PACS roll-out milestone hit in London and the South

All NHS hospital trusts across London and the South of England have now received systems to enable them to capture and store digital diagnostic images as part of the health service IT modernisation programme.

NHS Connecting for Health, the agency responsible for NHS IT, yesterday confirmed to E-Health insider that 56 digital picture archiving and communications systems (PACS) have now been installed in the past two years, covering all hospital trusts in the capital and South of England.

Prior to the NHS IT programme 18 trusts in the two regions had already put in PACS systems, taking the total number of installations to 74.

Mary Barber, national head of the PACS programme, told E-Health Insider: "As of today in London and the South all trusts have PACS, it’s not yet in all hospitals but in the coming months it will be." Homerton and Newham became the final in trust to go live with PACS in London on Saturday

Barber said that reaching the milestone felt "fantastic", and demonstrated that the national programme for IT "can deliver" the systems clinicians want. "We are working our way up the hierarchy of clinical needs." She praised the efforts of staff in all the trusts involved and the "very strong PACS team in each cluster".

Nationally there have been 84 installations of PACS by NPfIT suppliers in five regions. In March alone 12 systems were deployed. CfH says that the roll-out for the rest of England should be completed by the end of December

In the South images are already being archived in central image store, the first step to enabling the sharing of diagnostic images. In London all images are so far being stored locally, with a central cluster image store due go live later this year.

National medical director for the PACS programme, Dr Erika Denton, said: "Two years ago only 18 trusts in London and the South had PACS, as digital x-rays and scans were confined to those trusts who could afford the substantial investment."

Robin Evans, consultant radiologist at Mayday NHS Trust – the second PACS site in London – told EHI: "This is one of the most enabling pieces of technology I’ve dealt with in my career.

"It’s transformed the way we do things. Handling and finding images used to be inefficient and resource intensive and result in delays to patient care with their x-rays often being unavailable or elsewhere."

Stressing the benefits to patient safety PACS is now providing Evans said: "We have meetings to review errors and it had previously been a regular occurance that errors were made as images were not available." He added he was certain that PACS was a factor in radiology waiting lists now coming down.

Dr William Saywell, consultant radiologist at Yeovil in Sommerset, said: "PACS has transformed the way we work in the radiology department. As well as almost eliminating the problems of film and retrieval, it has dramatically improved reporting efficiency and throughput."

Saywell added: "We are eagerly awaiting the next step in the programme, which will enable the sharing of images between hospitals, making it unnecessary to send films or CD-ROMs with patients who are transferred to specialist centres, and giving access to previous examinations wherever a patient may attend for treatment."

Barber said that there was a growing evidence base of the clinical and business benefits the PACS programme was delivering, with evaluations so far done for five trusts. Before PACS she said that patient images were not available in up to 10% of cases.

"Turn around times for patients to clinician with their files is reduced by 50% from 6.2 days to 2.9 days. We’ve also seen reporting times decrease with far more reports now turned around within 48-hours."

On cost savings over traditional wet film the evidence is indicating that they are actually greater than had been predicted. "£250,000 to £320,000 in clinical savings from X-rays alone, higher than had been put into business cases".

Fujitsu, the LSP for the South of England is Fujitsu, have completed 35 installations linked to a central image store. They are rolling out a PACS system supplied by GE.

Barber said that four weeks ago Sheffield Children’s NHS Foundation Trust became the first trust to receive a PACS system linked to the national Spine for single sign-on and role-based access. "We’re just about to also put this into two much larger trusts Basildon and Thurrock and Scarborough."

Peter Hutchinson, managing director UK public sector for Fujitsu, said: "It is a fantastic feeling to be able to deliver, on time and on budget, on a project that is making such a difference to patients and clinical staff alike."

BT, the LSP for London, have completed 21 installations. They are rolling out a PACS solution supplied by Philips.

Paul White, chief executive of BT Health London, said: "It has been hard but rewarding work for BT and our suppliers, but the real credit should go to the Trusts for their commitment and collaboration. The return on their investment of time and effort is already being delivered – and main beneficiaries are the patients."