WHICTS County ICT Programme Board

1
Worcestershire Health ICT Services County ICT
Programme Board Presentation - Key Points
Notes (17th Jul 07) (Notes from meeting are in
white text new links in white, old links (in
yellow) please refer to agenda papers for
these) John Thornbury Director, Worcestershire
Health ICT Services John.thornbury_at_nhs.net 078
667 213 71 (wictp_n_070717.ppt)
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Apologies / Attendees
3
Actions (PCT including General Practices)
4
Actions (Acute)
5
Actions (MHP)
6
Actions (ICT Specific)
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Ag. 2 Matters Arising (not covered elsewhere in
agenda)

• Previous Notes
• Full notes actions (Attachment 1), summaries
  (Attachment 2)
• New / Unaddressed ICT Report actions highlighted
  (Attachment 3) responsibility of Chairs of
  Trust ICT Programme Boards.
• Clinical / Trust Representation / Governance
• Representation good
• Clinical Reference Group (Attachment 4, Page 28)
• Primary Care Working Group (Attachment 4, Page
  28)
• Project Boards (Adoption process being enforced)
• County Information Governance Group
• Trust ICT Programme Boards now in place Acute
  functioning well
• Rachel Overfield Acute Action (replacement for
  County Board sought) Michelle Norton attending.
• MHP Trust absence noted PB to discuss with MHP
  Trust CEO
• County Communications Lead.
• Janet Ferguson now nominated to act as
  Communications Lead.

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Ag. 2 Matters Arising (Contd.)

• ICT Vacancies (previous action refs 7, 8, 9)
• Agreement that plan required reinstatement of
  frozen post on a phased basis considering
  _at_risk staff before recruiting elsewhere.
• 1LS (7 posts)
• 3 appointments made serving trial period
  (1LS001,002,006)
• 2 posts to advert (1LS004,007)
• 2 posts on hold (1LS003,005)
• ICT Training (4 posts)
• 2 appointments made serving trial period
  (TRA001,002)
• 2 posts on hold (TRA003,004)
• Knowledge Management (5 posts 3.5 wte)
• 2 appointments made in post (1.5 wte)
  (KMT003,004)
• 1 to be interviewed 6th Jul 07 (1 wte) (KMT001)
• 2 posts re-advertise (1 wte) (KMT002,005)
• Clinical Informatics (2 posts 2 wte)
• 2 posts filled (CIF003,004)
• JT to write to JR to confirm that ICT posts are
  no longer frozen and as agreed ICT Prog Board
  will sanction posts where necessary

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Ag. 3 - ICT Services Report (General)

• Full report available (Attachments 4, 5, 6, 7, 8)
• Service Availability
• Full figures (Attachment 5)
• Generally excellent Up time nwork (99),
  servers (100).
• Significant improvements since Dec 06 due to
  installation of pro-active monitoring and
  purchase of nwork probes.
• Adoption of countywide network by N3 - cost
  avoidance 400k p.a.
• Provision of Equipment
• Jun 07 full figures available (Attachment 4 Page
  8)
• Summary

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

• Service / Helpdesk Calls (Attachment 4 Page 7)
• BH to discuss SLA alignment with IMG re Service
  Desk outputs / costs
• Number of outstanding calls falling reduced
  from approx. 900 to 400 mainly due to change in
  working practices and aided by remote resolution
  the result of expansion of users migrated onto
  WHITS domain.
• Development of Super User function whereby
  locally identified service users can be given
  additional administrative functions (reset /
  change passwords, add accounts etc.) is having a
  positive effect on overall service.
• 78 calls logged online (70 - Jan 07, 82 - Mar
  07)
• GP extensive use (89 of those calls opened, done
  so via web)
• Jun 07 Application Calls
• a number of system specific issues arise that
  underlie some of the stats these are reported
  on a monthly basis in main report (Attachment 4
  Page 7).
• 33 Acute Oasis system
• 31 Account set ups
• 29 NCRS
• 3 CaB
• New National Service Desk - poor service provided
  to local teams. National remedial plan developed
  cessation of call charges until resolved.

