Choice of scan guidance published
 A new document from the Department of Health provides guidance on the implementation of the government’s Choice of Scan programme.
The programme, which aims to encourage all providers to reduce their overall waits, is being rolled out in two phases. From 30 November 2005, patients facing long waits for scans at their local hospital will be offered the choice of going to another provider and having their scan within a maximum of 26 weeks. In phase 2, from April 2006, the waiting time will be reduced to 20 weeks.
Despite many concerns about the Choice of Scan programme itself, the SoR has welcomed the guidance document as a positive step. “It indicates that the DoH has learned something from the mistakes of the past,” said Richard Evans, CEO.
However, he feels that the document may not go far enough. “Developed with input from stakeholders (not sure who these are!), the guidance covers many, but not all of the issues that will arise from implementation,” said Richard.
“It does not set out to say how the work will be done and makes light of the impact on services that are already under pressure. This fact, along with some apparent anomalies in the advice, is hardly likely to endear the document or the programme to members working in CT and MRI services.”
Richard highlighted some of the problem points:
- There will be a need for management and clerical time to manage the waiting lists, liaise with alternative scanning providers, transfer request details and arrange to receive completed records after the scan;
- The guidance claims that there will be no net cost to originator trusts as episodes will be paid back under ‘payment by results’ (PBR). These are unlikely to cover extra management and other costs and are in any case unreliable, as the PBR tariffs for diagnostic imaging are not yet agreed;
- The level of financial risk to trusts which have long waits is, however, highlighted as an incentive for them to introduce measures to improve efficiency;
- The underlying message seems to be that NHS organisations can be bullied into performing better. Experiences where redesign has been successfully implemented have relied much more on positive collaboration between staff and management.
The SoR accepts, however, that the programme is going ahead and that the guidance does give some useful background and information on how it should work. “A better, faster service for patients is what everyone wants to see and managers of scanning services should seek opportunities for discussing how to introduce improvements with their trusts and with the local PCTs and SHA,” said Richard Evans.
Click here to download a pdf copy.
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