WHICTS County ICT Programme Board

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Worcestershire Health ICT Services County ICT
Programme Board Presentation - Key Points (13th
Mar 07) John Thornbury Director,
Worcestershire Health ICT Services John.thornbury_at_
nhs.net 078 667 213 71 (wictp_n_070313.ppt)
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Apologies / Attendes
3
Summary of Actions
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Ag. 2 Matters Arising

• Previous Notes
• Full notes actions (Agenda Attachment 1)
  (Accepted)
• Summarised actions by organisation (Agenda
  Attachment 2) (Accepted)
• Unaddressed ICT Report actions highlighted
  (Agenda Attachment 12) responsibility of Chairs
  of organisational ICT Programme Boards
• Clinical Representation
• Schedule adjusted to accommodate as much as
  possible (new schedule at bottom of agenda)
  (Actioned)
• Clinicians have likewise adjusted their schedules
  to accommodate
• Communications Lead.
• Paul Lynn nominated to act as Communications
  Lead. (Actioned)
• Draft JD (Agenda Attachment 3) provided for
  discussion / sign off. (Accepted)
• Reference Group
• Information Governance Chair (Rob Neill) now
  included on Board. (Actioned)

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Ag. 3 - ICT Services Report (1 - General)

• Service Availability (Pages 2 - 6)
• Generally very good network, server and
  application all green (lt1 unscheduled
  downtime) in Feb 07
• Service / Helpdesk Calls
• Number of outstanding calls rising averaging
  900 from 50 prior to recruitment freeze (6 posts)
  (Agenda Attachment 8)
• 82 calls logged online (up from approx. 70 in
  Jan 07)
• Query re externalising Service Desk equivalent
  cost for non account setting (30 of workload)
  was 80K internal to 250K external.
• Feb 07 Application Calls
• 41 Acute Oasis system
• 31 Account set ups
• 22 NCRS a number of system specific issues
  arising and so a specialist report will be
  generated in future monthly ICT report.
• 2 CaB

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Ag. 3 - ICT Services Report (2 - Projects)

• Choose Book
• Query Jan 07 meeting re referral figures
  understood to be clarified. (Confirmed)
• Dashboard report available (Agenda Attachment 9)
• 22 referrals
• gt9000 referrals since Apr 06
• 2 week wait pilot, additional training, comms
  internally / externally
• iPM / Community / Mental Health System.
• Training requirements continue to be assessed
• Conversion of data to single PCT code requires
  next version of software as well as decision on
  which date to use.
• Reaching 2nd anniversary of smartcards see IG
  section
• PCT Project Exec yet to be nominated (To be
  actioned)

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Ag. 3 - ICT Services Report (3 - Projects)

• Electronic Prescription Service (Release 1
  Technical).
• GP Pharmaceutical suppliers slow to get systems
  accredited
• 13 General Practices operational
• 33 pharmacies operational
• Annex 3 requires monthly increase in usage and
  estimates confident planning and governance in
  place to achieve this but
• dependent on system rollout
• no national data available to allow LHC level
  figures to be gained or estimates to be generated
  from current usage.
• PACS
• WRH PACS going live as speak
• Community PACS (Brief signed off last meeting to
  commence after WRH sign off resources do not
  exist to start earlier)
• Technical issues (crosshatch and hanging
  protocols) resolved
• Management issues (Vascular Surgery) resolved
• Discussion re migration to Cluster solution
  continues new implications re network coverage
  arisen - 2.9m rev consequence.
• (Further meeting arranged with SHA on 23rd Mar)

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Ag. 3 - ICT Services Report (Info. Gov.)