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

• Other (IT Ops 1st, 2nd 3rd Line Support)
• ICT developed Directed Enhanced Services (DES)
  Web site
• Enabling GPs to record status e.g. data
  accreditation, paper lite status etc with
  evidence to support payments.
• Acknowledged by clinical leads
• PCT e-mail merge
• Estimate Dec 07 completion
• Migrate old POWCH e-mail system to WHITS domain
  main task
• Other old e-mail being currently migrated
• Being done in conjunction with site migrations
• Migration of sites mainly complete Tenbury
  significant
• Some minor sites will not be migratable
• E-mail groups / lists JF to discuss required
  groupings / lists with Richard Stringfellow and
  pass onto JT.
• Site / Departmental Moves
• Continuing lack of warning given to IT Ops on
  site / dept moves.
• Significant waste of resources (e.g. Claines
  Closure) and diversion (IRS Team St Annes
  Orchard) away from originally planned work.
• All Trusts asked to ensure service location plans
  shared with IT Ops as early as possible.
• Agreed there is a need for an estates strategy -
  tbd

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Ag. 3 - ICT Services Report (Projects)

• Adoption of New Projects
• JT given devolved authority to adopt on behalf of
  County ICT Board subject to Trust business case
  approval. Lessons learnt identify strong
  governance and proactive Board input necessary.
• There remain projects appearing without service
  business cases.
• Adoption Schedule
• 2 Projects formally adopted
• Theatres (Bluespier)(Alex. Hsp.)(existing
  interfaces)
• Countywide infection control management system
• 7 Project Briefs under construction (see below)
• 3 further projects in Mandate stage
• Chlamydia screening management system
• Acute correspondence / letters
• AE (Tenbury)
• 6 projects to commence closure processes
  following successful outcomes
• W3i PACS (WRH)
• W3k - Acute MPI (duplicates removal)
• W17 Oasis Admissions, Discharge, Transfer
  automation (Noted that power sockets outstanding
  - JT)
• W12 GP OOH Triage Interface (tbc)
• W3c Theatres (Kidd. Hsp.)
• W3f - Interim Orders

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Ag. 3 - ICT Services Report (Projects Contd)

• Acute Clinical Systems - Agreed
• Agreement to partner Capula (admin) Bluespier
  (clinicals).
• Facilitates smoother transition to NCRS
• Electronic Discharge Summaries Project Brief
  (previous action ref 6)
• Some work has been undertaken where existing
  system in use.
• Bluespier discussion opens new possibilities
  being examined further.
• Fuller update to be provided next meeting.
• W23 Acute Theatres (Alex. Hsp. Bluespier
  Existing )
• Status adopted (est. completion Feb 08)
  (Priority 4)
• Summary Sheet (Attachment 10)
• Bluespier - existing interfacing to Oasis
• Alexandra Hospital proof of technology
• Completion estimated Jan 08
• Other sites to be adopted individually (to ensure
  local service input)

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Ag. 3 - ICT Services Report (Projects Contd)

• W24 Diabetic Retinopathy - Agreed
• Status to be adopted (estimate Jul 07)
  (Priority 3)
• Development partnership between NHS, Digital
  Healthcare, Savience
• Completion estimated Jan 08.
• 2 Phases
• Interfacing diabetic register in GPractices with
  DR system electronically
• Interfacing general clinical results /
  correspondence from other systems back to
  GPractice systems
• W25 Web Taxonomy - Agreed
• Status to be adopted (estimate Jul 07)
  (Priority 5)
• Summary Sheet (Attachment 11)
• Development partnership between NHS Folding
  Space
• Completion (pilot) estimated Nov 07 then
  depending on Trust take-up.
• 2 main components
• Replacement of existing PUNCH web authoring tool
• Align to document workflow management system to
  allow tracking docs.

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Ag. 3 - ICT Services Report (Projects Contd)

• W26 ICT Reporting - Agreed
• Status to be adopted (estimate Aug 07)
  (Priority 6)
• Approach to be determined
• Completion estimate Mar 08.
• 2 main components
• Assessing future reporting requirements for
• Programme Project Management
• Wider ICT Services
• Aligning system to document workflow management
  system
• W27 Acute Medical Records - Agreed
• Status to be adopted (estimate Aug / Sep 07)
  (Priority 2)
• Supplier Identification (3 identified) /
  Procurement processes commenced
• Completion tbc.
• Main components
• Determine Medical Records service configuration
• Determine level of change to be supported by new
  system
• Deploy system(s)

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Ag. 3 - ICT Services Report (Projects Contd)

• W28 Infection Control
• Status adopted Jun 07 (Priority 2) (very high
  service input)
• Summary Sheet (Attachment 12)
• Supplier ICNet
• Completion estimated Jan 08.
• Main components
• Standardise county IC working practice
• Data extraction and interfacing with PAS and
  pathology
• W29 GP2GP - Agreed
• Status to be adopted (no estimate) (Priority 1)
• National ICT Project - enabling patients'
  Electronic Health Records (EHRs) to be
  transferred directly from one practice to another
  (average 500 transfers per practice p.a.)
• Completion tbc - depending on outcome of pilot.
  (Update awaited from Mina Chauhan SHA PM)

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Ag. 3 - ICT Services Report (Projects Contd)

