Patients exposed to excess radiation by out-of-date radiology device

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Trust’s board papers reveal long list of equipment which needs replacing
Birthing beds, theatre lights and vital signs monitoring equipment among those listed
Trust trying to mitigate risks to patients

Patients are being exposed to radiation doses at the “upper limit of safe” because a hospital is relying on a radiology machine three years after its “end of life” with a substandard second-hand part.

The risk was revealed in board papers from Medway Foundation Trust, in Kent, among several other serious problems linked to outdated equipment.

The trust said it planned to replace the “interventional radiology machine” – which has had an “end of life certificate” since 2020 and an “end of service certificate” since 2022 – in the summer but has limited capital.

Recent board papers said the machine was necessary for maintaining the trust’s interventional radiology service which includes being on-call 24/7.

It said: “Owing to the age of the machine we are experiencing a growing number of faults and breakdowns and due to its age no new parts are available.

“At present a second hand tube has been installed to replace the existing faulty equipment.”

But the papers went on to say the second-hand part has a defect “causing serious issues with the imaging [which] has the potential to increase imaging acquisitions required which will increase patient radiation dose and lengthen the procedure time”.

A business case for a new machine described current radiation doses as “within the upper limit of safe”.

The trust’s medical physics team had insisted it must “no longer be utilised” from March. However, Medway FT indicated to HSJ last week it was still in use, although it has now committed funds for a new machine, with plans for installation to begin in the summer.

The trust indicated “mitigations” are in place, including additional reviews of patients who use it.

Its board papers suggested that – in addition to the device above – an outdated X-ray machine at its Sittingbourne Hospital site is also delivering radiation above usual levels to get readable images. “Until this equipment is replaced we cannot easily reduce the dose to patients,” the risk register said, although the trust is taking other measures to avoid over-exposure, and has applied for funding to replace it.

Chief executive Jayne Black said in a statement: “Like many trusts across the country we are maximising every opportunity to bid for additional funding and utilising our limited capital allocation to replace essential equipment. This is part of a rolling programme over multiple years so we can continue to provide safe services for our patients.

“We have already invested heavily in diagnostic equipment, with more to follow in the next financial year. This includes investing in community diagnostic centres in Medway and Swale so patients have easier access to a range of vital tests and scans.

“Stringent guidelines are in place to keep patients safe which is our priority.”

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Updated at 8.05am on 11 March to correct error referring to “MRI scanner” and at 15.15 with addition quote from Jayne Black.

Medway FT’s risk register revealed several other serious problems with outdated equipment, including:

Birthing beds in the delivery suite in “disrepair” and may not be capable of repair, with parts unavailable due to their age. There is potential for harm if they malfunction, but a “lack of funding” for replacements;
Elderly image intensifiers used in theatres need downtime and are causing delays and can’t be used on some patients;
Some procedure trollies have had to be taken out of use, adding to theatre turnaround time, with the potential for on-day cancellations if more become unusable;
Failing lights in theatres could pose a safety risk because of difficulty obtaining spare parts. Consultants have threatened to cancel lists;
Vital signs monitors in the high-dependency unit are more than 10 years old and spare parts can’t be bought. Alternatives are being loaned or shared; and
Machines used to process X-rays are unreliable and prone to breaking down with difficulties getting parts due to their age.