WHICTS County ICT Programme Board

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Worcestershire Health ICT Services County ICT
Programme Board Presentation (29th Jan
09) John Thornbury Director, Worcestershire
Health ICT Services John.thornbury_at_nhs.net 078
667 213 71 (wictp_n_090129_00_presentation.ppt)
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Ag. 2 Map of Medicine Presentation

• The Map is a web-based visual representation of
  evidence-based patient care journeys covering 28
  medical specialties and 390 pathways
  (http//www.mapofmedicine.com/)
• As healthcare provision becomes much more
  specialised the need to plan and then benchmark
  clinical practice against national standards
  whilst incorporating local intricacies is key.
• Worcestershire selected as pilot for MoM
  supporting County Diabetes Care Pathway Group.
• Presentation by
• Debbie Westwood (Programme Lead, Clinical
  Development).
• (debbie.westwood_at_nhs.net) (01905 733695)
• Dawn Edwards (Diabetes Specialist Nurse).
• (dawn.edwards_at_worcsacute.nhs.uk) (01562 512324)
• Denise Hewitt (Project Manager).
• (denisehewitt_at_nhs.net) (079 187 318 71)

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Ag 3 - Actions List (PCT)
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Ag 3 - Actions List (Acute)
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Ag 3 - Actions List (MHP)
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Ag 3 - Actions List (ICT)
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Ag 3 - Actions List (ICT)
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Ag 3 - Actions List (SHA)
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Ag. 4 ICT Strategy (2009-10)

• Draft Plan (Attachment 1) provided for
  consideration.
• Background Guidance
• Follows national guidance, particularly
• Darzi Report High Quality Care for All.
• Supporting Health Informatics Review, esp. The
  Clinical 5.
• Operating Framework (service Informatics).
• SHA Investing for Health.
• Aligns with Trust service plans where provided.
• Key Features
• Prioritises projects that move County closer to
  integrated working.
• Seeks to retain single countywide approach.
• The Clinical 5 are being addressed, where not
  already in place.
• Roadmap towards Lorenzo functionality developed -
  commencing for PCT / MHP but uses interim gap
  fillers where necessary consistent with Darzi.
• Acute Trust PAS migration moved back to ensure
  Oasis development opportunities are not missed
  BUT Trust must address lack of use of ADT which
  is critical to real time management and
  reporting.
• GPs continue to be supported and encouraged along
  GPSoC route.
• Infrastructure is well defined but progress along
  NIMM will continue.
• Deployment of MS Business Intelligence tool set
  will address need for more flexible reporting
  capacity.
• Additional resources are now required to move the
  County forward into more integrated ways of
  working.

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Ag. 4 ICT Strategy (2009-10)

• Outstanding Items / Issues
• No PCT Provider service strategy made available
  discussions have taken place with senior service
  leads to ensure alignment.
• SHA Strategic Alignment Tool not considered
  helpful to local products already used, but SAT
  mandated which caused diversion of time. Also
  did not align with OIP modules which makes
  discussions over deployments confusing.
• CSCA Lorenzo product / deployment planning
  information is poor
• Functional detail for planning purposes is not
  readily available either very high (advert
  level) or too detailed (technical / manual).
• Functional information on central repositories is
  not easy to navigate, versions and naming
  conventions are confusing.
• Lack of information on typical deployment periods
  for LRC3 4 deployments. These are critical if a
  judgement as to when planning and change
  management work should commence.
• Access to local Lessons learnt reports from early
  adopters / recent take up s are not available or
  are controlled by CSCA, which will not provide a
  full picture.
• Clearer guidance on resource levels for each
  deployment would be welcomed so that better
  planning / discussions with funding organisations
  can take place asap.
• CSCA retention on deployment processes for
  specific deployments leads to LHC being on catch
  up for getting activities planned, resourced and
  actioned.

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Ag. 4 ICT Strategy (2009-10)

• Next Steps
• Draft had to be with PCT for submission for close
  of Jan 09.
• Board asked to agree plan in principle to allow
  further detailed work to continue.
• Main plan will be made available for next (Mar
  09) meeting.

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Ag. 5 - ICT Services Report (Operational)

• Full report available in Attachment 2 of agenda
  papers.
• Service Availability
• Networks Server consistently excellent.

