At the end of November all NHS trusts will have to offer patients the choice to go elsewhere for a MRI or CT scan if they have waited longer than 20 weeks. However, the Department of Health has yet to make a decision on whether this will apply to foundation trusts.

A spokesperson for independent regulator Monitor said foundation trusts would not be expected to meet the target because it was not set down in the DoH’s target framework National Standards, Local Action.

Network chair Sue Slipman criticised the government for ‘undermining’ the strength of the legally binding contracts under which foundation trusts now operate.

She told HSJ: ‘The government can’t keep introducing in-year change and expect foundation trusts to be efficient and effective.’

She warned the DoH that they were ‘undermining the potential success of the system they created’.

Ms Slipman said the constant barrage of new targets set in-year is damaging foundation trusts’ performance and making it difficult for them to carry out business plans.

Last month the DoH issued guidance setting out how, from November, providers should offer alternatives to patients waiting over 20 weeks for CT or MRI scans.

Trusts will also be expected to offer a choice of alternative provider to patients waiting over 16 weeks for all types of scans from April 2006, with a maximum waiting-time target of 20 weeks.

The letter, sent by the DoH’s national implementation director Matthew Kershaw to acute and primary care trust chief executives, urges trusts to offer patients the choice of an Alliance Medical scan.

In July 2004 the government awarded a five-year, £80m contract to the company and secured an extra 130,000 scans per year. But in its first year only half the scans bought, just 65,000, had been used.

However, according to Alliance Medical, the company has now carried out 90,000 operations on behalf of the NHS.

Alliance Medical managing director Jonathan Walsh told HSJ ‘patient throughput is now very high’. He said the company had scanned 8,500 patients in October.

‘It is not our responsibility to find patients,’ said Mr Walsh, but he added that ‘the continuing focus on patients waiting over 20 weeks and the choice target means we are now almost completely full and can’t do any more scans than we are doing’.

A DoH spokesperson said: ‘Discussions are still taking place and the decision will be clarified before choice of scan commences on 30 November.’

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