Benefits to NHS Hospitals Service Benefits High clinical standards The accuracy of colourflow duplex ultrasound depends on the quality of our instruments and technologists. The Vascular Surgical Society recommends that each vascular centre should have at least three accredited vascular scientists who should perform a minimum of 600 duplex investigations annually. Our staff specialise only in vascular ultrasound imaging, each member of staff performing between 1,500 to 2,500 investigations per year. In 2007 IVS performed over 20,000 ultrasound investigations. Our staff are audited in all diagnostic techniques every six months. Most Vascular consultants have confidence in IVS services and plan operations based only on IVS reports. Reduced risk to patients Techniques such as diagnostic arteriography and venography are useful in the diagnosis of disease but expose patients to radiation and are invasive with a combined 1-3% risk of thrombosis, pseudoaneurysm, arterial dissection or reaction to contrast media. Most hospitals, purchasing full time services from IVS, no longer perform carotid angiography or venography and rarely use peripheral arteriography for diagnosis. CT-imaging for aneurysm is needed when operative intervention is planned. Rapid diagnosis and Reporting IVS guarantees that all urgent inpatient or A&E requests received before 3.00pm will be performed the same day in those hospitals with relevant contracts. IVS has invested over £30,000 in a dedicated database and reporting system, which is fully portable. Formal reports are available 10 minutes following investigation. This allows us to perform 'one-stop' clinics where patients are investigated and attend the consultant at the same appointment. Guaranteed NHS targets IVS has wide experience in developing diagnostic follow up and surveillance services undertaken by vascular nurse specialists or technologists which help the NHS meet targets by: reducing A&E waiting times as most investigations can be performed and reported within two hours reducing general vascular outpatient waiting times by nurse or technologist lead clinics for graft surveillance and aneurysm screening or surveillance 'one-stop' clinics allow more efficient use of consultant time with accurate same day diagnosis accurate diagnosis at the first visit allows efficient planning of treatment; patients are frequently discharged or listed for treatment at their first visit. efficient follow-up as patients can attend vascular technology or nurse-lead clinics and only need to see the consultant if a problem arises Flexible, tailor-made services Not all hospitals require a full-time non-invasive vascular imaging service. IVS can provide high quality portable instruments which allow hospitals to purchase diagnostic sessions as required. We can also provide a daily on-call service which can be used to cover urgent imaging for DVT or acute arterial thrombosis. Financial Benefits Reduced service costs A reliable duplex ultrasound imaging service can make savings of over £400 per investigation compared to other diagnostic techniques such as angiography, CT or Magnetic Resonance Angiography. For an NHS hospital to offer the same level of service they would need to employ twice the number of staff. The demand for trained vascular technologists is intense, staff costs and migration is high. Capital investment made by the NHS in instruments is subject to VAT. An NHS hospital purchasing a service from IVS will make savings in staff, administration and be able to recover VAT; particularly if IVS provides capital and maintenance expenses for equipment. Compared to setting up the services internally, an NHS Trust may make savings of between 37% and 50%, depending on the number of sessions purchased (graph 1 & 2) Stroke accounts for 4% of the NHS annual budget. Each stroke costs between £10-13,000 in the first year alone. Twenty five percent of symptomatic patients with a 70% carotid artery stenosis, detected by duplex ultrasound imaging, will have a disabling stroke within three years. Saving just eight strokes per year will pay for a full-time IVS service. Reduced medico-legal expenses New guidelines for Greater Manchester advised that all patients suffering transient ischaemic attacks or stroke should have carotid duplex imaging within four weeks. NHS Trusts which fail to meet these guidelines may be exposed to litigation. An IVS service guarantees carotid ultrasound waiting times in days not weeks. Recently a Manchester NHS Trust, that failed to diagnosis a DVT, settled a legal claim for over £130,000. This would cover the entire cost of a full time IVS service for two years. NHS contract price examples IVS offer flexible contracts tailored to the needs of the hospital, with packages dependent upon contract terms and whether equipment is required in addition to staff. Below are some examples but please contact us on: 0161 291 4037 to discuss further options, including short term waiting list initiatives. Table 1. NHS costs per session (3.5 hours) based on an annual renewable contract Number sessions No. of investigations Staff only Staff & portable instrument Staff and fixed instrument 2 750 £19,500 £22,500 Not available 5 1750 £42,000 £52,500 Not available 10 3500 £77,000 £94,500 £96,250 All prices are subject to VAT All services include use of the IVS rapid access reporting and database system, portable continuous wave Doppler equipment and blood pressure cuffs. IVS will maintain all equipment provided. As a ‘contracted-out’ service NHS hospitals can recover VAT on services including equipment.