WHICTS County ICT Programme Board

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Worcestershire Health ICT Services County ICT
Programme Board Presentation - Key Points
Notes (26th Nov 07) John Thornbury Director,
Worcestershire Health ICT Services John.thornbury_at_
nhs.net 078 667 213 71 (wictp_a_071126_00
_presentation.ppt)
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Ag. 2 Actions from Last Meeting (17th Jul 07)
Actions (PCT)
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Actions (Acute)
4
Actions (MHP)
5
Actions (ICT Specific)
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Ag. 3 New / Escalating Actions(in addition to
follow up actions from previous meeting)
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Ag. 4 - ICT Services Report (Operational)

• Full report available (Attachments 1,2,3,4,5)
• Service Availability
• Networks Server consistently excellent
  (Detail Attachment 2)

• Applications (Detail Attachment 1 Pg 3)
• scheduled and unscheduled downtime consistently
  below 1
• covers NCRS, Oasis, Oasis theatres, AE Patient
  First, CaB
• Aug 07 last period when gt1 (AE Patient First -
  5 hrs scheduled, 10 hrs unscheduled).

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Ag. 4 - ICT Services Report (Operational Contd.)

• Service / Helpdesk Calls (Detail Attachment 1 Pg
  3-4)
• Application Call
• Calls closed (667 in Oct 07) exceed calls opened
  (657 in Oct 07)
• Calls opened closed in same month consistently
  gt 90
• Calls to CfH (NCRS, CaB, N3, RA, SUS) remain very
  low (231)
• Above a function of additional staff agreed and
  changes to processes
• Call makeup (Oct 07)
• 40 Account set up
• 28 NCRS
• 25 Oasis
• 3 CaB
• 3 EDS
• 2 AE Patient First
• Service Desk
• Calls closed (2377 in Oct 07) exceed calls opened
  (2292 in Oct 07)
• Averaging 77 calls logged online.
• GP extensive use of web facility to log calls
  (average 90 of calls)

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Ag. 4 - ICT Services Report (Operational Contd.)

• Provision of Equipment

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Ag. 4 - ICT Services Report (Projects)

• Full summaries available (Attachment 1 - Pg 10-12
  3)
• SHA Report NPfIT Deployments (Detail
  Attachments 6 Pg 6, 15)

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Ag. 4 - ICT Services Report (Projects)
SHA Report NPfIT Deployments (Contd.)
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Ag. 4 - ICT Services Report (Projects)
SHA Report NPfIT Deployments (Contd.)
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Ag. 4 - ICT Services Report (Projects)

• (W2a) NCRS Community / Mental Health System.
  (PRIORITY 1)
• Project now moved to operational running.
• Risk W2A015 - concern continues that MH Change
  Managt role is stretched (IG / RA is included in
  JD).
• Some equipment rollout and training requirements
  continue to be assessed.
• Conversion of data to single PCT code completed.
• (W2b) Choose Book (PRIORITY 1)
• System continues to function well.
• Service process significant risks
• (W2_5_19i) WAHT reducing slots. Slot
  availability fallen to 14. Understood PCT
  written to GPs identifying alternative suppliers.
• (W2_5_17i) Lack of Acute Implementation Manager
• Proposal under development to increase
  utilisation to 50 by Mar 08.
• SHA Report Detail Attachment 6 Pg 7-9,15

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Ag. 4 - ICT Services Report (Projects)
(W2b) Choose Book (PRIORITY 1) (Contd. SHA
Charts)
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Ag. 4 - ICT Services Report (Projects)
(W2b) Choose Book (PRIORITY 1) (Contd. SHA
Charts)
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Ag. 4 - ICT Services Report (Projects)
(W2b) Choose Book (PRIORITY 1) (Contd. SHA
Charts)
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Ag. 4 - ICT Services Report (Projects Contd.)

• (W2c) Electronic Prescription Service (R1
  Technical) (PRIORITY 1).
• GP Pharmaceutical suppliers slow to get systems
  accredited
• PCT prescription rate is 4th highest in SHA. Q2
  up 113 on Q1.
• 47 General Practices operational (31 in Jul)
  BUT 78 systems functional discussion with
  practices on usage.
• 47 pharmacies operational (39 in Jul 07) BUT
  94 systems functional discussion with SHA as
  to how to encourage more use.
• SHA Report Detail Attachment 6 Pg 10-11,15

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Ag. 4 - ICT Services Report (Projects)
(W2c) EPS (PRIORITY 1) (Contd. SHA Charts)
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Ag. 4 - ICT Services Report (Projects)
(W2c) EPS (PRIORITY 1) (Contd. SHA Charts)
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Ag. 4 - ICT Services Report (Projects Contd.)

