HSJ EXCLUSIVE DoH urges NHS to make use of extra capacity bought from Alliance Medical

Published: 18/08/2005, Volume II5, No. 5969 Page 5

The NHS is failing to use thousands of extra diagnostic scans bought by the Department of Health from the private sector last year, HSJ can reveal.

More than half of the MRI (magnetic resonance imaging) scans - almost 70,000 - that the DoH bought on behalf of the NHS from Alliance Medical last year have yet to be used.

Last July the government awarded a five-year£80m contract to the private company and secured an extra 130,000 scans per year for the NHS.

But the DoH confirmed this week that just 62,000 scans have been carried out.

Now the DoH has issued a letter urging organisations to make use of the scans already paid for centrally.

In a letter sent to strategic health authority, trust, and primary care trust chief executives this month, DoH director of access Margaret Edwards says the NHS's new diagnostic scan waiting-time targets should be used as 'an opportunity for local health systems to fully utilise the capacity already resourced within the Alliance Medical MRI contract'.

The DoH is also considering widening the terms of the contract to cover urgent as well as non-urgent scans in order to make use of the spare capacity.

Last month health secretary Patricia Hewitt told the NHS that it would have to offer patients a diagnostic scan within six months by November in an attempt to reduce patient 'bottlenecks' (news, page 11, 28 July).

Any patient who has been waiting longer than 20 weeks for an MRI or CT (computerised tomography) scan will be offered the option of getting the scan done at another hospital - NHS or private - making the maximum wait 26 weeks.

A DoH spokesman confirmed that the DoH and Alliance Medical were 'assessing the options and feasibility of increasing the case-mix of the original contract'.

He added that the DoH was 'determined not just to use every scan but to use them where patients are waiting the longest'.

Alliance Medical managing director Jonathan Walsh confirmed that 'over 60,000' of the 130,000 scans contracted had been carried out in the year ending last month. He told HSJ that 'in some instances [Alliance Medical] has been unable to find patients to fulfil the NHS contract', but added 'that discussions were under way to widen the contract'.

Mr Walsh said that a 'huge amount of capacity' had now been put into the system and that 'as MRI waiting lists come down and as clinicians start realising that there are not waiting lists for our scans I think demand will catch up again'.

However, NHS Alliance chief executive Mike Sobanja questioned how the DoH had arrived at the figure for the number of extra scans it had bought: 'It seems to me a little bit sad that the centre is not able to create contracts that are really needed by the NHS, ' he said.

A controversial contract

July 2004 Alliance Medical wins five-year£80m scanning deal. It is immediately accused of 'cronyism' when it emerges that the deal was signed six months after former health secretary Alan Milburn was appointed to the advisory committee of Alliance Medical's parent company Bridgepoint Capital. Alliance Medical dismisses the media coverage as 'nonsense'.

In the same month, Professor Adrian Dixon of the Royal College of Radiologists warns that the deal is 'interfering' with funding for MRI scanners already based in NHS hospitals. In December 2004, the Department of Health appoints Professor Dixon as 'clinical guardian' of the contract.

December 2004 A letter sent by the five MRI cluster leads to the DoH raises concerns over 'parlous position' of the contract, including a lack of clarity about the nature of activity covered, and fears that the programme is being mobilised too quickly.

This month, Alan Hodgkinson, director of capacity development at Cheshire and Merseyside strategic health authority insists that initial concerns had now been 'addressed'.

June 2005 Five acute trusts refuse to continue using the company' services, claiming they had experienced a range of problems and delays with the scans.

Leeds, Sheffield, Lewisham, Hull and East Yorkshire, and South Tees hospitals all pull out of the contract. But HSJ understands that Leeds, Sheffield and South Tees have since signed up again.