NHS
NHS
Modernisation Agency
National Programme for
Information Technology
National PACS Team (NPfIT) and National
Radiology Service Improvement Team (MA)
PACS Benefits Realisation and
Service Redesign Opportunities
National Radiology Service
Improvement Team
NHS Modernisation Agency
3rd Floor
St John’s House
East Street
Leicester
LE1 6NB
National PACS Team
National Programme for
Information Technology
2nd Floor
St John’s House
East Street
Leicester
LE1 6NB
Tel: 0116 222 5100
Fax: 0116 222 5101
Tel: 0116 222 5100
Fax: 0116 222 5101
www.modern.nhs.uk/radiology
www.npfit.nhs.uk
The NHS Modernisation Agency is
part of the Department of Health
National PACS Team (NPfIT) and National Radiology Service Improvement Team (MA)
Contents
Introduction
4
Section 1
Benefits realisation – general benefits
identified by participating sites
7
Section 2
Benefits and redesign opportunities
18
Section 3
Lessons learned
23
Section 4
The bigger picture – organisational benefits
26
Section 5
Strategic benefits
31
Section 6
Future vision and directions
32
Section 7
NHS Plan delivery
35
Glossary of terms
53
Further reading and key links
53
PACS Benefits Realisation and Service Redesign Opportunities - 3
National PACS Team (NPfIT) and National Radiology Service Improvement Team (MA)
National PACS Team (NPfIT) and National Radiology Service Improvement Team (MA)
Introduction
The Potential of PACS (Picture Archiving and Communications Systems)
“Delivering the NHS Plan” (April 2002) set at its heart a vision of a patient
centred service offering more choice, leading to improved services for all patients
and staff, including healthcare outcomes and improved value for money. PACS
has a very pivotal and extensive role to play in the delivery of the NHS plan.
It lies at the heart of modernisation of the NHS IT infrastructure, and is
inexorably linked to service improvement, advancing technology and a changing
and developing workforce. PACS therefore has an amazing potential for the
modernisation of service delivery for both patients and staff. PACS is a
computer system that captures, stores, distributes and displays digitised images.
Images can be relayed to any destination capable of receiving them, and can be
reviewed in different destinations simultaneously. Improving the imaging of
patients in healthcare will inevitably increase the efficiency of the healthcare
system as a whole. This document sets out to demonstrate the impact that
PACS can have across the wider healthcare community.
Roy Male Chief Executive Officer, Blackpool Victoria Hospital,
(Blackpool Fylde and Wyre NHS Hospital Trust) has said:
“Putting all the technical and other benefits of going filmless aside, to my mind
the true impact of PACS is that it has demonstrated real benefit to clinicians in
their day to day work from IT systems. It changes the whole perception of IT
from the back office to the clinical arena.”
Paul Unsworth, Chief Executive Tendering PCT has said:
“This is a very helpful report which demonstrates from the pilot sites the benefits
to be delivered from PACS and breaks them down by qualitative, quantitive (non
cash releasing) and cash releasing. It is our responsibility as commissioners and
providers of health services to ensure we get maximum health gain from PACS in
each of these areas. Therefore, there should be a well constructed plan to
quantify and realise these benefits supported by strong performance
management throughout the programme to justify this sizable but welcome
investment.”
4 - PACS Benefits Realisation and Service Redesign Opportunities
This document is designed to assist NHS managers to take full advantage of the
introduction of PACS through sharing the experience of users to date. It is a guide
to the potential and realisable benefits offered by the technology from clinical and
managerial perspectives in a range of service areas. The objective is to deliver the
best possible outcomes for patient care.
The Evidence
Initially four sites were brought together for an exploration exercise, each site had
a history of service redesign and full PACS. A day was spent exploring the benefits,
lessons learned, impact on targets and the service redesign opportunities that
PACS has demonstrated. It is accepted that PACS should not be limited to acute
trusts but should be deployed throughout the healthcare community. It should
also be linked to training establishments, and include numerous imaging
specialities eg Radiology, Pathology, Endoscopy, Ophthalmology and Dermatology
to name just some. PACS should support the wider modernisation of health
services.
The information in this report represents the experiences of the four sites and
serves as a checklist that will demonstrate the benefits that can be achieved and
where redesign opportunities exist for a whole range of users.
It is envisaged that more information will be needed from other sites to confirm
the messages in this document, and this will be one of the next steps. A further
step will be the exploration of the concept of the extension of PACS to other
specialities that generate digital images or images capable of digitalisation in their
services.
The sections are clearly laid out in the document and can be read in isolation
if desired.
PACS Benefits Realisation and Service Redesign Opportunities - 5
National PACS Team (NPfIT) and National Radiology Service Improvement Team (MA)
National PACS Team (NPfIT) and National Radiology Service Improvement Team (MA)
Section 1
Benefits realisation - general
benefits identified by
participating sites
The introduction of PACS in the NHS in England opens up potential
to deliver a range of benefits to patients. Clinicians will be able to
access images taken at stages along pathways and readily access
relevant patient records. This will streamline care and speed up
diagnosis and treatment.
PACS offers the opportunity for radiology reporting to be done
remotely, utilising telemedicine and potentially facilitating much more
flexible working of radiologists who will be able to access images on
a 24-hour, seven day a week basis. It challenges traditional radiology
reporting structures and encourages organisational review and
reconfiguration of imaging services across health communities for
maximum efficiency.
Critically, used to its maximum potential, PACS will be pivitol in all
imaging to delivering the objective set out in the NHS Plan, a
maximum wait of 18 weeks from the point of referral to the start of
treatment. With the enabling of imaging services in primary care,
PACS also underpins the concept of choice in imaging services.
This section provides a comprehensive list of benefits that can be
gained from the implementation of PACS and service redesign. The
degree to which any benefit will be “cash releasing”, “non-cash
releasing” , “quantitative” and “qualitative” will obviously
depend upon the position of a department prior to PACS
implementation, the realisation of benefits within a period of time
will also vary.
Benefits have been listed with their dependencies, to provide an
‘at a glance’ insight into:
•
•
•
•
6 - PACS Benefits Realisation and Service Redesign Opportunities
Clinical Benefits
Patient Benefits
Staff Benefits
Business Benefits
PACS Benefits Realisation and Service Redesign Opportunities - 7
National PACS Team (NPfIT) and National Radiology Service Improvement Team (MA)
BENEFITS
National PACS Team (NPfIT) and National Radiology Service Improvement Team (MA)
BENEFITS
£ Cash
releasing
Quantitative
non-cash
releasing
Qualitative
Dependency
Who Benefits
£ Cash
releasing
Direct benefits from implementing PACS
CLINICAL
Image and Report
Availability and Transfer
Image and Report
Availability and Transfer
A&E waiting times reduced,
images quickly available,
opportunity for quicker
reporting.
Benefits other departments
(access to IT), other
departments able to
remotely access relevant
images and reports for
patients.
No lost images, less wasted
time for staff hunting
images and reports. Images
and reports instantaneously
available to clinicians at any
destination.
Home access ‘on call’,
clinicians can successfully
work from home where
appropriate, to give expert
advice at the most
appropriate time.
Communication with other
departments, instant
information transferred
electronically across single
or multiple organisations.
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Appropriate
workstations and
reporting areas.
Patient, Trust,
Clinicians,
Primary Care
Appropriate staff
available with skills to
allow process to work
eg. Reporting clinical
staff.
Patient, Trust
Appropriate sitting
and provision of
viewing stations.
Patient, Trust,
Clinicians,
Clinical staff
Rapid image availability for
wards, clinics, other areas,
images remotely available
any time any place.
Multiple viewing of images,
numerous specialists in
various locations can view
images simultaneously.
Clinical outcome of IRMER
improved, good quality
images at source no repeat
imaging.
Y
Y
Dependency
Who Benefits
Consistency of
comparability of images
(clinical governance and
audit)
Y
Patient, Trust,
Clinicians,
Clinical staff
Improved knowledge
management, up to date
information and results for
patients allowing for
appropriate patient
management decisions.
Suitable technology at
home to ensure
appropriate transfer of
patient information,
images and safety of
information.
Clinicians,
Clinical staff,
Patients
Y
Full PACS availability
across healthcare
community.
Trust, Radiology
department
Teaching, images available
in PACS mode will be
extremely versatile and
transportable for teaching
purposes, especially in
training academies. Access
to speciality opinion and
teaching will be possible.
Linking of modalities, ability
to view images from various
modalities simultaneously.
Y
Y
Y
Full PACS availability
across healthcare
community.
Patient, Trust,
Clinicians,
Clinical staff
Staff are fully
competent and
confident with the
PACS system.
Patient, Trust
Appropriate archiving
facility.
Clinician
Full PACS availability
across healthcare
community.
Trust, Patient,
Clinician,
Clinical staff
Full PACS systems in
place across
organisations. Training
academies with IT of
appropriate
specifications.
Clinicians,
Clinical staff
Full PACS systems in
place.
Clinicians, Patient,
Y
Y
Y
Clinicians must be able
to use IT and there
must be sufficient
viewing stations
available.
8 - PACS Benefits Realisation and Service Redesign Opportunities
Qualitative
Direct benefits from implementing PACS
CLINICAL
Shorter reporting times,
images immediately
available, no manual
handling of analogue
images.
Quantitative
non-cash
releasing
PACS Benefits Realisation and Service Redesign Opportunities - 9
National PACS Team (NPfIT) and National Radiology Service Improvement Team (MA)
BENEFITS
National PACS Team (NPfIT) and National Radiology Service Improvement Team (MA)
BENEFITS
£ Cash
releasing
Quantitative
non-cash
releasing
Qualitative
Dependency
Who Benefits
£ Cash
releasing
Direct benefits from implementing PACS
CLINICAL
Image and Report
Availability and Transfer
Image and Report
Availability and Transfer
Y
Research, long term
availability of a
comprehensive set of
images and reports for
patients will aid those
carrying out research.
Y
Near patient image viewing
i.e. patients in clinical
cubicles, beds or patients in
GP surgeries. Patient
satisfaction, high quality
intervention at consultation
times by appropriate
people. Images and reports
available at any stage of the
patient’s journey.
Reduction in hardware costs
(e.g. reduction of film
costs).
Ease of consultation
between clinicians, clinicians
can consult in real time with
the ability to view images
simultaneously.
Clinicians assisted, quick
viewing of images and
previous images
instantaneously available.
Y
Y
Qualitative
Dependency
Who Benefits
Direct benefits from implementing PACS
CLINICAL
No “plastics” (temporary
envelopes), all patients
images include previous
images, available in one
place.
Quantitative
non-cash
releasing
No image printing –
consider patients with
previous analogue
images.
Trust, Clinicians,
Clinical staff
Availability of images
electronically –
consider previous nondigital images.
Patient, Clinicians
Appropriate
specification and
availability of
workstations etc.
Patient, Clinicians
Elimination of time wasting
for junior doctors re film
management, junior doctors
will not have to chase
images and reports they will
be available at the
destination of the junior
doctors.
Improved quality of image,
reduced repeat images due
to poor quality. Image
manipulation allowing
reporting clinicians more
versatility for image viewing
for diagnosis.
Free transfer of images
between institutions will
provide knowledge and
learning.
Y
Trust, DOH,
Economics,
Environment,
Patient
Staff must be fully
conversant with digital
systems, excellent
digital acquisition
systems.
Patient, Trust
Clinicians,
Clinical staff
Y
Willingness of
clinicians to share
expertise and
knowledge.
Patient,
Clinicians,
Clinical Staff
Trust, Patient,
DOH
Y
The rest of the process
must work well eg
discharge plans,
consultant ward rounds
or nurse-led discharge to
take out medicines
Y
Availability of sufficient
viewing and workstations
across organisations.
Clinicians
Clinical staff
Admin & clerical
Y
Sufficient viewing and
workstations available
throughout organisation.
Adequate quality PACS
and RIS systems and
good quality interfaces.
Patient,
Clinician, PCT,
SHA, Trust
Y
Y
Y
Sufficient workstations
and IT competence for
clinicians.
Y
Y
Y
Healthcare Process
Y
Y
Y
Y
Y
Y
Y
Y
Full PACS available
across organisations.
Full PACS available
across organisations.
Trust, Patient
Trust, Patient
Clinicians
Contribution to decreased
length of patient stay,
images and reports available
at destination in a timely
fashion, can potentially
accelerate patient discharge.
Reduced phone calls, fewer
interruptions, fewer queries
regarding reports or images.
Sufficient workstations
or viewing areas.
10 - PACS Benefits Realisation and Service Redesign Opportunities
Patient, Trust,
Clinicians
Reports attached to image
comprehensive patient
imaging record available.
