Plymouth Hospitals shelve radiosurgery plans
HOSPITAL bosses in Plymouth have been forced to shelve plans to invest in state-of-the-art Cyberknife radiosurgery technology as they struggle to balance the books in the current financial climate.
As part of an ongoing commitment by Plymouth Hospitals NHS Trust to improve the quality of care provided to patients, and in particular develop cancer and neurosurgical services, three linear accelerators (LINACs) were due for replacement. At 15 years old next year, they are already five years past their recommended life expectancy.
The original plan was to replace all three and build a new radiation bunker to house the £2.6m Cyberknife, which is a non-invasive robotic radiation system that delivers high beams of dose radiation to tumours with greater accuracy than standard treatments.
Given the current financial climate and the impact on resources we have to review every penny we spend and prioritise spend on the most pressing clinical need
But, while the first new LINAC has been purchased and is in use and the second is a priority for the coming year at a cost of £2.3m, the trust said it is concentrating on finding the cash for the third and has had to put the Cyberknife procurement on hold.
The trust's director of finance, Joe Teape, explained: "Given the current financial climate and the impact on resources we have to review every penny we spend and prioritise spend on the most pressing clinical need.
"In the coming year - 2011/12 - we have set aside £12m for capital investment. We are using the funds we have to replace equipment that is now in need of upgrading and are postponing the purchase of the more advanced Cyberknife. We hope to be in a position to do this in the future pending further capital reviews. Concurrently, we are also exploring other ways of raising funds which, if we can, would allow us to invest in the Cyberknife earlier."
He added that while concentrating on replacing the LINACs in the short term, the trust is hoping to return to the Cyberknife project in 2012/13.
Teape said: "The current capital spending envelope does not allow for all projects to be financed and the trust cannot spend money it does not have.
The current capital spending envelope does not allow for all projects to be financed and the trust cannot spend money it does not have
"Deferring the Cyberknife project will mean the purchase of the new machine and the building of a bunker can be phased over two years. It will also allow time for the trust and commissioners to continue to absorb developing evidence on appropriate stereotactic radiosurgery treatments and develop full and cost-effective patient pathways.
"In the light of nationally-changing growth assumptions about the use of radiotherapy, it will give time for the trust to consider whether a third LINAC replacement is needed or whether two LINACs plus a Cyberknife would offer a better range of treatments."
The use of stereotactic radiosurgery and radiotherapy into non-cranial sites is currently being reviewed by a sub-group of National Radiotherapy Advisory Group (NRAG). The review is now complete and it is understood that the researchers have recommended that there is data to support lung cancer treatments and modest evidence to support its application in other sites.
