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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 1 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. 2 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