The Quality Standard for Imaging

Supporting and enabling quality improvement in imaging services

Download the Standard

Introduction to the Standard 

The College of Radiographers (CoR) and the Royal College of Radiologists (RCR) developed the Quality Standard for Imaging (QSI) to support diagnostic imaging services to make continuous improvements ensuring patients consistently receive high quality services delivered by competent staff working in safe environments.

Services meet the Standard through accreditation via an independent third party.

The Standard reflects wide consultation with professional colleagues, as well as relevant UK government agencies and regulatory bodies. It has been assessed for use in all four countries of the UK.


Key documents

The Quality Standard for Imaging [pdf] QSI Contextual Guidance Document [pdf] QSI Infographic [pdf] Development and Support Tool [xlsx]



The QSI process: 

QSI update 2021

QSI 2021 has undergone a rigorous development and review process and represents the judgements of panels of lay representatives, radiographers, radiologists, medical physicists, and sonographers who have overseen its creation and revision. It reflects wide consultation and valuable comments and suggestions received from professional colleagues and relevant UK government agencies, professional and regulatory bodies. The QSI has been assessed for country-specific applicability.

The QSI aims to improve the quality of care for people attending an imaging service. It sets out best practice to improve patient care and outcomes. Clinical practice is a continually evolving field, and the QSI will be independently reviewed every four years. 

The new QSI 2021 standard can be found here.


QSI and UKAS

The United Kingdom Accreditation Service (UKAS) delivers accreditation against all elements of QSI, providing formal third-party recognition that a provider has demonstrated their organisational competence to deliver high quality imaging services.

Many services across the UK have attained accreditation and they are all happy to answer questions you may have about their experiences. You are welcome to visit their sites. Find their details here.

Accreditation to Professional Standards is supported by the Care Quality Commission, NHS England, NHS Northern Ireland, and NHS Wales


QSI and radiotherapy 

When radiotherapy equipment (CT, MRI, Ultrasound) is used for diagnostic imaging purposes then there must be policies, procedures and protocols in line with statutory requirements in place. It is recommended that these are in accordance with or duplicated from the local Diagnostic Imaging department to ensure consistency of high quality scanning. Appropriately trained Operators (diagnostic imaging staff) must be used to perform diagnostic imaging and there should be assurance that all relevant equipment QA for imaging purposes has been performed and is up to date. Staff should participate in Image Optimisation groups.

The use of radiotherapy scanning for planning purposes is not covered by the QSI as it is not, at that point, a diagnostic imaging tool.


QSI 2021 support 

The RCR and the CoR acknowledge that many imaging services are operating in an environment where time, money and resources are very limited. The QSI 2021 has reframed the standards with a focus on outcome measures with the aim of reducing the burden of evidence input requirements for services.

Please find a list of resources below that can help you navigate the QSI:

  • When using the 2021 Standard remember to review the contextual guidance document and QSI infographic
  • Use the development and support tool to assess your service against the QSI 2021. The tool will RAG rate your current standing and provide examples of evidence for reference. Should your service want to proceed to accreditation you can use the gap analysis to gauge your readiness.
  • Request an introductory presentation to the Standard and the support available by contacting our Quality Improvement (QI) Partners.
  • Attend a gap analysis workshop (commencing in November 2021) which covers all aspects of the Standard.
  • Join the online network created on Future NHS, that helps all QSI leads to keep in touch with each other; to share information, good practice, documentation, and ask questions of other services, by contacting our QI Partners.

Templates and downloads

Frequently asked questions


  • What is the Quality Standard for Imaging?

    The Quality Standard for Imaging (QSI) sets national quality criteria for imaging services. It is against this standard that services should evaluate their performance and make improvements where needed to meet and continually improve against the set criteria.

    Meeting the standard can be independently evidenced by accreditation through UKAS.

  • How can I learn more about the Standard?

