A large New Zealand hospital radiology service is looking to restructure and improve its functioning. I have been asked to work with them to apply the VSM to the task. I expect to have completed the diagnosis phase and would like to present the key challenges for discussion and input of ideas. Radiology is the primary service for some patients, but a support service for many, so modelling it as a coherent unit may present some challenges. Of course there is always a tension managing demand across emergency / urgent / routine streams of patients.