MRI EXPANSION Managers express concerns at operation of NHS deal

Published: 16/12/2004, Volume II4, No. 5936 Page 7

Senior managers have launched a series of criticisms about the operation of an NHS contract to expand magnetic resonance imaging scanning capacity via the private sector.

The heads of five 'clusters' in charge of implementing the MRI expansion programme have written to the Department of Health outlining a series of 'failings' they have experienced since a contract to carry out 120,000 scans each year was awarded to independent company Alliance Medical in June.

The letter, signed by the five MRI cluster leads in charge of implementing the scheme across the NHS, says they are 'both surprised and troubled' not to have been involved in a central exercise examining 'the failings of this contract'.

The letter, sent to DoH national implementation director Ty Robinson and head of secondary care Matthew Coats last month, and revealed in the Yorkshire Post, charges the DoH chiefs with ignoring concerns raised by the MRI cluster leads.

The letter says there are 'two key underlying causes of the current parlous position': lack of clarity about the nature of activity covered, and the programme being mobilised too quickly. It is signed by the 'five MRI cluster leads' covering the country: Avril Johns, Alan Hodgkinson, Denise Potter, Kamran Bhatti and Alison Knowles.

Alliance Medical managing director Jonathan Walsh said there had been delays in the early stages of the contract - because trusts had not provided correct patient data.

Mr Walsh said that scans were also being double-checked by the company's radiologists to address NHS concerns about the interpretation of scans.

Mr Walsh told HSJ that the company had set up a full clinical governance reporting structure and a 'quality and assurance audit process' with the DoH. And he said that an independent clinical guardian should have been appointed by the DoH to audit the governance structure at the outset of the contract but that the DoH had only appointed a guardian, Professor Adrian Dixon of the Royal College of Radiologists, last week.

A DoH spokesman said that a clinical guardian had been appointed in a 'normal timeframe' and did not accept that there had been a delay. He said that as a new initiative the MRI expansion programme would take time to integrate into the system.

The managers' main concerns

Delays in returning scans (up to six weeks).

Scans misinterpreted.

Lack of requirement in the contract for subspecialisation in reporting, meaning it is unsuitable for much of the NHS waiting-list case-mix.

Lack of clinical governance structure and no way for the NHS to report concerns.

NHS financial loss due to underuse of contract.