    The Standard can be found on these web pages: www.rcr.ac.uk/qsi and www.collegeofradiographers.ac.uk/qsi or email one of the Quality Improvement Partners at [email protected] 

  • How do we access the Colleges’ support?

    The Quality Improvement Partners are available by email, phone or to visit your department at any stage. Online resources have been updated and can be found on the QSI webpages www.rcr.ac.uk/qsi  or www.sor.org/qsi

    Further supporting documentation & training/networking days will be communicated through the QSI Future NHS webpages as they become available. 

    Suggestions for useful tools can be sent to our Quality Improvement Partners via [email protected] .

    Resources and support are available through QSI Future NHS web pages or a WhatsApp groupalong with regular monthly remote meetings, with talks from experienced QSI staff from a number of UK services.Contact the Quality Improvement Partners for a list of upcoming topics and to be included on the invitation list.

  • What will QSI offer that is different?

    We know that many services are under severe constraints, both financially and with workforce shortages of both radiologists and radiographers nationally. We want to provide support to services to meet the standard.

    The QSI is written:

    • to support clinicians in improving the quality of care; it sets a minimum level of expectation rather than a ceiling of quality.
    • to stand alone, and services can use it as part of their own internal improvement assessment.
  • How does the college help me meet the standard QSI work?

    The Colleges are developing a range of supporting resources which will help services meet the standard through a staged approach. This can ultimately lead to accreditation. Ongoing college support will be available for all stages.

  • Does QSI apply to all four UK countries?

    Yes – and to NHS, commercial and not for profit imaging services in any of those countries.

  • How much will this cost?

    There will be no charge for the support made available through the Colleges. UKAS will continue to charge fees for assessment and accreditation. 

  • Our service is in the TLR system or is already accredited - what does this change mean for us?

    The only change will be the enhanced support available through the Colleges using the colleges’ Gap Analysis Tool as found on the QSI webpages and support will be provided by your allocated UKAS assessment manager with regards to the assessment process to the new standard.

  • We have no interest in accreditation- is QSI relevant to us?

    Yes - The QSI enables services to develop quality improvement building on their existing evidence base.  

    By working through the Standard you can be assured that the entire evidence healthcare regulators require will be easily available within your quality management system and a quality culture is embedded across your service.

  • Our service has a CQC rating of excellent/good. Why do we need QSI too?

    The CQC, and devolved nation equivalents, provide regulation for services via rules and guidance which must be followed as a legal requirement. 

    The QSI considers quality with specific reference to imaging services.Imaging services are obliged to meet their legal obligations via the CQC and other healthcare regulators.  

    In meeting the QSI you will have approval from a professional body that you have met an external standard that exceeds the baseline requirements of regulators and embeds the culture of quality improvement within your team. 

  • Is it just a lot of work for no reward, with no funding or staff to do this?

    The staged approach to quality improvement being offered by the Colleges will help support you in reaching your service performance and quality goals as well as meeting professional guidance recommendations.

    Compliance with existing regulations are already requirements for service delivery and you will find that your service already meets many of the standards.

    Enhanced support from the Colleges should make gaining recognition for your commitment to quality and safety more manageable and achievable.

  • What is the role of UKAS with the QSI?

    UKAS is the independent accreditation body for the UK and works with the colleges to support those services who wish to apply for independent accreditation.

    UKAS will assess services that have applied to become accredited and to grant accreditation.

    Accreditation continues to enable demonstration that you have all the systems in place for a competent, safe, effective and continually improving imaging service.

  • Do we have to be UKAS accredited?

    The QSI process allows your service to build the evidence base for accreditation.

    UKAS undertake assessments for accreditation independently against the QSI. UKAS Accreditation is recommended by NHS England/Improvement and the Care Quality Commission in England and is supported by the statutory healthcare bodies across the UK.

  • How can I find out which services have been accredited to the standard?

    The full list of accredited services can be found on the UKAS website here

If you have any further questions or need help using the Standard, please contact our Quality Improvement Partners.