"Half of this high value medical equipment is
due to be replaced within the next three years. This is a challenge
requiring planning by individual trusts since there is no longer a
centrally funded programme. Turning to efficient management of this
equipment, trusts across the NHS lack the information and
benchmarking data required to secure cost efficient procurement and
sustainable maintenance of these key elements in modern diagnosis
and treatment."
Amyas Morse, head of the National Audit Office, 30
March 2011
Value for money is not being achieved across
all trusts in the planning, procurement and use of ‘high value
equipment’, such as CT, MRI scanners and Linear Accelerator
Machines (linacs). There are significant variations across
England in levels of activity and a lack of comparable information
about performance and cost of machine use.
Trusts are not collaborating to purchase
machines and they are not getting the best prices. According to the
National Audit Office, around half of all CT and MRI scanners and
linac machines are due for replacement within three years. Were
trusts to replace existing machines, they would collectively need
to find £460 million within three years.
The number of diagnostic scans carried out on
NHS patients using CT and MRI machines has increased almost
threefold in the last ten years. For radiotherapy, the number of
treatment sessions has increased two and a half fold over the same
period. The workforce supporting delivery of scanning and
radiotherapy has increased but shortfalls remain in capability to
deliver services. Many trusts face resource constraints in meeting
increasing demand, with vacancy rates for consultant radiologists
of around seven per cent and high rates of attrition for people
training to become therapeutic radiographers delivering
radiotherapy treatment.
There is wide variation in utilisation rates
of MRI and CT scanning machines. However, because there is no
central collection of data, individual trusts cannot compare their
utilisation rates and costs with other trusts in order to improve
efficiency. Trusts report their average costs per scan, but they do
so differently. In 2008-09, the average cost per CT scan ranged
from £54 to £268; and, for MRI, it was between £84 and £472 per
scan. However, for radiotherapy, the Department of Health has
developed a dataset which will enable comparisons to be made about
efficiency and utilisation between radiotherapy treatment
centres.
Today’s report points out that trusts are not
collaborating to get the keenest prices on purchasing or
maintenance of machines. One quarter of purchases in 2009–10 were
made outside existing framework agreements and opportunities were
missed to secure lower prices by grouping together requirements for
new machines.
Publication details:
HC: 822, 2010-2011
ISBN: 9780102969580