Y
Y
Y
Y
Y
PACS Benefits Realisation and Service Redesign Opportunities - 11
National PACS Team (NPfIT) and National Radiology Service Improvement Team (MA)
BENEFITS
National PACS Team (NPfIT) and National Radiology Service Improvement Team (MA)
BENEFITS
£ Cash
releasing
Quantitative
non-cash
releasing
Qualitative
Dependency
Who Benefits
£ Cash
releasing
Direct benefits from implementing PACS
Dependency
Who Benefits
STAFF
Y
CHOICE – Potentially the
cross site availability of
electronic images and
reports can contribute to
patients desire to exercise
choice of location for
treatment.
NEAR PATIENT IMAGE
VIEWING – Patients in
clinical consultation areas,
beds or patients in GP
surgeries. Patient
satisfaction, high quality
intervention at consultation
times by appropriate
people. Images and reports
available at any stage of the
patient’s journey.
Qualitative
Direct benefits from implementing PACS
PATIENT
MDT – Links to other
centres, complies with the
standard that every patient
with cancer must be
discussed at MDT meetings.
Quantitative
non-cash
releasing
Y
Y
Appropriate IT systems
at all places
participating in MDTs
good timing between
them and a main
archive.
Patient (access to
third or specialist
opinion),
Clinicians
Full PACS available
across healthcare
community and
between communities.
Patient
Appropriate
specification and
availability of
workstations etc.
Y
Y
Patient,
Clinicians
Improved Working
Lives
Reduced stress levels,
happier staff, improved
processes that improves
working lives, less time
wasted in futile tasks.
Reduced paperwork,
electronically generated and
held reports lead to less
paper shuffling and less
stationery costs.
No chemicals , Control of
Substances Hazardous to
Health (COSHH), reduced
hazard to staff and reduced
costs. Improved working
environment.
Y
Y
Y
Y
Y
Y
Y
Redesign of processes
and PACS
implementation
supporting the
redesigned processes.
Patient, Trust,
Clinical staff,
Clinicians, Admin
& Clerical, Porters,
Organisation as a
whole (reduced
grievances)
No image or report
printing except in
exceptional
circumstances
ie non PACS unit
Trust (less
stationery costs)
Admin & Clerical
Assume no film
printing or very little
film printing in special
circumstances only.
Trust,
Clinical staff,
Environment
Timely IT training and
competency
assessment, priority
given to being able to
navigate the system.
Clinicians,
Clinical staff,
Admin & Clerical,
(Lifelong learning
for IT)
Flexible use of
resources, both human
and material.
Patient, Trust,
Clinicians,
Clinical staff,
Porters
Staff Development
Staff development (IT
literacy), staff need to be
fully conversant with the IT
system that produces,
manipulates and transfers
images, this will lead to
staff competence and
confidence.
Redesigned department
and workflow, streamlined
patient processes and
improved electronic
pathways will allow staff
to work very differently.
12 - PACS Benefits Realisation and Service Redesign Opportunities
Y
Y
Y
Y
Y
PACS Benefits Realisation and Service Redesign Opportunities - 13
National PACS Team (NPfIT) and National Radiology Service Improvement Team (MA)
BENEFITS
National PACS Team (NPfIT) and National Radiology Service Improvement Team (MA)
BENEFITS
£ Cash
releasing
Quantitative
non-cash
releasing
Qualitative
Dependency
Who Benefits
£ Cash
releasing
Direct benefits from implementing PACS
BUSINESS
Health Care Process
Health Care Process
Reduced transport costs,
there will be no need for
the physical transportation
of either images or paper
reports these will all be
available at any destination
electronically.
Healthcare efficiency,
diagnostic procedures
become much more
streamlined leading to more
effective and efficient
hospital treatment, patient
flow and more effective
primary care.
Reduced downtime of
equipment compared to
chemical “processing”, less
equipment to maintain and
less equipment failure.
“Sceptics converted”, good
planning and
implementation overcoming
original fears of systems
failure.
Fully integrated
radiology information
system with PACS.
Y
Y
Y
Full PACS availability
across healthcare
community.
Y
Patient, Trust,
Clinician,
Clinical staff
Y
Commitment to no
printing of images or
reports.
Y
Qualitative
Dependency
Who Benefits
Direct benefits from implementing PACS
BUSINESS
Reduced waiting times,
appointments and time
within department,
streamlined process which
leads to a more efficient
service procedure at
appointment stage and on
day of diagnostic test.
Quantitative
non-cash
releasing
Trust, PCT
Trust, Patient,
SHA, PCT
Y
Redefined staff roles, new
ways of working as a result
of streamlined process, role
enrichment opportunities,
better usage of staff skills.
More quality time with
patient.
Y
Outsourcing reporting,
where a department cannot
cope for capacity reasons
with the reporting work
load images requiring
reporting can potentially be
transported to other
reporting centres. PACS
offers the opportunity for
reorganisation of radiology
reporting to make the most
efficient use of resources
through telemedicine
/remote image reporting.
Y
Y
Y
Must be able to
redesign workflow of
the department and
take opportunities to
work differently.
Trust, Clinical
staff, Clinicians,
DOH
Clinically sound
reporting service
available at other sites
within UK and
without.
Trust, Patients,
Clinicians
Capital and revenue
costs of PACS,
displaced staff
appropriately and
satisfactory redeployed
in a new system.
Trust, SHA (less
procedure cost
per patient),
Patient
Y
Financial Aspects
Y
Y
Y
Y
Y
No conventional film
processing
undertaken.
Excellent planning and
good PACS manager
in place.
14 - PACS Benefits Realisation and Service Redesign Opportunities
Patient, Trust,
Clinician,
Clinical staff
Trust, Clinicians,
Clinical staff
Financial savings, there is
potential for financial
savings in the area of more
appropriate use of staff
cost, saving on chemistry
and machine maintenance.
However these benefits
must be viewed against
original capital out lay and
costs.
Y
PACS Benefits Realisation and Service Redesign Opportunities - 15
National PACS Team (NPfIT) and National Radiology Service Improvement Team (MA)
BENEFITS
National PACS Team (NPfIT) and National Radiology Service Improvement Team (MA)
BENEFITS
£ Cash
releasing
Quantitative
non-cash
releasing
Qualitative
Dependency
Who Benefits
£ Cash
releasing
Direct benefits from implementing PACS
BUSINESS
Financial Aspects
Medico-legal images
Y
Y
Adherence to policies
around imaging and
reporting ensuring
that images and
reports are always up
to date and sorted
centrally.
Trust
Y
Dependency
Who Benefits
Medico-legal images
converted to CD ROM, no
longer have to pull films
physically, no packaging and
no posting
Y
Y
Y
Sufficient IT to view in
solicitors destinations.
Discussions should
begin early.
Trust,
Patient
Flexibility in the
approach to the use of
resources, need for
more flexible budgets
Patient (services
closer to home),
SHA, DOH
These benefits will
only be realised with
full PACS systems,
including at satellite
sites.
Patient,
Environment,
Trust,Clinical
Staff
Redesign the way the
department will be
working, use of PACS
to support effective
workflow, etc.
Patient, Trust
Clinicians,
Clinical staff
Capacity Planning
Comprehensive Patient
Record
Aids audit and Clinical
Governance, ready
availability of images and
reports and continuity of
care.
Qualitative
Direct benefits from implementing PACS
BUSINESS
Reduced litigation costs,
potentially because no films
or reports will be lost and
images and reports will
always be available in a
timely fashion, for
appropriate patient
management, this could
lead to less litigation costs.
Quantitative
non-cash
releasing
Good RIS and PACS
system Integrations.
Patient, Trust,
Clinician
Delivery of the NPfIT
Programme.
DOH, SHA
Trust, Patient
Y
Service Reconfiguration, the
image availability and
transportability of PACS will
aid service reconfiguration
and help address demand
and capacity issues. There
is a potential for sharing
examination and reporting
capacity.
Y
Y
Y
Environmental Issues
Supports the development
of ICRS, in line with the
NPfIT programme for
comprehensive patient
records.
Security of images, patient
confidence up held by a
security system, all images
held together centrally.
Y
Y
Y
Y
Y
Individual systems
must be totally secure.
16 - PACS Benefits Realisation and Service Redesign Opportunities
Patient, Trust
Less background radiation
(less unnecessary exposures)
less chemistry and pollution.
However consider energy
use especially where air
conditioning units are
required.
Film storage eliminated, less
physical space required, No
manual filing or pulling of
images and reports.
Y
Y
Y
Y
Y
PACS Benefits Realisation and Service Redesign Opportunities - 17
National PACS Team (NPfIT) and National Radiology Service Improvement Team (MA)
National PACS Team (NPfIT) and National Radiology Service Improvement Team (MA)
Section 2
Benefits and redesign
opportunities
This section identifies how particular benefits have strong links
to service redesign.
Representatives from the sites agreed that implementation of
PACS would only be truly beneficial along with the appropriate
service redesign. In some situations the service redesign may
have taken place prior to PACS implementation or may take
place alongside PACS implementation.
It is hoped that this section will give the reader a valuable
insight into the possibilities of different types of redesign, to
establish a robust and sustainable PACS benefits maximisation.
To achieve the NHS of the 21st Century departments need to
consider different and innovative ways of working. PACS
implementation offers an ideal opportunity to reassess working
patterns and be at the forefront of truly effective service
redesign.
18 - PACS Benefits Realisation and Service Redesign Opportunities
PACS Benefits Realisation and Service Redesign Opportunities - 19
National PACS Team (NPfIT) and National Radiology Service Improvement Team (MA)
National PACS Team (NPfIT) and National Radiology Service Improvement Team (MA)
General benefits and redesign opportunities
BENEFITS
REDESIGN LINKS
BENEFITS
REDESIGN LINKS
Redefined staff roles
PACS will fundamentally alter some departmental staff roles. Instant
availability of electronic images means that valuable staff will no longer have
to chase film packets and reports meaning that their skills can be better
utilised. Clerical and administrative staff and former ‘dark room’ staff are
capable of taking enriched roles and are able to take up opportunities to
undertake studies to extend their roles. The Changing Workforce Program
has evidence of such changes.
Speed and ease of MDTs
PACS, with appropriate structure, applications and links across a whole
health care community can lead to fully informed MDT meetings.
Remote reporting
Reports for images can be generated from remote areas allowing images to
be accessed by appropriate experts wherever they are and therefore quality
reports to be sent rapidly back to the referrer.
Release of storage space
Physically, PACS releases significant space with the removal of old
equipment and minimal space required for the storing of images.
Multiple location image availability
and rapid reporting turnaround
times
Network upgrade and appropriate workstations. Work-list production and
PACS reporting room. Increasing the number of PCs for viewing around the
hospital means that images are available quickly. The production of a worklist and a PACS reporting room allows for faster reporting. There are benefits
from links to other centres, with image transmission externally. Centralised
reporting is possible and radiologists could report across health communities,
with easier access to specialist opinion.
Comparison and availability of
previous studies
PACS allows an easier comparison when previous studies are available
digitally, the early availability of such images saves a significant amount of
staff time and frustration.
Staff development IT literacy
There is a need for staff development such as European Common Driving
License ECD ROML, for IT.
Teaching, audit and research
A museum archive. There is a great improvement in the availability of
images for teaching because of the archive. Improved way of delivering
education and passing on knowledge, more easily accessible and quicker
links.
Electronic links to other Trusts and
organisations
Image transmission externally across healthcare community.
Communication with other
departments
PACS allows for rapid transfer of images and reports in a timely package,
hence providing efficient and effective communication.
Improved information flow and
knowledge management.
PACS will allow for improved information flow. It will also contribute to a
comprehensive patient record, leading ultimately to an improved quality of
care for the patient. Paper records will be superseded by electronically
transferred data in a timely and dynamic fashion.
Teaching and Learning
Digital projection, MDTs, Smart Board, cascade learning, lecture preparation
and medical photography.
Audit and Clinical Governance
Consistent image display for clinical conferencing Dicom 14 and Integrated
Healthcare Enterprise (IHE).
Redesign department processes
The hospital’s IT and departmental IT networks may have to be redesigned
alongside both physical and geographical redesign efforts.
Service reconfiguration
Future planning. The potential for choice for patients improving the quality
of care; images available at any time anywhere would make this more
feasible. Image, report and opinion availability leads to more flexible
reconfiguration.
Environment
Reduced paperwork in radiology
Physical layout and COSHH needs to be considered. Designing the
appropriate environment around PACS leads to an improved clinical
environment and more staff satisfaction. The environment is improved due
to reduced Health and Safety risk.
PACS implementation means that there is no longer a need for transferral of
paper based information. This effects the typing of reports referrals into the
service and booking of appointments.
Reduce radiation doses for patients
Redesigned acquisition phase of imaging. There are less repeat images and
therefore the potential for lower patient dose.
Preparation for MDTs
Data preparation can be carried out quickly and effectively by both clerical
and clinical staff.
