We read with interest the editorial by Peden ‘Anaesthetists and sedation in the radiology department: involved or left behind?’[1]. As the author comments, the publication of the RCR Guidelines on sedation and analgesia in interventional radiology [2] caused considerable debate amongst radiologists but little comment from the anaesthetic community. However, we strongly feel that the editorial does not truly represent the NCEPOD findings in their report into interventional radiology [3]. This report did identify 303 deaths during the period surveyed. However, it is at pains to point out that the 30-day mortality was 2.3% and ‘the number of days from procedure to death was so widely distributed that most patients died for reasons unrelated to the procedure’. Whilst it also points out the inadequacies of monitoring in a small percentage of patients at the time of data collection, it does not suggest that deaths were due to a failure to monitor or were the result of the sedation and anaesthesia they received. The report demonstrates that most patients in fact do receive safe sedation and analgesia. However, the mortality figures highlight just how ill the patients that undergo interventional radiological procedures are and this is stressed in the NCEPOD report: ‘many were extremely unwell and not fit for open surgery...the majority being ASA3 or higher’. Whilst the majority of patients are treated perfectly adequately with appropriate sedation and analgesia and monitored within radiology departments by trained and experienced radiologists and nursing staff, there is clearly a group of patients that do require urgent treatment who would be best served by the involvement of anaesthetists and their technical helpers. This is particularly so out of normal working hours. Any move amongst anaesthetists to recognise that these patients should be given equal priority with open surgical patients and any move that involves trainee and senior anaesthetists in the interventional radiological operating rooms would be most welcome and a considerable step in the right direction.