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Archive through January 13, 201113-01-11  07:51 amVenumadhav Vedula20
Archive through January 24, 201124-01-11  10:09 amNeelam Dugar20
Archive through May 18, 201118-05-11  05:11 pmNeelam Dugar20
Archive through May 29, 201129-05-11  07:04 pmNeelam Dugar20
Archive through December 12, 201212-12-12  09:59 pmNeelam Dugar20
 Link to this message Chris Bull  posted on Monday, December 17, 2012 - 06:56 am Edit Post Delete Post Print Post
My major concern over the supply chain is that a Trust is swapping a LSP for another organisation who has the direct contact with the suppliers. It would appear that the major saving will be with the contract. My recommendation is to get help with the OJEU from a Consultancy like ours or other Trust who has already completed a successful tender process before any decision is made. Check out some of the posting from the last RCR PACS meeting in Birmingham.
 Link to this message Rory Dennis  posted on Monday, December 17, 2012 - 04:12 pm Edit Post Delete Post Print Post
Before any Trust pays for expensive consultancy they should consider one of the savings NHS SC Framework offers is free advice and a legal method for procuring systems over OJEU threshold. Also the framework terms and conditions that can save a Trust both time and money.

NHS SC and its Framework are a route to market not a management solution; the contract awarded will be managed by the trust who can be assured they will have a direct and open communications with the winning supplier. After the award has been made and contracts agreed NHS SC will not be involved in the on-going management of the contract or winning supplier on behalf of the trust.

As it would appear that non-NHS consultants are misinformed on the ability of the framework, the NHS Supply Chain PACS senior Buyer, Dave Burns would be delighted to host you in Normanton to discuss the framework and how it assists trusts. Please feel free to DM me and I will be able to set this up for any consultant that requires this update.
 Link to this message Chris Bull  posted on Tuesday, December 18, 2012 - 03:52 am Edit Post Delete Post Print Post
How do you know that we are expensive? How is the NHS SC Framework funded if not by a percentage of the cost being within the overall costs of the systems provided as it uses an outside agency. The major benefit of using independent Consultancy is that we have carried out the OJEU processes many times and the services can be used on a day to day bases by the Trust. The Framework may be the best way of the Trusts provision but it is not the only way, there are still lots of items and documents that need to be completed by the Trust before a contract can be sighed using each method.
 Link to this message Neelam Dugar  posted on Tuesday, December 18, 2012 - 09:14 pm Edit Post Delete Post Print Post
Whether Trusts go through OJEU or framework,
a. make sure that you have a fair & equal process for judging.
b. your functional specification is EMBEDDED in the contract
c. if you get consultants or contractual help, make sure that they are not biased and leading you to a particular supplier--due to a commercial relationship. They need to be neutral. PACS Manager, radiologists & clinical users should be involved in choosing the right system.
 Link to this message Neelam Dugar  posted on Monday, March 25, 2013 - 10:32 pm Edit Post Delete Post Print Post
Patient Banner Information on RIS & PACS must be kept in sync by ADT feed from PAS
a. Name
b. DOB
c. Sex
d. NHS No.
e. PAS No.
f. Current Patient Location
g. Current Responsible consultant
NB: Current Patient Location & Current Responsible Consultant ONLY apply for INPATIENTS.

These must be differentiated from HL7 ORM messages which come from RIS or Ordercomms which describe requesting consultant & patient location at time of request.
 Link to this message Chris Bull  posted on Wednesday, April 24, 2013 - 11:07 pm Edit Post Delete Post Print Post
I wonder how the Framework day went as I hear that limited to key PACS providers only and with a details that going through an OJEU is difficult. Remember that the framework is provided by another supplier who takes a percentage of the deal offered. As they consider changing the systems that the opportunity to future proof their purchases to cope with the new demands in the future? This RCR site has spent a lot of time and effort on outlining the requirements of XDS, XDSi and the use of VNAs to provide the need of future proofing.
Going through an OJEU allows the Trust to have direct contact and see first-hand the potential suppliers to make their selection from this. The ability to evaluate the market is very important as your selection will live with you for the time of the contract.
Again using the OJEU process is comparatively easy using folk who can assist in the process we have been able to achieve this in under 9 months and hold the necessary documents including an update to the MS-Con, T&Cs updated by a NHS Trust who is happy to share it.
There are other teams who can assist and the cost of this is built on a number of days to achieve the contract. If you wish to know more please contact me and I can help So please consider the options outside the framework and there are many successful procurements using OJEU.
 Link to this message David Burns  posted on Thursday, April 25, 2013 - 04:03 pm Edit Post Delete Post Print Post
Hi Chris

Thanks for your comments regarding the PACS and RIS event yesterday. It was a great success with extremely positive comments received from both suppliers and Trusts alike. The event was used by Trusts to find out about all of the suppliers on the NHS Supply Chain Framework Agreement (which includes all of the main PACS suppliers) and to understand which of these may be able to meet their future requirements. As the specification used in the tender process for the Framework Agreement was the RCR specification Trusts can be assured that they are talking to the suppliers that meet these requirements.

