funding investment programmes
Understanding how a healthcare vendor like Siemens takes into account the commercial implications of
its solutions alongside the clinical benefits reveals something of the economic forces underlying the NHS
additional CT resources to draw upon. Trusts
are therefore being empowered in a difficult
Economic forces within the NHS
economic climate to reduce their unit costs Understanding how a healthcare vendor like
for each income-generating activity. Siemens takes into account the commercial
implications of its solutions alongside the
Additional financial benefits
clinical benefits reveals something of the eco-
nomic forces which underlie the NHS.
While shortening the time needed to generate a These are complex and have become in-
complex image using the integrated PET and creasingly so over the past twenty years as
CT scanner has an immediate benefit to the pa- financial responsibility has devolved gradu-
tient in terms of stress, and a higher throughput ally from Whitehall to local ‘business units’ –
of those ‘customers’, there are other attractions the Trusts.
which might not be immediately obvious. The Private Finance Initiative (PFI) provided
PET imaging requires the use of an ad- a major stimulus to the construction and main-
vanced glucose compound, FDG, containing tenance of many NHS Trust facilities, from
a radioisotope. The half-life of this material – new wings to complete hospitals. Mr Harrison
an indication of the rate at which it loses its noted that Siemens had become involved in
radioactive potency – is 110 minutes. PFI contracting, when a relationship between
As Peter Harrison observed, due to the ra- private financier and property developer was
dio-pharmaceutical’s radiation decay, there seen as the only way of adding new premises
is typically only a two-hour window between to the NHS estate.
producing the radioactive isotope in a cyclo- Establishing a public-private partnership of
tron off site and its delivery to the imaging this kind was conditional upon those devel-
centre. In addition to the decay during delivery, opers seeing an economic return on their in-
the decay clearly continues once the radio-phar- vestment from the Trust’s management.
maceutical arrives at the imaging centre. “Some of the PFI arrangements – which are
Conscious of these constraints, Siemens designed to last twenty to forty years – in-
has invested in technology which enables volve equipping hospitals in addition to build-
scanning with doses of radiopharmaceuticals ing and maintaining them.”
with reduced activity levels, thereby extend-
ing this previous 2 hour constraint. “We now
supply sites by road over 200 miles away from
our production facility.”
But there are other potential revenue ben-
efits achieved by the reduced scan time. If the
time to complete a scan can be reduced, the
hospital can potentially gain benefit from re-
duced radiopharmaceutical cost per study,
perhaps using the same batch of isotope ma-
terial for a greater number of patients.
“It’s expensive to transport radiopharma-
ceuticals around the country so increasing the
number of studies that can be performed from
a single delivery can result in significantly
reduced unit delivery costs. The efficiency of
the system can therefore be increased, and
the cost per patient imaging session conse-
quently reduced.”
The Informed Executive
43
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