Some Trusts have been asking what we can learn from other similar projects so I have done some background research and compiled a list of similar RIS PACS adverts that have been placed in the official Journal of the European Union (known as OJEU or OJEC) recently.
I have then used these to prepare a first draft advert (I stress … a first draft) aimed at a consortium of NHS Trusts, who want to end up with a flexible multi-lot framework contract consisting of one or more suppliers that they can each choose from. The background research report is attached and the draft advert is below, based mainly around the current “All Wales PACS Procurement” and other for the "lots" approach, such as the Airedale NHS Foundation Trust Electronic document management system (EDMS).
My purpose of doing this is to provide “something to critique”, to stimulate discussion and revision locally. The example procurement is for the following Lots:-
LOT NO: 1. TITLE: RIS and / or PACS LEGACY DATA MIGRATION LOT NO: 2. TITLE: RADIOLOGY INFORMATION SYSTEM (RIS) LOT NO: 3. TITLE: PICTURE ARCHIVING & COMMUNICATION SYSTEMS (PACS) LOT NO: 4. TITLE: IMAGE ARCHIVE LOT NO: 5. TITLE: MANAGED SERVICE
Structuring the advert correctly determines how subsequent stages progress. It encapsulates most of the big strategic decisions around procurement approach (there are several approaches available this draft example assumes the more flexible, “Competitive dialogue”, as does the “All Wales PACS Procurement”, others tend to use the more traditional “Restricted procedure”)…
Feedback, views etc are very welcome
Notice Details UK-NW: RIS and PACS system 2011/9 99-999999
CONTRACT NOTICE Services
SECTION I: CONTRACTING AUTHORITY
I.1) NAME, ADDRESSES AND CONTACT POINT(S) XYZ NHS Trust [as hosts of the xyz consortium] 99 XXXXXX XXXX John Smith M14 3BC UNITED KINGDOM Tel. +99 999 9999 E-mail: email@example.com
Further information can be obtained at:
As in above-mentioned contact point(s)
Specifications and additional documents (including documents for competitive dialogue and a dynamic purchasing system) can be obtained at: As in above-mentioned contact point(s)
Tenders or requests to participate must be sent to: As in above-mentioned contact point(s)
I.2) TYPE OF THE CONTRACTING AUTHORITY AND MAIN ACTIVITY OR ACTIVITIES
National or federal agency/office Health The contracting authority is purchasing on behalf of other contracting authorities Yes
SECTION II: OBJECT OF THE CONTRACT
II.1.1) Title attributed to the contract by the contracting authority Radiology Information System (RIS) and Picture Archiving and Communication System (PACS). II.1.2) Type of contract and location of works, place of delivery or of performance
Service category: No 7
Main place of performance - Various Participating Organisations as set out in the contract documents.
NUTS code UKD (this means NW England)
II.1.3) The notice involves A public contract
II.1.4) Information on framework agreement
Framework agreement with a single or more than one operator
Duration of the framework agreement: Duration in year(s): 7 with option to extend to 10 years.
Justification for a framework agreement, the duration of which exceeds 4 years: The Authority’s requirement will require the replacement and support, on a managed service basis, of complex and advanced RIS and PACS managed services that will need to be phased in over a significant period of time.
Existing contracts for the support of the current RIS & PACS managed service and equipment base will expire over a period longer than 4 years. The end date of the current contract for all Participating Organisation is June 2013 but there is an option for some that require it to extend one year to June 2014 and then by a further 2 years to complete transition to a new arrangement for a further 2 years to June 2016. KR Note - So if this contract is agreed in 2012 and the CSC contract is extended for some Participating Organisation for the full 3 years that takes the end date of the current contract for them to June 2016. The Authority wishes to appoint a contractor, or contractors, on the basis of a solution, or solutions, that will be available to all NHS NW Participating Organisations over a period of time and providing a value for money charges offer that remains competitive over the term of the framework. This will not be achieved unless the framework is available for the entire period, longer than 4 years, over which the current estate requires replacement.
II.1.5) Short description of the contract or purchase(s)
IT Based Solution in respect of a replacement Radiology Information System and Picture Archiving and Communication System Managed Service Solutions to be used by NHS Bodies [as defined in the National Health Service Act 2006] and bodies succeeding NHS Bodies or assuming any of their functions and maintenance and support, implementation and development and other associated services may be required by any of those bodies over the term of the contract. Services may be required in respect of the delivery, hosting or service provision of the RIS and PACS in relation to their integration or interoperation with other NHS systems and software.
II.1.6) Common procurement vocabulary (CPV)
72311100-9 Data conversion services 48329000-0 Imaging and archiving system, 33197000-7 Medical computer equipment, 48814000-7 Medical information systems 48814400-1 Clinical information system 48311100-2 Document management system, 48314000-2 Voice recognition software package 48318000-0 Scanner software package,
Supplier will probably get alerts and search on thses codes so the above codes should alerts most that would be interested to this opportunity.
II.1.7) Contract covered by the Government Procurement Agreement (GPA) Yes
II.1.8) Division into lots
Yes. Tenders should be submitted for one or more lots.
II.1.9) Variants will be accepted Yes – check this??
II.2) QUANTITY OR SCOPE OF THE CONTRACT
II.2.1) Total quantity or scope Offers will be invited for one or more of xx lots detailed herein: Certain lots are alternatives to one another as detailed.
The Awarding Authority retains the right to determine if it should let a specific Lot and is not required to let any or all Lots.
The Awarding Authority does not commit to letting a contract(s) for any or all the components above, should it become evident that it is not economically advantageous to do so.
