Realising the value of innovation at Poole Hospital, University Hospitals Dorset NHS Foundation Trust

Fast-forward three years, in 2020 and through to 2021, the COVID-19 pandemic led to an unforeseen slowdown in diagnostics and treatments. Hundreds of thousands of people in England have been forced to wait more than six weeks for one of 15 standard diagnostic tests – including MRI, and even more have seen treatments postponed [2].

Despite this, MRI scans remain an essential part of the treatment journey for millions of patients. In total, 3.36 million scans are performed in the UK every year [3] – costing the NHS almost £450 million [4].

An important element behind these rising costs is the price of helium, an increasingly finite gas used as a cooling agent in MRI scanners. Recent estimates predict that the earth could run out of its helium supply in as little as 25-30 years [5], creating an increasing need for more sustainable approaches to the use of the gas in MRI technology. As the burden of COVID-19 reduces, the need for innovative and effective diagnostic tools increases, to ensure the NHS can manage the resurgence in standard procedures and enabling patients to receive timely care – whilst also deploying solutions which can be managed much more sustainably.

Against this backdrop, in 2019 Poole Hospital became the first UK hospital to introduce the Philips Ingenia Ambition X 1.5T MR - the UK’s first helium-free [6] MR operations system. With growing patient demand and growing helium shortage, the Trust were searching for solutions that enabled them to sustainably scale up their services.

Based on a decade of innovation, the Ingenia Ambition X 1.5T MR operates with only seven litres of liquid helium, instead of the usual 1,500 litres in conventional MR system designs, with the fully sealed BlueSeal magnet. This is particularly important considering the rising costs of helium, which grew by nearly three quarters in 2021 to £15.49 a litre compared to £11.61 a year previous.

Furthermore, the Philips BlueSeal magnet uses a highly efficient, new micro-cooling technology. It is fully sealed, so no helium can escape, either suddenly during a loss of field or gradually. As a result, this technology has a significant impact on the long-term continuity, security and cost of MR operations.

Dr Ravi Ayer, Poole Hospital Consultant Radiologist:

“We are very proud to be the first NHS trust in the UK to offer our patients this breakthrough MR technology. The Ingenia Ambition X not only ensures high quality diagnostic care but also all but eradicates potentially costly disruptions to service when helium doesn’t remain cool enough to work with.

MR technology is a high-level investment that needs frequent use to ensure return on investment, so removing this problem is of great appeal to the team. And vitally, it will support us to see more patients more quickly, without compromising quality. This is a new approach to diagnostic imaging and exactly the kind of service we are proud to bring to our community.”

Having an MRI scan can be daunting for many patients; some may feel anxiety about the process or struggle with claustrophobia. The patient experience has informed the design and build of the Ingenia Ambition X from the very start.

Eliminating these concerns for patients has been a Philips goal from the beginning. For example, many patients who would have previously needed general anaesthetic are able to tolerate the scan without sedatives. Furthermore, the screening can also be well tolerated by children as young as 3 years old and those with autism. Philips has created an ambient experience, including screens on the back wall of the system to play media and the introduction of soothing music through headphones.

For too long MRI machines have required multiple clinicians and healthcare workers to set up the system for each patient. In designing the Ingenia Ambition X, Philips applied the latest technologies and insights from clinicians to develop a machine operable by just one MRI radiographer, with a second MRI radiographer present for safety reasons. The software used guides an MRI radiographer through an intuitive programme, in turn improving workflow and freeing up wider clinician resources.

For MRI radiographer teams this is revolutionary. Not only does each machine save money for the hospital and reduce finite gas use, it frees up vitally important clinician capacity. Together with Philips Compressed SENSE technology, the Ingenia Ambition X can speed up exam times by up to 50%, meaning patients spend less time being scanned with no compromise on image quality [8].

According to Consultant Radiologist Dr Ravi Ayer, “Philips lead the way when it comes to better imaging and better patient care. A people-centric approach which takes into consideration all elements of the ambient experience and environmental wellness of the patient also creates a more productive and efficient process, by reducing patient stress levels and increasing more first-time right imaging.”

Studies have shown that Philips Compressed SENSE technology allows hospitals to scan more than five extra patients per day within the same scanning hours enabling clinicians to reduce patient backlog [9]. Dr Ayer continued to say, “Other specialties put on clinics for their backlogs, they’ll put in evening and weekday clinics, meaning many patients come into have scans. Often the scans are to diagnose cancer so have to be done within two weeks.” However, it is a different story at Poole. “We are able to prioritise scanning some of the most unwell and challenging inpatients on the Ambition thus enabling us to deal with the increased amount of imaging arising from these additional clinics.” Despite the postponement of MRI scans during the height of COVID-19, Poole Hospital has since reduced backlogs and waiting times in 2021. The hospital is now averaging an extra 30 patients scanned per month this year, compared to 2020.

MRI Deputy Superintendent Radiographer, Aleksandra Kudyk also discussed the value the Ingenia Ambition X brings with treating older age patients. “Every year we see an increase of patients with pacemakers and implants. With ScanWise Implant we can easily adopt all those conditions and meet criteria. We scan the majority of pacemaker patients on Ambition because it is so simple. I have confidence my patient is safe and we know the implant will still work after the scan.”

For clinicians it is also essential to provide comfort to patients. MRI Deputy Superintendent Radiographer, Aleksandra Kudyk speaks passionately about this. “Every day we have patients who are very thankful for the experience. For us as radiographers it is a game changer, it is a completely different way of working. We can clean everything in between patients and we can keep the environment safe”.

Charlie McCaffrey, Philips UKI Health Systems Lead:

“The MRI was invented in the UK, so it is fitting that the UK has introduced another imaging first at Poole Hospital.

“Philips has long been committed to making the world both healthier and more sustainable through meaningful innovation, and these values come together in the Ingenia Ambition X. Helium is a finite resource, with a large proportion being used in MR imaging scanners across the world. I am proud that we can offer this breakthrough technology that not only supports more patients in getting the care they need but also does so in such a way that enables greater respect for the limited resources on Earth.

“We are looking forward to strengthening our relationship with the team at Poole and bringing a new era of MR to the Trust.”