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Ag. 5 - ICT Services Report (Operational Contd.)

• Service / Helpdesk Calls
• Application Call
• Dec 08 Calls closed continue to match calls
  opened.
• Calls opened closed in same month consistently
  gt 90
• Call makeup (Dec 08)
• 40 Account set up
• 24 NCRS
• 24 Oasis
• Service Desk
• Dec 08 calls closed (3064) gt calls opened (2939)
• Averaging gt90 calls logged online.

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Ag. 5 - ICT Services Report (Operational Contd.)

• Provision of Equipment (Quarterly)

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Ag. 5 - ICT Services Report (Projects)

• (W040) GPSoC (PRIORITY 1).
• An amalgamation of other projects (EPS, GP2GP,
  CaB).
• Current supplier makeup
• EMIS 36/67(54)
• LV 15
• PCS 21
• iSoft 20/67(30)
• Premiere 4
• Synergy 16
• InPS 11/67(16)
• Current local take-up / enabled
• Level 1 (CaB) 64/67 (96)
• Level 2 (EPS) 47/67 (70)
• Level 3 (GP2GP) 14/67 (21)
• Level 4 (hosted) 0/67 (0)
• Further uptake to get to L2 L3 now dependent on
  suppliers.
• Move to L4 unlikely until GPs have confidence in
  LSP hosting arrangements.

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Ag. 5 - ICT Services Report (Projects)

• (W02b) Choose Book (PRIORITY 1)
• System continues to function well.
• Stats
• Utilised for 40 Dec 08 (37 in Sep 08). Target
  was 50 by Sep 08.
• Referrals
• 2006/7 (11390)
• 2007/8 (26709) Q1(6346), Q2(6477), Q3(7057),
  Q4(6829).
• Q1(Apr08Jun08) 6017 (216118581998)
• Q2(Jul08-Sep08) 6445 (187518832687)
• Q3(Oct08-Dec08) 8030 (286624712693)
• (W02c) Electronic Prescription Service (R1
  Technical) (PRIORITY 1).
• GP Pharmaceutical suppliers slow to get systems
  accredited
• 67/67 (100) of General Practices now capable of
  being operational.
• 49/67 (73) are operational (mainly iSoft Synergy
  issues)
• 88/90 (98) of pharmacy systems are approved.
• 84/88 (95) of pharmacies live more being
  encouraged to go live.
• PCT prescriptions transmitted rate is 3rd highest
  in SHA.
• Release 2 project structures in place.

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Ag. 5 - ICT Services Report (Projects Contd.)

• (W029) GP2GP (PRIORITY 1)
• Good progress
• 20/21 of initial InPS EMIS practices are live
  (1 withdrawn).
• Further 4/5 practices (InPS) also enabled.
• Remaining deployments on hold as iSoft not
  expected to become accredited until 2009.
• (W022) NSTS Closure (PRIORITY 1)
• Phase 1 now complete.
• Phase 3 (Batch Trace Replacement) work has
  commenced ahead of Phase 2 (Secondary Uses
  Services Reports) updates awaited from National
  Team.
• Acute RA Management (sponsorship - not smartcard
  issuing) has not functioned well during period of
  project a continuing issue that needs to be
  addressed.

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Ag. 5 - ICT Services Report (Projects Contd.)

• (W045) NHAIS (Exeter) to National Patient
  Demographics Service (PDS) Migration Stage 3
  (PRIORITY 1)
• A technical project to remove the use of
  temporary and old-format patient identifier
  numbers, and then ensure that FHS staff involved
  in patient registration are connected to the PDS
• Stage 1 complete (reduce old format / temporary
  NHS numbers).
• Stage 2 complete (eliminate old format /
  temporary NHS numbers).
• Stage 3 (direct updating of PDS) awaiting
  national products and pilots to complete (Mar
  09).
• (W049) Palliative Care (PRIORITY 1)
• Covers WRH, Alex Hsp, Evesham Hsp, POWCH 3
  hospices.
• PID signed off contractual clock is running
• Business change and infrastructural work
  underway.
• Technical Go Live 24th Mar 09
• Followed by Deployment Verification Period (45
  days) Business Go Live.

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Ag. 5 - ICT Services Report (Projects Contd.)

