Pukka-j migrates 38 million PACS images for Liverpool Heart and Chest Hospital NHS Foundation Trust. Liverpool Heart and Chest Hospital is one of the largest specialist heart and chest hospitals in the UK, providing specialist services in cardiothoracic surgery, cardiology, respiratory medicine including adult cystic fibrosis and diagnostic imaging. In 2010 the Trust was rated as the top performing hospital for “overall patient care” in the Care Quality Commission’s National Inpatient Survey.