Medico-legal cost savings
Digital images easily located and dropped onto CD ROM. There are medico
legal cost savings, images are now presented on a CD ROM.
Medico-legal cost savings
CD ROM. Legal cases images are produced on CD ROM quickly from
archive where available. Cost savings achieved.
The improved process times involved when PACS is introduced can lead to a
more streamlined service in general. Results include the potential for
reduced length of stay and cross modality streamlined processes.
Outsourcing reporting
Improved process time
CD ROM or direct image transfer. There is the potential for outsourcing
reporting, if direct PACS links are not available then images can be
transferred to CD ROM.
Redesign of RIS around PACS (and network) including interface, electronic
diary, post exam screen, clinical comments etc. The reports for images are
now available with the images, across the network involved close linking of
RIS and PACS.
Security of images
Rapid report availability attached to
images
Back-up processes. There is security for images and a back up process which
builds in resilience. Need for excellent PACS manager.
Clinical Governance
Robust contingency planning in line with clinical governance. Future
planning.
The readers attention is drawn to the following document: PACS Practical Experiences
20 - PACS Benefits Realisation and Service Redesign Opportunities
PACS Benefits Realisation and Service Redesign Opportunities - 21
National PACS Team (NPfIT) and National Radiology Service Improvement Team (MA)
National PACS Team (NPfIT) and National Radiology Service Improvement Team (MA)
Section 3
Lessons learned
This document would not be complete if we did not
acknowledge that along with the vast array of benefits that
accompany the implementation of PACS, there are also aspects
that were identified by the representatives from the
participating sites, as lessons learned.
This section is a record of these issues.
The representatives were asked what they have learned and
what they would have done differently.
22 - PACS Benefits Realisation and Service Redesign Opportunities
PACS Benefits Realisation and Service Redesign Opportunities - 23
National PACS Team (NPfIT) and National Radiology Service Improvement Team (MA)
National PACS Team (NPfIT) and National Radiology Service Improvement Team (MA)
Lessons Learned
Benefits Realisation – Time Scales
Transition Issues
Role Redesign
Unsuitable New Accommodation
General Comments
Benefits realised will depend upon
where you are now with respect to
electronic processes, equipment,
staffing and space. Not all benefits
will be realised instantaneously,
some cost benefits may only become
apparent after a period of time.
Some benefits attributed to different
ways of working may be realised
immediately.
This issue has become very apparent
around Multi Disciplinary Team
meetings, especially where there is
cross-site involvement. Where the
technology differs from one site to
another there are issues to consider
with respect to viewing images at
MDTs, how the images will be
supplied and equipment necessary
to view them.
It is important to consider early on
what impact PACS implementation
will have upon the way in which
people will be working. One of the
most obvious areas is that of clerical
and administrative roles. It is crucial
to plan for different ways of working
and it has been the experience of
some departments that some staff
can potentially be ‘displaced’.
Several general comments from a
less tangible aspect were alluded to,
but the sites recognised them as
real. They included work rates for
radiologists and secretaries; these
could begin to increase without
necessarily being recognised. Also
included were:
Upfront Cost Implications
Thought needs to be given to digital
equipment and image management
when equipment belongs to a
department not linked to PACS.
How will everything be linked up?
For example, ultrasound
examinations performed on
equipment not directly linked to a
main PACS department.
Additional Staff, such as a system
administrator will be required, the
role of radiology secretary may well
change with the introduction of a
voice recognition system.
One site in particular recognised that
unsuitable new accommodation can
have a serious effect on the working
environment with PACS; there is a
need to consider all aspects of
implementation for PACS. For
example, appropriate air
conditioning in PACS reporting
areas. Risk Assessment of all areas
with major equipment installations is
advisable. There is a need for
security of areas with several
expensive workstations. There is a
need to establish fireproof status
and process controls for computer
server rooms.
There are local cost implications:
• A good, electronic network system
throughout the unit or healthcare
community.
• Sufficient PC workstations and
clinical viewing stations.
• A dedicated PACS manager.
New Ways Of Working
There is a need to consider the
redesign of the existing department.
Space will be released and there will
need to be space for specific
activities such as reporting.
However, lessons from the sites
suggest that there will need to be
innovative thinking about how and
where activities take place.
Many users have found an airconditioned digital reporting room
to be an excellent resource for
increasing efficiency in reporting and
as a learning environment for staff.
Supportive Technology
Voice recognition systems are seen
as a potential positive innovation.
Evidence suggests that there are
some excellent systems available, the
concept is well supported and its
benefits acknowledged. PACS/RIS
Links and interfaces have been
identified as one of the main
difficulties to overcome . Redesign
associated with implementing voice
recognition will bring about:
• Changes in the role of the
radiology secretary.
• Improvements in reporting times.
• Real time reporting.
• What is the best way to work with
a new digital system?
• What challenges exist for altering
traditional ways of doing things?
These are challenges across the
entire patient process from referral
to report disseminated.
24 - PACS Benefits Realisation and Service Redesign Opportunities
• Identification of the impact on
staff roles should be carried out at
an early stage.
• Consider staff opportunities for
redeployment.
• Continuous good quality
communications is essential.
• Early involvement of the Human
Resource department is important.
Work-life Balance
The potential for stress emanating
from an alleged 24-hour availability
was identified. Unless expectations
are managed, the work-life balance
can be disturbed. There is the
potential for an unlimited call on an
individuals time. There needs to be
an established, accepted way of
working, including flexible working
using ‘at home’ technology.
Protocols
Establishing protocols at an early
stage was seen as beneficial to avoid
certain pitfalls, examples include:
• Loss of autonomy and control.
• Lack of urgency where there is no
visible workload, means, no piles
of paper and images.
• There is potential for de-skilling
with a completely digitised system.
There is a need to have plenty of
staff information about what’s
happening and issues and
concerns, and to involve staff
across the organisation.
• Clinical colleagues acting on all
electronically routed images before
the formal report is available
means that operator errors can go
unquestioned.
• Where radiology is a ‘gate
keeping’ service the rapid return of
reports is not to everyone’s
satisfaction.
This could be managed by
establishing protocols for ‘at home
working’ Additionally it may prove to
be an advantage to support flexible
working using at home technology.
PACS Benefits Realisation and Service Redesign Opportunities - 25
National PACS Team (NPfIT) and National Radiology Service Improvement Team (MA)
National PACS Team (NPfIT) and National Radiology Service Improvement Team (MA)
Section 4
The bigger picture organisational benefits
This section includes benefits specifically related to the wider
organisations. It includes benefits linked to inpatients and
outpatients, primary care and specifically changing workforce
issues.
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PACS Benefits Realisation and Service Redesign Opportunities - 27
National PACS Team (NPfIT) and National Radiology Service Improvement Team (MA)
National PACS Team (NPfIT) and National Radiology Service Improvement Team (MA)
Organisational benefits
Inpatient benefits
• Quicker reporting turnaround times, dependant on local circumstances –
reports attached to images
• Images available instantly between departments
• No lost images
• Near patient image viewing e.g. bedside, theatre, clinics and GP surgeries
• Home access on-call – expert advice at the most appropriate time
• Public expectation, reports and images available at any point through the
patient’s journey
• Elimination of wasted junior doctors time, less searching for forms and
reports
• Consistency of comparability of images.
Changing workforce
• Redefined staff roles
• Teaching and learning
• Redefined clerical roles, the PACS system has altered the way in which
the clerical staff need to work
• Clerical and darkroom staff are now helpers and assistants
• Role redesign for some staff. Staff have new roles as receptionists and
helpers
• Instant availability of images means valuable staff do not chase films, packets
and reports, they can be utilised more effectively elsewhere
• An Imaging support worker (formally a darkroom technician) became
assistant practitioner.
Outpatient benefits
•
•
•
•
Emergency care patients
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
Primary care benefits
•
•
•
•
•
•
•
•
•
•
•
•
Quicker reporting turnaround times dependant on local circumstances
No lost images
Near patient image viewing
Public expectation, reports and images available at any point through the
patients journey
Improved quality of image, image manipulation
Reduced dose to patient
Streamlined patient processes in department
Reduced waiting times for appointments, radiology and operations
Increased patient satisfaction
Ease of consultation between clinicians, simultaneous viewing of images
Choice for patients, Choice of location for treatment
Reduced transport costs between sites
Improved knowledge management – up to date information and results
for patients allowing appropriate patient management decisions.
Reports attached to images, comprehensive patient imaging record available
Shorter reporting times and more rapid turn around times
Aids audit and clinical governance, continuity of care
Multiple viewing of images at different destinations simultaneously
Near patient image viewing in GP surgery
Security of images, images held together centrally
Home access ‘on-call’ to give expert advice at most appropriate time
Public expectation, images and reports available at any stage of patients
journey
Service reconfiguration, address demand and capacity issues
Supports the development of full ICRs in line with comprehensive
patient records
Choice for patients- potentially cross site availability of electronic images,
contributes to patients desire to exercise choice of location for treatment
Improved knowledge management – up to date information and results for
patients allowing appropriate patient management decisions.
28 - PACS Benefits Realisation and Service Redesign Opportunities
•
•
•
•
•
•
•
•
Daycase patients
Shorter reporting times potential for more rapid turn around times
No lost images
Home access ‘on-call’ to give expert advice at most appropriate time
Communication with other departments
Rapid image availability
Clinical outcome under IRMER
Improved knowledge management - up to date information and results
No plastic wallets
Ease of consultation between clinicians, simultaneous viewing of images
Clinicians assisted quick viewing of images
Elimination of wasted junior doctors time, less searching for forms
and reports
Contribution to reduced length of stay
Reports attached to images, comprehensive patient imaging
record available
Near patient image viewing in A&E and theatres
Improved working lives of staff
Reduced paperwork
Redefined department workflows
Healthcare efficiency
Redefined staff roles.
•
•
•
•
•
•
•
•
•
•
Shorter reporting times potential for more rapid turn around times
No lost images
Improved communication with other departments
Consistency of comparability of images
Improved knowledge management - up to date information and results
Linking modalities
Near patient image viewing eg bedside, theatre, clinics and GP surgeries
Ease of consultation between clinicians, simultaneous viewing of images
Clinicians assisted rapid availability
Elimination of wasted junior doctors time, less searching for forms
and reports
• Reports attached to images, comprehensive patient imaging record available
• Choice for patients - potentially cross site availability of electronic images
contributes to patients desire to exercise choice of location for treatment
• Healthcare efficiency.
PACS Benefits Realisation and Service Redesign Opportunities - 29
National PACS Team (NPfIT) and National Radiology Service Improvement Team (MA)
National PACS Team (NPfIT) and National Radiology Service Improvement Team (MA)
Section 5
Strategic benefits
PACS has the potential to be a strategic asset in the delivery and the
management of healthcare. It has ramifications for the
comprehensive patient record with a service that will not only
support the day to day management of diagnostic services, but also
allow access to information and knowledge out of hours, at all
times at any destination.
PACS will contribute to improved service standards of delivery and
outcomes, and also contribute to improving value for money with
processes that are more streamlined and less wasted time in the
system.
Diagnostics are an integral part of a patient’s journey through
healthcare, PACS will enhance the performance in this area and
increase the effectiveness of healthcare delivery, where accompanied
by rigorous service redesign.
PACS can support1:
• A balanced range of services which promote health and well-being
and tackle health inequalities.
• Ensuring safe and high quality care, with an increasing element of
choice for the patient (the right care)
• Fast and convenient (at the right time)
• Ending delays at all stages of the elective and emergency system
Improved patient choice could include the availability of images and
reports in:
•
•
•
•
•
Walk in Centres
Treatment Centres
Minor Injury Units
One-Stop Clinics
Expanded GP Practices
A community wide storage of digital images, based on practicality
and affordability will aid successful collaborative care from multidisciplinary teams.
Ref (PACS programme strategy 2nd September 2003.)
1
30 - PACS Benefits Realisation and Service Redesign Opportunities
PACS Benefits Realisation and Service Redesign Opportunities - 31
National PACS Team (NPfIT) and National Radiology Service Improvement Team (MA)
National PACS Team (NPfIT) and National Radiology Service Improvement Team (MA)
Section 6
Future vision and direction
All Diagnostic Specialities linked:
Teaching and Training
PACS needs to be wider than one or two specialities. In
principle, any diagnostic service that produces digital images
could make excellent use of PACS technology. This would
mean that the entire imaging record of the patient could be
available at all times at any destination.
The ability to access images and reports
for teaching and training purposes is a
huge positive aspect of PACS. There is
a massive potential for learning and
sharing across the whole of the NHS.
With digitised information being able to
be retrieved at any accredited training
centre, and the advent of the new
training academies for radiology, this
potential offers an excellent training and
teaching resource.
