Trusts have been advised to be “careful” when buying picture archiving and communication systems and radiology information systems from framework deals. Tony Corkett, Health Director at Amor Group explains some of the potential pitfalls to watch out for.

1. NHS England – Taking Control
of RIS / PACS
Tony Corkett
2nd May 2012
© Amor Group 2012

2. Agenda
• Background
• Challenges
• Options to consider
• Procurement routes
• Example of recent project
• Lessons learnt
© Amor Group 2012

3. The successful PACS providers in England
North East cluster
Accenture
North West & West Agfa
Midland cluster
The CSC Alliance Eastern cluster
GE
ComMedica / Kodak Accenture
Agfa
Southern cluster
The Fujitsu Alliance
The CSC Alliance London cluster
GE Capital Care
Alliance, led by BT
Philips / Sectra
© Amor Group 2012

4. Challenges (1)
• LSP contracts ending (2013-15)
• 80% of Trusts have an element of LSP
PACS / RIS
• Many of the non LSP systems are also up
for renewal in the same time window
© Amor Group 2012

5. Challenges (2)
• NHS capacity and capability
• Supplier capacity
• Business case sign off
• Procurement process – which one
• What do I replace with what
– PACS / RIS / EPR / VNA / CR / breast
screening / cardiology ……
• Data migration / retrieval
© Amor Group 2012

6. Options
• Consortium or stand alone
• Shared systems or stand alone
• System architecture
– PACS-RIS (single supplier)
– PACS+RIS/EPR (could be EPR supplier)
– VNA – what is that?
– Other systems
• Managed service or cap and Rev
• What about CR
© Amor Group 2012

7. Do nothing is not an option
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8. Procurement Options
• OJEU
• Framework
• Extension
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9. OJEU
• the open procedure, under which all those interested may respond to the
advertisement in the OJEU by tendering for the contract;
• • the restricted procedure, under which a selection is made of those who
respond to the advertisement and only they are invited to submit a tender for
the contract. This allows purchasers to avoid having to deal with an
overwhelmingly large number of tenders;
• • the competitive dialogue procedure, following an OJEU Contract Notice
and a selection process, the authority then enters into dialogue with potential
bidders, to develop one or more suitable solutions for its requirements and on
which chosen bidders will be invited to tender; and
• • the negotiated procedure, under which a purchaser may select one or
more potential bidders with whom to negotiate the terms of the contract. An
advertisement in the OJEU is usually required but, in certain
circumstances, described in the Regulations, the contract does not have to be
advertised in the OJEU. An example is when, for technical or artistic reasons or
because of the protection of exclusive rights, the contract can only be carried
out by a particular bidder.
© Amor Group 2012

10. Frameworks
• Already through OJEU
• May be national, local or commercial
• Typically contract T&Cs set
• These may also be set:
– Price
– Term
– Supplier choice
• Often involves local tendering from
shortlist
© Amor Group 2012

11. Personal Comments
• Frameworks are a very valuable tool
• Work well for simpler or transactional
processes or products
• But in my opinion for complex system the ability
of the Trust(s) to set out their own
requirements, contract terms and conditions is
the better route – but you will need the skills
and knowledge to deliver
• Frameworks may be the only option if you don’t
start soon
© Amor Group 2012

12. Recent Example
• Actual PACS / RIS / VNA / Cardiology
Project
• Starting in Feb 2011
• Went live Feb 2012
• (non LSP)
• Work on-going – (key lesson)
© Amor Group 2012

13. Example Timeline
Week 1 Week 8 week 16 week 36 week 40 week 41+
OBC FBC Implemetation
Negotiations / Contract
OJEU/PQQ Competitive Dialogue complete
© Amor Group 2012

14. What we had
• Procurement support
• Sufficient resources
• Organised teams:
– Project Board
– Evaluation Team
• Commercial Team
• Site Visit Team
• Clinical Team
• Technical team
© Amor Group 2012

15. Competitive Dialogue Phases - OJEU
• OJEU Notice
– Kept options open on:
• Who to include as organisations
• What you are looking for
• If you will break it in to lots / multiple suppliers
– You can ask some questions at this stage to
rule out suppliers (legal and financial)
© Amor Group 2012

16. Competitive Dialogue Phases –
PQQ
• Pre-Qualification Questionnaire
– Clear timetable
– stated clearly that we would reject or
disqualify at this stage
– State costs are at supplier risk
– Consider FOI / COI / warranty
– Selection matrix and how we scored the
responses
© Amor Group 2012

