Royal Liverpool University Hospital NHS Trust commissioned Pukka-j to localise 87 million images. The Royal Liverpool University Hospital is the biggest and busiest hospital in Merseyside. It is part of the Royal Liverpool and Broadgreen University Hospitals NHS Trust. It currently has over 40 wards, more than 750 beds and has the main accident and emergency department for the city of Liverpool, the largest of its kind in the country, capable of dealing with major trauma and life threatening illness.