Replacement of three (3) Linear Accelerators for Sir Charles Gairdner Hospital Radiation Oncology

The Sir Charles Gairdner Hospital (SCGH) Department of Radiation Oncology requires:

• The provision of up to three (3) replacement Linear Accelerators, delivery, installation, training and service support.
• Trade-in and removal of the three (3) existing linear accelerators from Radiation Oncology, Cancer Centre, SCGH.

A key objective of the proposed procurement is to minimise structural alterations (e.g. radiation shielding/wall thickness), which may be time consuming, costly and disruptive to patient workloads in adjacent machines that continue to be used clinically. Additionally, SCGH wishes to ensure that the replacement units integrate with the other technologies used in the department; for example: treatment planning systems, imaging technologies, physics equipment, and other linear accelerators.

The inherent capabilities of the linear accelerator unit itself are also a consideration in terms of on-board imaging, capability to deliver specialist treatment techniques such as Intensity Modulated Radiation Therapy (IMRT), Volumetric Modulated Arc Therapy (VMAT), stereotactic, and other key performance characteristics.

When looking forward, SCGH needs to ensure that the volume and type of patients, and the quality of care needs is considered. Therefore, a further objective of the proposed procurement is to also provide an appropriate level of ‘future-proofing’ for the rapidly evolving Radiation Oncology health care service in WA.

SCGH is cognisant that dedicated tomotherapy linear accelerators that provide IMRT treatment are eligible for a limited reimbursement from the Medicare Benefits Schedule and are currently not eligible for Commonwealth Government Radiation Oncology Health Program Grants Scheme. As ‘standard linear accelerator’ systems are not subject to such limited reimbursements, SCGH would potentially risk inadequate reimbursements that may affect service funding and future equipment replacements were it to take up a dedicated tomotherapy linear accelerator.

The Radiation Oncology service employs a small but highly skilled engineering team who perform the frontline technical and maintenance support services. The team acquires and enhances its skills with technical training purchased as part of the periodic equipment procurement processes. Currently, the team also sources parts, manages remote access and has access to the supplier’s technical information specific for each linear accelerator as part of a service support arrangement. SCGH has found this arrangement to be beneficial in reducing down-time and may seek a similar arrangement to consolidate frontline support with parts and related technical support under the proposed Contract.