National Audit Office report says half of all existing hi-tech machines will need replacing by 2014
NHS trusts could be faced with a £460m bill for replacing hi-tech machines to diagnose disease and treat cancer within the next three years, says the National Audit Office.
A new report from the NAO also warns that trusts do not get value for money when they buy expensive scanners and radiotherapy machines, and with changes to the way the NHS is funded, there is a danger that things will get worse.
Until now, the money for high-value equipment has come from a central purchasing fund, which was set up by the government to pay for the major investment in scanners and radiotherapy needed to improve cancer care in the NHS.
A large number of machines have been bought in the last 10 years, including 376 CT (computed tomography) scanners, costing £579,000 each and 267 MRI (magnetic resonance imaging) scanners, which cost £895,000 each.
There are also 246 linear accelerators in the NHS for radiotherapy treatment in cancer: these cost £1.4m each.
However, central funding has now been scrapped, which means that hospital trusts will have to buy new machines out of revenue and with loans.
The NAO says half of the high-value equipment in the NHS will need replacing within three years – at a potential total cost of £460m – and 80% will need to be replaced within six years, costing a further £330m.
The report says that trusts are not collaborating as they should in planning for patients' needs and procuring and using these expensive machines.
"Although the department [of health] publishes data on activity, there is very little co-ordination of planning across the NHS for identifying increasing demand for scanning services and how it can be met," it says.
There are other options besides buying these machines, it says, "including leasing machines, contracting out or extending the use of existing machines".
The report goes on to say that when they do buy equipment, trusts are not working together to make the best use of existing agreements that could help bring the price down.
The report also states that there is wide variation in the amount of use the machines get, but because there is no central collection of data, trusts cannot compare their usage with that of others to ensure they are getting value for money.
Amyas Morse, head of the NAO, said: "Half of this high-value medical equipment is due to be replaced within the next three years. This is a challenge requiring planning by individual trusts since there is no longer a centrally funded programme.
"Turning to efficient management of this equipment, trusts across the NHS lack the information and benchmarking data required to secure cost-efficient procurement and sustainable maintenance of these key elements in modern diagnosis and treatment."