New Models of radiology delivery? Improving collaboration between services; lessons from a collaborative.

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2 New Models of radiology delivery? Improving collaboration between services; lessons from a collaborative. DR NICHOLAS SPENCER, CONSULTANT RADIOLOGIST, MID YORKSHIRE HOSPITALS NHS TRUST CLINICAL LEAD, YORKSHIRE REGIONAL IMAGING COLLABORATIVE

3 At various times I have been Radiologist at Mid Yorkshire Hospitals since 1996 Clinical Director of Radiology Done losts of Kit procurement NPfIT and CfH PACS (from the beginning) Led commissioning of a PFI new Build from 2011 Trust Lead Cancer Clinician Advocate for Advanced radiographic practice, 7 Day working and Remote Reporting

4 Presently I am.. Consultant radiologist at MYHT Clinical lead for RIC-Y Medical Director at Medical Imaging Partnership Member of RCR Service Review Committee

5 Looking Back Pre-PACS Piles of Films Waiting Lists for CT and MRI 3-6 months Proprietary Workstations for CT and MRI Teleradiology and Report into RIS ISDN Return to work for emergencies and weeks on call, 1 in 4 PACS Transition Massive culture change, unifying force in multisite Trust

6 Present Cultures and Challenges PACS everywhere Teleradiology and Outsourcing Capacity Pressures Need for immediate imaging and reports Order Comms, EPR and MDT s for communication

7 Solutions System Change/New Ways of Working STP s Shared Services between institutions 7 day services Multi-professional Workforce Technological Innovations AI, CAD Performance Management (GIRFT and NHSI)

8 What might the future look like? Fewer boundaries System inter-operability Imaging provided in hospitals and in communities Care record joined up between primary and hospital sectors, with imaging integrated Patient will manage, access and control their own data

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10 Regional Imaging Collaborative - Yorkshire Purpose Multi-factorial, from PACS re-procurement & financial savings, through to service transformation and image sharing Drive for delivery Conceived during national PACS programme exit planning (Regional PACS Strategy Group), supported by Y&TH throughout and then hosted by HSCIC in later stages Limitations in current solutions, Challenges of Image Transfer/Sharing

11 WYAAT & STP s

12 RIC-Y is 9 Trusts WYAAT 6 plus North Lincolnshire and Goole Barnsley Hull and East Yorkshire WORKING TOGETHER PROGRAMME IN S YORKSHIRE

13 COMMON THEMES Collaboration Informatics/Technology to drive better patient outcomes and experience Sustainability Efficiency & Cost Saving Assuring Quality and delivering Transformation

14 Future Vision Image and report sharing Imaging Timeline Integration/Inter-operability with EPR Other Ologies archived and accessible Image Lifecycle management System rationalisation

15 Future Vision in Radiology Networked reporting Sub-speciality teams, across boundaries Workload balancing across institutions Extend home reporting and other intiatives that keep the workforce engaged On Call collaboration Other benefits emerging Patient portal plus

16 Back to RIC-Y Formed in September 2015 Memorandum of Understanding Financial Plan, with Commitment of all Trusts Multi-professional Programme Board Clear design to enable entry and exit, including re-joining later Only those in the programme can influence its work and direction Hosted by Bradford Hospitals Teaching NHS Trust Project assurance from Executive at another Trust (HEY)

17 RIC-Y mission statement Provide a proven, affordable enterprise imaging management solution for the Yorkshire and Humber region, which as a minimum replaces existing radiology PACS and which may also include RIS and/or other imaging solutions. The solution will enable the transformation of service delivery - enhancing care and the patient experience. o Deliver a best value strategic imaging solution o Enable service transformation o Improve patient experience

18 RIC-Y Activities at outset Project planning and Management Communications Member Trust engagement Regular highlight reports Liaison with other specialities, for whom an imaging sharing solution might yield transformation Mission Statement created by all

19 RIC-Y Activities 2 Requirements Workshops HLQs & OBS Support for management of current Trust Contracts, including extensions to suit collaborative as a whole Programme Board oversight Issues Register/Action Logs/Lessons Learned prospectively captured Design Benefits Realisation and Transformation components of the solution

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21 RIC-Y Team Programme Manager NHS Supply Chain (Local base in East Leeds) PACS Manager lead Clinical lead All accountable to Programme Board

22 RIC-Y Programme Board All Trusts represented, with quoracy rules articulated Multi-professional; Clinical (radiologists, radiographers, PACS team), Service Managers and Clinical Directors IT, technical, management and Executive Supplies, including procurement experts Project managers

23 RIC-Y Project vision Build an Outcome Requirements Document for use by NHSSC, who will invite Suppliers ( On Framework ) to Express an Interest in bidding for this award; deliver initial shortlist Construct an OBS fit for Purpose to capture current and future needs of an imaging solution, both for archive and display, as well as to facilitate improved care, seamless pathways, and other service transformation. Use this to select a suitable provider Deliver the solution across the Collaborative, minimising BAU disruption, and embed the transformation objective

24 RIC-Y Project - FOUR Phases 1. Initiation 2. Requirements Definition & Supplier Shortlisting 3. Detailed Evaluation (Preferred Supplier & BAFO) 4. A) FBC, Award of Contract B) Delivery of Solution and Transformation

25 RIC-Y Procurement 1 Phase 1 completed by December 2015 Phase 2 completed, under budget, at end of March suppliers bid against Outcome Requirements Document with high level Questions 7 shortlisted Incumbent Supplier Dialogue throughout, due to variations in current contract structure, Infrastructure and Application risks in member organisations

26 RIC-Y Procurement 2 Shortlisted Supplier Event on April/16 System Demonstrations, and Structured Supplier Presentations with Q&A New revised Budget to manage project Progressed into extensive and detailed solution development with single supplier Contract Negotaitions Menu Pricing

27 RIC-Y Procurement 3 Trusts develop their business cases individually supported by the programme management. Open Discussions between DoF s Oversight of WYAAT Feeding into STP during its development Management of relationships and contact between organisations and supplier Commencement of Implementation planning and Transformation design and proposals

28 RIC-Y Implementation Planning with Trusts and Supplier Baseline position Data Volumes Infrastructures Need for Inter-operability Complexity analysis Implementation

29 RIC-Y Transformation Challenge in some areas Some sub-speciality teams aware and up for it Trainee experience Contractual arrangements ON CALL arrangements Peer to peer support and challenge Scanning technique, and equipment differences How can we transact?

30 RIC-Y Benefits realisation Captured opportunities and ideas throughout Vanguard support for project STP for WY includes RIC-Y Breadth of engagement, multi-professional and all organisations

31 Summary Vision and Big Tent Team RIC-Y engaged across multiple STP footprints WYAAT and Working Together Project Phasing and where we are now? Next steps Any Questions?