• Rob Neill Chair of IG Reference Group
• Report available (Agenda Attachment 10)
• PCT policy / procedure consolidation continues
• Protocol for information sharing being developed
• New IG Toolkit nearing completion (31st Mar 07)
  around county
• New ToR (Agenda Attachment 11) for sign off by
  Board (Accepted)
• Registration Authority (RA) / Smartcards (To be
  actioned)
• 2nd anniversary of 1st (02) set of smartcards -
  these need to be replaced.
• Responsibility continues to be discussed
  originally agreed as HR responsibility to tie in
  with other HR processes (starters / leavers etc.)
  but lack of ownership has led to mix of
  organisational IG (sponsoring registering
  staff) and county ICT services (technical changes
  (PC identity agents) to desktops registering
  staff (Acute / MHP)) managing process.
• Technically (if technology allows) do this
  remotely but, if not, then resources will need
  to be found to undertake this manually (issue of
  vacancy freeze).
• Re-certification ICT assisting Acute / MHP ad
  hoc (PCT OK) but vacancy freeze leaves no
  resources to undertake this larger scale task in
  time (Apr 07).
• Out of Hours cover for pharmacies (and GP?) will
  add to pressure to system

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Ag. 3 - ICT Services Report (4 Other)

• Unaddressed Issues from Previous Reports.
• Agenda Attachment 12 collated by Trust
• Responsibility of organisational ICT Programme
  Chair to address as agreed in Jan 07 Board and
  within ToR.
• Majority now covered main ones outstanding
• Vacancy Issues covered in previous notes.
• Planning documentation (PCT / Acute) covered in
  previous notes.
• PACS (Cluster solution) covered in previous
  notes.
• NCRS Project Executive covered in previous
  notes.
• Management of Risk monthly reports unable to be
  sent to MHP / PCT as contact names have not been
  sent to chris.greening_at_nhs.net

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Ag. 4 - Countywide ICT Strategy / Plan (1)

• Decision at Jan 07 Board to combine Commissioner
  Provider Strategy / Plan.
• Executive Summary (Agenda Attachment 13) and main
  plan (Agenda Attachments 14, 15, 16, 17, 18, 19)
  first drafts completed.
• Focus of Plan.
• Confirm national service priorities via Nat.
  Operating Framework
• Combine to Nat. ICT Priorities (via Annex 3)
• Assess ICT support to address these and
  prioritise 1, 2, 3 characterised by.
• Priority 1 292K national imperatives, NPfIT
  deployments, countywide local initiatives in
  prep for migration to NCRS
• Priority 2 97K extend continuity and
  functionality of services in P1
• Priority 3 - 26K extend service support beyond
  traditional boundaries
• Determine first pass estimates on resources to
  cover these.
• Assumption is that frozen resources will be
  released from Apr 07
• 573K revenue removed in 06/07 reinstated -
  previously agreed
• Reinvest savings from telecoms convergence plan
  (Agenda Attachment 19)

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Ag. 4 - Countywide ICT Strategy / Plan (2)

• Current finance plan.
• In real terms m short of SHA expectations.
• Assume general inflationary uplift Board to
  confirm. (To be actioned)
• 573K rev removed 06/07 was to be reinstated,
  reduced to 250K
• Indicates a revenue shortfall of 187K or..
• After baseline covered, leaves only 228K to
  cover Priorities 1, 2, 3.
• Cannot cover Priority 1 (292K). (To be actioned)
• Capital shortfall extensive (JT to discuss with
  Brian Hannford)
• Options.
• Manage shortfall in year
• Most costs are fixed
• New resources shifted back to final stages of
  07/08 financial year
• Utilise savings from telecoms plan (estimated
  150K) (Accepted)
• Remove costs covering service input shortfalls
• Service change management (NCRS PCT - 15K, NCRS
  MHP - 15K)
• Service leads (infection control - 35K)
• Organisational data quality - 30K

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Ag. 4 - Countywide ICT Strategy / Plan (3)

• Implications if Only 228K Available
• In Priority 1 any areas requiring new
  resources, including
• System interfacing backbone to interim
  connection of systems.
• Results reporting clinical correspondence.
• Network continuity, Security and user
  functionality for desktops
• Data quality developments
• Delay to maternity deployment
• Delay to theatres deployment
• Delay to PACS migration to Cluster offering
• All Priority 2, which includes enhanced
• Building on bed managt work
• case note tracking, digital dictation
• Patient record work (discharge summaries,
  ordering services)
• All Priority 3, which includes
• Review of support service beyond normal working
  hours and locations.
• System deployment laboratory
• Energy saving review
• Additional journals in Knowledge Management

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Ag. 4 - Countywide ICT Strategy / Plan (4)

