NHS ‘concerns’ over replacing medical equipment

Nurses at the Edinburgh Royal Infirmary's Accident and Emergency department. Picture: Greg Macvean

SCOTLAND’S under pressure NHS has seen a massive £250 million in non-medical costs to keep hospitals running, it has emerged.

The rise in energy bills and PFI contracts are behind the increase which left the NHS with a total bill of £709m last year.

It comes at a time of growing pressures on hard-pressed hospitals which are struggling to meet waiting times in areas like A&E while demand for services soar.

There are also “concerns” that not enough is being invested to replace ageing equipment like kidney dialysis units, according to the Annual State of NHSScotland Assets and Facilities Report for 2014.

it also finds more than a third (35 per cent) of the NHS buildings are not “functionally suitable” for purpose. The cost of bringing buildings up to scratch is now almost £800 million.

Health boards are now under growing pressure to sell off surplus buildings, which may include under-used medical facilities, to meet the growing cash pressures as budgets are likely to remain tight.

Health Secretary Shona Robison said a total of £2.75 billion is set to be invested in NHS equipment and buildings over the next five years.

“These are major projects which will transform the way healthcare is delivered in Scotland, while also ensuring we provide the facilities and the capacity needed in our NHS for the future,” she said.

“Investment in infrastructure will also help us make best use of the NHS’s finite resources – reducing the cost of maintaining older and less suitable buildings.

“I’m pleased to see from this report that the amount of backlog maintenance has reduced substantially over the last three years and the planned investment programmes will help to reduce this even further.

“However it is still the case that our NHS is stuck with the legacy of historic PFI projects – and as this report shows PFI facilities management costs this year have increased by 16 per cent.”

Over the last decade, the cost of PFI contracts has doubled to reach £118 million, while energy costs have almost trebled and now stand at £105 million.

The backlog of £797 million - which is needed to bring those parts of the estate not in a “satisfactory condition” back up scratch - has come down by £61 million in the past year. But the report finds that 35 per cent of the estate needs either investment or major investment to achieve this.

The majority of the backlog is in either buildings planned to be disposed of in the next 10 years or in non-clinical parts of the estate.

The cost of replacing medical equipment including dialysis equipment, defibrillators, MRI scanners and radiotherapy equipment has now reached £940 million - up £180 million on last year’s figure.

This is partly down to a more stringent assessment of low value equipment.

There are “concerns” that almost a third of the country’s 920 dialysis machines are currently eight years old and the £1.4 spent on new equipment last year is “just adequate.”

Almost a fifth of endoscopic equipment, which is used for keyhole surgery and colonoscopies, is more than ten years old. NHS boards must now “carefully review and monitor” all this equipment, which includes equipment like the video screens needed to operate it.

NHS greater Glasgow is facing the biggest bill of £160 million - including a £69 million cost for imaging equipment like MRI scanners.

NHS Scotland owns physical assets worth around £5.4 billion. The majority of the NHS Scotland estate is owned, although PPP and PFI account for 12 per cent of the NHS estate.