The Awarding Authority, seeks IT based solutions in respect of replacement Radiology Information System and Picture Archiving & Communication System Managed Service Solution: The purchase, delivery, installation, data migration, integration, commissioning, support, upgrades, services/maintenance and allied services.
Authorities that may issue requirements under this framework agreement and for whom the Awarding Authority is acting in this procurement are NHS Trusts and in the NW, in particular but not limited to:-
• LIST NAMES OF TRUSTS IN THE SCOPE OF THE PROCUREMENT • ABC • DEF • GHI • ETC • XYZ • or any Authority that may replace or succeed them, together known as the Participating Organisations.
The solution will require implementation initially in ABC TRUST, DEF TRUST….ETC (KR - if this is known) but will be capable of being implemented across all Participating Organisations on the basis of localised requirements by means of call- off contracts under the framework agreement. The framework agreement will provide a degree of adaptation and localisation of the solution to reflect specific local needs.
It is anticipated that the solution will involve an appropriate transfer of risk to the supplier so as to enable Participating Organisations to ensure that, subject to full implementation across Participating Organisations, any image captured in any location in Participating Organisations is seamlessly viewable at any other location. Any solution will also be required to share images with Healthcare providers elsewhere in the UK. The systems will be able to operate on a multi-site, and possibly multi NHS Trust basis, and across different clinical specialities (not just Radiology) with high standards of resilience and performance. The successful supplier will be responsible for interfacing its Systems with a range of Participating Organisation systems, modalities (PACS) and for data migration (both RIS and PACS).
The most appropriate architecture for the Trust, including methods of data/image storage, migration, management and distribution, will be determined through the procurement process. The systems will be kept updated throughout the contract period to ensure the technology and functionality are kept at the leading edge.
Given that all Participating Organisations already have existing RIS and / or PACS solutions in place any proposed solution can offer, to accommodate and re-use any suitable Participating Organisation’s RIS and PACS equipment, operating and application software (where commercially possible under licensing agreements) and existing infrastructure services and facilities at the locations requiring the solutions.
Suppliers will be able to bid for one or more lots.
LOT NO: 1. TITLE: RIS and / or PACS LEGACY DATA MIGRATION LOT NO: 2. TITLE: RADIOLOGY INFORMATION SYSTEM (RIS) LOT NO: 3. TITLE: PICTURE ARCHIVING & COMMUNICATION SYSTEMS (PACS) LOT NO: 4. TITLE: IMAGE ARCHIVE LOT NO: 5. TITLE: MANAGED SERVICE Summaries of each are given below:- LOT NO: 1. TITLE: RIS and / or PACS LEGACY DATA MIGRATION 1) SHORT DESCRIPTION HSS CRIS and / or GE Centricity PACS Data Extraction, Manipulation [including computer based morphing of private DICOM image tags where necessary to secure correct import into the replacement PACS solution], and subsequent Migration of existing RIS & PACS data and image migration to the replacement solutions.
2) COMMON PROCUREMENT VOCABULARY (CPV)
72311100-9 Data conversion services
3) QUANTITY OR SCOPE.
Applies to all Participating organisations.
4) INDICATION ABOUT DIFFERENT DATE FOR DURATION OF CONTRACT OR STARTING/COMPLETION
Until completion only. Project to be undertaken as a discreet element as part of the pre-go live process only at each Participating Organisation. Once successfully completed and signed off at a participating organisation further iterations are not expected.
5) ADDITIONAL INFORMATION ABOUT LOT Suppliers must include all hardware and software and manpower requirements in their proposal. Suppliers can submit proposals for RIS Data Migration, or PACS Data Migration, or both together. LOT NO: 2. TITLE: RADIOLOGY INFORMATION SYSTEM (RIS) 1) SHORT DESCRIPTION Provision of RIS to be deployed on a Participating Organisation by Participating Organisation basis, or on a consortium basis (one system and database for use by all Participating Organisations on an “Instance” basis as at present) including • A range of application software functionality, the details of which can be found in the PQQ and subsequent Invitation to Participate in Dialogue (ITPD) documentation; • KR note – I have listed some of the requirements below to ensure they are not left out…. • Integrated seamless RIS digital dictation and voice recognition for image examination reporting within the clinical reporting workflow • Project management, implementation and training services; • RIS statistical and management reporting, with full access by Trusts to generate data sets and reports and meet local and national management and minimum data set DSCN reporting requirements; • RIS and PACS full desktop integration; • RIS hardware (e.g. servers, transcriptionist/typist and author dictation equipment, request card and document scanning equipment); • Business continuity solution(s) for RIS, including replication of data to reduce risk of data loss; • Full Patient Record Audit Logging with full online Trust access to interrogate those logs generated by RIS and provide workflow analysis and workstation and software usage intelligence directly to authorised Trust staff via an online system; • Provision of a range of standard documented interfaces to link to other applications including:- o PACS; o A range of different system used by Participating Organisations including:-  Data Warehouses;  Patient Administration Systems (PAS) / Electronic Patient Records (EPRs),  Order Communication and Results Reporting Systems (OCRR);  National Breast Screening System;  “Other Ology” Information and administration systems [such as Cardiology];  Report sharing systems including the Web Image Sharing Portal and Burnbank Image Exchange Portal.
2) COMMON PROCUREMENT VOCABULARY (CPV) 33197000-7 Medical computer equipment, 48814000-7 Medical information systems 48814400-1 Clinical information system 48311100-2 Document management system, 48314000-2 Voice recognition software package 48318000-0 Scanner software package, 3) QUANTITY OR SCOPE.
Applies to all Participating organisations.