• (W056) Equitable Access to Primary Care Medical
  Services
• ICT providing project assurance resource to PCT
  project.
• 9 Pre Qualification Questionnaire (PQQ)
  evaluated.
• Supplier selected Elgar Healthcare (S Worcs GP
  consortium).
• Contract signature date estimate 2nd Feb 09.
• Project structures to plan move to operational
  running in place.
• (W055) Map of Medicine Pilot (PRIORITY 1)
• MoM pilot supporting County Diabetes Care Pathway
  Group.
• Various training (reviewer, editing etc.)
  completed.
• Localisation of national diabetes care pathway
  stalled due to service resource issues.
• PEC happy with ratification process via Diabetes
  network Group but agreement process for pathways
  in general necessary as financial decisions as a
  consequence of new pathway structures cross
  Trusts Sandra Rote leading.

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Ag. 5 - ICT Services Report (Projects Contd.)

• (W059) Prison Systems (PRIORITY 1)
• Covers new configuration of HMP Hewell
  (previously Hewell Grange, Blakenhurst
  Brockhill) HMP Long Lartin
• PID signed contractual clock is running
• Technical Go Live
• HMP Hewell (17th Mar 09)
• HMP Long Lartin (30th Mar 09)
• Followed by Deployment Verification Period (45
  days) Business Go Live then phase 2 projects
  to cover those areas that require more
  substantial infrastructure work and to train
  those staff that are not available during initial
  Go Live period.
• (W03d) Maternity (PRIORITY 2)
• System reviewed 31st Mar 08 considered not fit
  for purpose.
• Agreement to prioritise on generation of
  maternity management reports (MIS) (for end Dec
  08) and then clinical functionality.
• MIS now live non critical follow up issues
  being addressed.
• Clinical functionality has been worked on in
  parallel and is continuing.
• Concerns over Acute service input paper being
  taken to Board (Jan 09).

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Ag. 5 - ICT Services Report (Projects Contd.)

• (W059) Acute Medical Records (PRIORITY 2)
• Preferred supplier Iron Mountain removed due to
  TUPE issues.
• Xerox contractual discussions and cost profiling
  now taking place.
• (W037) GP OOH Tender (PRIORITY 2)
• ICT Services both service and ICT project
  management components.
• (W036) tender project completed Total Care
  Network (TCN) preferred supplier.
• TCN took over full responsibility for service on
  1st Oct 08.
• Closure processes including follow on actions now
  taking place.
• (W048) Order Results Pilot (PRIORITY 3)
• Pilot to test Anglia system for ordering of
  results. c.6-9 months.
• 3 General Practices 5 Acute wards (incl. OP).
• Pathology Radiology basic test base.
• User lists and configuration continuing.
• Interface development continuing.
• Rollout delayed to allow priority work on
  theatres and maternity projects. 2 month delay
  poses risk of missing Go Live slot situation
  being assessed.

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Ag. 5 - ICT Services Report (Projects Contd.)

• (W024) GP Data Capture incl. Diabetic registers)
  (PRIORITY 3)
• Mechanism for capturing structured information
  from GP registers.
• Interfaced with diabetic management system.
• Can be extended to other structured GP data.
• 14/67 (24) sites installed of which..
• 6/14 (43) sites live.
• Significant technical issues have arisen leading
  to review with supplier. Closer examination of
  issues at pilot sites has provided more positive
  results further pilots now being identified.
• Other suppliers also being assessed in event of
  current supplier failing to provide a reliable
  solution.
• (W058) GP Notes Scanning (PCTi Docman) (PRIORITY
  3).
• Method of supporting general practices to move
  paper documentation into clinical system.
• 60/67 (90) sites Docman installed 51/67 (76)
  trained.
• 56/67 (84) sites Intellisense installed 46/67
  (69) trained.
• 1/67 (1) site Electronic Data Transfer (EDT)
  installed 0/67 (0) trained.

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Ag. 5 - ICT Services Report (Projects Contd.)