• (W22) NSTS Closure (PRIORITY 1)
• Very good progress currently the 3 Trusts are
  within top 19 nationwide, having completed
  technical go live.
• Looking to complete Ph 1 work by close of Dec 07.
  Future users will be covered by Trust operational
  RA leads letters in process of being sent out.
• Acute RA Management has not functioned
  continuing issue. Needs addressing by Trust as a
  matter of urgency.
• (W29) GP2GP (PRIORITY 1)
• Good progress for 22 practices involved
• 11 live - further 5 booked for Nov 07
• Discussions with remaining 6 taking place.
• SHA Report Detail Attachment 6 Pg 12,15

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Ag. 4 - ICT Services Report (Projects)
(W29) GP2GP (PRIORITY 1) (Contd. SHA Charts)
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Ag. 4 - ICT Services Report (Projects Contd.)

• (W3d) Maternity
• Data sets for normal pregnancies now complete
  testing planned .
• Data sets for abnormal pregnancies 20 complete
  service issue.
• System performance issue to be addressed by
  Bluespier exception report raised and
  discussions ongoing.
• Go live likely end of Mar 07 dependent on
  performance issue addressed.
• PACS
• (W3i) WRH closure processes commencing (legacy
  data transfer contd.)
• (W20) Comm POWCH Evesham installed. Malvern
  Tenbury planned
• Cluster Solution agreement to take RIS.
• SHA Report Detail Attachment 6 Pg 4
• PACS RIS Deployment Proposal Paper (Attachment
  7)
• Options are to remain with existing RIS, or
• Migrate to Cluster RIS offering.
• Concerns over existing RIS to cover future
  information sharing requirements.
• Recommend migration.

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Ag. 4 - ICT Services Report (Projects Contd.)

• (W36) GP OOH Tender
• ICT Services covering project management for both
  service and ICT components.
• Brief completed governance in place.
• PQQ sent out.
• (W28) Infection Control
• Good progress service governance very good
• Claire Constantine Project Executive
• Clare Kambal Service Lead
• Technical deployment commenced.
• Administration training planned.
• Go live anticipated close Jan 08.

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Ag. 4 - ICT Services Report (Vacancies)

• ICT Vacancies (Detail Attachment 5)
• 1LS (11 posts)
• 5 posts filled (1LS001, 002, 004, 006, 007)
• 1 interview scheduled (1LS008)
• 3 posts awaiting consideration (1LS009, 010,
  011)
• 1LS009 IT Desktop Technician
• 1LS010 IT Desktop Technician
• 1LS011 IT Transportation Officer
• 2 posts on hold (1LS003,005)
• 1LS003 IT Desktop Technician (Junior)
• 1LS005 IT Desktop Technician (Junior)
• ICT Training (5 posts)
• 3 posts filled (TRA001,002,005)
• 2 posts awaiting consideration (TRA003,004)
• TRA003 E-Learning Facilitator
• TRA004 IT Training Officer

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Ag. 4 - ICT Services Report (Vacancies Contd.)

• Knowledge Management (5 posts)
• 3 posts filled (KMT002, 003, 004)
• 2 interviews scheduled (1LS001, 005)
• Clinical Informatics (5 posts)
• 4 posts filled (CIF001, 002, 003, 004)
• 1 post to advert (CIF005)
• Project Management (3 posts)
• 3 posts awaiting consideration (PPM001, 002, 003)
• PPM001 Project Manager (Senior)
• PPM002 Project Manager (Standard)
• PPM003 Project Manager (Junior)

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Ag. 4 - ICT Services Report (Other)

• Realtime Admissions, Discharge Transfer (ADT),
  Electronic Discharge Summaries (EDS) and Orders
  Results Communications.
• Paper available Attachment 8.
• Acute has requested update on when EDS and Orders
  Results Communications will be deployed.
• A number of issues to be resolved first
• Use of existing electronic ADT removal of ward
  based paper methods this require Acute Exec
  intervention ICT can only take the process a
  certain distance this has been reached.
• The Bluespier EDS module has to be specified
  service input required.
• An Orders Results Communications system has to
  be identified and funds made available for this
  additional purchase.
• Deployment period for all 3 is significant
  unlikely that current schedule and these can be
  managed in parallel. May require additional
  change management, training and project
  management if to be brought forward as a matter
  of urgency.
• Board needs to advise whether this is now
  considered a new priority and how to be resourced
  / other priority removed.

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Ag. 4 - ICT Services Report (Other Contd.)

