In June 2003 the National Institute for Clinical Excellence (NICE) issued guidance on the management of head injuries in the UK. The key features of this guidance were that the indications for computed tomography (CT) should be widened and that CT should replace skull radiography in the investigation of minor head injury. Reaction among my colleagues to these guidelines ranged from despair to disbelief.

Despair because this is yet another piece of central guidance that has been issued with little regard for its operational or financial consequences.

For example, an initial assessment of the impact of this guidance in this hospital indicates that an additional 725 CT scans will be required each year, of which about half will be performed outside office hours. Given that there is a national shortage of radiologists, is it a good idea to promote a policy that demands so much additional radiologist input?

Data issued by the National Radiological Protection …