4) INDICATION ABOUT DIFFERENT DATE FOR DURATION OF CONTRACT OR STARTING/COMPLETION
Likely to be deployed at Participating Organisations in one deployment replacing the existing system, but with scope to phasing. 5) ADDITIONAL INFORMATION ABOUT LOT None.
LOT NO: 3. TITLE: PICTURE ARCHIVING & COMMUNICATION SYSTEMS (PACS) 1) SHORT DESCRIPTION PACS application software, to be deployed on a Trust or consortium basis, including a. Provision of PACS to be deployed on a Participating Organisation by Participating Organisation basis, or on a consortium basis (one system and database for use by all Participating Organisations on an “Instance” basis), or a mix of, including • A range of application software functionality, the details of which can be found in the PQQ and subsequent Invitation to Participate in Dialogue (ITPD) documentation; • KR note – I have listed some of the requirements below to ensure they are not left out…. • Project management, implementation and training services; • PACS hardware including, as and if required, workstations, diagnostic quality screens, servers, interface engines; • RIS and PACS full desktop integration; • Web based image and report viewer capable of being used by a wide range of users within, and outside of, the consortium members • Audit Logging with online Trust access to interrogate those logs generated by PACS, and provide workflow analysis and workstation and software usage intelligence directly to authorised Trust staff via an online system; • Business continuity solutions for PACS including replication of data to reduce risk of data loss; • Full Patient Record Audit Logging with full online Trust access to interrogate those logs generated by PACS, and provide workflow analysis and workstation and software usage intelligence directly to authorised Trust staff via an online system; • Provision of a range of interfaces to link to other applications including:- o RIS; o A range of different system used by Participating Organisations including:-  Data Warehouses;  Patient Administration Systems (PAS) / Electronic Patient Records (EPRs),  Order Communication and Results Reporting Systems (OCRR);  National Breast Screening System;  “Other Ology” Information and administration systems [such as Cardiology];  Image sharing systems including the Web Image Sharing Portal and Burnbank Image Exchange Portal. • Functionality will entail (without limitation) the provision of integration to the chosen Radiology Information System, modalities and imaging management facilities to enable a Participating Organisation to acquire, process, print, distribute and archive images mainly (but not necessarily exclusively) generated in Diagnostic Imaging Departments within the Participating Organisation. • It will also include functionality to enable other digital images and documents within the Participating Organisations to be stored and accessed, such as, but not limited to other Non Radiology Imaging modalities http://pacsportal.northwest.nhs.uk/trackers/ologies.asp#ShowAll • :- • Cardiology (including ECG and Echo); • Dental (Extra Oral, Intra-oral); • Mammography (Breast Screening, Symptomatic); • Visible Light (Medical Illustration, ; Video Endoscopy); • Ophthalmology • Radiotherapy (Cancer Centre only) • Pathology (Specimen Radiology, Histo-pathology); • Laboratory (Lung Function, Audiology); • Non-Radiology Ultrasound; • Nuclear Medicine; • Scanned documents.
2) COMMON PROCUREMENT VOCABULARY (CPV) 48329000-0 Imaging and archiving system, 33197000-7 Medical computer equipment, 48814000-7 Medical information systems 48814400-1 Clinical information system 48311100-2 Document management system,
3) QUANTITY OR SCOPE.
Applies to all Participating organisations.
4) INDICATION ABOUT DIFFERENT DATE FOR DURATION OF CONTRACT OR STARTING/COMPLETION Likely to be deployed at a Participating Organisations in one deployment replacing the existing system, but with scope to phasing. 5) ADDITIONAL INFORMATION ABOUT LOT None LOT NO: 4. TITLE: IMAGE ARCHIVE 1) SHORT DESCRIPTION • Provision of an Image Archive to store images and other digitised documents capable of being interfaced to RIS and PACS to enable the storage and retrieval if images and electronic documents.. • Details can be found in the PQQ and subsequent Invitation to Participate in Dialogue (ITPD) documentation;
2) COMMON PROCUREMENT VOCABULARY (CPV) 48329000-0 Imaging and archiving system, 48311100-2 Document management system,
3) QUANTITY OR SCOPE.
Applies to all Participating organisations.
4) INDICATION ABOUT DIFFERENT DATE FOR DURATION OF CONTRACT OR STARTING/COMPLETION Likely to be deployed at a Participating Organisations in one deployment replacing the existing system, but with scope to phasing. 5) ADDITIONAL INFORMATION ABOUT LOT None.
LOT NO: 5. TITLE: MANAGED SERVICE 1) SHORT DESCRIPTION • Provision of a managed service on a 365-24-7 basis, that is flexible, scalable, resilient, secure and delivers high performance. • Details of which can be found in the PQQ and subsequent Invitation to Participate in Dialogue (ITPD) documentation; The requirement will include:- • clear service management response and fix times; • realistic supplier penalties for none performance and unscheduled downtime occurrences; • Provision of Help Desk Service with telephone and web based service call capture and progress reporting including email alerts as the calls progress; • Provision of regular service management reports against a defined set of key performance indictors on a quarterly basis linked to payments; • Support for, and during, upgrades. • Allows for amendments to the services and service levels • secure network connectivity Core requirements: A managed application hosting service for RIS and all or elements of PACS (latter to be defined dependent on the architecture of the chose PACS solution and participating organisations) application support, disaster recovery, data hosting and hardware hosting To include hardware, application software, operating system and database management software licences, or re-use therefore from existing estate where this represents value for money to do so. It is anticipated this managed service will operate with a charging model which allows new Participating Organisations to join the managed service with costs varying linearly as the number of Participating Organisations changes. The hosted service provider must demonstrate compliance and alignment with relevant legislative Acts of the United Kingdom, and EU, especially Data Protection Act given that the data held needs to remain highly secure and confidential. The Contract will need to be flexible to cater for additional optional requirements such as: • Addition of new Participating Organisations after contract award; • Removal of Participating Organisations from the managed service with reduction in costs, especially from 2 years before the end of the contract term; • Provision of a range of additional consultancy, training, development services; • Provision of service for enhancements (e.g. upgrades, development, maintenance, tuning) or similar advice, 2) COMMON PROCUREMENT VOCABULARY (CPV) 72514000-1 Computer facilities management services 72514300-4 Facilities management services for computer systems maintenance 3) QUANTITY OR SCOPE.