Access to Specialist Opinion
PACS would enable immediate access to specialist opinion not
only across the NHS but also globally. Two areas that have
been proposed as benefiting from this approach directly would
be paediatric medicine and neurosciences. There are, of
course, many more potential beneficiaries here, but some early
thoughts have been around these two. Other beneficiaries
would include:
•
•
•
•
•
•
Medical illustration
Dermatology
Endoscopy
Electro-physiology
Pathology
Ophthalmology
There is also the potential for PACS to play a part in Computer
Aided Diagnosis (CAD) and wireless technology.
Reporting Outsourcing
Where a department requires assistance
with reporting workload it is possible
that reporting could be outsourced, to
assist with the flow of diagnostic
patients. Obviously, quality assurance
needs to be in place, and departments
need to be able to demonstrate their
own lack of capacity in this area to
warrant reporting outsourcing.
Central Files
SHAs with centralised files storage, data
warehousing. Instant accessibility at all
times.
32 - PACS Benefits Realisation and Service Redesign Opportunities
PACS Benefits Realisation and Service Redesign Opportunities - 33
National PACS Team (NPfIT) and National Radiology Service Improvement Team (MA)
National PACS Team (NPfIT) and National Radiology Service Improvement Team (MA)
Section 7
NHS Plan delivery
The group believed that it was important to demonstrate that
the implementation of PACS not only benefits the NHS in
general ways, as in section 1, but also benefits the NHS in
very specific ways in relation to the most prominent of the
government targets.
This section is an attempt to link some of the benefits to such
targets.
The list of targets is extensive and we have endeavoured to
cover many aspects in quite a detailed way.
The relevant target is listed clearly, at the beginning of each
section, allowing the reader to skip from one target to
another or to read the text in its entirety.
34 - PACS Benefits Realisation and Service Redesign Opportunities
PACS Benefits Realisation and Service Redesign Opportunities - 35
National PACS Team (NPfIT) and National Radiology Service Improvement Team (MA)
NHS Plan and National Cancer Plan
Cancer Waiting Time Targets 2004, 2005, 2008
- p39- 48
Targets listing:
(For detailed explanation of targets please see page
numbers)
Cancer Plan:
PACS and Service Redesign can assist with the delivery
of the following targets.
Local Development Plans (LDP)
Access:
T1
Maximum wait in A+E - p37
T6
Pre-booked admission offering patient
choice - p37
T7
Maintain cancer waiting times leading
to maximum waits of 1-2 months by
December 2005 - p37
Cancer:
T9
Extending breast screening for all
women 65-70 years of age - p37-38
Coronary Heart Disease:
T12
Improve access and increase patient
choice by achieving a 2-week wait for
rapid access chest pain clinic - p38
T15
Improved management of patients with
heart failure - p38
Emergency Hospital Admissions:
T23
- Save more lives
- Patients with cancer to get
professional support
- Better use of skills of existing staff
- Redesigning services
- Earlier detection
- Faster diagnosis and treatment
- Consistent high quality services
- Improved quality of life through
better care
- Streamlining process of care
- Reduce waiting times
- Education and research
- New technologists
- Easy access to up to date accurate
information
- Co-ordination and continuity of care
- Expert advice formal reviews
- Increased capacity through new ways
of working
- Improve working times of NHS staff
- Multi disciplinary training and
effectiveness
- New ways of working in partnership,
access to latest expertise and
technology
- Improve quality of services and
minimise errors
- Timely discharge into appropriate
facilities
Choice Agenda (DOH)
- p48-52
Choice for patients summer 2004,
December 2005.
Less than 1% growth each year in
emergency hospital admissions - p38
A+E
IM+T Capacity:
4 hour wait - p52
- Access to Knowledge sources p38-39
- Results reporting
- Access to clinical records
36 - PACS Benefits Realisation and Service Redesign Opportunities
National PACS Team (NPfIT) and National Radiology Service Improvement Team (MA)
Benefits linked to targets
National Access Trgets:
Local Development Plan Targets:
Access
• Efficient utilisation of PACS is critical to delivery of the
NHS Plan target for 2008, that patients begin their
hospital treatment a maximum of 18 weeks from the
point of referral.
• PACS facilitates the concept of choice in imaging
services by enabling image services to be provided and
reported on in primary care.
• Improved access to diagnostic imaging services is also
critical to achievement and sustained delivery of
current access targets for 2005.
Access
A&E
• Around one third of all patients attending A&E require
an imaging test, particularly x-ray.
• Rapid access to diagnostic imaging and reporting is
therefore critical to sustained delivery of the four hour
target.
Outpatients
• Imaging services provided in primary care and linked
through PACS for reporting purposes - will enable
more patients to be seen, diagnosed and treated in
primary care.
• This will significantly reduce the number of outpatient
appointments and therefore outpatient waits.
Inpatients
• PACS enables remote reporting and therefore the
potential of many imaging tests being undertaken in
primary care settings (dependent upon expansion of
practitioner roles and sensible location of equipment
in addition to the existing secondary care base potential for formation of imaging service networks
across health communities).
• This could reduce unnecessary hospital inpatient
episodes, and current practice whereby patients are
admitted to hospital in order to gain speedier access
to imaging services.
T1 Reduce to 4 hours maximum A&E wait, from arrival
to admission, transfer or discharge, by March 2004 for
those trusts who have completed Emergency Services
Collaborative, and by the end of 2004 for all others:
• Reports attached to image, comprehensive patients
imaging record available.
• Benefits to other departments, other departments able
to remotely access relevant images and reports for
patients.
• Clinicians assisted, quick viewing of images and
previous images instantly available.
• Reduced waiting times within departments, due to
streamlined processes.
• A&E waiting times reduced, images quickly available,
quicker reporting.
• Near patient image viewing.
• Home access on-call, clinicians can successfully work
from home where appropriate, to give expert advice at
the most appropriate time.
T6 Increase the level of choice in each year, offering
routine choice of hospital provider at point of booking
for all patients by December 2005:
• Consistency of comparability of images.
• Service reconfiguration – image availability and
transportability
• Choice for patients, potentially the cross-site
availability of images and reports can contribute to the
patient’s desire to exercise choice of location for
treatment.
Cancer
T7 Maintain existing Cancer working time standards
and set local waiting time targets for 2003/4 and
2004/5, so that by the end of 2005 there is a maximum
one month wait from the diagnosis to treatment and 2
months from the urgent referral to treatment of all
cancers:
• Reports attached to image comprehensive patients
imaging record available.
• Improved quality of image, image manipulation,
allowing reporting clinicians more versatility for image
viewing for diagnosis.
• Aids audit, clinical governance, readily available images
and reports, continuity of care.
• Rapid image availability and multiple viewing of
images.
PACS Benefits Realisation and Service Redesign Opportunities - 37
National PACS Team (NPfIT) and National Radiology Service Improvement Team (MA)
• MDT meetings.
• Healthcare efficiency, diagnosis procedure becomes
much more streamlined leading to more effective and
efficient hospital treatment.
• Public expectation – patients now expect their images
and reports to be available at any stage of their
journey and in an appropriate time scale.
• Ease of consultation between clinicians, consult in real
time, viewing images simultaneously.
• Improved knowledge management, up to date
information and results, appropriate management
decisions.
T9 Extending breast screening to all women aged
65 – 70:
• No lost images, images and reports instantly available
to clinicians at any destination.
• Improved quality of image, image manipulation
allowing clinicians more versatility for image viewing
for diagnosis.
• Redesigned department and workflow, streamlined
patient processes
• Reduced working times for appointments and time
within departments
• Research, long-term availability of a comprehensive set
of images and reports.
• MDT meetings.
• Service reconfiguration, image availability and
transportability, address demand and capacity issues.
• Improved knowledge management, up to date
information and results for patients allowing for
appropriate patient management decisions.
Coronary Heart Disease.
T12 Improve access to services across the patient
pathway, and increase patient choice by achieving the
two week wait standard for Rapid Access Chest Pain
Clinics; setting local targets to make progress towards
the NSF goal of a 3 month maximum want for
angiography; and delivering maximum waits of 3
months for revascularisation by March 2005, or sooner if
possible:
• Reduced waiting times for appointments and reduced
waiting times within the department.
• Service reconfiguration, image availability and
transportation, address some demand and capacity
issues.
• Choice for patients.
T15 Improve management of patients with heart failure
in line with the NICE Clinical Guideline due in 2003, and
set local targets for the consequent reduction in patients
admitted to hospital with a diagnosis of heart failure.
• No lost images, image and reports instantly available
at any destination.
• Benefits to other departments, other departments
able to remotely access relevant images and reports
for patients.
• Reduced waiting times for appointments and times
within the department.
• Opportunity for quicker reporting in A&E – potentially
less admission.
• Home access on call, clinicians can successfully work
from home where appropriate, to give expert advice at
the most appropriate time.
• Elimination of wasted junior doctor time, images
available for doctors at multiple locations.
• Consistency of comparability of images.
• Improved knowledge management, up to date
information and results for patients allowing for
appropriate patient management decisions.
Emergency Hospital Admissions
T23 Each year there will be less than 1% growth in
re-admissions
• Consistency of comparability of images.
• Improved knowledge management, up to date
information and results for patients allowing for
appropriate patient management decisions.
• Rapid image availability, multiple view of images in
various locations simultaneously.
• Near patient image viewing, eg A&E. theatres.
• Home access on-call, clinicians can successfully work
from home where appropriate, to give expert advice at
the most appropriate time.
• A&E waiting time reduced, images quickly available,
opportunity for quicker reporting.
IM+T Capacity Assumptions
Electronic records
- Access to knowledge sources
- Results reporting (including pathology and radiology)
- Access to clinical records
• No lost images
• Reports attached to images- comprehensive record
• Benefits other departments, able to remotely access
relevant images and reports
• A&E time reduced, images quickly available,
opportunity for quicker reporting
• Teaching, image available in PACS fashion,
transportable, access to specialist opinion
38 - PACS Benefits Realisation and Service Redesign Opportunities
National PACS Team (NPfIT) and National Radiology Service Improvement Team (MA)
• Research, long term availability of a comprehensive
set of images and reports for patients, will aid those
carrying out research
• Links to other centres
• MDT meetings
• Near patient image viewing
• Security of images
• Home access on-call, clinicians can successfully work
from home, give expert advice at the most appropriate
time.
• Ease of consultation between clinicians, aiding
decision making
• Improved knowledge management, up to date
information and results for patients, allowing
appropriate management decisions.
Cancer waiting times targets 2004
Every patient diagnosed with cancer will benefit from
pre-planned and pre booked care.
• Communication with other departments, instant
information transferred electronically across single or
multiple organisations.
• Service reconfiguration, the image availability and
transportability of PACS will aid service reconfiguration
and assist in addressing some demand and capacity
issues.
• Sharing capacity for examinations and reporting,
potentially with electronic transfer of images a balance
may be struck with respect to peaks and troughs of
demand for reporting.
Cancer waiting times targets 2004
Maximum two-month wait for first outpatient
appointment for patients referred urgent for suspected
cancer by a GP.
• Communication with other departments, instant
information transferred electronically across single or
multiple organisations.
• Service reconfiguration, the image availability and
transportability of PACS which will aid service
reconfiguration will result to demand and capacity
issues.
• Sharing capacity for examinations and reporting,
potential with electrical transfer of images a balance
may be struck with respect to peaks and troughs of
demand for reporting.
Cancer waiting times targets 2005
Maximum two-month wait from urgent GP referral for
suspected cancer to first treatment for all cancers by
2005.
• Communication with other departments, instant
information transferred electronically across single or
multiple organisations.
• Service reconfiguration, the image availability and
transportability of PACS which will aid service
reconfiguration will result to demand and capacity
issues.
• Sharing capacity for examinations and reporting,
potential with electrical transfer of images a balance
may be struck with respect to peaks and troughs of
demand for reporting.
• Radiographer led ultrasound examinations.
• Improved process time for fluoroscopy.
• Medico-legal images converted to CD ROM, no
longer have to pull films physically no packaging
posting etc.
• Links to other centres, especially useful for such
events as MDT meetings.
• Multiple viewing of images, numerous specialists in
various locations can view images simultaneously.
• Rapid image availability wards, clinics, other areas,
images remotely available any time any place.
Cancer waiting times targets 2005
Maximum one-month wait from urgent GP referral to
treatment for children’s, testicular cancers and acute
leukaemia by 2005.
• Communication with other departments, instant
information transferred electronically across single or
multiple organisations.
• Service reconfiguration, the image availability and
transportability of PACS which will aid service
reconfiguration will result to demand and capacity
issues.
• Sharing capacity for examinations and reporting,
potentially with electrical transfer of images a balance
may be struck with respect to peaks and troughs of
demand for reporting.
• Radiographer led ultrasound examinations.
• Improved process time for fluoroscopy.
• Medico-legal images converted to CD ROM, no
longer have to pull films physically no packaging,
posting etc.
