PET/CT - the DH Perspective Richard Dale Medical Director DH Commercial Directorate

1. PET/CT - the DH Perspective Richard Dale Medical Director DH Commercial Directorate BNMS, 21st March 2007

2. Background • Motivation • Increased Access • National • 800 per Million population • Fair geographic distribution • Primarily Oncology • Procurement Specifics • 5 Year contract (option for 2 year extension at term) • Country split into 2 Regions: North & South • Designed in line with RCR recommendations

3. Procurement Timelines • Concept & Specification Development • OJEU • Memorandum of Information • Pre-qualifying Questionnaire • ITN issued 7 July 2006 • Bids received 19 September 2006 • Preferred Bidder awarded 21 December 2006 • Commercial Close expected March 2007 • Financial Close expected May 2007 • Service Delivery expected June 2007

4. Expected Volumes Obtained after consultation with Cancer Networks and Specialist Commissioning Groups Total scans = 91,991 (over 5 years)

5. Specifications • 20 Sites (8 in North, 12 in South) • 18FDG only • Oncology • Service specified, not equipment • Diagnostic PET; Attenuation correction CT for Anatomical location • Scan & Report = Activity Output • Mobile and Static sites • Focus on increasing access, capacity and proximity • Tight Time Standards • MDTM Support • Provide minimum of 35% of capacity for Training

6. Time Standards • 5 Business Days • To complete scan from receipt of referral • 2 Business Days • For referring clinician to receive Activity Output • 2 Hours • To transfer Patient and draft Activity Output if Urgent medical finding • 3 Minutes • For Crash team arrival

7. Equipment • BGO/LSO/LRSO • At least 6 slice CT • Fixed or Mobile • Siemens/Philips in South • GE in North

8. Reporting • Consultant on GMC Specialist register • ≥ 300 scans reported per annum to be eligible • Subject to review by relevant body (e.g.. Introduction of competencies) • Utilisation of local NHS reporters encouraged • Both providers keen to forge links with local reporters • Reporting houses to centralise resources (IT, scheduling, abide to Time Standards etc) • 10% Double reporting in randomised and blind fashion

9. Training • IS Provider to provide access to a minimum of 35% of its Activity to the NHS for the provision of training in any one contract year • Who? • Radiologists • Radiographers • Clinical Scientists (including Medical Physics Experts) • 35% of all scans, devoid of patient identifiers • 35% of all scans to be made available for training Radiographers • 35% of sessions for Clinical Scientists • Additional inclusions • NEMA testing • Quarterly QA/QC testing

10. Training 2 • UK PET CT Board • Develop training curriculum and associated competency standards • Design training schedules • Accredit training where applicable • Work with IS, NHS and training bodies (RCR, SOR, IPEM, UK PET CT Board) to develop PET CT training in UK • Up to training bodies to utilise training capacity • Trainees selected as current practise but open to review as training develops

11. Performance Monitoring • Key Performance Indicators • Quarterly Joint Services Review • Joint Services Investigation • Rectification Plan • Penalty • Immediate Deduction Performance Indicators • Immediate financial penalty • Joint Services Review • Rectification Plan

12. Additionality • Specific for Phase 2 • Any NHS employee may work for an independent sector provider during non-contracted hours • Clear and intentional compatibility between the Government’s policy on ISTCs, the requirements placed on consultants under the Consultant Contract, and other requirements that consultants must meet • Where consultants undertake work in ISTCs (or for any other employer) there is no conflict of interest or breach of the duty of fidelity in employment law, provided consultants comply with the requirements of the Consultant Contract (or any variation agreed with their NHS employer) and the Code of Conduct for Private Practice: Recommended Standards of Practice for NHS Consultants

13. PET/CT - the DH Perspective Richard Dale Medical Director DH Commercial Directorate BNMS, 21st March 2007