Applies to all Participating organisations.
4) INDICATION ABOUT DIFFERENT DATE FOR DURATION OF CONTRACT OR STARTING/COMPLETION
The Managed Service will need to be operational prior to the first go live at the first Participating Organisation in order to stand up the application software.
5) ADDITIONAL INFORMATION ABOUT LOT It is anticipated that the successful solution will be predominantly a service based one. It is the expectation of the Contracting Authority to enter into an arrangement for the supply of the required lots that will be structured in a manner that will facilitate VAT recovery by the Contracting Authority on all associated costs of the arrangement under the appropriate NHS VAT Contracted Out Services relief, on the basis that it qualified as a fully managed outsourced service by meeting all the requirements for such arrangements as laid down by the relevant Tax Authority. It is the expectation of the Contracting Authority to enter into an arrangement for the supply of any or some of the lots that will be structured in a manner that will allow all associated costs of the arrangement to be kept off- balance sheet under International Financial Reporting Standards. However the Awarding Authority may also seek solutions based upon a capital investment. Further details of the requirements will be outlined in the PQQ and subsequent ITT documentation.
. II.2.2) Options
II.3) DURATION OF THE CONTRACT OR TIME-LIMIT FOR COMPLETION • Duration in months: 84 (from the award of the contract) with an option to extend to 120 months. • Details can be found in the PQQ and subsequent Invitation to Participate in Dialogue (ITPD) documentation; KR note – duration needs to be confirmed obviously and its phasing by lots will need further thought
SECTION III: LEGAL, ECONOMIC, FINANCIAL AND TECHNICAL INFORMATION III.1) CONDITIONS RELATING TO THE CONTRACT III.1.1) Deposits and guarantees required Deposits and guarantees may be required as set out in the Invitation to Participate in Dialogue (ITPD) documents. The Contracting Authority reserves the right to request parent company and/or other guarantees of financial liability. KR Note – check this III.1.2) Main financing conditions and payment arrangements and/or reference to the relevant provisions regulating them As set out in the ITPD documents. III.1.3) Legal form to be taken by the group of economic operators to whom the contract is to be awarded None specified save that in the case of a partnership or consortia or other groups of more than one legal entity, liability shall be joint and several. In the case of consortia, one legal entity party will act as a prime contractor. Joint and several liability. The awarding authority may award more than 1 contract and these may be for all, or part only, of the services/products required. III.1.4) Other particular conditions to which the performance of the contract is subject No III.2) CONDITIONS FOR PARTICIPATION III.2.1) Personal situation of economic operators, including requirements relating to enrolment on professional or trade registers Information and formalities necessary for evaluating if requirements are met: The pre qualification questionnaire (PQQ), which is available as set out below, will provide all the details required. Any economic operator may be excluded from participation if it fulfils any of the criteria listed in Regulation 23 of the Public Contracts Regulations 2006 (as amended) / Article 45 EU Directive 2004/18/EC.
Information and formalities necessary for evaluating if requirements are met: (a) Is bankrupt or is being wound up, where his affairs are being administered by the court, where he has entered into an arrangement with creditors, where he has suspended business activities or is in any analogous situation arising from a similar procedure under national laws and regulations; (b) Is the subject of proceedings for a declaration of bankruptcy, for an order for compulsory winding up or administration by the court or of an arrangement with creditors or of any other similar proceedings under national laws and regulations; (c) Has been convicted by a judgement which has he force of res judicata in accordance with the legal provisions of the country of any offence concerning his professional conduct; (d) Has been guilty of grave professional misconduct proven by any means which the contracting authorities can demonstrate; (e) Has not fulfilled obligations relating to the payment of social security contributions in accordance with the legal provisions of the country in which he is established or with those of the country of the contracting authority; (f) Has not fulfilled obligations relating to the payment of taxes in accordance with the legal provisions of the country in which he is established or with those of the country of the contracting authority; (g) Is guilty of serious misrepresentation in supplying the information required under this section or has not supplied such information; (h) Has been the subject of a conviction for participation in a criminal organisation as defined in Article 2(1) of Council Joint Action 98/733/JHA; (i) Has been the subject of a conviction for corruption, as defined in Article 3 of the Council Act of 26.5.1972 and Article 3(1) of Council Joint Action 98/742/JHA3 respectively; (j) Has been the subject of a conviction for fraud within the meaning of Article 1 of the Convention relating to the protection of the financial interests of the European Communities; (k) Has been the subject of a conviction for money laundering, as defined in Article 1 of Council Directive 91/308/EEC of 10.6.1991 on prevention of the use of the financial system for the purpose of money laundering. A supplier may be disqualified who does not respond to the following in the requisite manner: Suppliers instructions how to express interest in this tender: 1. Register your company by [ …..INSERT] 2. Express an Interest in the tender by emailing [ …..INSERT] Who will then send you the PQQ/ITT 3. Responding to the PQQ/ITT by the deadline for completion following the instructions to complete the PQQ/ITT, 4. You must then submit your reply by email to [ …..INSERT]. If you require any further assistance please consult the online help, or contact …….. III.2.2) Economic and financial capacity Information and formalities necessary for evaluating if requirements are met: As set out in the PQQ including information and formalities necessary for evaluating if requirements are met: (a) Appropriate statements from banks or, where appropriate, evidence of relevant professional risk indemnity insurance; (b) The presentation of last three year’s accounts, including balance-sheets or extracts from the balance-sheets, where publication of the accounts is required under the law of the country in which the economic operator is established.