• Links to other centres, especially useful for such
events as MDT meetings.
• Multiple viewing of images, numerous specialists in
various locations can view images simultaneously.
• Rapid image availability wards, clinics, other areas,
images remotely available any time any place.
• Near patient image viewing i.e. patients in clinical
cubicles or beds or patients in GP surgery.
PACS Benefits Realisation and Service Redesign Opportunities - 39
National PACS Team (NPfIT) and National Radiology Service Improvement Team (MA)
Cancer waiting times targets 2005
Maximum two-month wait from urgent GP referral to
first treatment for breast cancer.
• Communication with other departments, instant
information transferred electronically across single or
multiple organisations.
• Service reconfiguration, the image availability and
transportability of PACS will aid service reconfiguration
will result to demand and capacity issues.
• Sharing capacity for examinations and reporting,
potentially with electrical transfer of images a balance
may be struck with respect to peaks and troughs of
demand for reporting.
• Radiographer led ultrasound examinations.
• Improved process time for fluoroscopy/mammography.
• Medico-legal images converted to CD ROM, no
longer have to pull films physically no packaging
posting etc.
• Links to other centres, especially useful for such
events as MDT.
• Multiple viewing of images, numerous specialists in
various locations can view images simultaneously.
• Rapid image availability wards, clinics, other areas,
images remotely available any time any place.
• Near patient image viewing i.e. patients in clinical
cubicles or beds or patients in GP surgery.
Cancer waiting times targets 2005
Maximum one-month wait from diagnosis to first
treatment for breast cancer
• Communication with other departments, instant
information transferred electronically across single or
multiple organisations.
• Service reconfiguration, the image availability and
transportability of PACS which will aid service
reconfiguration will result to demand and capacity
issues.
• Sharing capacity for examinations and reporting,
potential with electrical transfer of images a balance
may be struck with respect to peaks and troughs of
demand for reporting.
• Healthcare efficiency, diagnosis procedures become
much more streamline leading to more effective and
efficient hospital treatment, patient flow and more
effective primary care.
• Radiographer led ultrasound examinations.
• Improved process time for fluoroscopy/mammography.
• Medico-legal images converted to CD ROM, no
longer have to pull films physically no packaging
posting etc.
• Links to other centres, especially useful for such
events as MDT.
• Multiple viewing of images, numerous specialists in
various locations can view images simultaneously.
• Rapid image availability wards, clinics, other areas,
images remotely available any time any place.
• Near patient image viewing i.e. patients in clinical
cubicles or beds or patients in GP surgery.
Cancer waiting times targets 2005
Maximum one-month wait from diagnosis to first
treatment for all cancers by 2005
• Communication with other departments, instant
information transferred electronically across single or
multiple organisations.
• Service reconfiguration, the image availability and
transportability of PACS which will aid service
reconfiguration will result to demand and capacity
issues.
• Sharing capacity for examinations and reporting,
potentially with electrical transfer of images a balance
may be struck with respect to peaks and troughs of
demand for reporting.
• Healthcare efficiency, diagnosis procedures become
much more streamline leading to more effective and
efficient hospital treatment and patient flow and more
effective primary care.
• Radiographer led ultrasound examinations.
• Improved process time for fluoroscopy.
• Medico-legal images converted to CD ROM, no
longer have to pull films physically no packaging
posting etc.
• Links to other centres, especially useful for such
events as MDT meetings.
• Multiple viewing of images, numerous specialists in
various locations can view images simultaneously.
• Clinicians assisted quick viewing of images and
previous images instantaneously available.
• Near patient image viewing i.e. patients in clinical
cubicles or beds or patients in GP surgery.
Cancer waiting times targets 2008
No patient with suspected cancer will wait longer than
one month from urgent GP referral to treatment
• Communication with other departments, instant
information transferred electronically across single or
multiple organisations.
• Service reconfiguration, the image availability and
transportability of PACS which will aid service
reconfiguration will result to demand and capacity
issues.
• Sharing capacity for examinations and reporting,
potentially with electrical transfer of images a balance
may be struck with respect to peaks and troughs of
demand for reporting.
40 - PACS Benefits Realisation and Service Redesign Opportunities
National PACS Team (NPfIT) and National Radiology Service Improvement Team (MA)
• Healthcare efficiency, diagnosis procedures become
much more streamline leading to more effective and
efficient hospital treatment and patient flow and more
effective primary care.
• Radiographer led ultrasound examinations.
• Improved process time for fluoroscopy.
• Medico-legal images converted to CD ROM, no longer
have to pull films physically no packaging posting etc.
• Links to other centres, especially useful for such
events as MDT meetings.
• Multiple viewing of images, numerous specialists in
various locations can view images simultaneously.
• Clinicians assisted quick viewing of images and
previous images instantaneously available.
• Near patient image viewing i.e. patients in clinical
cubicles or beds or patients in GP surgery.
Executive summary 2
The Cancer Plan sets out the first comprehensive
national cancer programme for England. It has four
main aims: to save more lives…
• Shorter reporting times, images initially available no
manual handling of analogy images.
• No lost images, less wasted time for staff hunting
images and reports. Images and reports
instantaneously available to clinician at any
destination.
• Radiographer led ultrasound examinations.
• Improved process times for fluoroscopy.
• Medico-legal images converted to CD ROM, no longer
have to pull films physically no packaging posting etc.
• Links to other centres, especially useful for such events
as MDT meetings.
• Multiple viewing of images, numerous specialists in
various locations can view images simultaneously.
• Clinicians assisted quick viewing of images and
previous images instantaneously available.
• Near patient image viewing i.e. patients in clinical
cubicles or beds or patients in GP surgery
• Communication with other departments, instant
information transferred electronically across single or
multiple organisations.
• Teaching, images available in PACS mode will be
extremely versatile and transportable for teaching
purposes especially in training academies. Access to
speciality opinion and teaching will be possible.
• Aids audit, clinical governance, ready availability of
images and reports and continuity of care.
• Healthcare efficiency, diagnosis procedures become
much more streamline leading to more effective and
efficient hospital treatment and patient flow and more
effective primary care.
Executive summary 2
The Cancer Plan sets out the first comprehensive
national cancer programme for England. It has four
main aims: – to ensure people with cancer get the right
professional support as well as the best treatments
• Shorter reporting times, images initially available no
manual handling of analogy images.
• Radiographer led ultrasound examinations.
• Improved process times for fluoroscopy procedures.
• Medico-legal images converted to CD ROM, no longer
have to pull films physically no packaging posting etc.
• No lost images, less wasted time for staff hunting
images and reports. Images and reports
instantaneously available to clinicians at any
destination.
• Links to other centres, especially useful for such events
as MDT meetings.
• Multiple viewing of images, numerous specialists in
various locations can view images simultaneously.
• Near patient image viewing i.e. patients in clinical
cubicles or beds or patients in GP surgery.
• Electronic links to other Trusts and organisations.
• Communication with other departments, instant
information transferred electronically across single or
multiple organisations.
• Teaching, image available in PACS mode will be
extremely versatile and transportable for teaching
purposes especially in training academy. Access to
speciality opinion and teaching will be possible.
• Aids audit, clinical governance, ready availability of
images, reports and continuity of care.
Executive summary 28
Investment in staff and equipment the introduction of
these new targets will be supported by investment to
tackle key gaps in the cancer workforce and make better
use of the skills of existing staff, investing in extra
equipment for diagnosis and treatment, and action to
redesign and streamline existing services to cut out
delays.
• Redefines staff roles, new ways of working as a result
of streamlined process, role enrichment opportunities,
better usage of staff skills.
• Teaching, images available in PACS mode will be
extremely versatile and transportable for teaching
purposes especially in training academies. Access to
speciality opinion and teaching will be possible.
• Aids audit, clinical governance, ready availability of
images and reports and continuity of care
• Sharing capacity for examinations and reporting,
potentially with electrical transfer of images a balance
may be struck with respect to peaks and troughs of
demand for reporting.
PACS Benefits Realisation and Service Redesign Opportunities - 41
National PACS Team (NPfIT) and National Radiology Service Improvement Team (MA)
• Staff development (IT literacy), staff need to be fully
conversed with the IT system that produces,
manipulates and transfers images, this will lead to
staff competence and confidence.
Executive summary 31
Redesigning services, new investment alone is not
enough. Services need to be streamlined, and new
approaches are needed to make best use of skills in the
cancer workforce
• Redesign department and workflow, streamlined
patient process and improved electrical pathways will
allow staff to work very different.
• Aids audit, clinical governance, ready availability of
images and reports and continuity of care.
• Clinicians assisted quick viewing of images and
previous images instantaneously available.
• Shorter reporting times, images initially available no
manual handling of analogy images.
• Radiographer led ultrasound examinations.
• Improved process time for fluoroscopy.
• Medico-legal images converted to CD ROM, no longer
have to pull films physically no packaging posting etc.
• No lost images, less wasted time for staff hunting
images and reports. Images and reports
instantaneously available to clinicians at any
destination.
• Links to other centres, especially useful for such events
as MDT meetings.
• Multiple viewing of images, numerous specialists in
various locations can view images simultaneously.
• Rapid image availability wards, clinics, other areas,
images remotely available any time any place.
• Near patient image viewing i.e. patients in clinical
cubicles, beds or patients in GP surgery.
• Redefines staff roles, new ways of working as a result
of streamlined process, role enrichment opportunities,
better usage of staff skills.
• Teaching, images available in PACS mode will be
extremely versatile and transportable for teaching
purposes especially in training academies. Access to
speciality opinion and teaching will be possible.
• Healthcare efficiency, diagnosis procedures become
much more streamline leading to more effective and
efficient hospital treatment, patient flow and more
effective primary care.
The challenge of cancer 1.17
Nevertheless, there are some key challenges that must
be met if the NHS is to provide world-class cancer care:
….earlier detection…..
• Redesign department and workflow, streamlined
patient process and improved electrical pathways will
allow staff to work very differently.
• Reduced waiting times, appointments and time within
department, streamlined process which lead to more
efficient service procedure at appointment stage and
on day of diagnostic test.
• Communication with other departments, instant
information transferred electronically across single or
multiple organisations.
• Teaching, images available in PACS mode will be
extremely versatile and transportable for teaching
purposes especially in training academy. Access to
speciality opinion and teaching will be possible.
• Service reconfiguration, the image availability and
transportability of PACS will aid service reconfiguration
will result to demand and capacity issues.
• No lost images, less wasted time for staff hunting
images and reports. Images and reports
instantaneously available to clinicians at any
destination.
• Proportion of “helper” time spent with patients,
streamlined procedure and reduced none value added
work allowing worker to spend quality time with
patients.
• Sharing capacity for examinations and reporting,
potentially with electrical transfer of images a balance
may be struck with respect to peaks and troughs of
demand for reporting.
The challenge of cancer 1.17
However, there are some key challenges that must be
met if the NHS is to provide world-class cancer care:
….faster diagnosis and treatment….
• No lost images, less wasted time for staff hunting
images and reports. Images and reports
instantaneously available to clinician at any
destination.
• Shorter reporting times, images initially available no
manual handling of analogy images.
• Redesign department and workflow, streamlined
patient process and improved electrical pathways will
allow staff to work very different.
• Reduced waiting times, appointments and time within
department, streamlined process which lead to more
efficient service procedure at appointment stage and
on day of diagnostic test.
• Radiographer led ultrasound examinations.
• Improved process time for fluoroscopy.
• Medico-legal images converted to CD ROM, no longer
have to pull films physically no packaging posting etc.
• Links to other centres, especially useful for such events
as MDT meetings.
• Multiple viewing of images, numerous specialists in
various locations can view images simultaneously.
• Rapid image availability wards, clinics, other areas,
images remotely available any time any place.
42 - PACS Benefits Realisation and Service Redesign Opportunities
National PACS Team (NPfIT) and National Radiology Service Improvement Team (MA)
• Near patient image viewing i.e. patients in clinical
cubicles or beds, or patients in GP surgery.
• Communication with other departments, instant
information transferred electronically across single or
multiple organisations.
• Teaching, images available in PACS mode will be
extremely versatile and transportable for teaching
purposes especially in training academies. Access to
speciality opinion and teaching will be possible.
• Service reconfiguration, the image availability and
transportability of PACS which will aid service
reconfiguration will result to demand and capacity
issues.
• Sharing capacity for examinations and reporting,
potentially with electrical transfer of images a balance
may be struck with respect to peaks and troughs of
demand for reporting.
• Proportion of “helper” time spent with patients,
streamlined procedure and reduced none value added
work allowing worker to spend quality time with
patients.
• Healthcare efficiency, diagnosis procedures become
much more streamline leading to more effective and
efficient hospital treatment, patient flow and more
effective primary care.
The challenge of cancer 1.17
However, there are some key challenges that must be
met if the NHS is to provide world-class cancer care:
….consistent high quality services….
