NHS England has issued a new stakeholder briefing on PET-CT services in south Essex announcing new temporary arrangements for the PET-CT scanner service until a permanent decision is made on whether the service should be run at Basildon Hospital or Southend Hospital.
A PET-CT scan is used in cancer diagnosis, combining a CT scan and a PET scan into one to give more detailed information.
Stakeholder briefing issued on 22 November 2016 by Ruth Ashmore, Assistant Director Specialised Commissioning, East of England , NHS England:
"As you are aware, following the award of the new PET-CT contract in 2015 to a new independent provider, the new provider approached NHS England to request to move the service from a mobile facility attending Basildon Hospital, to a fixed site scanner at Southend Hospital.
"After receiving national clinical advice that there were long-term clinical benefits to locating the PET-CT service at Southend, NHS England consulted with the three local Health Overview and Scrutiny Committees to seek their views on the proposal and on plans for patient and public involvement.
"At these meetings, it was clear more research into the clinical case for each site and a more substantial plan for patient and public engagement was required, leading to a four-month period engaging with patients, local people and clinicians. At the end of this, we commissioned an independent clinical review of the feedback and evidence that had been collected. That review supported the Southend option.
"Having initially met as three Health Overview and Scrutiny Committees in October 2015, in September this year Essex and Southend local authorities formed a joint HOSC to review the findings whilst Thurrock opted to review the findings separately.
"The outcomes of those two meetings were very different with Essex and Southend supporting the recommendation and urging for implementation as soon as possible, and Thurrock referring the matter to the Secretary of State for Health. This has led to a delay in making a final decision.
"This delay has given NHS England the opportunity to discuss with the provider an interim solution to provide the service on both the Basildon site and Southend whilst we continue to work with all to deliver a final decision. We believe that we have looked closely at the implications of a continued delay on patients and have listened to the concerns raised. The further delay is causing us concern as demand for the service has grown at a much greater rate than expected, outstripping both NHS England’s expectations and the larger projections of the independent clinical panel.
"As we do not want patients’ diagnosis and treatment to be delayed, we have asked the provider to develop a temporary solution to increase the capacity of the service that takes into account the concerns of local people. This will enable us to meet the rising demand for the service while we respond to the issues raised by the Thurrock scrutiny committee and hopefully work with their members and with their colleagues in Essex and Southend to plan and agree a long-term way forward.
"The interim plans will see a service at Basildon continue at least until a permanent decision is made, but due to the scale of demand, we have taken the decision to also use the idle scanner at Southend to increase the number of PET-CT slots available and offer choice of location, and type of facility.
"The provider understands that we have agreed to this as an INTERIM measure only and they will simply move the scanner elsewhere if the decision is to site the permanent service at Basildon. There are no additional costs to the NHS of this interim measure as the contract is a set fee per scan, regardless of the facility used.
"The only alternative was to increase the number of days the mobile scanner visits the Basildon site, but we have already been doing this and the two main disadvantages have been the increased ‘down time’ when the scanner is not working after its journey and removing it from other parts of the country where it is also needed to keep diagnostic waiting times as low as possible.
"As we anticipated making a decision this autumn which would have led to the implementation of a permanent service in line with the contract, we did not feel it was appropriate to make use the Southend scanner. However, given the continued uncertainty and extended timeframe, we feel that it is now appropriate to temporarily take advantage of the equipment already in South Essex and release some capacity back into other parts of the country whilst we carry out this additional work."
From December, the interim arrangements for the service will be:
- 1 day per week of the mobile service at Basildon – an average of 13 patients per day / 52 patients per month. This number of days to be increased flexibly if this capacity is insufficient for the demand. There are currently 75 patients per month referred to the service from Basildon Hospital clinicians, which includes those patients seen at Basildon hospital who live closer to Southend.
- 2 days per week at the fixed service at Southend – an average of 18 patients per day / 128 patients per month. There are currently 105 referrals to the South Essex PET-CT service from hospitals other than Basildon.We hope you will understand and support our need to take temporary action in light of capacity concerns that are magnified by the continued delay in reaching a decision on the permanent solution.
Date: 22 November 2016