Minimum level(s) of standards possibly required As set out in the PQQ. III.2.3) Technical capacity Information and formalities necessary for evaluating if requirements are met: As set out in the PQQ including information and formalities necessary for evaluating if requirements are met: (a) A list of the similar projects carried out over the past five years, accompanied by certificates of satisfactory execution for the most important works. These certificates shall indicate the value, date and site of the works and shall specify whether they were carried out according and properly completed. Where appropriate, the competent authority shall submit these certificates to the contracting authority direct; (b) A list of the principal deliveries effected or the main services provided in the past three years, with the sums, dates and recipients, whether public or private, involved. Evidence of delivery and services provided shall be given: — where the recipient was a contracting authority, in the form of certificates issued or countersigned by the competent authority, — where the recipient was a private purchaser, by the purchaser's certification or, failing this, simply by a declaration by the economic operator; (c) An indication of the technicians or technical bodies involved, whether or not belonging directly to the economic operator's undertaking, especially those responsible for quality control and, in the case of public works contracts, those upon whom the contractor can call in order to carry out the work; (d) A description of the technical facilities and measures used by the supplier or service provider for ensuring quality and the undertaking's study and research facilities; (e) Where the products or services to be supplied are complex or, exceptionally, are required for a special purpose, a check carried out by the contracting authorities or on their behalf by a competent official body of the country in which the supplier or service provider is established, subject to that body's agreement, on the production capacities of the supplier or the technical capacity of the service provider and, if necessary, on the means of study and research which are available to it and the quality control measures it will operate; (f) The educational and professional qualifications of the service provider or contractor and/or those of the undertaking's managerial staff and, in particular, those of the person or persons responsible for providing the services or managing the work; (g) For public works contracts and public services contracts, and only in appropriate cases, an indication of the environmental management measures that the economic operator will be able to apply when performing the contract; (h) A statement of the average annual manpower of the service provider or contractor and the number of managerial staff for the last 3 years; (i) A statement of the tools, plant or technical equipment available to the service provider or contractor for carrying out the contract; (j) An indication of the proportion of the contract which the services provider intends possibly to subcontract; (k) With regard to the products to be supplied: (i) samples, descriptions and/or photographs, the authenticity of which must be certified if the contracting authority so requests; (ii) certificates drawn up by official quality control institutes or agencies of recognised competence attesting the conformity of products clearly identified by references to specifications or standards.
III.2.4) Reserved contracts No III.3) CONDITIONS SPECIFIC TO SERVICES CONTRACTS III.3.1) Execution of the service is reserved to a particular profession No III.3.2) Legal entities should indicate the names and professional qualifications of the staff responsible for the execution of the service SECTION IV: PROCEDURE IV.1) TYPE OF PROCEDURE IV.1.1) Type of procedure Competitive dialogue KR note – very important to choose correct approach – this approach emulates the current All Wales PACS approach. IV.1.2) Limitations on the number of operators who will be invited to tender or to participate
Envisaged minimum number 3 maximum number xx. Objective criteria for choosing the limited number of candidates: As set out in the PQQ.
IV.1.3) Reduction of the number of operators during the negotiation or dialogue Recourse to staged procedure to gradually reduce the number of solutions to be discussed or tenders to be negotiated - Yes IV.2) AWARD CRITERIA IV.2.1) Award criteria The most economically advantageous tender for one or more lots (as the contracts may be awarded in more than one lots to different suppliers) in terms of the criteria stated in the specifications, in the invitation to tender, or to negotiate, or in the descriptive document IV.2.2) An electronic auction will be used No IV.3) ADMINISTRATIVE INFORMATION IV.3.1) File reference number attributed by the contracting authority check IV.3.2) Previous publication(s) concerning the same contract None IV.3.3) Conditions for obtaining specifications and additional documents check IV.3.4) Time-limit for receipt of tenders or requests to participate 26h September - 16:00 IV.3.5) Date of dispatch of invitations to tender or to participate to selected candidates
IV.3.6) Language(s) in which tenders or requests to participate may be drawn up English. IV.3.7) Minimum time frame during which the tenderer must maintain the tender check IV.3.8) Conditions for opening tenders Check
SECTION VI: COMPLEMENTARY INFORMATION VI.1) THIS IS A RECURRENT PROCUREMENT No VI.2) CONTRACT RELATED TO A PROJECT AND/OR PROGRAMME FINANCED BY EU FUNDS No VI.3) ADDITIONAL INFORMATION The Contracting Authority will not accept completed PQQ's after the stated closing date. All tender costs and liabilities incurred by bidders shall be the sole responsibility of the bidders. The Contracting Authority reserves the right to award the contract in whole, in part for different lots, or annul the tendering process and not award any contract. All documents to be priced [where applicable] in sterling and all payments made in sterling. In relation to Section II.1.9 above - variants will be accepted to the extent permitted in the ITPD (if at all). The awarding authority proposes that call-offs from the framework agreement of up 5 years duration may be awarded, but will consider the duration of call-off contracts specifically in dialogue and reserves the right to award a framework contract permitting a longer call-off period if indicated for value for money reasons. KR note – check this
The tendering process may be undertaken in part via electronic means. Any specifications and additional documents will only be issued to the bidders selected at PQQ Stage.
