About a third of NHS trusts in England are scanning patients with “technically obsolete” imaging equipment dating back more than 10 years.
Of all trusts in NHS England, 27.1% said they are still using at least one CT scanner that is 10 years old or more, and 34.5% said they have at least one MR system that is the same, reports The Guardian
. The use of these systems goes against the advice of an NHS England report published last year that recommended that all imaging systems 10 years or older be replaced. This is because software upgrades may not be able to be installed on this equipment, or because older CT scanners may require higher radiation doses to produce the same image. Additionally, their use may pose risks to patients.
The issue was made public by Channel 4’s Dispatches programme, which learned about it through freedom of information requests. Among the trusts identified are King’s College hospital NHS Foundation Trust in London, Royal Berkshire NHS Foundation Trust, Royal Cornwall hospitals NHS trust, and Chelsea and Westminster hospital NHS Foundation Trust. Notable standouts were London North West university healthcare NHS trust, where half of the MR systems are 16 years old, and Great Ormond Street Hospital Trust, which has been using an MR scanner for 21 years now. In addition, Dispatches found X-ray equipment within the NHS dating back to the 1970s, 1980s and 1990s.
“We have backed the NHS with £525 million (more than $722 million) to replace diagnostics equipment over the last two years and have recently set up 40 new one-stop-shop diagnosis centers in the community to deliver 2.8 million more scans for patients across the country,” a spokesperson for the department of health and social care, told The Guardian.
Dr. Julian Elford, a consultant radiologist and medical director for the Royal College of Radiologists (RCR), says that CT and MR systems become technically obsolete when they reach 10 years old, as they are more likely to break down frequently, are slower, and produce poorer quality images. “We don’t just need upgraded scanners, though; we need significantly more scanners in the first place. The [NHS England report] called for doubling the number of scanners — we firmly support that call, and recommend a government-funded programme for equipment replacement on an appropriate cycle so that radiologists can diagnose and treat their patients safely.”
A similar predicament was reported last year in neighboring Ireland, where more than a quarter of the 69 CT scanners there were still in use, despite passing their life expectancy dates
. One at South Tipperary General Hospital was still in use despite passing its end of life in 2013. Relying on this equipment increases the risk for breakdowns, which could result in longer waiting times, critics argued. Fifteen scanners were found to be outdated, with eight others well within their own dates, and the remaining 34 have no end-of date information available.
Further compounding this issue in England is the shortage of 2,000 radiologists. This deficiency is expected to triple by 2030, says The Guardian. A separate report by the RCR predicts that the NHS could waste £420 million (over $578 million) by 2030 if it continues relying on expensive outsourcing and overseas recruitment. It also anticipates a shortage of 6,000 radiologists by this time, as well as a shortage of 600 for clinical oncologists as opposed to 200 now.
Additional concerns from coroners prompted Dispatches to assess five years' worth of prevention of future death reports that mentioned a lack of radiology kit or staff. It found 48 reports between 2016 and 2021 that connected a lack of scans and/or staff to a patient’s death.
The spokesperson for the department of health and social care also said that it has invested £52 million (over $71 million) in the cancer and diagnostic workforce over the next two years and has already made progress by adding 9% more radiologists than there were in 2019.
The British government, just this week, pledged an extra £5.9 billion (over $8 billion) to NHS England in its budget for new equipment, physical infrastructure and improvements to IT to help reduce waiting times for scans and tests, which have been exacerbated by the pandemic. More than five million people are waiting for NHS hospital treatment in England, with hundreds of thousands waiting more than a year, according to the BBC
About £2.3 billion (over $3 billion) of the funding will go toward more diagnostic tests, including CT, MR and ultrasound. An additional £1.5 billion (over $2 billion) will be spent on beds, equipment and new “surgical hubs”, and £2.1 billion (over $2.8 billion) on improving IT and digital technology within the NHS. A proportionate amount will also go to health services in Scotland, Wales and Northern Ireland.
While health bodies say the funding helps, they add that it will not solve the issue of staffing shortages.