Download Proposal for 2 MRI scanner in the NHSCT

PRESENTATION TO TRUST BOARD: PROJECT SUMMARY Aug 2012
Project Title: Proposal for 2nd MRI scanner in the NHSCT
Section 1: Overview of NHSCT MRI Service
A single Siemens Harmony MRI scanner supports the full MRI service for all of the
NHSCT/Board patient population.
The existing MRI scanner, based in Antrim Hospital, was installed in 2004, and is
central to the delivery of a wide range of clinical specialities. The increasing demand
for MRI scans is placing a continuous heavy workload on the single aging scanner.
To meet current demand an average of 16 out-of-hours sessions are required each
month.
In the field of cancer, MRI plays an increasing role in diagnosis, characterisation,
staging and assessment of treatment response
Recent developments in MR include Breast imaging and biopsy. The demand for
Breast MRI will require 2 sessions per week to meet current and unseen demand.
The service is not funded nor routinely available at present.
There is a significant local demand for a general anaesthetic (G.A) service for
paediatric MRI neurology cases currently referred to the BHSCT; the waiting time at
present is approximately 2 years. The demand equates to approximately two GA
sessions per week (two patients per session) to reduce and maintain the waiting
times of NHSCT GA referrals to 9 weeks.
Section 2: Aims, Needs & Objectives
The aims of the project are is to provide:
Additional MRI capacity for the NHSCT to meet demand
MRI Breast and GA scanning capacity
A more resilient service, particularly at times of equipment breakdown and
servicing
Value for money
Available Capacity
Currently the Antrim MRI service is funded to operate on an 8.30 am - 5.00 pm
basis, Monday to Friday. The scanner is running at full in –hours capacity. In addition
an average of four evenings per week is required to meet current demand; providing
16 hours scanning time per week. In total these sessions provide 5,500 scans per
year.
There is currently no MRI scanner on the other acute hospital site at Causeway,
resulting in a lack of provision of a local MRI service for the population of the
Northern Sector of the NHSCT
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PRESENTATION TO TRUST BOARD: PROJECT SUMMARY Aug 2012
Demand
Current Demand is approximately 6,650 patients per year. There has been a yearon-year increase in demand for MRI scanning of approximately 20% per year since
the commissioning of the service in 2004/05. The demand will significantly increase
with the commencement of breast and GA MRI scanning.
Objectives
Increasing MRI Capacity in the NHSCT to provide capacity to undertake six
general MRI sessions, two Breast Imaging/biopsy sessions and two GA MRI
sessions per week.
Meeting the trust’s strategic direction
Providing Access and Equity of service
Meeting Risk Management and Clinical Governance Requirements by
ensuring that good clinical quality standards are met with regard to timely access
and accurate and prompt reporting of scans
Ensuring Speed and Ease of Implementation of the 2nd scanner by
introducing the service efficiently and effectively in the minimum time with
minimum disruption to existing services.
Ensuring Quality of Service
Section 3: Stakeholder Issues
The 2nd MRI scanner project has received widespread support from Primary and
Secondary clinical users of the service within the Northern Health Board and Trust
area including Commissioning managers, DHSSPSNI Health Estates managers and
GP, Medical and surgical clinical staff.
Section 4: Options
The following options have been identified for consideration:
Option 1
Do nothing.
Option 2
Purchase and commission 2nd NHSCT MRI scanner in the Antrim MRI
Unit.
Option 3
Purchase and commission 2nd NHSCT MRI scanner to be sited in
Causeway Hospital
Option 4
Purchase MRI capacity from Independent Sector providers
Option 5
Extend the MRI service to 3 sessions per day for 7 days per week to
provide additional MRI Capacity in Antrim.
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PRESENTATION TO TRUST BOARD: PROJECT SUMMARY Aug 2012
Section 5: Costs
High Level Cost
Benefit Analysis
Option 1
Do
Nothing
(£000’s)
Option 2
Antrim
(£000’s)
Option 3
Causeway
(£000’s)
Option 4
Refer to
IS
(£000’s)
Option 5
Extend
Working day
(£000’s)
Capital Cost (£’000)
Nil
2,054
2,054
Nil
Annual Revenue Cost
(Pay )
Annual Revenue Cost
(Non Pay)
Increase in Revenue*
351
874
874
351
155 (GA
equipment)
837
222
519
519
1622
405
-
820
820
1,400
669
:
Section 6: Funding & Affordability
Capital funding is £2.054m and revenue funding of £820k per annum is required for
Options 2 and 3.
Revenue Funding of £1.4m is required for Option 4.
Capital funding of £155k and revenue funding of £669k is required for Option 5.
Full Funding for the capital costs is being sought from the DHSSPSNI.
Full funding for the revenue costs is being sought from the HSCB.
Section 7: Benefit Realisation Plan
Benefit
Increasing MRI funded capacity within the
Trust from 5,500 scans to 8,430 examinations
per year on commissioning of the new
scanner including 300 MRI Breast
examinations, 30 Breast Biopsy examinations
and 200 MRI GA examinations
Benefit Measure
Measurement
Method
2,930 additional
NIPACS/NI Radiology
scans performed per
Information System
year on completion of
recruitment and
training of staff
3
Responsibility for
Achieving
Radiology Clinical
Director
Current
Value
NonMonetary
Measurement
completed by
Trust CT
Radiography
Manager
Responsible
for Measuring
General
Manager
Radiology
Date
On opening
(2013), then
monthly