Expressions of interest which are submitted without the information requested may not be considered. The awarding authority reserves the right not to proceed with the process at any stage of the procurement process and shall not be responsible for any abortive bid costs incurred. The right is reserved to award contracts to more than one bidder and to split the award into lots.
The awarding authority reserves the right to also purchase on behalf of other additional local NHS Trust’s who join at a later date as " Partners". The actual contracts awarded along with those Partner Trust(s) who will contract will depend on the dialogue process. GO Reference: GO-201121-PRO-2155132. KR Note – check this VI.4) PROCEDURES FOR APPEAL VI.4.1) Body responsible for appeal procedures Check
VI.4.2) Lodging of appeals Precise information on deadline(s) for lodging appeals: The Authority will allow a minimum 10 calendar day standstill period between notifying the award decision and awarding the contract. Unsuccessful tenderers and applicants are entitled to receive reasons for the decision, including the characteristics and relative advantages of the winning bid and the reasons why the tenderer/applicant was unsuccessful. Should additional information be required it should be requested of the addressee in section I.1. Aggrieved parties who have been harmed or are at risk of harm by breach of the procurement rules have the right to take action in the High Court (England and Wales). Any such action is subject to strict time limits and must be brought promptly in accordance with the Public Contracts (Amendments) Regulations 2009. VI.4.3) Service from which information about the lodging of appeals may be obtained VI.5) DATE OF DISPATCH OF THIS NOTICE: 22.8.2011
Thanks Keith for posting this to enable Trusts to think about how to write an OJEU advert.
There may be variations in approach. You have described 5 lots. Some Trusts may wish to keep it relative simple and leave the data migration to the incumbent PACS & RIS vendor 1. PACS, with enterprise wide display, DICOM image archive for radiology modalities for a data retention period of 7 years (with some exceptions) and DICOM data migration from existing PACS, and project management 2. RIS to support radiology workflow as described in doc and ability to convert & migrate radiology reports into CDA format, meeting data retention period requirements. & project management
"The most economically advantageous tender for one or more lots (as the contracts may be awarded in more than one lots to different suppliers) in terms of the criteria stated in the specifications, in the invitation to tender, or to negotiate, or in the descriptive document " I would be careful of using this statement, as our Trust was challenged by a supplier on Ordercomms when we did not choose the cheapest solution.
I think it is common knowledge that NHS supply chain is coming in to provide a framework for providing PACS & RIS in the NHS (avoiding need for OJEU). I am aware that OJEU is a huge costly excercise for vendors & a huge problem for Trusts.
Provision of a framework via NHS Supply Chain within NHS for PACS & RIS procurement avoiding OJEU is good news with some warnings: 1. Does the framework provide enough competition for RIS & PACS--are there enough good PACS & RIS vendors signing up for this 2. Are the PACS & RIS vendors willing to provide solutions through the framework (is it commercially viable for them)? 3. Will our functional specifications (requirements of those of us who work who use these systems) be met? 4. Will there be direct realtionship between PACS/RIS vendor for support & future development?
I welcome any initiative that improves the process of PACS & RIS replacements. As it is this type of commodotising of IT solutions which will lead of innovation in NHS IT. However, we all know for replacements & migrations to be easy, now & in future, adoption of image (DICOM), document (CDA) & message (HL7) standards are absolutely critical. What Trusts do for PACS & RIS in 2013 will have far reaching consequences for NHS Healthcare IT.
Trusts are required to draw up 1. Clinical Specification 2. Technical/IT Specification in prepartion for OJEU/NHS Framework
Just to clarify Lot 5 MANAGED SERVICE - I was asked about this today - it could just be for "Provision of a off site hosting sevice" - to differentiate that lot from an LSP model (systems integrator)- in case that is not what Trust are looking for, or if they are looking for an LSP look alike then it could be defined in LSP like terms.
I have also had feedback from Order Comms too... a Trust that already has order comms for inpatients has pointed out that one of the key issues they experience is the fact that if a referrer cancels a radiology request it does not automatically cancel on HSS CRIS. This does create quite a lot of problems fo rthem, not least the potential for an unintentional dose of radiation leading to a radiation incident or a wasted slot that could have been given to another patient. So in essence the Trust in question is saying that it may be useful to put something into the advert that asks for the order comm facility to have a 2 way communication between the PAS and RIS......sounds very sensible to me. Views?
posted on Friday, May 06, 2011 - 07:51 am
Hi Keith thats an odd posting as it is impossible to have Order Comms without a bi-directional interface. I wonder, is the site attempting to cancel something from the ward which now belongs to radiology?
The way that OCS works is that the ownership of the Order belongs to the RIS once Radiology accept the order and start scheduling, attending, reporting the patient etc. This is to stop people on the ward cancelling a procedure which you have started work on without your knowledge. For instance you may have ordered radio-isotopes or stock or specialist staff for this procedure.
The customers OCS system should understand that once Radiology have ownership of an order they have no ability to modify it directly. They need to modify the procedure on the RIS which will then cancel / amend / add back to the OCS.
This is not CRIS functionality, this is the way that all OCS integrations work that I have seen in the last 15 years or so.
If this scenario is not the one the customer is experiencing I suggest they check if they are sending the correct HL7 cancellations to CRIS and speak to their CRIS integration partner i.e. CSC or HSS and/or get their TIE people to have a rummage through some messages to see why they are not being processed.
Yes we are talking about orders that have been accepted on CRIS.
