IR(ME)R annual report 2021 to 2022

In April 2022, we announced a programme of inspections to services run by chiropractors registered with the General Chiropractic Council (GCC). The aim of this ‘snapshot’ inspection programme was to increase our understanding of compliance standards within chiropractic using radiography, and to address the small number of historic concerns raised by the public or other healthcare professionals.

Although this is outside of the 2021/22 period for this annual report, we highlight some early feedback to acknowledge the poor level of compliance found from the initial 3 inspections.

Although subject to professional regulation from the General Chiropractic Council, chiropractors are exempt from registering with CQC under the Health and Social Care Act 2008. However, IR(ME)R still applies.

What we found

In general, compliance with IR(ME)R was poor. The first 2 inspections resulted in Improvement Notices. These required the employers to appoint a medical physics expert and/or to adopt diagnostic reference levels. You can see further information on these notices on our enforcement register.

In other findings:

• Employer’s procedures were generally incomplete and not maintained or regularly reviewed.
• The concept of referral guidelines was not understood and these were either unavailable or there were several different sets.
• Arrangements for quality assuring equipment varied from not happening at all to a visual inspection only, or a medical physics expert QA testing equipment once every 3 years.
• There were no records of practical or equipment training for chiropractors who took X-rays.
• In one case, there was no evidence of the use of collimation to reduce the amount of tissue exposed, and no DAP meter fitted, despite installing the X-ray set in February 2022.

We are keen to continue our pilot chiropractic inspection programme, as we remain concerned about poor compliance and understanding of IR(ME)R requirements among this profession.

We believe it is crucial for chiropractors to work closely with their medical physics experts. We will be sharing our concerns with the General Chiropractic Council and working together to improve compliance.