• GP System of Choice (GPSoC).
• Aimed at supporting healthcare by standardising
  systems over time, to a set of approved suppliers
  and systems ultimately resulting in migration to
  a fully integrated model (Level 6) with the NHS
  Care Records Service and other healthcare systems
  .
• Centrally negotiated contracts with system
  suppliers provide economies of scale, whilst also
  relieving some financial pressure in GP system
  purchases from PCTs. Some costs remain for PCTs
  and GPs depending on the migration path chosen.
• Changing practice systems outside the natural
  migration path requires a business case to be
  developed by the practice and approved by the
  PCT. This is not funded by GPSoC.
• Strategic migration plans are required by SHAs
  from each PCT by close of Dec 07. ICT has
  drafted (Attachments 9, 10, 11) framework on
  behalf of PCT - treated as a portfolio of work as
  individual projects (CaB for Level 1, EPS for
  Level 2, GP2GP for Level 3) are in place.
• Hosting is an option from Level 2 onwards in
  addition to additional functionality.

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Ag. 4 - ICT Services Report (Other Contd.)

• Home Working Summary of Technology Office
  Considerations.
• Paper available Attachment 12.
• Initially raised from request to identify current
  technological options to support service based
  flexible working requests.
• Paper focuses on
• Current technology available from ICT Services
  and its current use not just administrative
  (e.g. OOH Pathology).
• Extensive broadband coverage making technology
  options viable.
• Benefits to employer and employee.
• Responsibilities of both parties.
• Recommendations / Next Steps
• Discuss the potential benefits in principle for
  home working for the Trust as a whole, as well as
  to specific sections of the Trust.
• If favourable, assess the business case for home
  working.
• Better cost benefit analysis.
• Assessment of likely take up.
• Determine likely rollout of technology.
• If favourable determine the approach.

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Ag. 4 - ICT Services Report (Other Contd.)

• Portfolio Management
• Paper available Attachment 13.
• Initial discussion paper to identify whether
  Board wishes to examine more closely the
  extension of existing project management coverage
  to other service based work.
• Paper focuses on
• Emphasis on service programmes driving work
  programme.
• Few projects are primarily ICT focussed but
  virtually all use ICT danger that focus on
  service delivery is lost in ICT deployment.
• ICT has the majority of accredited project
  managers this should potentially be a resource
  for all.
• If remit widened, benefits / implications,
  potentially include
• Centralised expertise on tap subject to
  adoption criteria.
• Enterprise based view on service development
  priorities removes duplication and aids
  benefits realisation processes supporting LDP.
• Centralised project resource pool, removing delay
  in appointment of more expensive temporary non
  local project managers. The current resource
  pool would be inadequate require fund pooling.
• Centralised reporting on whole programme and
  project portfolio.

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Ag. 4 - ICT Services Report (Other Contd.)

• Estates Management (ICT Strategy)
• Agreed at Jul 07 meeting to discuss how Trust
  Estates departments ensure that ICT are included
  in early discussions regarding
• Refurbishments / relocation of services that
  either affect existing ICT resources or may
  adjust existing ICT plans. There have been
  occurrences of site moves taking place shortly
  after expensive infrastructural work.
• Policy decisions on booking building work and
  access to sites for ICT suppliers.
• Child Health
• Mandate to be received (Attachment 14)
• Health Visitors and School Nurses within
  Worcestershire do not currently have access to a
  universal Community IT system.
• The current CCH2000 child health system has also
  been adopted by the Cluster as the Connecting for
  Health (CfH) tactical solution in advance of
  Lorenzo.
• No licencing issues to stop deployment commencing
  locally in 2008/9 ahead of CSCA DIP timetable
  (close of 2008/9).
• Recommend implementation for Health Visitors,
  School Nurses and other community staff working
  with children.

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Ag. 5 - Countywide ICT Strategy / Plan

• Operating Framework (ICT) awaited, however
• SHA (16th Nov) draft guidance for IMT Plans
  Attachments 15, 16, 17.
• Completion of 1st draft by close of Jan 08 full
  plan by close of Mar 08.
• PCTs to act as leads in delivery (based on
  governance set up 2007/8).
• LHC based plan, PLUS
• Provider Trusts (incl. PCT as provider) to have
  individual IMT plans. We recommend that these
  are a section within the main LHC based IMT
  plan.
• Plans must contain
• Operational level detail for 2008/9
• Local service transformation plans requiring IMT
  input.
• Benefits planning against service deliverables
  from IMT perspective.
• Clear outline of governance arrangements.
• Investment against baseline as well as local,
  regional Nat devt.
• Capacity and capability planning.
• Longer Term Plans to 2010/11
• Anticipated service priorities.
• Progress towards Maturity Model.
• Indicative roadmap for regional and national
  solutions.

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Ag. 5 - Countywide ICT Strategy / Plan (Contd.)

