Existing Systems and GP Systems of Choice GPSoC

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Existing Systems and GP Systems of Choice (GPSoC)

• Presentation to BCS Primary Healthcare Specialist
  Group
• Wednesday 2nd July 2008
• Peter Dyke,
• Head of Industry Liaison
• NHS Connecting for Health
• peter.dyke_at_nhs.net
• 07834 602768

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Agenda

• Whats been delivered so far
• The Existing Systems Provider (ESP) delivery
  channel
• Spine Compliance LSP Compliance
• How NHS CFH works with ESPs
• Learning points looking forward
• Questions

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National Programme for IT (NPfIT)

• 6.2Bn programme initiated in 2001 over 10 years
• (NHS Annual Budget 95bn-ish)
• Provides new services for the NHS in England
• Choose and Book (CAB) 7,963,113 bookings made (c
  50 of bookings)
• Electronic Prescriptions Service (EPS) 77,427,445
  prescription messages issued (c 17)
• Picture Archiving Communications (PACS) 640
  million images, 25.5m patient studies
• GP2GP records transfer 3,951 practices live,
  108,334 records transferred
• Summary Care Record live 153,188 records live on
  the spine
• New National Network (N3) 29,730 connections
• NHSmail 341,322 registered users
• National Care Records Service Spine 469,856
  registered users
• Local Care Records Services (Local Service
  Providers LSP)

Data as of 7/4/08
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Delivering NPfIT

• Delivered via two main routes (since 2004)
• Prime Contractors to NHS CFH National
  Application Service Providers (NASPs) and Local
  Service Providers (LSPs)
• Via Existing Systems Providers (ESPs) with
  contracts already in place with NHS Trusts, PCTs
  or other care provider organisations

..If a supplier hasnt built it, a customer cant
use it..
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NPfIT is delivered to users by LSPs and ESPs
ESPs Care is delivered outside the traditional
NHS boundary. Aligned specialist IT system
markets exist Social Care, Independent Sector,
Community Pharmacy, Dentistry, Opticians etc.
These are serviced by non-LSP suppliers whose
integration with NPfIT may be enabled and
optimised in support of improved patient care.
100 of NHS Clinical IT Systems Market
ESPs The fragmented existing systems and
supplier base will consolidate in the various
market niches. A degree of integration with NPfIT
will be required and enabled for these
systems (e.g. CAB). A number of systems will
cease to be supported within the NHS market
LSP Services are deployed, in some cases
incorporating former existing systems as part of
their portfolio.
0
2004
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NPfIT Supplier Architecture
2004
2005 2006
2007

Spine (NASP - BT)
SSB Spine Security Broker
PDS Personal Demographics Service
PSIS Personal Spine Information Service
SUS Secondary Uses Service
SDS Spine Directory Service
CAB Choose and Book (NASP - Atos/Cerner)
Transaction Messaging Service (TMS)
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Spine Compliancevs.LSP Compliance
..plus departmental specialist systems..
NHS Care Records Service Spine
Direct spine connection for certain ESP systems
CSC LSP
BT LSP
System G
Spine Compliance
iSOFT (Lorenzo)
Cerner (Millennium)
Specialist or departmental functionality included
within core Lorenzo/Millenium clinical application
Specialist 1..n
Specialist 1..nx
System X
System A
LSP provided specialist or departmental system
from other supplier
System Y
System B
System Z
System C
Existing Specialist or departmental system
interfacing with LSP solution
Scope of CSC/NME Departmental Systems
Integration project
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How CFH progresses work
NHS Connecting for Health
NHS CFH Programme teams drive delivery
SCPEA Social Care PDS Early Adopters
Summary Care Record
Systems Of Choice
Secondary Uses Service
Electronic Prescriptions
Choose and Book
Picture Archiving
PDS Birth Notifications
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Being Spine Compliant1. PDS/IG Compliance
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Being Spine Compliant (2)2. Current
Functionality
GP System
Summary Record NPFIT-FNT-TO-TIN-0830
GP2GP Transfer NPFIT-FNT-TO-TIN-0402
Electronic Prescriptions NPFIT-FNT-TO-TIN-1050
Choose and Book (CAB) NPFIT-FNT-TO-TIN-1032
PDS/IG Compliance (PDS NPFIT-FNT-TO-TIN-1023,
IG NPFIT-FNT-TO-TIN-1031)
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Being Spine Compliant (3)3. New for 2008
Telehealth, Pathology, Discharge
Notifications, etc etc etc.
Birth Notifications
PACS
Social Care
PACS Cluster Store
eSAP/CAF
Birth Notifications
In draft
PDS/IG Compliance (PDS NPFIT-FNT-TO-TIN-1023,
IG NPFIT-FNT-TO-TIN-1031)
Note Dotted line boxes indicate detailed
Compliance Baseline is draft or not published
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A few points to note

• It takes about 9 12 months to become
  compliant from scratch
• Compliance is specific to a functionality,
  spine version and supplier software version not
  a general status
• Spine Compliance must be maintained it is not
  static
• Spine compliance has a cost, and must deliver a
  benefit (or why do it?)

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Learning Points

• Interoperability is achievable at scale
• Needs market-wide configuration control
• Mind the (vast) knowledge gaps
• Attend to basic governance structures
• Communication skills
• Foster a culture of mutual respect
• Understanding that LSP and ESP is OK
• Align supplier motivation commercials
• End user engagement

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Closing the knowledge gap
Receive, use and pay for the service Own the
contracts with suppliers Must derive benefit and
value Have generally not met NHS CFH May compare
notes (e.g. user group) Need to assure themselves
Open, constructive, three-way dialogue is key to
success
Understand the Spine CAB Assure systems to
protect the spine Become a new part of supplier
solution Work with 66 separate suppliers Dont
understand supplier business Dont understand the
supplier solution Have generally not met the
users Dont understand the users business
Understand their business Understand their
solution Understand their customers Incorporate
CFH services into theirs Dont understand CFH
services (yet) Incur costs (factor of 4
variance!) Deliver service to users
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NHS CFH ExistingSystems (2008)
Others, Industry Liaison Peter Dyke
Existing Systems
The original generic Existing Systems programme
has grown significantly since its creation in
2004. It has been restructured to align works
with suppliers in the market sectors in which
they operate.
Dentistry Tim Bentley
Child, Social Care Steve Smith
PACS Independent Mary Barber
GPSoC Kemi Adenubi
(ESP) delivery to each market Sector is led by
individual senior managers within NHS CFH
Pharmacy Tim Donohoe
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Future Opportunities

• Even greater scale (double)
• Even greater clinical complexity
• Taking cost out across the value chain
• Stepping up - whilst letting go
• Suppliers Users doing it for themselves
• Stopping the 3-way blame game
• Product Portfolio Discipline
• Education, Education, Education

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Existing Systems and GP Systems of Choice (GPSoC)

• Questions?
• Peter Dyke,
• Head of Industry Liaison
• NHS Connecting for Health
• peter.dyke_at_nhs.net
• 07834 602768