Open/Wide-bore MRI

Policy No: SRP 076

Status: Individual prior approval
Effective date: 1 April 2026
Next review date: 1 April 2031

Essex ICB commissions Open/Wide-bore MRIs on a restricted basis.

Funding will only be approved where at least one of the following clinical criteria is met:

  • Morbid obesity preventing access to locally commissioned MRI services.

or

  • Significant co-morbidities that place the patient at increased clinical risk if scanned in a standard MRI scanner.

Claustrophobia

Claustrophobia alone is not an indication for non-standard MRI. Before any non-standard MRI is considered, the local radiology service must document that: 

  • Standard mitigation measures were used and failed (e.g., modern short-bore scanner, feet-first positioning where feasible, communication/reassurance, music/headphones). 
  • Sedation was considered and, if clinically appropriate, offered and attempted under radiology team arrangements (not primary care), and failed; or sedation was clinically inappropriate with the reason documented

Note: Sedation for imaging should be organised by the radiology team in line with Royal College of Radiologists (RCR) 2024 guidance (trained team, pre-assessment, monitoring, recovery). GP-prescribed ‘pre-scan’ sedatives are not appropriate.

Patients who remain unable to tolerate standard MRI despite the above, or who cannot be safely scanned in a conventional unit for physical reasons (e.g., body habitus, inability to lie flat), may be considered for open/wide-bore MRI via Individual Prior Approval, provided the request includes the above documentation. 

Information:

Standing, upright, weight-bearing or positional MRI is not routinely funded.

It is the responsibility of the referring clinician to provide evidence to support the application. Patients should be made aware that closed MRI machines generally produce higher quality images than open MRI machines. Decisions on funding are made based solely on the information provided.

Information:

Patients not meeting the above criteria will not be funded unless there are clinically exceptional circumstances. 

Individual funding requests should only be made where the patient demonstrates clinical exceptionality.

Further information on applying for funding in exceptional clinical circumstances can be found on the ICB website.

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