• We also have the following as guidance
• SHA have provided guidance to PCTs (Attachment
  18) on Assurance Frameworks (Peter Spilsbury
  letter 17th Oct 07)
• Our NHS Our Future focus on 8 clinical
  pathways
• Investing in Health 7 Big Challenges
• National draft Performance Framework (targets)
  we have a copy of these.
• We have existing and new national service
  challenges PLUS local priorities previously
  identified that appear to require rollover
• Reducing health inequalities and promoting health
  and well being.
• Extend Improve Joint Commissioning
• Supporting efficiency use of public health
  information Infection Control.
• OOH
• Financial balance
• GPSoC
• 18WW

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Ag. 5 - Countywide ICT Strategy / Plan (Contd.)

• Initial summary provided (Attachment 19)
• Produced ahead of guidance so fuller checks
  against guidance now required.
• Comments on Summary welcomed.
• Biggest dependencies on completion
• Trusts forward initial thoughts on service
  priorities MHP already available.
• Draft budget to be agreed by CEOs.
• Clarification on DIP agreements.
• Matching of resources against initial plan.
• Intend to distribute 1st draft of summary by
  close of Dec 07, then..
• Fuller plan for 15th Jan 08 Board send to SHA
  by close of Jan 08, then..
• Full plan for end Feb 08 ahead of sign off at
  Board meeting of 17th Mar 08.
• Fully signed off plan to SHA for close of Mar 08.

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Ag. 5 - Countywide ICT Strategy / Plan (Contd.)
Production of Plan (NB Due to recent receipt of
guidance a Red RAG may merely indicate that
clarification on terminology is awaited, not
necessarily that work has not been completed)
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Ag. 5 - Countywide ICT Strategy / Plan (Contd.)
Production of Plan (Contd.)
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Ag. 5 - Countywide ICT Strategy / Plan (Contd.)
Production of Plan (Contd.)
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Ag. 5 - Countywide ICT Strategy / Plan (Contd.)
Production of Plan (Contd.)
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Ag. 6 Information Governance

• Full report available (Attachment 20)
• Statement of Compliance (SoC)
• Agreement (based on 17 standards) between Trust
  and CfH.
• Actions plans have been submitted.
• Each Trust currently fails in one area or another
  compliance by Mar 08.
• New version IG Toolkit
• Now includes knowledge base framework,
  requirements under SoC (above) and additional
  requirements for PCTs to support PbR and
  Secondary Uses.
• Next version was due in Sep 07 still awaited.
• RA resource issues continue (Attachment 21)
• Countywide Security Officer has now left post
  to be changed support tbc.
• MHP NCRS Change Manager also IG and RA Lead
  question as to whether person will be able to
  commit fully to each area.
• MHP RA Agent 6 month sabbatical in Sept 07.
  exacerbates issue.
• Acute Trust - relies solely on part time RA
  Management.
• OOH coverage for CaB, NCRS, EPS.
• National RA process / equipment configuration
  changes exacerbate issue.
• Inter-agency Information Sharing Protocol out of
  date Acute to sign standard.
• Care Record Guarantee specific reference for
  compliance (Attachment 22)

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Ag. 7 - Monthly Budget Report

• Attachment 23 (text).
• Attachment 24 (figures).

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Ag. 8 - Any Other Business

• 5 Key Steps to Mitigate Data Protection Risk
• Carry out a risk assessment - As always you
  cannot manage what you cannot measure. A
  benchmark of the organisational security posture
  is key.
• Create an Information Security Forum with
  executive powers - Security is a cross department
  issue. A security failure will drag in everyone
  from Legal, I.T to Marketing. They all have to
  become owners of this issue.
• Develop and disseminate a User Awareness Campaign
  - Having best practice written in an employee
  handbook is not a credible attempt at data
  protection. The battle for information security
  is incessant. No-one in the organisation should
  be unaware and hence become the weakest link.
• Determine your security posture balance in
  relation to business agility and then stick to it
  - Information Security requires sacrifices to be
  made in relation to business agility. From remote
  access to device control, user functionality must
  take second place to security. Gain executive buy
  in and stay the distance.
• Its rarely a technology issue - institutionalise
  information security via a governance framework
  such as ISO27001, COBIT, ITIL - Make security
  part of the fabric of your organisation. Don't
  reinvent the wheel but rather adopt methodologies
  already proven in the industry such as
  ISO27001,COBIT and ITIL.

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Ag. 8 - Any Other Business (Contd.)

• Draft Meeting Schedule beyond Jan 08.
• Intention is to continue with quarterly meetings
  but include a Mar 08 and Apr 08 meeting for
  finalising plan / sign off.
• Draft schedule in next slide

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Ag. 9 Date Time Next Meeting
Previous Schedule Agreed (also in Attachment 25)
Draft Schedule to be Agreed