title: Radiotherapy equipment--purchase or lease?
abstract: Against a background of increasing demand for radiotherapy equipment, this study was undertaken to investigate options for equipment procurement, in particular to compare purchase with lease. The perceived advantages of lease are that equipment can be acquired within budget and cashflow constraints, with relatively low amounts of cash leaving the NHS in the first year, avoiding the necessity of capitalizing the equipment and providing protection against the risk of obsolescence associated with high technology equipment. The perceived disadvantages of leasing are that the Trust does not own the equipment, leasing can be more expensive in revenue terms, the tender process is extended and there may be lease conditions to be met, which may be costly and/or restrictive. There are also a number of technical considerations involved in the leasing of radiotherapy equipment that influence the financial analysis and practical operation of the radiotherapy service. The technical considerations include servicing and planned preventative maintenance, upgrades, spare parts, subsequent purchase of "add ons", modification of equipment, research and development work, commencement of the lease period, return of equipment at the end of the lease period and negotiations at the end of the lease period. A study from Raigmore Hospital, Inverness is described, which involves the procurement of new, state-of-the-art radiotherapy equipment. This provides an overview of the procurement process, including a summary of the advantages and disadvantages of leasing, with the figures from the financial analysis presented and explained. In addition, a detailed description is given of the technical considerations to be taken into account in the financial analysis and negotiation of any lease contract.
authors.affiliation: Department of Medical Physics and Bio-Engineering, Raigmore Hospital, Old Perth Road, Inverness IV2 3UJ, UK.
authors.forename: A
authors.initials: A
authors.lastname: Nisbet
authors.forename: A
authors.initials: A
authors.lastname: Ward
mesh_terms: D017721:Hospital Costs; D006801:Humans; D007860:Leasing, Property / Q000191:economics*; D017008:Negotiating; D011682:Purchasing, Hospital / Q000191:economics*; D011878:Radiotherapy / Q000191:economics / Q000295:instrumentation*; D012606:Scotland; D013222:State Medicine / Q000191:economics