This is the 15th annual RCR clinical radiology census report - presenting a comprehensive picture of the clinical radiology workforce as it stood in October 2022. Once again, we have secured a 100 per cent response rate, enabling us to speak decisively about the state of the radiology workforce across the UK. The workforce is not keeping pace with demand for services. In 2022, the clinical radiology workforce grew by just three per cent. In comparison, demand for diagnostic activity is rising by over five per cent annually, and by around four per cent for interventional radiology services. The UK now has a 29 per cent shortfall of clinical radiologists, which will rise to 40 per cent in five years without action. By 2027, an additional 3,365 clinical radiologists will be needed to keep up with demand for services. This will have an inevitable impact on the quality-of-care consultants are able to provide. Only 24 per cent of clinical directors believe they had sufficient radiologists to deliver safe and effective patient care.