for an enforcement notice - the policy is derived directly from the Health and Safety at Work Act
• advising providers what they need to do to be compliant with the Notice and specifying a date for when this must be achieved.
• following up to seek assurances from the provider and confirm that they have completed the actions.

During 2024/25, we issued fewer formal enforcement Improvement Notices in both diagnostic imaging and radiotherapy, despite carrying out more inspections.

But in nuclear medicine, there was a notable increase in the number of Improvement Notices issued. This is a result of carrying out more inspections as opposed to more non-compliance within this clinical speciality.

We believe that enforcement notices are a positive function to support employers to meet the statutory requirements of IR(ME)R, and ultimately to drive patient safety improvements within a service.

Figure 3: Total Improvement Notices issued for breach of regulations, 2024/25 and 2023/24 by modality

We continue to see areas of non-compliance with IR(ME)R in most of our inspections, which results in issuing quality improvement recommendations. Although they do not meet the threshold for an enforcement notice, they do require an employer to make changes to ensure compliance with IR(ME)R and other published standards that support current best practice and enhance quality of care for patients.

The number of recommendations in both diagnostic imaging and radiotherapy remained relatively similar to 2023/24, with another substantial increase noted in nuclear medicine. Again, we can attribute this to the increased number of inspections completed during this period. We noted persistent themes associated with gaps in compliance with the regulations and provide a detailed breakdown of inspection and enforcement activity under each modality.

Figure 4: Total recommendations issued in 2024/25 and 2023/24, by modality