If referrers have a cancel button on OCS, then they will use it and all the training and retraining in the world for a constantly rotating set of staff won't safely ensure that they contact Radiology in every event to cancel, as our clinical incident record shows.
I think it would be much safer for the cancellation message to be acted upon by the RIS (obviously up to the point that the exam is actually performed). We would continue to impress upon the referrer that they should contact Radiology to inform them in case appointments have already been sent or radioisotopes ordered etc.
However, I would much rather have a wasted radiopharmaceutical dose or a patient turning up for an appointment that has been cancelled than to actually scan them inappropriately, with the follow-up incident reporting, often externally to the Trust, and having the embarrassment of explaining why the same system has failed yet again. These incidents have increased with the introduction of our OCS.
A short-term alternative might be to take away the cancel button on OCS altogether - maybe this is the case on some systems?
Status Synchronization between RIS, Ordercomms & PACS is key
"D. Change and Cancel requests on Ordercomms Status synchronization between Ordercomms & RIS is key here. An Ordercomms system should only allow a user to cancel or change a request at the “REQUESTED” stage (because until then the radiology department has not dealt with the request).
Once the RIS has taken the request and dealt with it with a status change to—“vetted”, held, “scheduled/appointment given”, “patient arrived/attended”—the Ordercomms should not allow a clinical user to cancel or Change a request. The following message should come up on the Ordercomms system---“this request is now with the radiology department---if you wish to change or cancel please ring extn----“."
This is what we wrote in our group document which has subsequently adopted by RCR
Our OCS does not allow requesters to cancel a request once it has been submitted. We initially thought this would be a problem but hasn't turned out to be. All requesters now know that if they wish to retract a request they have to contact the xray dept, as the vast majority do not have access to or know how to use our RIS. This was DRUMMED into them during OCS training. Allowing OCS to somehow cancel a request in RIS was to allow potential for chaos in our view. Do patients get unnecessary tests as a result? Possibly but the radiographers have got good at looking at the patient's xray history on RIS prior to any examination to check they haven't had a similar exam recently. If a referrer has simply forgotten to contact us to cancel a test, too bad. The audit trail is clear - they are responsible. The radiographer cannot be held accountable for justifying a request in good faith on the basis of incorrect RIS info they had at the time. We also have an alert that pops up in OCS that alerts users to recent similar requests.
It is just as important to know how your RIS posts HL7 messsages back to OCS, especially w.r.t. rejections & alterations created within xray. For example, with our RIS if you change an examination during vetting from a CT to MRI, no notification of this feeds back to OCS until the MRI is performed AND reported. (There are ways round this). This could be days/weeks after the intial request for the CT. Similarly, if you reject a request how do you feed this back to the referrer? Our RIS has no email or messaging function and referrers certainly aren't going to check their 'sent' requests to check if they've been rejected or not. We have set up a rule whereby one of our p.a.s regularly trawls the list that all 'unjustified' requests get put on to and sends a note to the relevant referrer, cut and pasted from what we have typed into RIS, as to why. Finally, one of our biggest safety issues has been busy juniors (usually) requesting tests on the wrong patient. This is not that difficult to do and again is a BIG training issue. It is analagous to picking the wrong sticky label off a shirt sleeve and putting it on a request card. We're only human...
It is complicated and you only learn these details as you go along!
SUMMARY (for this particular thread) - 1. allow OCS cancellation in RIS at your peril (in my view). 2. specify slick alteration and cancellation messaging from RIS back to OCS 3. context specific email/messaging function in RIS highly desirable 4. Make it ABUNDANTLY clear in OCS which patient's episode you are in at the requesting phase - a size 12 font name display in a blue bar at the top of the screen is insufficient in my view.
As per our Ordercomms document: "E. Change and Cancel requests on RIS At vetting stage or later an order maybe cancelled on RIS. Through status synchronization the status in Ordercomms & RIS to cancelled. The reason for changing or cancelling the Request is documented in RIS. The reason for cancellation must populate the results field on Ordercomms. This will allow for appropriate communication to referring teams."
I would suggest using the document or parts of it when specifying Ordercomms & RIS integration with Ordercomms AT THE START OF YOUR PROJECT. Good specification is key to avoiding future headaches.
We have done a lot of work as a group of WORKFLOW STATUS. Insist that OCS, RIS & PACS suppliers conform to workflow status defined by you--and the workflow status ALWAYS in sync between all systems.
How do people think procurements should evaluate supplier Lot offerings?
An example of weighting:- The most economically advantageous tender in terms of:- 1. Cost. Weighting 25 % 2. Financial status. Weighting 10 % 3. Service requirements. Weighting 20 % 4. Functional requirements. Weighting 20 % 5. Experience Weighting 25 %
Would different weights apply to different Lots?
LOT NO: 1. TITLE: RIS and / or PACS LEGACY DATA MIGRATION LOT NO: 2. TITLE: RADIOLOGY INFORMATION SYSTEM (RIS) LOT NO: 3. TITLE: PICTURE ARCHIVING & COMMUNICATION SYSTEMS (PACS) LOT NO: 4. TITLE: IMAGE ARCHIVE LOT NO: 5. TITLE: MANAGED SERVICE / REMOTE SYSTEM HOSTING SERVICE
Of the 12 most recent RIS PACS examples:- Restricted Procedure was used by 7, competitive dialogue by 4 and open procedure by 1 (all listed below).
Wales are using the competitive dialogue procedure for their All Wales PACS project. The majority (7 out of 12) use Restricted (is it faster?). I have listed who is using what at the end.