• No lost images, less wasted time for staff hunting
images and reports. Images and reports
instantaneously available to clinicians at any
destination
• Redesign department and workflow, streamlined
patient process and improved electrical pathways will
allow staff to work very differently.
• Reduced waiting times, appointments and time within
department, streamlined process which lead to more
efficient service procedure at appointment stage and
on day of diagnostic test.
• Image manipulation, allowing reporting clinical more
versatile for image viewing for diagnosis.
• Communication with other departments, instant
information transferred electronically across single or
multiple organisations.
• Teaching, image available in PACS mode will be
extremely versatile and transportable for teaching
purposes especially in training academies. Access to
speciality opinion and teaching will be possible.
• Aids audit, clinical governance, ready availability of
images, reports and continuity of care
• Shorter reporting times, images initially available no
manual handling of analogy images.
• Proportion of “helper” time spent with patients,
streamlined procedure and reduced none value added
work allowing worker to spend quality time with
patients.
• Sharing capacity for examinations and reporting,
potentially with electrical transfer of images a balance
may be struck with respect to peaks and troughs of
demand for reporting.
• Healthcare efficiency, diagnosis procedures become
much more streamline leading to more effective and
efficient hospital treatment, patient flow and more
effective primary care
The challenge of cancer 1.17
However, there are some key challenges that must be
met if the NHS is to provide world-class cancer care:
….improved quality of life through better care...
• Radiographer led ultrasound examinations.
• Improved process time for fluoroscopy.
• Medico-legal images converted to CD ROM, no longer
have to pull films physically no packaging posting etc.
• Links to other centres, especially useful for such events
as MDT meetings.
• Multiple viewing of images, numerous specialists in
various locations can view images simultaneously.
• Rapid image availability wards, clinics, other areas,
images remotely available any time any place.
• Near patient image viewing i.e. patients in clinical
cubicles or beds, or patients in GP surgery.
• Teaching, images available in PACS mode will be
extremely versatile and transportable for teaching
purposes especially in training academies. Access to
speciality opinion and teaching will be possible.
• Reports attached to image comprehensive patient’s
imaging record available.
• Catalyst for IT staff training.
• Elimination of wasted junior doctors time re film
management, junior doctors will not have to chase
images and reports, they will be available at the
destination of the junior doctor.
• Reduction of manual handling (film packets and
chemistry).
• Reduced phone calls, less interruption about queries
regarding reports or images.
• Ease of consultation between clinicians, clinicians can
consult in real time with the ability to view images
simultaneously.
• No chemicals (COSHH), reduced hazard to staff and
reduced costs.
• Financial savings, there is potential for financial savings
in the area or more appropriate use of staff cost
saving on chemistry and machine maintenance
however these benefits must be viewed against
original capital out lay and costs.
PACS Benefits Realisation and Service Redesign Opportunities - 43
National PACS Team (NPfIT) and National Radiology Service Improvement Team (MA)
• Improved clinical environment.
• Communication with other departments, instant
information transferred electronically across single or
multiple organisations
• Teaching, images available in PACS mode will be
extremely versatile and transportable for teaching
purposes especially in training academies. Access to
speciality opinion and teaching will be possible.
• Aids audit, clinical governance, ready availability of
images and reports and continuity of care.
• Reduced waiting times, appointments and time within
department, streamlined process which leads to a
more efficient service procedure at appointment stage
and on day of diagnostic test.
• Proportion of “helper” time spent with patients,
streamlined procedure and reduced none value added
work allowing worker to spend quality time with
patients.
• No lost images, less wasted time for staff hunting
images and reports. Images and reports
instantaneously available to clinicians at any
destination.
• Sharing capacity for examinations and reporting,
potentially with electrical transfer of images a balance
may be struck with respect to peaks and troughs of
demand for reporting.
• Healthcare efficiency, diagnosis procedures become
much more streamline leading to more effective and
efficient hospital treatment, patient flow and more
effective primary care.
• Shorter reporting times, images initially available no
manual handling of analogy images.
The challenge of cancer 1.19
Shorten the time taken to diagnose cancer by
streamlining the process of care and investing more in
equipment and staff….
• No lost images, less wasted time for staff hunting
images and reports. Images and reports
instantaneously available to clinicians at any
destination.
• Redefines staff roles, new ways of working as a result
of streamlined process, role enrichment opportunities,
better usage of staff skills.
• Staff retention.
• Shorter reporting times, images initially available no
manual handling of analogy images.
• Radiographer led ultrasound examinations.
• Improved process time for fluoroscopy procedures.
• Medico-legal images converted to CD ROM, no longer
have to pull films physically no packaging posting etc.
• Links to other centres, especially useful for such events
as MDT meetings.
• Multiple viewing of images, numerous specialists in
various locations can view images simultaneously.
• Rapid image availability wards, clinics, other areas,
images remotely available any time any place.
• Near patient image viewing i.e. patients in clinical
cubicles or beds, or patients in GP surgery.
The challenge of cancer 1.19
Reduce waiting times for cancer treatment – recognising
the urgency of the condition….
• Redesign department and workflow, streamlined
patient process and improved electrical pathways will
allow staff to work very differently.
• Reduced downtime of equipment compared to
chemical “processing,” less equipment maintain and
less equipment fail Reducing downtime in equipment.
• Reduced waiting times, appointments and time within
department, streamlined process which lead to more
efficient service procedure at appointment stage and
on day of diagnostic test.
• Shorter reporting times, images initially available no
manual handling of analogy images.
• Radiographer led ultrasound examinations.
• Improved process time for fluoroscopy procedures.
• Medico-legal images converted to CD ROM, no longer
have to pull films physically no packaging posting etc.
• No lost images, less wasted time for staff hunting
images and reports. Images and reports
instantaneously available to clinicians at any
destination.
• Links to other centres, especially useful for such events
as MDT meetings.
• Multiple viewing of images, numerous specialists in
various locations can view images simultaneously.
• Rapid image availability wards, clinics, other areas,
images remotely available any time any place.
• Near patient image viewing i.e. patients in clinical
cubicles or beds, or patients in GP surgery.
• Redefines staff roles, new ways of working as a result
of streamlined process, role enrichment opportunities,
better usage of staff skills.
• Communication with other departments, instant
information transferred electronically across single or
multiple organisations.
• Service reconfiguration, the image availability and
transportability of PACS which will aid service
reconfiguration will result to demand and capacity
issues.
The challenge of cancer 1.19
To prepare for the future through education and
research…..
• Aids audit, clinical governance, ready availability of
images, reports and continuity of care.
• Links to other centres, especially useful for such events
as MDT meetings.
44 - PACS Benefits Realisation and Service Redesign Opportunities
National PACS Team (NPfIT) and National Radiology Service Improvement Team (MA)
• Research, long term availability of a comprehensive set
of images and reports for patients will aid those
carrying out research.
• Medico-legal images converted to CD ROM, no longer
have to pull films physically no packaging posting etc.
• Shorter reporting times, images initially available no
manual handling of analogy images.
• Image manipulation, allowing reporting clinical more
versatile for image viewing for diagnosis.
• Near patient image viewing i.e. patients in clinical
cubicles or beds, or patients in GP surgery.
• Communication with other departments, instant
information transferred electronically across single or
multiple organisations.
• Teaching, images available in PACS mode will be
extremely versatile and transportable for teaching
purposes especially in training academies. Access to
speciality opinion and teaching will be possible.
Improving screening 3.13
New technologies may assist the screening process. The
NHS Breast Screening Programme is to publish the
results of a working party group which has reviewed
Computer Aided Detection in breast screening. We are
closely monitoring other new technologies such as
digital mammography, on-site processing of
mammograms and new innovative designs for screening
vans and will refer them to NICE for appraisal, if
appropriate.
• Shorter reporting times, images initially available no
manual handling of analogy images.
• Radiographer led ultrasound examinations.
• Improved process time for fluoroscopy.
• Medico-legal images converted to CD ROM, no longer
have to pull films physically no packaging posting etc.
• No lost images, less wasted time for staff hunting
images and reports. Images and reports
instantaneously available to clinicians at any
destination.
• Links to other centres, especially useful for such events
as MDT meetings.
• Research, long term availability of a comprehensive
set of images and reports for patients will aid those
carrying out research.
• Image manipulation, allowing reporting clinical more
versatile for image viewing for diagnosis.
• Near patient image viewing i.e. patients in clinical
cubicles or beds, or patients in GP surgery.
• Reduction of manual handling (film packets and
chemistry).
• Reduced phone calls, less interruption about queries
regarding reports or images.
• Ease of consultation between clinicians, clinicians can
consult in real time with the ability to view images
simultaneously.
• No chemicals (COSHH) reduced hazard to staff and
reduced costs.
• Improved clinical environment.
• Communication with other departments, instant
information transferred electronically across single or
multiple organisations.
Improving Treatment 6.7
A consistent theme in the “improving outcomes”
guidance is that cancer services are best provided by
teams of clinicians – doctors, nurses, clinical staff and
other specialists – who work together effectively. Team
working brings together staff with the necessary
knowledge, skills and experience to ensure high quality
diagnosis, treatment and care. It also improves the coordination and continuity of care for patients.
• No lost images, less wasted time for staff hunting
images and reports. Images and reports
instantaneously available to clinicians at any
destination.
• Shorter reporting times, images initially available no
manual handling of analogy images.
• Aids audit, clinical governance, ready availability of
images, reports and continuity of care.
• Clinicians assisted quick viewing of images and
previous images instantaneously available.
• Links to other centres, especially useful for such events
as MDT meetings.
• Research, long term availability of a comprehensive set
of images and reports for patients will aid those
carrying out research.
• Medico-legal images converted to CD ROM, no longer
have to pull films physically no packaging posting etc.
• Image manipulation, allowing reporting clinical more
versatile for image viewing for diagnosis.
• Near patient image viewing i.e. patients in clinical
cubicles or beds, or patients in GP surgery.
• Healthcare efficiency, diagnosis procedures become
much more streamline leading to more effective and
efficient hospital treatment, patient flow and more
effective primary care.
PACS Benefits Realisation and Service Redesign Opportunities - 45
National PACS Team (NPfIT) and National Radiology Service Improvement Team (MA)
Improving Treatment 6.11
The care of all patients with cancer should be formally
reviewed by a specialist team. This will be done either
through direct assessment or through formal discussion
with the team by the responsible clinician. This will help
ensure that all patients have the benefit of the range of
expert advice needed for high quality care. The delivery
plans to be prepared by the cancer networks should set
out a timetable for the achievement of this standard.
• No lost images, less wasted time for staff hunting
images and reports. Images and reports
instantaneously available to clinicians at any
destination.
• Shorter reporting times, images initially available no
manual handling of analogy images.
• Aids audit, clinical governance, ready availability of
images, reports and continuity of care.
• Improved quality of image, excellent digital acquisition
systems, reduced repeat images due to poor quality.
• Clinicians assisted quick viewing of images and
previous images instantaneously available.
• Links to other centres, especially useful for such events
as MDT meetings.
• Research, long term availability of a comprehensive set
of images and reports for patients will aid those
carrying out research .
• Medico-legal images converted to CD ROM, no longer
have to pull films physically no packaging posting etc.
• Image manipulation, allowing reporting clinical more
versatile for image viewing for diagnosis.
• Near patient image viewing i.e. patients in clinical
cubicles or beds, or patients in GP surgery.
• Redefines staff roles, new ways of working as a result
of streamlined process, role enrichment opportunities,
better usage of staff skills.
• Redesign department and workflow, streamlined
patient process and improved electrical pathways will
allow staff to work very differently.
• Service reconfiguration, the image availability and
transportability of PACS which will aid service
reconfiguration will result to demand and capacity
issues.
• Communication with other departments, instant
information transferred electronically across single or
multiple organisations.
• Reduced waiting times, appointments and time within
department, streamlined process which leads to more
efficient service procedure at appointment stage and
on day of diagnostic test.
• Proportion of “helper” time spent with patients,
streamlined procedure and reduced none value added
work allowing worker to spend quality time with
patients.
• Sharing capacity for examinations and reporting,
potentially with electrical transfer of images a balance
may be struck with respect to peaks and troughs of
demand for reporting.
Investing in Staff 8.32
Increased Capacity through new ways of working these
initiatives to increase the number of staff in training will
ease the pressures on the cancer workforce and improve
the service to patients. But further action is needed to
tackle problems in specific areas, notably diagnostic and
therapeutic radiography.
• Shorter reporting times, images initially available no
manual handling of analogy images.
• Radiographer led ultrasound examinations.
• Improved process for fluoroscopy.
• Medico-legal images converted to CD ROM, no longer
have to pull films physically no packaging posting etc.
• No lost images, less wasted time for staff hunting
images and reports. Images and reports
instantaneously available to clinicians at any
destination.
