DIAGNOS TICS
shows that more than 500,000 patients in England have been waiting at least six weeks for key diagnostic imaging, like an MRI.3 Despite the best efforts of the Government to convince the public that the NHS is ‘open for business’, coronavirus has meant that people are hesitant to visit their doctor and even less willing to go into hospital. Sadly, this combination of delayed appointments and late diagnosis will lead to a surge in demand for equipment and beds over the next year. Analysis has shown that the NHS waiting list, already at 4 million, could reach 10 million by the end of the year, with this figure going even higher if there is a second wave of COVID-19 and a lack of effective treatment or vaccine.4
There will be no easy way out of this
quandary. The NHS Confederation’s report contained many recommendations, from an extension of emergency funding across all sectors of the NHS to a review of the impact of COVID-19 on the NHS and social care workforce. Interestingly, the report also calls for an ongoing arrangement with the private sector, saying that such an arrangement will be vital to provide the capacity to respond to the backlog of treatment required. There are dozens of ways in which the NHS uses the private sector effectively. Around 22% of the English health spending goes to organisations that are not NHS Trusts or other statutory bodies.5
One key
service which the NHS can outsource effectively is medical imaging via mobile or relocatable units. Medical imaging is the bedrock of diagnosing and treating thousands of illnesses and injuries, often acting as an intermediary point before referrals to specialists. X-ray, CT, MRI and Ultrasonography based examinations, in particular, are fundamental to both curative and palliative care. From March 2019 to February 2020, there were 45.4 million radiology images reported in England.6 Imaging is a crucial part of delivering diagnostic healthcare. However, we are now at a point where many hospitals are struggling with capacity in their radiology departments. In June 2020, Addenbrookes Hospital in Cambridge, for example, had 39,009 patients awaiting imaging studies – 632 of these were cancer patients. This number is up 28,684 from the same time last year. Official data across the NHS shows that more than half of all patients in England referred for imaging diagnostics are waiting for six weeks or more, with that number going up from 20,898 in May 2019 to 326,525 in May 2020.7
In the words of a spokesperson for NHS England, “there is no doubt that the NHS does need more diagnostic capacity”.8 But how can the NHS boost that capacity in a cost-effective and timely way? And
how will clinical radiologists deal with the unprecedented backlog which the NHS is now facing?
Mobile diagnostics imaging offers a solution to the diagnostic demands which are presented by the increasing backlog of patients on NHS waiting lists. Mobile diagnostic imaging allows private hospitals and NHS hospitals to utilise a solution for the increasing demand for imaging services by having temporary mobile diagnostic imaging units – in the form of trailers or trucks – available on site, and with a full array of imaging solutions. The mobile aspect of the service means that capacity can be increased with agility and speed on a case-by-case basis – for example, CT backlogs can be addressed early by deploying a truck or trailer to that Trust. These can go anywhere where there is a power connection and suitable base, even a hospital car park.
While mobile imaging cannot be the panacea to shortages of diagnostic equipment in the NHS, it can certainly help boost capacity in hospitals where there is a real and immediate problem, by offloading some of the waiting list of patients to a mobile unit provider who can supply the equipment, staff to image the patient and even provide the diagnostic report if required. This could be considered the initial step to begin to solve the capacity problem as our NHS embarks on their return to normal. Another key aspect of mobile diagnostics is that, generally, the patient can be scanned outside hospital building. Given the understandable anxiety many are feeling about going into hospital during the COVID-19 pandemic, this may allow patients to feel more relaxed while still receiving the diagnostic care they need. The vehicle – whether a trailer or truck – can be cleaned and sanitised easily, quickly and thoroughly in between patient visits, minimising any
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risk of infection for staff and patients alike. Cambridge University hospitals’ medical director, Ashley Shaw, a radiologist, has already said that mobile imaging will form part of the solution to the shortfall in scanners.
The wide deployment of mobile diagnostics technology would also help to support with another long-term problem in the NHS; outdated and faulty equipment. A significant proportion of the NHS’s CT, MRI and general X-ray equipment is older than 10 years old. Indeed, official data shows that at least 14% of CT equipment and 34% of MRI equipment is 10 years or older.9
In
July 2020, the Guardian reported that some NHS Trusts have warned that many scanners currently in use were faulty and unreliable, causing delay, disruption and added anxiety for patients. At HealthTrust Europe, we understand the value of cutting-edge equipment which is why all our appointed suppliers have been rigorously evaluated through a robust, compliant process which verifies their quality and value propositions. Mobile diagnostic units could provide ‘back- up’ support while older imaging equipment internally at NHS hospitals is replaced, repaired or during any other downtime eventualities on a flexible basis. The work of the NHS, as always, is so well appreciated, particularly in the past few months as they fight the frontline battle with COVID-19. There is no doubt that, as an organisation, it will face its biggest ever challenge in the coming year as the twin threats of a second wave of coronavirus and mounting waiting lists come together in the winter months. While the recently announced Government funding will be welcome to many in the NHS, it is clear that there needs to be a re-think on how the NHS can keep moving forward with diagnosing patients. The crisis now needs a fast solution. Mobile imaging is – by its very nature –
MARCH 2021
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