There were some comments in your post where I thought it would be helpful to provide some more information to you about the way that the NHS Supply Chain Framework Agreement operates. Firstly, NHS Supply Chain is not a supplier. NHS Supply Chain has no PACS or RIS products which it sells, rather NHS Supply Chain is the procurement organisation that allows Trusts to access suppliers of these products and services. We do not charge Trusts for this. This facilitation role can include assistance with OBS setting, framework approved contract documentation, and also with the competition phase of the procurement. Importantly, as many Trusts have a lot of experience in house this support is flexible and scalable to meet a Trust’s local requirements. The framework process also allows Trusts to have direct contact with suppliers during the process while still maintaining the integrity of the OJEU regulations.
As the basis of the framework specification has been the RCR specification this will compliment Trusts’ future requirements such as XDS / XDS-I etc. Together with software assurance being a core framework requirement, Trusts can be assured of an application that meets their requirements now and as they grow in the future.

Secondly, the use of a national Framework Agreement allows suppliers to access any NHS Trust or any other NHS entity. The feedback we receive from suppliers is that this means this reduces their tendering costs. As they then take part in just one tender process (rather than having to complete an OJEU tender process for each of the individual Trusts) it then means that their subsequent cost of sale can be reduced.

In terms of the timescales you mention, I would say also that under the correct circumstances NHS Supply Chain has been able to offer new contracts to Trusts within 10 days and new managed service contracts in 12 weeks. As you will be aware, if the Trust is using consultants to assist it in their procurement process then, depending on the value of these services, the Trust may also need to factor into their timeline a similar process for the consultant’s procurement and appointment.

Finally, the terms and conditions used by NHS Supply Chain have been approved for use by the Department of Health. A substantial amount of money and effort has been invested in getting these terms up to a standard acceptable for use with PACS and RIS solutions within the NHS whilst also allowing for local Trust requirements. This investment was and is fully funded by NHS Supply Chain for the wider benefit of the NHS. We would strongly advise that any Trust carrying out its own tender process takes it own independent legal advice about whether a set of terms and conditions which have been provided for another Trust and their specific requirements are then suitable and offer them adequate protection for their own individual circumstances.

If you do have any further information about how the NHS Supply Chain Framework Agreement works, please do not hesitate to speak to me and I will be happy to discuss with you in further detail.

Kind regards

 Link to this message Ed McDonagh  posted on Thursday, April 25, 2013 - 04:54 pm Edit Post Delete Post Print Post
Hi Dave

Just for clarity, how is Supply Chain's considerable investment in this framework agreement and associated support for Trust procurements funded?

Kind regards

 Link to this message Neelam Dugar  posted on Thursday, April 25, 2013 - 08:28 pm Edit Post Delete Post Print Post
Trust need to make their own decisions.
Both options have benefits.

We are currently looking at status update messages from RIS to PACS, results reporting system or any other IT system. We are considering the following:

1. Scheduled--they are aware that patient has an appointment & the date and time of appointment
2. Exam performed--i.e. images have been taken but report not issued as yet
3. Exam Not Performed --whether Cancelled/Patient DNA/Exam not performed--an written explanation should be provided to the referrer
4. Report Dictated
5. Report Authorised.
6. Report Addendum

Rest of status update messages do not need to "broadcast" outside the department. Any views or comments?
 Link to this message David Burns  posted on Friday, May 17, 2013 - 09:10 am Edit Post Delete Post Print Post
Morning Ed

Apologies for not responding sooner, I've been on leave and am catching up with things. The question you ask is quite a complex one and doesn't lend itself well to a response on a message board. However we would very much welcome the opportunity to discuss this with you face to face. This tends to more productive and ensures that all of your questions can be answered in one go rather than a back and forth.
If this is something that would be of interest to you please let me know and I will arrange for myself and the regional business manager for London to pop into the trust and have this discussion?