• Links to other centres, especially useful for such events
as MDT meetings.
• Multiple viewing of images, numerous specialists in
various locations can view images simultaneously.
• Rapid image availability wards, clinics, other areas,
images remotely available any time any place.
• Near patient image viewing i.e. patients in clinical
cubicles or beds, or patients in GP surgery
• Sharing capacity for examinations and reporting,
potentially with electrical transfer of images a balance
may be struck with respect to peaks and troughs of
demand for reporting.
• Healthcare efficiency, diagnosis procedures become
much more streamline leading to more effective and
efficient hospital treatment, patient flow and more
effective primary care.
Investing in staff 8.41
The NHS Plan sets out wide-ranging new initiatives to
improve the working lives of NHS staff which will benefit
cancer staff. Improving the working lives of staff
contributes directly to enhance cancer services through
improved recruitment and retention. Offering new
opportunities for development and extended roles will
open up new career opportunities for staff that have
previously faced restriction and dead ends.
• Reduction of manual handling (film packets and
chemistry).
• Improved working environment, no chemistry no
wasted tasks (film hunting) more physical space(overall
future requirement may be for less physical space
leading to reduced capital costs), rooms fit for purpose
(e.g. reporting) less manual handling.
46 - PACS Benefits Realisation and Service Redesign Opportunities
National PACS Team (NPfIT) and National Radiology Service Improvement Team (MA)
• Retention of staff.
• Catalyst for IT training.
• Elimination of wasted junior doctors time re film
management, junior doctors will not have to chase
images and reports, they will be available at the
destination of the junior doctor.
• Reduced phone calls, less interruption about queries
regarding reports or images.
• Ease of consultation between clinicians, clinicians can
consult in real time with the ability to view images
simultaneously.
• No chemicals (COSHH), reduced hazard to staff and
reduced costs.
• Research, long term availability of a comprehensive set
of images and reports for patients will aid those
carrying out research.
• Medico-legal images converted to CD ROM, no longer
have to pull films physically no packaging posting etc.
• Financial savings, there is potential for financial savings
in the area or more appropriate use of staff cost
saving on chemistry and machine maintenance
however these benefits must be viewed against
original capital out lay and on costs.
• Improve clinical environment.
• Redefines staff roles, new ways of working as a result
of streamlined process, role enrichment opportunities,
better usage of staff skills.
• Teaching, images available in PACS mode will be
extremely versatile and transportable for teaching
purposes especially in training academies. Access to
speciality opinion and teaching will be possible
• Aids audit, clinical governance, ready availability of
images, reports and continuity of care
•Staff development (IT literacy), staff need to be fully
conversed with the IT system that produces,
manipulates and transfers images, this will lead to
staff competence and confidence.
• Prestige.
Investing in staff 8.51
Education and training for cancer staff will need to
underpin cancer network workforce strategies. All
cancer service providers will be required to draw up a
written training strategy for cancer clinicians, both
medical and non-medical. Multi-disciplinary training will
support and develop the effectiveness of the specialist
multi-disciplinary teams providing cancer care.
• No lost images, less wasted time for staff hunting
images and reports. Images and reports
instantaneously available to clinicians at any
destination.
• Shorter reporting times, images initially available no
manual handling of analogy images.
• Aids audit, clinical governance, ready availability of
images, reports and continuity of care.
• Image manipulation, allowing reporting clinical more
versatile for image viewing for diagnosis.
• Clinicians assisted quick viewing of images and
previous images instantaneously available.
• Links to other centres, especially useful for such events
as MDT.
• Research, long term availability of a comprehensive set
of images and reports for patients will aid those
carrying out research.
• Medico-legal images converted to CD ROM, no longer
have to pull films physically no packaging posting etc.
• Near patient image viewing i.e. patients in clinical
cubicles or beds, or patients in GP surgery
• Teaching, images available in PACS mode will be
extremely versatile and transportable for teaching
purposes especially in training academies. Access to
speciality opinion and teaching will be possible.
• Improved knowledge management, up to date
information and results for patients convenience
available allowing for appropriate patient
management decisions.
• Staff development.
• Prestige.
Investing in facilities 9.10
In implementing this expansion, we will explore the
scope for public private partnerships with service
providers and the industry, particularly in relation to
pathology and imaging. Where new ways of working
offer advantages to patients, they need to be
implemented.
• Shorter reporting times, images initially available no
manual handling of analogy images.
• Radiographer led ultrasound examinations.
• Improved process time for fluoroscopy.
• No lost images, less wasted time for staff hunting
images and reports. Images and reports
instantaneously available to clinicians at any
destination.
• Links to other centres, especially useful for such events
as MDT meetings.
• Multiple viewing of images, numerous specialists in
various locations can view images simultaneously.
• Rapid image availability wards, clinics, other areas,
images remotely available any time any place.
• Near patient image viewing i.e. patients in clinical
cubicles or beds, or patients in GP surgery.
• Service reconfiguration, the image availability and
transportability of PACS which will aid service
reconfiguration will result to demand and capacity
issues.
PACS Benefits Realisation and Service Redesign Opportunities - 47
National PACS Team (NPfIT) and National Radiology Service Improvement Team (MA)
Investing in facilities 9.12
These new partnerships will extend over a number of
NHS organisations rather than being restricted to a
single NHS Trust. Public private partnerships offer new
ways to organise services in a way which improves
services for patients and provides them with access to
the latest expertise and technology where and when
they are required.
• Shorter reporting times, images initially available no
manual handling of analogy images.
• Radiographer led ultrasound examinations.
• Improve process time for fluoroscopy.
• No lost images, less wasted time for staff hunting
images and reports. Images and reports
instantaneously available to clinicians at any
destination.
• Links to other centres, especially useful for such events
as MDT meetings.
• Multiple viewing of images, numerous specialists in
various locations can view images simultaneously.
• Rapid image availability wards, clinics, other areas,
images remotely available any time any place.
• Near patient image viewing i.e. patients in clinical
cubicles or beds, or patients in GP surgery
• Redefines staff roles, new ways of working as a result
of streamlined process, role enrichment opportunities,
better usage of staff skills.
• Redesign department and workflow, streamlined
patient process and improved electrical pathways will
allow staff to work very differently.
• Service reconfiguration, the image availability and
transportability of PACS which will aid service
reconfiguration will result to demand and capacity
issues.
• Communication with other departments, instant
information transferred electronically across single or
multiple organisations.
Non Referenced
The supportive and palliative care guidance recommends
that patients and carers are offered high quality
information materials, tailored to their individual needs,
at appropriate points in the care pathway
• Patient satisfaction, high quality intervention at
appointment times by appropriate people based on
images available.
Choice Agenda (DOH)
All patients waiting over six months for surgery will be
offered a choice of moving to another hospital or
provider (Summer 2004)
• No lost images, less wasted time for staff hunting
images and reports. Images and reports
instantaneously available to clinicians at any
destination.
• Improved quality of image, excellent digital acquisition
systems, reduced repeat images due to poor quality.
• Image manipulation, allowing reporting clinical more
versatile for image viewing for diagnosis.
• Clinicians assisted quick viewing of images and
previous images instantaneously available.
• Shorter reporting times, images initially available no
manual handling of analogy images.
• Radiographer led ultrasound examinations.
• Improved process time for fluoroscopy.
• Medico-legal images converted to CD ROM, no longer
have to pull films physically no packaging posting etc.
• Links to other centres, especially useful for such events
as MDT meetings.
• Multiple viewing of images, numerous specialists in
various locations can view images simultaneously.
• Rapid image availability wards, clinics, other areas,
images remotely available any time any place.
• Near patient image viewing i.e. patients in clinical
cubicles or beds, or patients in GP surgery
• Communication with other departments, instant
information transferred electronically across single or
multiple organisations.
• Public expectation, patients now expect their images
and reports to be available at any stage of their
journey and in an appropriate time scale.
• Redefines staff roles, new ways of working as a result
of streamlined process, role enrichment opportunities,
better usage of staff skills.
• Choice for patients, potentially the cross-site
availability of electrical images and reports can
contribute to patient’s desire to exercise chose of l
ocation for treatment.
• Comprehensive patient record.
All patients who may require planned surgery will be
offered a choice of four or five hospitals or providers
when they are referred by their GP (From Dec 2005)
• Shorter reporting times, images initially available no
manual handling of analogy images.
• Improve process time for fluoroscopy.
• Medico-legal images converted to CD ROM, no longer
have to pull films physically no packaging posting etc.
• No lost images, less wasted time for staff hunting
images and reports. Images and reports
instantaneously available to clinicians at any
destination.
• Links to other centres, especially useful for such events
as MDT meetings.
• Multiple viewing of images, numerous specialists in
various locations can view images simultaneously.
• Rapid image availability wards, clinics, other areas,
images remotely available any time any place.
• Near patient image viewing i.e. patients in clinical
cubicles or beds, or patients in GP surgery
48 - PACS Benefits Realisation and Service Redesign Opportunities
National PACS Team (NPfIT) and National Radiology Service Improvement Team (MA)
• Choice for patients, potentially the cross-site
availability of electrical images and reports can
contribute to patient’s desire to exercise chose of
location for treatment.
• Comprehensive patient records.
• Patient satisfaction, high quality intervention at
appointment times by appropriate people based on
images available.
MA document
Radiology National Framework for Service Improvement
– support redesign in diagnostic imaging and extend the
role of healthcare professionals
• Shorter reporting times, images initially available no
manual handling of analogy images.
• Improved process time for fluoroscopy.
• Medico-legal images converted to CD ROM, no longer
have to pull films physically no packaging posting etc.
• No lost images, less wasted time for staff hunting
images and reports. Images and reports
instantaneously available to clinicians at any
destination.
• Links to other centres, especially useful for such events
as MDT meetings.
• Multiple viewing of images, numerous specialists in
various locations can view images simultaneously.
• Rapid image availability wards, clinics, other areas,
images remotely available any time any place.
• Near patient image viewing i.e. patients in clinical
cubicles or beds, or patients in GP surgery
• Redefines staff roles, new ways of working as a result
of streamlined process, role enrichment opportunities,
better usage of staff skills.
• Teaching, images available in PACS mode will be
extremely versatile and transportable for teaching
purposes especially in training academies. Access to
speciality opinion and teaching will be possible
• Service reconfiguration, the image availability and
transportability of PACS which will aid service
reconfiguration will result to demand and capacity
issues.
• Improved knowledge management, up to date
information and results for patients convenience
available allowing for appropriate patient
management decisions.
• Retention of staff.
• Staff development (IT literacy), staff need to be fully
conversed with the IT system that produces,
manipulates and transfers images, this will lead to
staff competence and confidence.
NHS Cancer Plan (DOH)
Preface 5 – The NHS will work continuously to improve
quality services and to minimise errors. The NHS will
ensure that services are driven by a cycle of continuous
quality improvement. Quality will not just be restricted to
the clinical aspects of care, but include quality of life and
the entire patient experience. Healthcare organisations
and professions will establish ways to identify
procedures that should be modified or abandoned and
new practices that will lead to improved patient care. All
those providing care will work to make ever safer, and
support a culture where we can learn from and
effectively reduce mistakes. The NHS will continuously
improve its efficiency productivity and performance.
• Aids audit, clinical governance, ready availability of
images and reports and continuity of care.
• Shorter reporting times, images initially available no
manual handling of analogy images.
• Improved process time for fluoroscopy.
• Medico-legal images converted to CD ROM, no longer
have to pull films physically no packaging posting etc.
• No lost images, less wasted time for staff hunting
images and reports. Images and reports
instantaneously available to clinician at any
destination.
• Links to other centres, especially useful for such events
as MDT meetings.
• Multiple viewing of images, numerous specialists in
various locations can view images simultaneously.
• Rapid image availability wards, clinics, other areas,
images remotely available any time any place.
• Near patient image viewing i.e. patients in clinical
cubicles or beds, or patients in GP surgery.
• Research, long term availability of a comprehensive set
of images and reports for patients will aid those
carrying out research Improved.
• Image manipulation, allowing reporting clinical more
versatile for image viewing for diagnosis.
• Catalyst for IT skills.
• Elimination of wasted junior doctors time re film
management, junior doctors will not have to chase
images and reports they will be available at the
destination of the junior doctor.
• Reduction of manual handling (film packets and
chemistry).
• Reduced phone calls, less interruption about queries
regarding reports or images.
• Ease of consultation between clinicians, clinicians can
consult in real time with the ability to view images
simultaneously.
• No chemicals (COSHH), reduced hazard to staff and
reduced costs.
• Financial savings, there is potential for financial savings
in the area or more appropriate use of staff cost
saving on chemistry and machine maintenance
PACS Benefits Realisation and Service Redesign Opportunities - 49
National PACS Team (NPfIT) and National Radiology Service Improvement Team (MA)
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however these benefits must be viewed against
original capital out lay and on costs.