Choice of procurement procedure :-
Four award procedures are provided for in the Regulations:
• the open procedure, under which all those interested may respond to the advertisement in the OJEU by tendering for the contract;
• the restricted procedure, under which a selection is made of those who respond to the advertisement and only they are invited to submit a tender for the contract. This allows purchasers to avoid having to deal with an overwhelmingly large number of tenders;
• the competitive dialogue procedure, following an OJEU Contract Notice and a selection process, the authority then enters into dialogue with potential bidders, to develop one or more suitable solutions for its requirements and on which chosen bidders will be invited to tender; and
• the negotiated procedure, under which a purchaser may select one or more potential bidders with whom to negotiate the terms of the contract. An advertisement in the OJEU is usually required but, in certain circumstances, described in the Regulations, the contract does not have to be advertised in the OJEU. An example is when, for technical or artistic reasons or because of the protection of exclusive rights, the contract can only be carried out by a particular bidder.
If we are going to do better that last time with CFH contracts with suppliers---we need to get into the suppliers shoes & look at the commercial model they will be pursuing.
I think the big issues with PACS contracts have been lack of responsiveness & poor service provision felt by many. How can we write the contract so that the emphasis moves to a service provision.
Current Commercial models have been dependent on 1. Storage hardware--more storage a Trust buys the more money vendor makes. Making the storage requirements finite will remove that commercial model-- a. define the radiology modalities you will connect now & ones in the pipe b. define data culling after 7 years ----(as per national guidance) c. explicit understanding for adding a new modality & extra storage defined. 2. Display Hardware--PACS companies previously have been dependent on this mark-up for revenue. Define clearly that they will allow you to buy independently based on their specification 3. Specialist Applications---Most PACS vendors also depend on supplying you with modules for specialist display as part of their revenue. MPR, PET-CT, Mammography displays etc now are included within a standard PACS display by most vendors. Make sure this is well specified. Make sure you specify that PACS display will context integrate with 3rd party specialist vendor for Ortho-templating, CAD, CT colon, Cardiac CT so as to ensure PACS vendor does not pursue this commercial selfishness for revenue.
If we can remove these distorted commercial incentives we are more likely to get vendors who pride themselves on their service provision & quality of sofware & meeting workflow requirements.
PACS is not going to be cheap in 2013 but let us hope it will meet the needs for NHS better.
posted on Monday, September 19, 2011 - 12:21 pm
I know Keith has written a more complex advert. However, here is a basic advert of the relevent parts--- if Trusts are simply considering a RIS & PACS replacement (and put the responsibility of migration to the vendors to subcontract). This is based on Imperial & GOSH competitive dialogue OJEU
NOTICE ABSTRACT OJEU/X/X For a 2 separate systems: 1. Radiology information system and 2. Radiology PACS (picture archive and communication system). Suppliers can bid for 1 or both of the systems. The Trust would like to purchase and have supported (for the life of any product) a Radiology information system and a Picture Archiving and Communication System. The systems will be able to operate on a multi-site basis across different clinical specialties with high standards of resilience and performance. The Systems will enable full desktop integration within the clinical reporting workflow. The successful suppliers will be responsible for interfacing its systems with Trust systems and radiology modalities and for data migration. The most appropriate architecture for the Trust, including methods of data/image storage, migration, management and distribution, will be determined through the procurement process. The Systems will be kept updated throughout the contract period to ensure the technology and functionality are kept at the leading edge.
II.1.1) Title attributed to the contract by the contracting authority OJEU/X/X 1. Radiology information system 2. Radiology PACS
II.1.5) Short description of the contract or purchase(s) The Trust would like to purchase and have supported (for the life of any product) 1. Radiology information system and a 2. Radiology PACS (Picture Archiving and Communication system). The systems will be able to operate on a multi-site basis across different clinical specialties with high standards of resilience and performance. The Systems will enable full desktop integration within the clinical reporting workflow. The successful supplier/suppliers will be responsible for integrating its systems with Trust systems and modalities and for data migration. The most appropriate architecture for the Trust, including methods of data/image storage, data migration, management and distribution, will be determined through the procurement process. The Systems will be kept updated throughout the contract period to ensure the technology and functionality are kept at the leading edge.
II.1.8) Division into lots Yes. Tenders should be submitted for one or more lots. LOT 1 –RIS LOT2---Radiology PACS
II.2) QUANTITY OR SCOPE OF THE CONTRACT
II.2.1) Total quantity or scope The purchase, delivery, installation, migration, integration, commissioning, support, upgrades, service/maintenance for the life of the system and allied Services for each of the lots. SECTION III: LEGAL, ECONOMIC, FINANCIAL AND TECHNICAL INFORMATION
SECTION IV: PROCEDURE
IV.1) TYPE OF PROCEDURE
IV.1.1) Type of procedure Competitive dialogue
IV.1.2) Limitations on the number of operators who will be invited to tender or to participate Envisaged minimum number 3 maximum number 5 Objective criteria for choosing the limited number of candidates: The Trust reserves the right to gradually reduce the number of solutions to be discussed or tenders to be negotiated during the process.
IV.1.3) Reduction of the number of operators during the negotiation or dialogue Recourse to staged procedure to gradually reduce the number of solutions to be discussed or tenders to be negotiated Yes
IV.2) AWARD CRITERIA
IV.2.1) Award criteria The most economically advantageous tender in terms of the criteria stated in the specifications, in the invitation to tender or to negotiate or in the descriptive document
A number of Trusts recently are including VNA in their PACS/RIS Replacements. Hence, I have put some sample wordings of some of the relevant sections for a PACS, RIS & VNA which I hope you find useful to send to your procurement team when they are drawing up the adverts for you.