Kind regards

 Link to this message Neelam Dugar  posted on Saturday, May 18, 2013 - 10:37 am Edit Post Delete Post Print Post
At the meeting on Monday, the statistics provided showed more or less an even split between Supply Chain vs. OJEU. Having been through procurement my simple view is this:
Make sure your clinical requirements are defined/ "written" clearly in the contract. Verbal promises do not hold. Supply chain contractual specification should be based on group specification documentation. Dave Burns and I had many chats about this. OJEU from Trusts are also using group specification documentation when writing their contracts. NHS Trusts are happy to share their experiances too. Please ask to see the specification written in the contract and ensure it meets local requirements.

At UKRC we have a session on procurement. My one advice to those considering OJEU --please seek external help with process & documentation. Local hospital procurement teams generally do not have expertise in complex IT systems procurement.
 Link to this message Chris Bull  posted on Wednesday, May 22, 2013 - 11:07 am Edit Post Delete Post Print Post
I would like to commend Dr Dugar for her last post as I am still not sure that the Supply Chain approach is the right one for moving the systems forward for the next 5 to 7 years unless you are staying with the same supplier. The issue is that we are stuck with the same old PACS – RIS provisions as it is an easy root to provide the contract changes moving from the current contracts to a new one. Also the provision of the Supply Chain is moving from one LSP type provider taking a percentage of the overall cost based on the size of the contract. My other concern is how any new providers can gain access to this process?
There needs to be very careful consideration taken by the Trusts to what the users require and will require in the future especially with the development of ECM and related tools of access to the data using software as a service. Sometimes (SaaS)referred to as "on-demand software" supplied by ISVs or "Application-Service-Providers" (ASPs), is a software delivery model in which software and associated data are centrally hosted on the cloud. SaaS is typically accessed by users using a thin client via a web browser. The use of mobile devices and access to other patient information to user other that radiology is a major requirement.
We have helped a few Trust achieve their move away from their current supplier and are fully contracted having gone through an OJEU process. We have all the processes and tools required to achieve this. Because of this knowledge this also helps the providers/supplier ‘fit’ their provision to meet the requirements of the Trusts. Trust should not be worried about using the OJEU route as external help can provide the necessary processes and documentation to suit local requirements and also help in guiding through the suppliers information.
We would be happy to provide a ‘free’ day of consultation to help Trusts understand the processes and current market and to ensure it meets local requirements and standards. Drop me a note if I can be of help?
 Link to this message David Burns  posted on Friday, May 24, 2013 - 09:38 am Edit Post Delete Post Print Post
Yet another inaccurate post by Mr Bull. I do not find it difficult to believe your statement “I am still not sure that the Supply Chain approach is the right one” as you have not taken my offer to explain how the framework process works. NHS Supply Chain has and is working with independent consultants to assist trusts purchasing their replacement systems. These consultants have been therefore able to offer the trusts they are engaged with balanced and informed advice.
All frameworks offered by NHS Supply Chain allow innovation, so as new developments are released by suppliers they have a compliant process to add these to their current framework offerings. All resulting contracts have been let with a change control process that allows the trust to drive changes that become required during the life of the contract.
I would like to point out that under the framework trusts already can take advantage of hosted solutions delivered on a unitary payment model. These models can be tailored to support the local trusts requirements. Early adopters of new technology in the PACS and RIS area has limited appetite in our recent experience, with most trusts seeking to locate all date and hardware within their infrastructure.
As for offering some free consultancy, NHS Supply Chain team make no charge for their service to the trust. This is not just a day’s free consultancy but a free service throughout the process irrespective of timescales. I appreciate an independent consultancy cannot make this offer as they typically charge per day for their services. As I am sure the readers will understand, the longer a OJEU procurement goes on a retained consultant (working on the above charging structure) will cost the trust more based on their involvement. As the framework has completed rather a lot of this OJEU process this will reduce the time available to the independent consultancy market to be engaged with these procurements. I therefore understand objections to a framework of this type by the independent consultancy market.
I would agree that the OJEU route is a valid route to market (please see below re costs), however I would also suggest that the work required to form the framework has and will continue to offer advantages to trusts. This has proved the case since the framework went live as there has been no independent OJEU activity for PACS or RIS applications.

I once again would offer to explain to Mr Bull or any independent PACS / RIS consultant, the opportunity to discuss how the framework operates so they have all the correct information to advise any trust they engage with.

 Link to this message Brandon Bertolli  posted on Friday, May 24, 2013 - 10:18 am Edit Post Delete Post Print Post
David, I am also curious to know the answer to Ed McDonagh's question. You said:

"The question you ask is quite a complex one and doesn't lend itself well to a response on a message board. However we would very much welcome the opportunity to discuss this with you face to face. This tends to more productive and ensures that all of your questions can be answered in one go rather than a back and forth."