Improved clinical environment.
Aids audit, clinical governance, ready availability of
images, reports and continuity of care.
Reduced litigation costs, potentially because no films
or reports will be lost and images and reports will
always be available in a timely fashion for appropriate
patient management, this could lead to less litigation
costs.
Improved knowledge management, up to date
information and results for patients convenience
available allowing for appropriate patient
management decisions.
Investing in facilities 4.4
Respondents saw the use of intermediate care as central
to this more joined up approach. It should concentrate
on maintaining and restoring independence, and on
rehabilitation. It would act as a bridge between
community and hospital care. Both staff and patients
would experience new ways of working which would
blur the boundary between primary and secondary care.
Specific elements of the new service would include
...fast access to diagnostics and pathology leading to
effective interventions….
• No lost images, less wasted time for staff hunting
images and reports. Images and reports
instantaneously available to clinicians at any
destination.
• Shorter reporting times, images initially available no
manual handling of analogy images.
• Redesign department and workflow, streamlined
patient process and improved electrical pathways will
allow staff to work very differently.
• Image manipulation, allowing reporting clinical more
versatile for image viewing for diagnosis.
• Rapid image availability wards, clinics, other areas,
images remotely available any time any place.
• Reduced waiting times, appointments and time within
department, streamlined process which leads to more
efficient service procedure at appointment stage and
on day of diagnostic test.
• Clinicians assisted quick viewing of images and
previous images instantaneously available.
• Radiographer led ultrasound examinations.
• Improved process time for fluoroscopy.
• Medico-legal images converted to CD ROM, no longer
have to pull films physically no packaging posting etc.
• Links to other centres, especially useful for such events
as MDT meetings.
• Multiple viewing of images, numerous specialists in
various locations can view images simultaneously.
• Rapid image availability wards, clinics, other areas,
images remotely available any time any place.
National PACS Team (NPfIT) and National Radiology Service Improvement Team (MA)
• Near patient image viewing i.e. patients in clinical
cubicles or beds, or patients in GP surgery
• Redefines staff roles, new ways of working as a result
of streamlined process, role enrichment opportunities,
better usage of staff skills.
• Service reconfiguration, the image availability and
transportability of PACS which will aid service
reconfiguration will result to demand and capacity
issues.
• Communication with other departments, instant
information transferred electronically across single or
multiple organisations.
• Comprehensive patient records.
• Proportion of “helper” time spent with patients,
streamlined procedure and reduced none value added
work allowing worker to spend quality time with
patients.
• Communication with other departments, instant
information transferred electronically across single or
multiple organisations.
Investing in facilities 4.4
Respondents saw the use of intermediate care as central
to this more joined up approach. It should concentrate
on maintaining and restoring independence, and on
rehabilitation. It would act as a bridge between
community and hospital care. Both staff and patients
would experience new ways of working which would
blur the boundary between primary and secondary care.
Specific elements of the new service would include
...timely discharge into appropriate settings…
• Supports the development of ICRS, in line with the
NPfIT programme for comprehensive patient record.
• Communication with other departments, instant
information transferred electronically across single or
multiple organisations.
• Environmental, less background radiology (less
unnecessary exposure) less chemistry and pollution.
However consider energy use especially where air
condition units are required.
• Hospital efficiency.
• Radiographer led ultrasound examinations.
• Improved process time for fluoroscopy.
• Medico-legal images converted to CD ROM, no longer
have to pull films physically no packaging posting etc.
• Links to other centres, especially useful for such events
as MDT meetings.
• Multiple viewing of images, numerous specialists in
various locations can view images simultaneously.
• Rapid image availability wards, clinics, other areas,
images remotely available any time any place.
• Near patient image viewing i.e. patients in clinical
cubicles or beds, or patients in GP surgery
• Shorter reporting times, images initially available no
manual handling of analogy images.
• Contribution to decreased length of patient stay,
images and reports availability at destination in a
timely fashion can potential accelerate patient
discharge.
• Redefines staff roles, new ways of working as a result
of streamlined process, role enrichment opportunities,
better usage of staff skills.
• Redesign department and workflow, streamlined
patient process and improved electrical pathways will
allow staff to work very differently.
• Service reconfiguration, the image availability and
transportability of PACS will aid service reconfiguration
will result to demand and capacity issues.
Investing in NHS staff 5.5
These are very challenging targets but we must meet
them – and, if possible, exceed them – if the NHS is to
make the service gains for patients they need. We will
achieve them by... improving the working lives of staff.
50 - PACS Benefits Realisation and Service Redesign Opportunities
Investing in facilities 4.22
NHS staff will also benefit from the investment in new
information technology. Staff will get easy access to upto-date and accurate information on patients’ medical
histories. NHS staff will be able to order tests, refer
patients and make booking of appointments for patients
using new IT. The National Electronic Library for Health
will provide electronic access to state-of-the-art
information on latest treatments and best practice. This
investment will allow for greater efficiency and also for
easier access to the information necessary to monitor
local performance and practices against national
standards and performance indicators.
• Reduced stress levels, happier staff, improved process
that improves working lives less time wasted in futile
tasks.
• Reduced phone calls, less interruption about queries
regarding reports or images
• Redefines staff roles, new ways of working as a result
of streamlined process, role enrichment opportunities,
better usage of staff skills
• Staff retention
• Improved working environment, no chemistry no
wasted tasks (film hunting) more physical space
(overall future requirement may be for less physical
space leading to reduced capital costs), rooms fit for
purpose (e.g. reporting) less manual handling.
• Catalyst for IT skills
• Elimination of time wasted for junior doctors.
• Reduced manual handling risks
• Ease of consultation between radiologists and other
clinicians
• Improved teaching and research facilities
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•
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•
Production of portables images CD ROM
Medico-legal cost savings
Rapid reporting turnaround times
Recruitment and retention
Staff development
Teaching and learning
Electronic links to other Trusts and organisations
Investing in NHS staff 5.16
The Improving Working Lives standard means that every
member of staff in the NHS is entitled to belong to an
organisation that can prove that it is investing in their
training and development, tackling discrimination and
harassment, improving diversity, applying a zero
tolerance on violence against staff, reducing workplace
accidents, reducing sick absences, providing better
occupational health and counselling services, conducting
annual attitude surveys – asking relevant questions and
acting on the key messages. Standards and targets have
already been established to support these goals. It is
now down to NHS employees to deliver them. As a
result of the NHS Plan we give their efforts a further
impetus.
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Improved environment (COSHH)
Reduced manual handling
Reduced telephone calls
Reduced stress levels
Catalyst for IT skills
Redefine staff roles
Teaching and learning
Clinical governance
Training facilities (Academies and local)
Knowledge management
Recruitment
Changed systems for the NHS 6.11
Support to design care around patients ... planning the
pathway or route that a patient takes from start to finish
to see how it could be easier and swifter – every step,
from the moment a patient arrives at the GP up to and
including when they are discharged. Unnecessary stages
for care are removed, more test and treatment are done
on a one-stop and day-case basis.
•
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•
Radiographer led ultrasound examinations
Improved process time for fluoroscopy
Production of portable images CD ROM
Speed and ease of MDT meeting
Simultaneous multi-user access to images and reports
24 hour availability of images
Electronic link to other Trusts and organisations
Rapid reporting turnaround times
Redefine staff roles
Improved information flow
PACS Benefits Realisation and Service Redesign Opportunities - 51
National PACS Team (NPfIT) and National Radiology Service Improvement Team (MA)
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Service reconfiguration
Redesign departmental processes
No lost images
Hospital efficiency
Cutting waiting for treatment 12.10
By 2004, no one should be waiting more than four
hours in accident and emergency from arrival to
admission, transfer or discharge. Average waiting times
accident and emergency will fall as a result to 75
minutes. By then we will have ended inappropriate
trolley waits for assessment and admission. Of course,
some patients such as those emergencies arriving by
ambulance will clinically need to be assessed on a trolley,
but after that if they need a hospital bed they should be
admitted to one without undue delay.
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A & E waiting time reduced
Radiographer led ultrasound examinations
Improved process time for fluoroscopy
Production of portable images CD ROM
Speed and ease of MDT meeting
Simultaneous multi-user access to images and reports
24 hour availability of images
Electronic link to other Trusts and organisations
Rapid reporting turnaround times
Redefine staff roles
Improved information flow
Redesign departmental processes
Service reconfiguration
No lost images
Aim A3.1
To transform the health and social care system so that it
produces faster, fairer services that deliver better health
and tackles health inequalities.
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Redefine staff roles
Improved information flow
Redesign departmental processes
Service reconfiguration
Hospital efficiency
Rapid reporting turnaround times
Radiographer led ultrasound examinations
Improved process time for fluoroscopy
Production of portable images CD ROM
No lost images
Speed and ease of MDT meetings
Simultaneous multi-user to access and reports
24 hour availability of images
Electronic links to other Trusts and organisations
Improved teaching and research facilities
•
•
•
•
•
•
•
Rapid report availability attached to images
Image manipulation
Catalyst for IT skills
Elimination of time wasted by junior doctors
Reduced manual handling risks
Reduced telephone calls
Ease of consultation between radiologists and other
clinicians
• Improved environment (COSHH)
• Medico-legal cost savings
• Improved clinical environment
A & E 4-hour wait
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No lost images
Rapid report availability attached to images
Redefine staff roles
Reduced waiting times in department
Reduced downtime of equipment
Radiographer led ultrasound examinations
Increased helper time with patient
Elimination of time wasted for junior doctors
Remote reporting
Image manipulation
Electronic links to other Trusts and organisations
Consistency and comparability
24 hour availability
Improved information flow
Meeting public expectation
Audit and clinical governance
Redesigned departmental processes
Choice for patients
Shared capacity
Reduced radiation dose for patients
Reduced length of stay
Comprehensive patient record
Politically appropriate
52 - PACS Benefits Realisation and Service Redesign Opportunities
National PACS Team (NPfIT) and National Radiology Service Improvement Team (MA)
Glossary of terms
PACS - Picture Archiving and Communications Systems
Further reading and
key links
RIS - Radiology Information System
IRMER - Ionising Radiation (Medical Exposure)
Regulations
COSHH - Control of Substances Hazardous to Health
NPfIT - National Programme for Information Technology
PACS Practical Experience
www.npfit.nhs.uk/programmes/pacs
Radiology: A National Framework for Service
Improvement. NHS Modernisation Agency (June 2003)
NHS Modernisation Agency radiology website
www.modern.nhs.uk/radiology
ICRS - Integrated Care Record System
CD-Rom - Compact Disc Read Only Memory
CR - Computerised Radiology
Secondary care booking: towards a fully booked NHS
www.modern.nhs.uk/access
National Programme for Information Technology
(NPfIT) website www.npfit.nhs.uk
DR - Digital Radiology
MDT - Multidisciplinary Team
National Programme for Information Technology
(NPfIT) electronic booking website
www.chooseandbook.nhs.uk
IHE - Institute of Health Education
PC - Personal Computer
SHA - Strategic Health Authority
IT - Information Technology
PACS Benefits Realisation and Service Redesign Opportunities - 53
National PACS Team (NPfIT) and National Radiology Service Improvement Team (MA)
Acknowledgements
Our thanks go to the following people for their contribution to this report.
Dr. Laurence Sutton
Consultant Radiologist, Calderdale Royal Hospital,
Diane Rooney
Service Lead, Calderdale Royal Hospital
Mark Rodgers
Radiology Service Manager, Calderdale Royal Hospital
Glynis Wivell
Acting Service Manager, Norwich & Norfolk
Helen Clarke
PACS Systems Administrator, Norwich & Norfolk
Will Smith
Radiology Services Manager, Telford
Richard Williams
PACS Manager, Telford
Julie Young
Superintendent Radiographer, Telford
Douglas Manton
Directorate Manager, Derriford Hospital
Dr. Graham Hoadley
Consultant Radiologist, Blackpool, Fylde & Wyre.
National Clinical Lead for Radiology Service Improvement
Stewart Whitley
Radiology Services Manager, Blackpool, Fylde & Wyre
David Dewitt,
General Manager X-ray Services, Blackpool, Fylde & Wyre
Dr Stephen Davies
Consultant Radiologist, Royal Glamorgan Hospital
Paul Unsworth
Chief Executive Tending PCT
Beverly Peacock
Director of Finance, Bolton NHS Hospital Trust
Keith Smith
Branch Head - DH Diagnostic Services Branch
Kate Prangley
Director of National PACS team
Lesley Wright
Associate Director - Diagnostics, NHS Modernisation Agency
Sue Beckman
National Manager for Radiology, NHS Modernisation Agency
David Jennings
NPfIT PACS Team
Report Composition by Sue Beckman, Hannah Bywater and Shirley Steeples
54 - PACS Benefits Realisation and Service Redesign Opportunities