• (W033) Acute Incident Reporting (PRIORITY 4)
• Initiative to increase capture of incidents
  reported and enhance subsequent management
  processes incl. uptake of recommendations.
• Upgrade to existing system (Datix) but involves
  significant remapping of processes service /
  ICT training.
• Maternity live 12th Dec 08
• Radiology training being planned.
• Gynae and paediatrics planned commenced.
• Project will move to closure when above complete
  and hand over to operational rollout.
• (W051) WRH Theatres (PRIORITY 4)
• await Alex Hsp theatres interfacing. Without
  this, double entry required.
• Preparatory work (change management,
  infrastructure etc continuing)

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Ag. 5 - ICT Services Report (Projects Contd.)

• (W025) Web Publishing (PRIORITY 5)
• Internets
• Acute live but not FS (under review)
• MHP live
• PCT live
• ICT not live (Trusts a priority structure
  under review)
• Intranets
• Acute to follow Internet
• MHP populate site Jan 09 Go Live immediately
  afterwards
• PCT Go Live planned 2nd Mar 09
• ICT not live (Trusts a priority structure
  under review)
• Move to operational running and closure being
  planned.
• (W026) Programme Project Reporting (PRIORITY 5)
• Internal approach using MS Enterprise PM has now
  commenced.
• Internal staff self training on products.

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Ag. 5 - ICT Services Report (Projects Contd.)

• (W061) MHP / PCT Phone Replacement (PRIORITY 5)
• Site refreshes complete.
• MHP surveys complete.
• PCT surveys ongoing est. end Feb 09 completion.
• Wychavon area Go Live estimate 7th Feb 09
• Bromsgrove area Go Live estimate 21st Feb 09
• Redditch area Go Live estimate 7th Mar 09
• Malvern area Go Live estimate 21st Mar 09
• Worcester area Go Live estimate 4th Apr 09
• Telephone directories current directories are
  not being updated by departments. A new
  technical solution will only marginally improve
  this situation Trusts should ensure they are
  using the existing systems appropriately.
• Longer term intention is to interface with
  Electronic Staff Record (ESR) during the next
  deployment phase (Self Service). This still
  requires service to update details.

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Ag. 5 - ICT Services Report (Projects Contd.)

• (W050) Digital Dictation Framework (PRIORITY 5)
• System is live and stable.
• Operational rollout of system to new users is via
  request to Service Desk and assessment of
  readiness.
• Project closure processes underway.

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Ag. 5 - ICT Services Report (Vacancies)

• Total of 12 Vacancies Open in Directorate
• 3 post awaiting consideration
• 1LS021 (IT Service Desk Operator)
• TRA007 (IMT ETD Specialist)
• TRA008 (Trainee Trainer)
• 1 being advertised
• CIF007 (Deployment Lead)
• 1 interview scheduled
• 1LS020 (Service Desk Manager)
• 3 Appointments made (positions serving notice)
• KMT006 (Library Informatics Assistant,
  Worc/Eve)
• TRA006 (IT Training Officer)
• CIF008 (Clinical Administrator Assistant)
• 4 posts on hold
• 1LS003 (IT Junior Desktop Technician),

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Ag. 6 Information Governance

• Laptops - Safeboot McAfee encryption software
  installed on 820 laptops throughout the county.
  If not loaded and access to the network is
  attempted Safeboot will automatically download
  when a laptop next connects to WHICTS domain. A
  register is being consolidated.
• GP IG Statement of Compliance (IGSoC)
• Covers 8 key IG security areas.
• 30/67 (45) compliant. Remainder being worked
  with via action plans.
• Worcestershire Standard for Sharing Personal Data
  draft produced for discussion and agreement at
  Feb 09 meeting.
• Memory Sticks on no account can unencrypted
  sticks be used that hold Patient identifiable
  Data. Sticks issued according to policies
  developed. Register held
• PCT issued 40 sticks
• MHP issued 15 sticks
• Acute issued 1 stick
• Significant IG Related Risks / Issues
• IG01 - Out of Hours RA Support required for
  staff who access to CfH compliant applications.
  This is exacerbated in the Acute Trust where
  issues over RA management arrangements remain.
• IG02 - WHICTS IG Related Policies - Many of the
  WHICTS IG related policies are out of date and
  need renewing. Update to policies now nearing
  completion.
• IG07 IT Hardware Asset Register particularly
  around mobile devices such as laptops and tablets
  is being worked on.

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Ag. 7 - Monthly Budget Report

• Figures.
• Narrative.

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Ag. 8 - Any Other Business

• .

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Ag. 9 Date Time Next Meeting
Schedule