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Radiation Assurance is being rolled out in phases across the United Kingdom. We currently accept studies taking place in the NHS (or HSC in Northern Ireland) in any of the following: 

  • cardiology
  • neurology
  • oncology
  • rheumatology
  • studies involving general radiology which do not involve the above specailist clinical areas

From 01 November 2021, we will accept any study involving ionising radiation which is taking place in NHS/HSC secondary care settings.

What is general radiology?

General radiology procedures are those which can be justified and authorised by any Clinical Radiation Expert (CRE). They can be used and/or requested in a variety of settings eg GP surgeries, A&E etc. General radiology does not include procedures which are more specialist in nature and require a CRE with particular expertise in that area.

General radiology covers:

  • most plain film radiography (eg chest x-rays, hip x-rays)
  • CT head scans for common problems such as stroke, headaches or head injury
  • low dose procedures (eg plain films and DEXA)
  • safety tests (eg CT chest scan to preclude infection, post tumour image-guided biopsy)

General radiology does not include more specialist radiology exposures such as:

  • angiography
  • fluoroscopy
  • mammography
  • scans to check for the location and/or size of tumour

Please note that neither list is exhaustive. It does not include exposures to radioactive substances (nuclear medicine) or radiotherapy and any associated planning or on-treatment scans. For guidance on whether a radiology procedure can be considered general radiology, please contact a clinical radiation expert (if you have access to one) or radiation.assurance@hra.nhs.uk.

How does the process work?

Radiation Assurance is a pre-submission review, which takes place before e-submission of the IRAS Form and before an application is made to the Administration of Radioactive Substances Advisory Committee (ARSAC).

Once we've received your study application, we will conduct a consistency review, which ensures that regulators and sites receive consistent information across an application.

Please make sure you include all of the required documents.

You can view our consistency review criteria on the IRAS website.

If you plan to submit your application via the combined review process, separate guidance is available.

You will also need to tell us which management route you would like your study to be processed through.

Once we've completed the consistency review, the study can be sent for review by the Medical Physics Expert(s) (MPEs) and Clinical Radiation Expert(s) (CREs).

There are two management routes for Radiation Assurance:

HRA-managed 

The HRA-managed option is available to commercial and non-commercial studies. This process is managed by the HRA on behalf of the applicant and involves a review fee payable to the reviewing trusts, organisations or independent reviewers. Applicants should be aware that if a study involves multiple modalities, for example radiology and radiotherapy, it may be necessary to select more than one MPE and CRE reviewer to complete the review, which can impact on the overall cost of the review fees payable. For further details on review fees and nation variability, please read our Payments Framework Guidance.

Applicants submitting studies through the HRA-managed route have the choice to request up to three trusts, health boards or individual reviewers for the HRA to approach to undertake the review. Alternatively, we will select appropriate HRA-registered reviewers with the appropriate expertise in the clinical specialisms and imaging modalities required by the study.

This flow chart shows the process for the HRA-managed route.

Radiation Assurance HRA-managed flowchart
Long description

Self-managed

This option is available to:

  • non-commercial studies where the sponsor (or co-sponsor) is the same as the reviewing trust or health board
  • commercial studies where the reviewers are registered with the HRA to review self-managed studies with the submitting applicant.

Please read our Payments Framework Guidance for further details.

Applicants submitting studies through the self-managed route will manage the selection of reviewers and the review process. Reviewers undertaking the review on behalf of the applicant should meet the following criteria:

  • be registered with the HRA - please see our list of currently registered reviewers
  • have appropriate experience in the clinical specialisms and imaging modalities required by the study
  • non-commercial studies only: be based at the sponsoring trust/health board.

You are expected to specify which reviewers have been selected when registering your application for self-managed review. If you have reviewers that you prefer to use, who are not currently registered with us, please encourage them to regsiter. More information is available on our reviewer registration page.

As part of this route, you will still submit all of your study documentation for registration and have a consistency review conducted by the HRA.

This flow chart shows the process for the self-managed process. 

Radiation Assurance self-managed process
Long description

What are the timelines for review?

During the roll out phase, we are testing a timeline for HRA-managed studies of a maximum of 40 calendar days (excluding queries). For self-managed studies we aim to complete the consistency review within a maximum of 14 calendar days (excluding queries). As the rest of the process is managed by the applicant, we do not provide a timeline for this. You can see the timelines we are currently achieving on our main Radiation Assurance page. As we collect more data about the actual time taken for Radiation Assurance, timelines may adjust.

Feedback from both commercial and non-commercial sponsors has shown that they have benefited from a reduction in queries around consistency of radiation information and dose and risk calculations during the review process. They also report fewer queries at sites about the practical arrangements relating to radiation set-up, leading to quicker set-up times.

Still got questions?

Visit our FAQs page.

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