Liverpool trust rejects delayed PACS

A leading NHS trust in the North West and West Midlands cluster has been forced to scrap its implementation of a Connecting for Health (CfH) Picture Archiving and Communication System (PACS), due to delays and technical problems with the system.

Royal Liverpool and Broadgreen University Hospitals NHS Trust told E-Health Insider that it had taken the decision to reject the PACS, after the initial experience of a trial implementation at the Royal Liverpool University Hospital.

The intention had been to then implement the PACS at the trust’s new £75 million Broadgreen Hospital in time for its opening in March 2006. The new hospital has been specifically designed to be digital and filmless.

The trust had originally been due to implement the PACS this August, but has seen the promised delivery date pushed back twice.

The CfH PACS digital x-ray system was due to be provided by ComMedica with  Kodak providing the Computed Radiology (CR) component.  The systems were to be delivered by CSC Alliance, the local service provider for the North West and West Midlands of England.E-Health Insider understands that Kodak’s CRs have been installed satisfactorily and are already in use.

However, faced with the prospect of having to open the new Broadgreen Hospital without a functional PACS, the trust board decided two weeks ago it had no option but to drop the CfH system being offered by CSC Alliance.

The CfH solution provided to Liverpool and Broadgreen University Hospitals was a ComMedica viewing and image application integrated to the trust’s Radiology Information System (RIS) supplied by HSS, sources indicate that it was the integration of the PACS with the trust’s existing RIS that has been the main source of problems.  CSC’s chosen solution is a Kodak CR and RIS package with Commedica PACS.

A trust spokesperson told EHI the system was due to have gone live a week ago, but the trust board had now decided not to proceed. "The trial implementation at the Royal Liverpool was less than satisfactory; the problems were more than glitches."

He stressed that CSC and its suppliers had made strenuous efforts to resolve outstanding problems.

The spokesperson said that in addition to the delivery delays there had been a "series of clinical functionality issues" that CSC and its suppliers have not yet been able to put right. "The first and second implementation dates were not completed to the satisfaction of our radiology department."

These outstanding issues are understood to include problems with getting interfaces between systems to work and with implementing a clinical coding system on diagnostic images.

He added: "The trust has spoken with the provider [CSC] who are arranging for an alternative that will be on site by March of next year. "We’re now looking for a tried and tested system".

E-Health Insider understands that the trust may now look to implement a proven off-the-shelf PACS. Sources suggest that a replacement – possibly from Agfa of GE – would still be installed under a CSC banner.

A spokesperson for Cheshire and Merseyside Strategic Health Authority told EHI that capital funding for PACS came from three main sources: CfH, the SHA and the trust itself. The spokesperson added that if the trust was to now get another PACS through its LSP it would not necessarily have to re-submit its business case unless the capital funding requirement was significantly different.

The trust spokesperson emphasised that work was underway on implementing other systems from CSC, including a new theatre system, a community information system and Choose and Book. "We are also hoping to have a new PAS system installed in the next couple of months".

CSC referred all questions to CfH, who said: "CSC continues to work towards successful deployment in the four early adopter sites for PACS in the North West (Mid Cheshire, Good Hope, Countess of Chester and Royal Liverpool)."

The statement added: "CfH is in regular, ongoing discussion with its service provider, with a view to optimising the delivery of PACS services to the North West Cluster. Current plans for the North West Cluster show the first PACS solutions going live in 2005."

EHI has so far been unable to identify which of the other early implementation sites in the cluster are confident of going live soon, with responses indicating delays are not confined to Royal Liverpool.

A spokesperson for Countess of Chester NHS Trust told EHI: "We were due to be one of the first wave trusts to get PACS, but the go live date is under review at the moment and has not been finalised."

The spokesperson added: "It was due to have been 21 November, but that’s not the date anymore."