MPs say they are “shocked” by the “unacceptable” variations between NHS trusts in waiting times for scans and the numbers of scans performed.
The response times for certain conditions is “unacceptable,” says the House of Commons Committee of Public Accounts (CPA), in its latest report on managing high-value equipment, such as Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) scanners, plus Linear Accelerator (Linac) machines for cancer treatment, in the NHS in England.
In the past three years, NHS trusts in England have spent around £50 million a year on buying these three specific types of high-value capital equipment, and their current value is around £1 billion, but the way this equipment is bought and used is not providing value for money for the taxpayer, the Committee says.
“A modern NHS should not allow 50% of people who have a stroke to wait more than 24 hours for a scan,” said the Committee’s chair, Margaret Hodge. There are also unacceptable variations between trusts in the number of scans per machine – from 7,800 to almost 22,000 a year, opening hours – ranging from 40 to over 100 hours a week – and waiting times, she added.
Moreover, an estimated 13% of cancer patients are not getting access to radiotherapy when it could prolong their lives, says the report.
“The Department of Health has got to look at how machines can be used more efficiently to make the best use of scarce resources,” said Ms Hodge, who is Labour MP for Barking.
The Committee’s report finds that too few NHS trusts are taking full advantage of the framework agreements negotiated by NHS Supply Chain. And, even when they do, money is being wasted because trusts do not join together to buy equipment and get the best deals by exploiting their bulk-buying power, it says.
Bundling orders together across trusts presents much greater scope to save money, as the Department showed through its Cancer Equipment Programmes of 2006-7 which delivered savings of around £38 million through aggregating demand, says the Committee. However, NHS Supply Chain has so far placed no bulk orders for any of these three types of machines, despite now purchasing over 80% of such equipment for the NHS, it says.
“This is a lost opportunity to use collective buying power to get lower prices, and we expect NHS Supply Chain and other collaborative procurement bodies to work with trusts to share plans on future needs and get better prices and value for money by exploiting the joint buying power,” say the MPs.
They note that while the Department is accountable for securing value for money in health spending, it has no way of getting trusts to work together or tell them how to buy equipment. “At a time when the NHS has to make £20 billion of savings, it is unacceptable that money is being wasted,” say the MPs.
They urge the Department to set out how it will be driving value for money in a devolved world where every trust is an independent foundation trust and not answerable to it, and they also express concern about whether the NHS will be able to meet the growing demand for scans and radiotherapy at the same time as delivering such big financial cuts. Half of all machines will need to be replaced over the next three years, at a cost of around £460 million, they point out.