17. Example PQQ Scoring Matrix
PQQ Section (and Information Weighting (%)
sub-questions)
Section A Background Information
Questions 1-7 Organisation details Information only
(not scored)
Section B Financial and economic information
Question 1 Banker’s details Pass/Fail
Question 2 Accounts information Pass/Fail
Question 3 Financial Turnover (minimum annual turnover of £xxm) Pass/Fail
Question 4 Insurance Details (Please note that Candidates are required to demonstrate, for each type of insurance (i.e. Pass/Fail
employers’ liability, public liability and professional indemnity insurances), a minimum cover of £xx million
Question 5 Litigation/legal proceedings Pass/Fail
Section C Technical information
Question 1 Experience in delivering relevant services 35
Question 2.1 Experience of integration and neutral archive 22
Question 3 References Pass/Fail
Question 4.1 Support resources & location 10
Question 4.1 Staff resources 13
Question 4.2 Out of hours support model 10
Question 4.3 State the products that you are seeking to provide and state which ones will be through a sub contractor Information only
(not scored)
Question 4.4 Confirm your commitment to performance standards linked to a performance/payment regime. Pass/Fail
Question 4.5 Provide in outline the significant product developments you have released over the last 2 years and what you are 10
planning for the next 2 years
Question 5.1 Deductions for damages Pass/Fail
Question 5.2 Contract/employment termination Pass/Fail
Question 5.3 Failed contract renewal Pass/Fail
Question 5.4 Legal proceedings pending Pass/Fail
Question 6.1, 6.2 Unlawful discrimination finding Pass/Fail
Section D Statement relating to Good Standing Pass/Fail
Section E Checklist Information only
(not scored)
Total weighting 100
© Amor Group 2012

18. Outcome of PQQ
• The aim was to reduce the number of
candidates to a manageable number –
you can suggest how many in the OJEU
notice
• The PQQ needs therefore to be built
around what you are trying to achieve
and are able to manage
• Debrief
© Amor Group 2012

19. Competitive Dialogue Phases - IPCD
• Invitation to Participate in Competitive
Dialogue
– Background to the project
– Rules on completion and pricing (recommend
you do not use costs for shortlisting), and
procedure
– Evaluation criteria
– Timetable
– Offer site visit to see the Trust
– High level requirements
– Example of the contract
– Formal response date © Amor Group 2012

20. Competitive Dialogue Phases – IPCD -
requirements
• Keep it high level
• What are the key areas that you need
addressed
• Provide the detail that will help the
suppliers:
– Key systems and functional needs
– Activity
– Equipment
– Technical
– approach to implementation
© Amor Group 2012

21. Competitive Dialogue Phases – IPCD -
dialogue
• Enter into dialogue with the suppliers
• Discuss
– Their initial responses / questions
– Consider demonstration days
– Reference site visits
– Presentations
• The Trust is seeking to understand what the
supplier can offer and how it can solve the
needs as much as the supplier is seeking to
understand the Trust needs
• This is a dialogue!
© Amor Group 2012

22. Competitive Dialogue Phases – IPCD -
evaluation
• Issue the scoring criteria
– You can include:
• Site visits
• Demonstrations
• Dialogue responses
• Contract comments
• Presentations
– Use a team based approach to scoring
and be consistent
© Amor Group 2012

23. Outcome of IPCD
• The aim is to reduce the number of candidates
to a manageable number – you can suggest
how many in the OJEU notice – suggest 3
• The IPCD needs therefore to be built around
what you are trying to achieve and are able to
manage
• Debrief suppliers
• (some may withdraw on their own if they realise
that they cannot deliver what you need)
© Amor Group 2012

24. Competitive Dialogue Phases – IPDD
• Invitation to Participate in Detailed
Dialogue
– Key here is to build out the specification
– As your needs become clearer and you can
see what is available on the market
– It is an iterative process
– But be consistent
– Keep a record of actions and who is
delivering them by when
© Amor Group 2012

25. Outcome of IPDD
• Are the suppliers that are left capable of
meeting your detailed needs and contract
terms
• Confidence to issue BAFO
© Amor Group 2012

26. Competitive Dialogue Phases – BAFO
• Best and Final Offer
• Formal Document
– Needs to be issued and received under
Trust SFIs for OJEU tenders
• Issue final contract schedules
© Amor Group 2012

27. BAFO – Scoring
• Issue the scoring criteria and be consistent with
IPCD
– You can include:
• Site visits
• Demonstrations - scripted
• Dialogue responses
• Contract comments
• Presentations
– Use a team based approach to scoring and be
consistent
– Then look at price and see which supplier offers
the best score per £
– Ensure that you are comparing apples to apples
© Amor Group 2012

28. Preferred Bidder
• Once decision made and approved by
Trust
• Enter Alcatel period – suggest 10 days
• Then complete final tidy up of contract
• Sign contract
• Debrief all unsuccessful bidders
• The hard work then begins –
implementation….
© Amor Group 2012

29. Example Timeline
Stage Days / Weeks
OJEU 30 days
PQQ 3 weeks
IPCD 10 weeks
IPDD 12 weeks
BAFO 2 weeks
Total 32 weeks – (~8 months)
© Amor Group 2012

30. Implementation
• Dedicated PM
• Strong Project Board
• Training and change is key
• Technical:
– Data migration
– Data storage (if local)
– Networking
– Interfacing
• Supplier should be a partner – drive out
any benefits © Amor Group 2012

31. Lessons Learnt
• It can be done!
• Have sufficient skills and resources
– This is a key hospital wide system
– Understand what you planning on – VNA is
bigger than just radiology
• The project to BAU transition may take
longer than planned
• Ensure the supplier had the resources
available to meet your needs
© Amor Group 2012

32. Tony Corkett, Health Business Unit Director
With over 15 years experience working for the
NHS, Tony has a vast depth of knowledge in
providing health solutions that create cross
community efficiencies. Leading the Health
Business Unit, Tony’s passion is developing new
health products to help improve patient care across
the market. At the end of a long day in the
office, Tony likes nothing more than sitting down
with his feet up enjoying a large glass of wine.
Questions?
info@amorgroup.com © Amor Group 2012