• W30 Endoscopy - Agreed
• Status to be adopted (estimate Jul 07)
  (Priority 4)
• Unisoft (already in use on Kidd Hsp.) Standardise
  working practices and migrate remaining users to
  Unisoft system
• Completion tbc
• W31 Local Service Desk Accreditation - Pending
• Status to be adopted (estimate Jul 07)
  (Priority 5)
• Accreditation to national service desk standards
  to allow direct interfacing to national service
  desk and reduce call charges for re-routed system
  queries.
• Completion tbc

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Ag. 3 - ICT Services Report (Projects)

• Full summaries available (Attachment 6)
• (W2a) NCRS Community / Mental Health System.
• New PCT Project Exec Brian Hanford (previous
  action ref 1)
• Concern that Change Management role is stretched
  (IG / RA included).
• Training requirements continue to be assessed.
• Conversion of data to single PCT code scheduled
  21/22 Jul 07 minimal impact on business
  continuity expected.
• Reaching 2nd anniversary of smartcards
• Remote updating being tested successful and
  rolled out
• (W2b) Choose Book
• Significant risks
• (W2_5_17i) Lack of Acute Implementation Manager
  - Acute Action
• (W2_5_19i) WAHT reducing slots to manage 18ww.
  Patients unable to book TAL appointments rose
  from 8 to 36 last week Jun 07. to be resolved
  (PCT Acute)
• Report available (Attachment 13)
• 27 referrals utilised CaB (May 07), gt6000
  referrals since Apr 07.
• 2ww now live, countywide marketing continues.
• New LES payments from 1st May 07.

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

• (W2c) Electronic Prescription Service (R1
  Technical).
• GP Pharmaceutical suppliers slow to get systems
  accredited
• 32 General Practices operational
• 39 pharmacies operational
• Annex 3 requires monthly increase in usage and
  estimates one of the best performing in SHA
  economy.
• LHC unsuccessful in bid for early implementer
  status.
• Neill Bucktin (Proj Exec) has left Lola Abudu
  to be confirmed as new Project Exec. New
  DoPrimary Care in process of being appointed
  will take on Project Exec role (PCT to initiate)
• (W22) NSTS Closure
• Good progress generally but some issues need to
  be resolved to ensure continuing progress
• MHP Lead confirmation required (MHP to
  confirm)
• Acute RA Management (non operational)
  confirmation required

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

• (W3d) Maternity
• Control of project (by service) now being gained.
• System functionality specification nearing
  completion Senior User to distribute for final
  sign off by clinical / service colleagues.
• PACS
• (W3i) WRH closure processes commencing (legacy
  data transfer contd.)
• (W20) Community technical installations
  commenced.
• Cluster Solution debate continues.
• Awaiting SHA formal response on final resolution
• (W3k) Acute Master Patient Index Data Quality
• Significant progress capable of moving into
  operational running.
• New criteria relating to active patients is
  being addressed.
• Acute master Patient Index - 97.5 have NHSNo.
• Management procedures to assure new processes
  nearing completion.
• Records capable of being cleaned will be
  remainder will be archived.
• JT Lessons learnt report to be forwarded to
  NCRS project

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

• (W17) Real Time Admissions, Discharge, Transfers
• Processes in place to administer ADT
  electronically (i.e. removal of paper books.
• Generally successful however success limited by
  lack of resources and changes to Acute
  structures. ICT can only have limited effect
  under circumstances.
• Closure processes have commenced.
• Rachel Overfield (Proj Exec) has left not
  replaced due to closure.
• Phase 2 (Real Time Bed Management) will be
  considered when service resources and structure
  changes available / complete.
• (W12) GP OOH Triage Interface
• Service understood to be under review decision
  required as to continuation of project by Board.
• 2 risks (clinical content and system performance
  discussed)
• Agreed JT to discuss risks with Jane Pugh /
  Teresa French and decision as to whether to
  continue resolving issues made.

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

• (W3f) Interim Orders
• Issues apparently resolved by supplier. Testing
  continues.
• If confirmed then move to operations and commence
  closure.
• (W21) Digital Dictation (Evesham Hsp.)
• Go live complete for secretarial staff. 7
  consultants awaiting post go live period before
  committing.
• (W17) Enterprise Intelligence Systems
• Data Quality / Reports being reviewed.
• Automated feed tests being finalised.
• Nearing completion of agreed scope commence
  closure processes.

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

• (W14) Exeter NHAIS to National Pat. Demographic
  Service
• National release anticipated 23rd Jul.
• Move to operational running - commence closure
  processes.
• (W13) Document Workflow Management
• Pilot system testing completed.
• Awaiting supplier follow up actions.
• (W15) Project Management Training
• Basic components now complete.
• Processes migrated to ICT Training Dept.
• Closure processes commenced.

