New suppliers look highly likely to be brought in an effort to sort out the mired Picture Archiving and Communications Systems (PACS) programme in the North West and West Midlands region of the NHS, E-Health Insider has learned.

Computer Sciences Corporation (CSC), the local service provider for the NHS National Programme for IT in the North West and West Midlands (NWWM) region of England, has begun negotiations with alternative PACS and Radiology Information System (RIS) providers.

In response to questions from EHI CfH last Friday published a joint statement on its website that said it had granted CSC permission to begin negotiations with alternative PACS/RIS suppliers. The statement was removed from the website by Saturday.

A senior spokesperson for CfH, however, told EHI on Monday: “CfH can confirm that it is in discussion with CSC about arrangements for the provision of PACS/RIS for the NWWM cluster.”

EHI has learned from several sources that CSC was told by CfH to begin negotiations with GE as an alternative PACS supplier, apparently replacing its incumbent PACS and RIS sub-contractors ComMedica and Kodak respectively. GE is the current PACS provider to Fujitsu Alliance the LSP for the South of England

It is unknown whether an alternative PACS/RIS system would be a cluster-wide enterprise solution, as required in the original contracts awarded to LSPs by CfH, or instead a series of local systems. Similarly it is unclear how the additional costs of any switch would be met.

A spokesperson for Kodak, CSC’s current RIS supplier for NWWM, told EHI: "We have been told that the National Health Service and CSC Computer Sciences Limited are exploring alternative PACS and RIS solutions for the Connecting for Health initiative in the North West and West Midlands regions of England. We will stay close to the situation to determine Kodak’s role going forward."

The Kodak spokesperson said: "We have had no notice of termination. They added: "There are no Kodak product or solution specific concerns that Kodak has been made aware of that are preventing the ability to continue deployments in NWWM." The company said its RIS product is successfully installed in more than 100 sites across Europe, including at Hereford in NWWM.

ComMedica declined to comment and referred questions back to CSC and CfH.

 As first reported by EHI in November the PACS programme in NWWM has stalled due to problems with the CSC Alliance’s reference PACS/RIS solution, for which it awarded contracts in December 2004. A series of implementation deadlines were missed in 2005, with none of the initial NHS sites going live by a deadline at the end of last month.

One of the initial NHS sites was to have been Royal Liverpool and Broadgreen University Hospitals NHS Trust, which was originally meant to implement CSC’s ComMedica PACS system – in conjunction with its existing HSS RIS system – in August 2005.

The trust finally called time on a costly implementation programme in mid-November and rejected the system citing delays, a series of outstanding technical problems and “clinical functionality issues". The trust required a PACS system in time for the opening of its new £75m Broadgreen Hospital this March.

The trust has since begun implementing an alternative PACS/RIS system supplied by Fujitsu and GE. A spokesman for the trust said that the GE system was being provided “under the umbrella of CSC”.

Royal Liverpool was following a precedent already set in NWWM by Coventry and Warwickshire University Hospitals NHS Trust, which in 2005 began work on a GE PACS solution, again in order to have a system ready in time for the opening of its new hospital. Implementation work on this system is understood to be underway.

Mid-Cheshire Hospital NHS Trust, another ‘early adopter’ site in NWWM, was also meant to have the CSC PACS/RIS solution implemented by December. The trust is now understood to have ended its project to implement the ComMedica/Kodak system. Asked whether the trust is now planning to install a GE system instead, a spokesperson said: “I understand that is the case. This is what has been proposed to us by CSC.”

Sources acknowledge that CSC’s PACS/RIS project has faced a variety of problems connected with developing and implementing an innovative PACS system as an enterprise-wide solution across the region. In particular many clinician’s in the cluster are understood to have been reluctant be first to take what some saw as a beta product.

Most of the outstanding issues are thought to have been addressed in a mid-December software release with the solution receiving extensive testing by CSC in recent weeks. However, it appears this work came too late and that CfH had by then lost confidence in the ability of CSC and its sub-contractors to deliver PACS/RIS.

Almost 19-months have now elapsed since the Department of Health announced the award of PACS contracts, to be delivered by LSPs Accenture, CSC, BT and Fujitsu, under the NPfIT programme. Implementation was to begin in summer 2004, with the whole of the English NHS scheduled to have PACS by 2007.

However, protracted contract negotiations between the LSPs and their PACS sub-contractors have created lengthy delays. Delays were exacerbated in the North East and Eastern regions by an unsuccessful legal challenge by Fuji which led to Accenture only finally signing a deal with Agfa to supply PACS in September 2005, with details of the pricing of this yet to be finalised.

To date only Fujitsu and GE in the South, and BT and Philips in London have yet delivered any live PACS systems. So far under NPfIT 9 NHS trusts have gone live with GE PACS systems, and 4 trusts with PACS supplied by Philips.

According to latest figures from NHS CfH 13 PACS implementations have occurred so far. The agency was last week still making the very bullish prediction that PACS systems will go in at the rate of one a week throughout 2006.