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Perspective: Future Developments

John SomersConsultant RadiologistNottingham University Hospitals Trust. Lead for EEM Cluster

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CV

• Consultant Radiologist (Paeds) 1991• Chair LIS IfH 2000-2003• Lead clinician Trent SHA NPfIT• Cluster lead for Acute/PACS EEM 2005• National Clinical PACS lead 2006• Nottingham early adopter EEM

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Political environment• Cancer 31/62 day wait

• 18 week target

• Delivering services closer to the patient

• Patient choice

• PBR

• ISIP

• Extended working hours

• On-call/Hospital at night

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Number of Radiologists per million population

0

20

40

60

80

100

120

140

Austria

Belgium

Bulgar

ia

Cyprus

Czech

Rep

ublic

Denmark

Finlan

d

Franc

e

German

y

Hunga

ry

Icelan

d

Irelan

dIta

lyLa

tvia

Luxe

mbour

g

Nether

lands

Norway

Poland

Portug

al

Russia

Spain

Sweden

Switzer

land

Turke

y

Ukraine

United

King

dom

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Political environment• Acute Trusts• Primary care• Foundation Trusts• Independent Sector Treatment

Centres• Private Hospitals• World

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PACS challenges• Unique ID’s

• Removal of artificial boundaries; Entity, SHA, Cluster

• Integration of RIS function

• Faster networks/compression

• Teleradiology

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What is the future of PACS?

• Integration with CRS • Breast screening programme• Endoscopy• Cardiology• Dermatology• Retinopathy screening• Medical photography

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Radiology in 2010?

• Assume truly national RIS/PACS as part of CRS• Geography becomes irrelevant for majority of

imaging• Most images aquired against protocol anywhere• Specialist employed in regional centres

providing service Nationally

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Radiology in 2010?

• On call or 24/7 working arranged across cluster• General (plain film, MRI, CT, NM) work put up

to report (for tarrif) by anyone able to report in specified time e.g. 24hrs

• Job plans based on income targets i.e. Earn your salary

• Treat NHS as private practice

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