Perhaps you have a document we can read, detailing the complexities?
I think you will find that most people who have had any involvement as an end user in the LPfIT are wary of any kind of middleman who has a contractual relationship with the vendor that the Trust doesn't have sight of.

If you can't provide a document that answers Ed's question, that's a big red flag to me!
 Link to this message Neelam Dugar  posted on Friday, May 24, 2013 - 07:35 pm Edit Post Delete Post Print Post
David & Chris,
I will not be drawn into a debate on what is better. Each Trust needs to make its own decision.

However my one advice is
"Suppliers are only required to deliver what is written in the contract". So make sure your contract has in black & white what you expect. Good contracts are key to good long term relationship with your suppliers.

We have a full session on procurement at UKRC 2013.
 Link to this message Chris Bull  posted on Thursday, June 20, 2013 - 11:29 pm Edit Post Delete Post Print Post
After the sessions at UKRC I am still not sure how the supply framework team is funded as I am sure that you do not work for free. I believe that this is just one way of providing the replacement of the systems without going down the road of fully understanding what is out there or getting an unbiased view. My concern is the provision or the same old, same old systems while we have a chance to break the hold of the data within the PACS vendors into true middleware technologies that will allow easy access and change in the future.
We do charge for our services but they are not hidden in the overall cost of any tendering project. We also have experts who have provided this requirement on both side of the industry. There is space in the market for both but I believe that the only way a Trust can openly decide what is best to do is to break from the larger body of a framework and look to partner with other trusts and save any hidden cost with in the project. Some of which are going live while we speak. It would be good to get some lessons learnt information at the next meeting in November from the different teams who have changed this June.
 Link to this message Tim Taylor  posted on Friday, June 21, 2013 - 09:22 pm Edit Post Delete Post Print Post
Dear Neelam,

A quick thanks to you and others for organising the PACS sessions at UKRC this year. Illuminating. I've been following discussions on these fora with interest. I must admit that I find myself looking for the Conflicts of Interest for many of the forum contributors, and am grateful to those of you who make these clear in your user signatures or user details.

Our procurement is just about underway now. Before I go back to lurking, I thought I'd add something to the mix, to those considering their options over the coming months. Many NHS Trusts have both large ICT depts and large Procurement depts. In addition, many have already worked through large-scale commercial procurement exercises for PAS or EPR systems. Neelam is right, Trusts need to make their own decisions- but this needs to be a whole-Trust, rather than just Radiology, decision and in the process you might find a great deal of useful prior experience and knowledge already exists.
 Link to this message Neelam Dugar  posted on Wednesday, June 26, 2013 - 08:29 pm Edit Post Delete Post Print Post
Naming of Data Fields on PACS with common NHS terms.

With our PACS replacement we are looking at naming our data fields with "common NHS terms" so that training is minimised for users.

This is what we are planning to use--comments please

Referring Consultant/GP
· Current Consultant
· Location at Request
· Current Location
· Study date
· Report date
· Study Description
· Status
· Reporter
· Reporter Grade
· Speciality (Referrer)
· Priority
 Link to this message Chris Bull  posted on Monday, July 01, 2013 - 11:42 am Edit Post Delete Post Print Post
I think your comments about PACS & VNAs are good and also the discussion on the way information will be treated in the future. My worry is that Trusts will just replace like for like and we will end up with the same old same old issues as before where Radiology is taking the lead while leaving the rest of the hospital isolated. This is where a true VNA provides the benefit as it should be able to route data to the required destination from the information from the source.
The real key is to identify the requirements of the users based on experience on what has worked with the current RIS/PACS and build on this. The PACS should be treated as a modality that is more focused on Radiology, When using a true VNA that will store all types of patient information the importance of understand the workflow requirements of the whole Trust becomes more significant as the data storage grows. I know that this concept of workflow has improved over the years this is why I believe that a session of workflow would be so important as users look to replace their current systems with new one and should be able to put to their new suppliers their workflow requirements. On one for the VNAs I have seen the workflow tasks being setup on a web page and will send the information to the users at a touch of a mouse click. This is why the requirement to get some expert help rather that just replace the like for like is critical now.
 Link to this message Neelam Dugar  posted on Saturday, May 09, 2015 - 09:34 am Edit Post Delete Post Print Post t%20-%20Dr%20Neelam%20Dugar.pdf

I wrote an article on RAD magazine on PACS Procurement.
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