Equipment and IT: A major challenge for the next government, despite some welcome recognition

Capital investment, waiting lists and productivity

It's an open secret that NHS capital investment has been seriously overlooked in recent years.[1] This had a material impact on the services the NHS can provide. A shortage of functional, modern equipment can prevent care from being delivered in a timely fashion. Politicians often focus on the NHS's productivity problem - but it's rare for this lack of investment to be acknowledged as a major cause.

Clinical radiology and clinical oncology are significantly impacted by this lack of investment, given our two specialties' technology-centric natures. About 20% of the capital budget is spent on plant, equipment and transport, which includes CT and MRI scanners.[2]

Election manifestos: some encouraging signs

Political parties from across the spectrum have made manifesto commitments on NHS estates and equipment capacity.

The Conservatives' pledges include building 50 more Community Diagnostic Centres (CDCs). It isn't yet clear whether these would be totally new CDCs, or whether they would be transformations from CDCs currently open in a temporary capacity. (Currently, of the 160 operational CDCs, 54 are operating under temporary capacity. [3]) However, the implicit commitment is an investment in more CT and MRI scanners and other equipment to fully kit out these new, permanent facilities.

The CDCs pledge comes on top of the Conservatives' 2024 Spring Budget promise to spend £2bn on 100 AI-enabled scanners. We previously warned the government [4] about the potential unintended consequence of these upgraded scanners - namely, that they would generate sufficient extra scans each year to necessitate employing an extra 40.6 clinical radiologists to interpret and report them. The root issue is, of course, the shortage of clinical radiologists.

Labour have announced their 'Fit for the Future Fund', a commitment to double the NHS's CT and MRI scanners.

This is a welcome pledge [5], though it remains to be seen how it will be delivered within the NHS's current workforce capacity. There would be little value in purchasing hundreds of new scanners without the staff to report the scans.

The Liberal Democrats have not explicitly committed to further investment in diagnostic scanners. However, they have pledged to replace outdated computers and other IT hardware, as well as ageing radiotherapy machines. This is all welcome, if somewhat light on detail. Nonetheless, a larger cohort of Lib Dem MPs in parliament may influence the direction of a future government's health agenda.

The case for investment in diagnostics equipment

This week, the RCR published a new policy report, which makes the case for greater investment in diagnostic imaging equipment. It refreshes and hones the College's recommendations on the provision of much-needed CT and MRI scanners, making the case for greater investment in radiology services.

Our report makes several recommendations to the next government and to NHS England. These include: protecting NHS capital budgets; supporting imaging networks to centrally commission equipment; assisting imaging networks to ensure they have processes to ensure their equipment fleets are kept up to date; implementing the NHS Long-Term Workforce Plan; amongst others.

Opinion polling consistently show public support for greater investment in the NHS, as well as record levels of dissatisfaction.[6] [7]

In this general election campaign, most political parties are promising to make tackling stubbornly high waiting lists a priority for the new government they would like to lead. Committing to expanding and refreshing the NHS's diagnostic equipment fleet is not likely to be a vote winner on its own. Nonetheless, it will need to be a central component of any realistic plan to bring down waiting lists - which surely is a commitment that is likely to win votes. Our new report will assist the next government to deliver its pledges on addressing the crumbling NHS estate and stagnating waiting times.

We will continue to champion this issue. Whoever the Prime Minister and Health Secretary are, we will work to convince them to take on board and implement our policy recommendations.