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Ag. 3 - ICT Services Report (Other ICT Work)

• Telecommunications
• Convergence of Voice Data
• Agreement from Mar 07 meeting to renew existing
  PCT / MHP voice contract and converge existing
  data / voice with Acute systems.
• (previous action ref 5 confirm financial plan
  and commence deployment)
• Due diligence being undertaken to ensure we
  assess user requirements and no financial
  surprises.
• Discount for GPs negotiated with several
  practices interested Wythall live. Enables
  integration with countywide proposed solution.
  Free calls between all NHS primary care sites.
• WiFi
• Concerns raised from recent BBC Panorama report
  (http//www.bbc.co.uk/pressoffice/pressreleases/st
  ories/2007/05_may/21/panorama.shtml)
• Health Protection Agency Information (Attachment
  14)
• PCT PHM will assess information and provide a
  further statement
• Implementing the Summary Care Record (Attachment
  15 for info)
• DQ in primary care needs to be assessed
• IT DES will assist

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Ag. 4 - Governance

• Partnership Articles of Agreement
• For consideration (Attachment 16) BH to review.
  If acceptable PB to take to CEO Group for sign
  off.
• Tightens up existing partnership arrangements
  draws together governance, SLA and reporting
  agreements into single summary.
• Trust ICT Programme Boards
• PCT ICT Programme Board
• First meeting taken place
• Strong service ownership, all PCT initiatives
  approved via this route
• Supporting IT DES monitoring process
• Support new approach for diabetic retinopathy
  data exchange
• Lively debate with acute pathology services on
  how pathology can become more customer focussed
  and exploit ICT
• MHP Information Governance Board
• Jun 07 meeting notes awaited.

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Ag. 4 Governance (Contd)

• Acute ICT Programme Board
• Revitalised 2 senior clinicians Stephen Lake
  and Santi Vathenen 2 general managers
• Significant clinical engagement over past months
  much stronger local ownership (also via Clinical
  Reference Group Project Boards)
• Clinical ICT Groups
• Clinical Reference Group
• Last meeting Apr 07, next meeting Jul 07
• Primary Care Working Group.
• Last meeting Jun 07
• DR change of Approach supported
• IT DES portal supported
• Programme Project Management
• Significant staff changes expected in next 6
  months (retirement, changes to working hours,
  planned resignation).
• Changes to structures planned to align with
  future NCRS level project needs these are in
  line with current plan.
• Proposal agreed internally (Attachment 9)

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Ag. 5 - Countywide ICT Strategy / Plan

• Feedback from SHA (Attachments 17, 18)
• Best in SHA (used as template for other LHCs)
• 18/23 areas Green (78)
• 5/23 areas Amber (22) one disputed
• 0/23 red
• Revision addressing ambers sent back to SHA on
  25th Apr 07 including covering letter from PB
  (Attachment 19)
• CG thanked for work on plan
• Current finance plan.
• Budget agreed by CEOs
• No further comments from SHA
• Last years end of year statement - 12k under
  spend in line with projection c/fwd. Reflects
  active management of 380k revenue gap.
• DH Performance Monitoring of IMT and IMT Plans
• Received via SHA (Attachment 20)
• Comments sent to SHA on difficulties concerning
  completion these are supported by SHA who are
  discussing further with DoH.

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

• NHS Local Ownership Programme (NLOP).
• Plans for SHAs to take local ownership for
  shaping and delivering the NHS IT Programme
• Discussions apparently continue no further
  information available locally but understood that
  may not be implemented before the autumn.
• Majority SHAs indicate that they have achieved
  first step in gaining localised IMT plans.
• Understood SRO London meeting cancelled
• SHA dates changed PB unable to attend

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Ag. 6 Information Governance

• Report available (Attachment 21)
• Statement of Compliance (SoC)
• Agreement (based on 17 standards) between Trust
  and CfH.
• To be completed prior to connecting to N3 and CfH
  digital services.
• 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 due in Sep 07 focus on reports /
  benchmarking.
• RA resource issues continue
• Overall concern regarding level of RA resources
  across Trusts
• 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 taking 6 month sabbatical in Sept
  07. exacerbates issue.
• Acute Trust - relies solely on part time RA
  coverage.
• OOH coverage for CaB, NCRS, EPS.
• 2nd anniversary of 1st (02) set of smartcards.
• National RA process / equipment configuration
  changes exacerbate issue.
• Feb 08 likely to be critical point for Acute if
  have not resolved issues.

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Ag. 7 - Monthly Budget Report

• Attachment 1 (text)
• Attachment 2 (figures)

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Ag. 8 - Any Other Business

• Purchasing IT Equipment (Capital V Revenue
  debate)
• Brian Hanford leading
• New plan and move to revenue base to be
  discussed. Proportionality discussions to be
  opened (DoFs to lead via BH).
• Linkage to SLA to be made (BH to discuss with
  IMG)

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Ag. 9 Date Time Next Meeting