Exclusive: Anger at big bill for scans that never happened

Significantly fewer patients than expected have been referred for PET-CT scans under a multi-million-pound private sector deal signed by the Department of Health to provide the technology that offers doctors better information about cancer.

Latest figures for the 11 months to February show that there was a shortfall of 1,000 scans at the eight centres where they are being provided across the North, with 88 per cent of the anticipated 8,300 procedures actually being carried out.

Take-up in Yorkshire has been much lower. Only 71 per cent of 4,100 patients were scanned in the 12 months to December.

Under the terms of the deal, which is worth 26.7m over five years in Yorkshire, taxpayers have to pay a portion of the 1,040 cost of each scan which is not carried out and the bill is likely to run into hundreds of thousands of pounds.

The under-performance has prompted renewed criticism after similar problems with contracts signed with controversial independent sector treatment centres (ISTCs) where companies are paid regardless of the numbers of patients treated.

And urgent talks are underway to find out why fewer people are receiving the scans amid concerns some who would benefit are not being referred.

Deputy chairman of the British Medical Association's GPs' committee Leeds GP Richard Vautrey said the lower take-up illustrated problems with private sector deals. "It's yet another example of how money is being wasted by investing in private sector rather than being better used in mainstream NHS services," he said.

In parts of the region, use of the technology is well below target. Only 59 scans were carried out on patients from Bradford, compared with the 334 expected under the first year of the deal, just 18 per cent of the total – although local NHS chiefs say patients are being referred under a different contract.

In Barnsley, just 41 per cent of the expected number of scans have been carried out.

Across the North Trent cancer network, covering South Yorkshire and the North Midlands, take-up is lower than other areas at less than 60 per cent. But more patients from Leeds and Wakefield got access than anticipated.

Concerns about value for money of private sector deals for NHS care led to the last-minute abandonment of a number of new schemes in 2007.

But the PET-CT deal for 48,000 scans over five years by private firm Alliance Medical was approved by Ministers, although its start was delayed in Yorkshire by six months.

Millions of pounds have been paid to ISTCs in Bradford, York and Barlborough, near Chesterfield, since they opened in 2004 for treatment which has not been carried out.

Latest figures for the Barlborough centre reveal the value of work carried out between April and January fell to 74 per cent – an under-performance of 4.5m against the full contract.

The Bradford and Barlborough contracts are due for renewal but decisions have been delayed until later this year amid uncertainty over demand.

NHS chiefs in Bradford said patients were still being referred to a local centre under a previous deal for PET-CT scans.

A spokeswoman said: "The number of patients receiving PET-CT scans is not reflected in the national figures, but from this month the Department of Health is going to negotiate to merge our local activity into the national contract.

"Our existing service provides excellent access for patients and there is no waiting list."

NHS Yorkshire and Humber bosses said it would take time to build up the number of procedures being carried out as doctors and patients became familiar with the service but numbers had increased every quarter since it was launched.

"This service enables NHS patients to access cancer diagnosis and staging closer to their homes," said a spokesman. "The strategic health authority and primary care trusts will work with the provider to maximise utilisation and are confident that this will be achieved over the life of the contract."

Alliance Medical said: "We continue to work with our NHS partners locally to promote the service and encourage referrals."

The benefits of pet scanning

Positron emission tomography-computed tomography (PET-CT) gives a more precise diagnosis in cancer and also improves surgical planning and the targeting of radiation therapy during treatment.

The technique uses a small amount of a radioactive tracer which is injected into the body and then imaged to produce pictures showing how the body is functioning.

The diagnostic tool can also demonstrate changes in the way cells are working before there is any detectable change in the size and shape of organs and tissues.

Until recently, the technology was only available in the South East.

Under a NHS contract with private provider Alliance Medical, it is now available at eight centres in Sheffield, Hull, Leeds, Middlesbrough, Newcastle, the Wirral, Liverpool and Stoke.

It was brought to Hull in December 2008, to Leeds in January 2009 and to Sheffield in April last year.

It is recommended for patients with lung cancer, lymphoma and colorectal cancer and could also help those with head and neck cancer, oesophageal cancer, brain tumours and some less common cancers.