Worcestershire Health Community EBooking

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Worcestershire Health CommunityE-Booking
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Objectives

• Increase understanding of e-Booking and links to
  Access and Choice
• Agree how to progress this agenda in
  Worcestershire

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Agenda

• Context Access, Booking and Choice
• National Programme for IT
• E-Booking Solution
• Implementation Outline
• Booking Management Services
• Next Steps

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Electronic Booking Solution
Primary Care Trust
GDP
GP
Electronic Booking Service Single national
solution Implemented by NPfIT, National Booking
Programme, Clusters SHAs, PCTs, HTs for
Patients Booking Management Service Single point
of contact Open 7am-10pm
Acute Trust
Other Specialist Services
DTC
Community Trust
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Context - 1

• Choice
• For patients waiting gt 6 months by 2004
• At point of referral by December 2005
• Select from 4 or 5 different providers
• PCT agrees range of choice through commissioning
• Booking
• By Dec 2005 all hospital appointments booked
• Implement e-Booking by 2005
• Move from partial to full booking aim for 100
  full booking by Dec 05

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Context - 2

• E-Booking BMS is HOW Choice Booking will be
  delivered so must be integral to choice/booking
  implementation
• Key Issues
• How will GPs and Patients determine choices
  (e-Booking/Directory of Services)
• Where will choice decision be made
• Making services bookable
• Other PCT objectives referral management,
  alternatives to hospital

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NPfIT key components
National Spine (NASP) Patient Demographic Service
Integrated Care Records Service (LSP)
Electronic Booking (NASP)
Electronic Transfer of prescriptions (NASP)
N3 - connecting the NHS with secure Broadband
(NISP)
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The Booking Process- Core Services
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Several Key Providers
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Directory of Services

• Directory of Services will contain data on both
  bookable and non-bookable services from
  providers, booking guidance, which services have
  been commissioned by which PCTs
• So for GP and patient wanting referral for
  orthopaedics
• May provide decision support guidance on
  selection of appropriate service
• Will indicate which services have been
  commissioned into PCT choice
• Which are directly bookable
• Waiting times
• Info re quality, transport

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Booking Guidance

• Ranges from simple questions to process maps to
  complex decision trees
• PCTs and Trusts to agree format and type of
  guidance within overall SHA/Cluster approach
• Guidance should be agreed across all services
  commissioned by a PCT for a particular specialty
• Developing acceptable booking guidance is
  difficult, time consuming, needs to start now

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E-Booking Scope

• Initially GP to hospital
• Additional services can be called off
• Booking into Primary Care
• DiTV access
• Linked appointments each with an individual
  Unique Booking Reference Number (UBRN)
• Transport booking
• Primary to Primary Bookings (e.g. GPwSI, Nurse
  Endoscopy etc).
• Tertiary Booking and Referral
• Integration with call centre technology
• Follow-up appointments

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BMS Models

• Commissioning of NHS Direct (nationally preferred
  model)
• Approach based on existing call centres in Acute
  Trusts
• Call centres in PCTs
• Combinations of above
• Note BMS must meet 11 national standards
  including extended hours of working setup
  funding dependant on this

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BMS Models

• Commissioning of NHS Direct (nationally preferred
  model)
• Approach based on existing call centres in Acute
  Trusts
• Call centres in PCTs
• Combinations of above
• Note BMS must meet 11 national standards
  including extended hours of working setup
  funding dependant on this

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Implementation Timeline
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Phase 2Organisational Readiness

• Establish management structures
• Develop implementation plans
• Develop BMS strategy / plan
• Develop a marketing strategy
• Build clinical, admin patient ownership
• Continued process redesign
• Collect data for the Directory of Services

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Phase 2 cont. Organisational Readiness

• Review Commissioning Rules
• Agree Booking Guidance
• Detailed due diligence of system and
  infrastructure readiness
• Determine changes to end user systems
• Prepare for the appointment of the LSP

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Major Redesign Issues

• Primary Care
• How / where choice decisions are made
• How/where booking is done
• Waiting lists managed in PCTs
• Establishing BMS
• Impacts GPs, practice admin staff
• Acute
• Clinics fully bookable
• Agreed booking guidance
• How BMS fits with Trust call centres
• Impacts clinicians, med secs, med recs, wait list
  and call centre staff
• Agree Booking Guidance
• Detailed due diligence of system and
  infrastructure readiness
• Determine changes to end user systems
• Prepare for the appointment of the LSP

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Lessons from pilots - CSFs

• Clinical Engagement Primary and Secondary
  articulate benefits
• Service redesign bookable services
• Robust IT infrastructure
• Clear BMS strategy
• PCTs taking responsibility for waiting lists
• Creation and maintenance of Directory of Services
• Simple effective booking guidance

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Discussion Points - 1

• Structures
• To manage e-Booking
• To link to Access and Choice
• Where does BMS sit ?
• 1 Health Community Structure or separate PCT and
  Acute ?
• Roles
• Exec Leads (1 or 2) ?
• Project Manager (1 or 2 ?, scope e-Booking,
  BMS, Booking, Choice)
• Process Redesign (Primary Secondary)
• Technical Lead / Support
• BMS Lead ?
• Funding

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Discussion Points - 2

• Development of local implementation plan
• Development of BMS plan
• Communications
• Timescale mismatch issues
• Administering choice at 6 months
• Early choice at referral pilots
• Extending full booking from now on
• Any Wales issues ?
• What do you want from SHA
• Co-ordination of BMS approach
• Co-ordination of booking guidelines
• Readiness assessments