Annual State of the NHSScotland Assets and Facilities Report for 2012

Annex J

National Medical Imaging Programme

In response to the Audit Scotland report "Better Equipped to Care (2004)", the Scottish Government recognised the need to provide sufficient funding for sustainable investment in medical equipment and chose to provide a specific investment to NHS Boards in the last spending review to cover major purchases. It was recognised within this report that equipment needed to be the "correct type in the correct place at the correct time" to ensure patient safety and allow up to date medical practice.

Over the last spending review period a total of £30m capital funding was allocated annually to Boards in recognition of the need for continued and sustained investment in medical equipment. This additional investment allowed Boards to proactively manage equipment through robust capital planning and guaranteed replacement programming.

Within the last 10 years new hospitals have been built and new equipment procured for the commissioning of the new builds. The majority of this equipment, along with existing equipment, is coming to the end of useful life due to age and technical obsolescence and is urgently needing replaced.

Investment in equipment has been essential to Boards achieving national performance challenges such as the "4-week target for diagnostic tests" and the "18-week referral to treatment targets". Without sustained investment in equipment the ability to meet these challenges diminishes.

National Imaging Equipment

Imaging directorates contribute significantly to the management of almost all NHS patients treated in hospital and many seen in primary care. The Audit Scotland Review of NHS Diagnostic Services: 2008 stated NHS diagnostic activity had grown between 2003/04 and 2006/07, reporting increases of 38% in the number of radiology tests. This trend has continued with an increase of 37% between 2006/07 and 2009/10 in the number of patients who have had a CT, MRI or ultrasound test. The imaging directorates must ensure that these examinations are carried out appropriately and efficiently to facilitate the management of patients and to ensure that clinical services achieve the challenging targets that they have been set.

In addition to diagnostic procedures, there are also an increasing number of interventional or therapeutic procedures carried out within imaging directorates. In many cases these have replaced major surgical procedures with minimally invasive procedures, which have significantly reduced morbidity and length of hospital stay. Effective and efficient equipment management and replacement is core to providing a state of the art service. Failure to fund and manage equipment effectively ultimately results in:

• Breaches in waiting time guarantees
• Increased downtime
• Increased costs
• Decrease in staff morale and patient confidence within the service.