6 Resource impact for the NHS
6.1 The purchase cost of a portable 2-D ultrasound machine currently lies between £7000 and £15,000. The additional disposables necessary for the ultrasound-guided procedure cost less than £1 per procedure. Estimates made by the Assessment Group analysis indicate that the additional cost of using ultrasound equipment for the CVC placement procedure is likely to be less than £10 per procedure.
6.2 It is likely that the NHS will need to invest in a significant number of additional 2-D ultrasound machines, although it is impossible to predict how many will be required, as local circumstances will vary considerably. Implementing the guidance will require local decisions regarding optimal number of machines, staff training and device service contracts.
6.3 The Assessment Group analysis suggests that in the long term the implementation of ultrasonic locating devices will be costsaving. The majority of these savings are likely to be due to releasing resources such as staff, and operating theatre and ITU/HDU time and beds.
6.4 A constraint upon the implementation of this technology will be the need to ensure that there are adequately trained competent operators to support the services. Many CVC placement procedures are performed on an emergency basis at the bedside in a diverse number of locations and therefore the necessary skills need to be spread across several related disciplines