CQC’s annual report on our work to enforce the Ionising Radiation (Medical Exposure) Regulations (IR(ME)R) in England during 2025/26 is now published.
The regulations protect patients, carers and comforters from the risks associated with medical exposures involving ionising radiation. These exposures include diagnostic imaging procedures such as X-rays, CT scans and nuclear medicine examinations, as well as radiotherapy treatments. Healthcare providers are required to notify CQC of significant accidental and unintended exposures that meet the threshold for reporting under IR(ME)R.
The report presents an overview of the notifications received between 1 April 2025 and 31 March 2026 and summarises the key findings from our inspection and enforcement activity during the same period.
During 2025/26, we received 996 statutory notifications relating to significant accidental and unintended exposures, compared with 842 notifications in 2024/25.
Notifications increased across all 3 types of services (modalities) that use ionising radiation in health care:
- 492 notifications relating to diagnostic imaging
- 334 relating to radiotherapy
- 170 relating to nuclear medicine.
Diagnostic imaging continued to account for the largest proportion of notifications received during the year, reflecting the volume and diversity of imaging examinations undertaken across England.
The increase in notifications is likely to reflect a combination of factors, including rising demand for services, increasing complexity of patient pathways and technologies, and continued positive engagement with reporting incidents and learning processes. As in previous years, we consider reporting of significant accidental and unintended exposures to be a positive indicator of an open and learning culture. The purpose of notification is not to apportion blame but to support learning, identify opportunities for improvement and strengthen patient safety.
Although the specific causes of incidents varied between modalities, investigations frequently identified common contributory factors including failures in the referral pathway, patient identification issues, communication failures, software and equipment-related problems, and weaknesses in verification processes.
During 2025/26, we carried out 83 IR(ME)R inspections across diagnostic imaging, radiotherapy and nuclear medicine services. Inspection findings continued to highlight recurring themes relating to:
- employers’ procedures
- arrangements for training, checking and maintaining competency of staff
- justification and authorisation of exposures
- referral management processes
- governance and oversight arrangements.
For the first time, our report also includes a national analysis of the outcomes from providers’ investigations following significant accidental and unintended exposures and the corrective measures they identified. Analysis of 1,220 investigation outcomes and corrective measures showed that most actions to improve focused on training, communication, procedures and governance arrangements. This analysis provides a baseline for comparing future investigations and supports understanding of how employers translate learning from incidents into practical improvement activity.
By publishing our report, we aim to support employers, healthcare professionals and IR(ME)R duty holders in identifying opportunities to improve local practice and strengthen compliance with IR(ME)R. We encourage employers to review the themes and learning identified in the report and to consider our recommendations as they may be relevant within their own services.