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Navigating the Dark Side: Private Sector PET/CT Experience in Birmingham

Learn about the journey of establishing an on-site PET/CT facility in Birmingham, insights, challenges, and successful integration with the Trust. The importance of teamwork, IT integration, and service quality.

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Navigating the Dark Side: Private Sector PET/CT Experience in Birmingham

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  1. Dabbling with the Dark Side Birmingham experience of an on-site Private Sector PET/CT facility Chris Boivin Head of Nuclear Medicine, University Hospital Birmingham

  2. Birmingham PET Centre • Background • How service works • Lessons learned

  3. Background • 1997 – Gamma Camera PET • Really wanted proper PET ASAP • DH funding? • Always about 2 years away • Local business case? • Non-starter since no guaranteed income • Independent sector? • Began to show interest 2001

  4. 2001: PET scanners per 10m

  5. ‘Procurement’ • Independent sector managed facility • On-site PET/CT facility at no cost to Trust • Alliance Medical preferred provider 2003 • Lengthy contract negotiations • Freedom to negotiate our own contract, but also freedom to cock it up

  6. Time line • Oct 2003: Mobile PET • July 2004: Mobile PET/CT • July 2005: PET Centre opens • Jan 2006: 1000th scan

  7. PET scans per quarter

  8. Our Requirements • Partnership – integration with Trust Imaging services • Involvement in choice of PET/CT camera & centre design • Bells & whistles • Radiotherapy treatment planning • Respiratory gating • Low-cost research access • Involvement of Nuclear Med staff

  9. PET Centre Operation • Staffed by Alliance • Manager/operator, operator, helper, 2 x clerical • FDG shipped in • IRR99 & RSA93 – Alliance • IRMER – Trust (control over procedures) • ARSAC & reporting – Trust radiologists • MPE – St George’s, shortly to be transferred to Trust physicists • RPA – Trust physicists • Trust authorised officer – contract monitoring • Monthly service meetings Trust & Alliance

  10. IT Integration • Probably the most complicated bit • Alliance private network with firewalls to Trust network • All patients registered on Trust PAS & RIS • DICOM worklist RIS to PET/CT • Images pushed to Trust PACS • Scan reporting on Trust RIS, access to Trust PACS in PET Centre

  11. Trust Staff Integration • Radiologists – ARSAC, reporting, training • Physicists – report checking, IRMER, RPA, incident investigation, audit & contract monitoring, RIS & IT support (bubbling under – MPE, R&D) • Technologists – injection assistance (future – supernumerary rotation, permanent staffing?)

  12. Service Integration • Emergency medical cover • Medical & consumable supplies • Infection control • Waste disposal • Cleaning • Portering • Fire alarms • Utilities infrastructure

  13. Lessons learned • Their targets are not necessarily our targets (eg 31 & 62 day cancer waits) • IT links and data sharing are a challenge to seamless integration • Useful to transfer risk of spiralling costs • Glossy literature & service marketing

  14. Conclusion • High-quality PET/CT service established • From user point of view, day-to-day function similar to other Trust imaging modalities • radiologists, IT integration, MDTs etc • Goodwill & good communication essential • overcame initial teething troubles, everyone working well together

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