• Telecommunications Convergence Proposal.
• Agenda Attachment 19.
• Seeks to renew existing PCT / MHP voice contract
  and converge existing data / voice with Acute
  systems.
• Development partnership with BT / CfH provides
  opportunity significant reductions on cost for
  development time / reference site.
• Over time will enhances service significantly
• More efficient use of network cost savings
  approx 150K p.a.
• Expansion into telemedicine assistive
  technologies
• Integrated call centre with digital functionality
  (e.g. voice recognition / call forwarding /
  message handling).
• Integration with other administrative / back
  office functionality
• Costs
• Current (601K VAT)
• Future (2nd Year ) (400K) (VAT recoverable)
• 1st Year Set Up Costs
• 1 year project management post (integrated with
  existing post) (20K)
• Featurenet licence cancellation (93K).
• (Business Case approved in principle finances
  to be confirmed by PCT / MHP Dofs)

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Ag. 4 - Countywide ICT Strategy / Plan (5)

• Outstanding Items statements on.
• PCT service plans remain unavailable OF used as
  proxy
• Acute service plans remain unavailable OF used
  as proxy
• PCT / MHP / Acute Information Management
  holding statement in place.
• PCT / MHP / Acute Data Quality / Management
  holding statement in place.
• PCT ICT Manpower information (cost, wte, plan)
• Background information on proposed infection
  control project
• Rollout of national summary intentions (ICT
  Services)
• Sign Off Method?
• Agreement on changes to plan financial balance /
• Final changes completed
• Recommend a single letter via Chair countersigned
  by each member indicating level of commitment
  from each organisation.
• Sent to SHA via Dir. ICT Services
• (Revised Exec Summary to be sent to members )

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Ag. 5 - Monthly Budget Report

• Attachment A (Notes).
• Attachment B (Spreadsheet)

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Ag. 6 - Projects Submitted for Adoption

• None submitted, but.
• Awaiting retrospective Brief for maternity.
• Project Briefs for remaining theatres projects
  (WRH, Alex, Evesham) under development for future
  consideration.
• Results Reporting, Order Communications Briefs
  under development but unlikely to take place
  based on current plan. Will be retained for
  future discussion as principle stands.
• Brief for Electronic Discharge Summaries under
  development but unlikely to take place based on
  current plan. Will be retained for future
  discussion as principle stands. (Project Brief to
  be brought to next meeting)

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Ag. 7 - Current Vacancies

• Detail in Agenda Attachment 8.
• 17 vacancies
• 6 in 1st 2nd Line Support (service desk /
  technicians) (to be actioned)
• 2 in Clinical Informatics (application support)
  (Actioned ATR 654 / 934)
• 4 in ICT Training (trainers) (to be actioned)
• 5 in Knowledge Management (librarians /
  e-facilitator / trainers). (to be actioned)
• Significant impact on baseline services.
• Significant impact on support to projects.
• ICT Plan is based on release of equivalent
  resources from Apr 07. Board approval sought.

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Ag. 8 - Any Other Business

• Housekeeping - Receipt of Board Agendas Notes
• Printing papers en masse stopped 12 months ago to
  save paper. No ICT resources to undertake this
  task. Organisational P.A.s cover this if
  required by member please notify them of this.
  Acute also restrict printing.
• Previous method was to post on Internet and then
  send an e-mail to members that papers were ready
  to view / download. Advantage was that e-mail
  system was not clogged.
• However, Internet not preferred - some notes were
  considered sensitive.
• Use of extranet an option but not all members
  have access.
• Use of e-mail is not reliable for large files and
  clogs e-mail system.
• Method needs to be consistent for all members to
  stop confusion as to which mechanism they have
  accessed the files from.
• Internet preferred method options to managing
  sensitivity
• Accept that files are in public domain.
• Place passwords on sensitive files and e-mail
  password to members if A.N. Other wishes access
  then file can be e-mailed to that person with
  password removed. (would not wish to divulge
  password which would allow access to other
  sensitive files) .
• Do not place sensitive files on Internet but
  e-mail out - messy mixture of methods.
• Action Agreed Summary sheet for papers as per
  presentation detailed papers referenced.
  Members recommended not to print detail. Files
  to be placed on Internet site, link e-mailed to
  members, sensitive files to be pass-worded, FOI
  requests for sensitive files to be considered
  individually if released then e-mailed with
  password removed.