Download Appendix N – Outcome to Project Mapping

‘One Person, One Digital Record’
2020 Digital Roadmap
Kernow CCG
South Devon & Torbay CCG
Northern, Eastern and Western Devon CCG
Footprints
Final v1.0
May 2016
Page 1 of 55
Table of Contents
1
Review and Approval ..................................................................................................................5
1.1
Reviewers ....................................................................................................................................5
1.2
Approvals ....................................................................................................................................5
1.3
Document Status.........................................................................................................................7
1.4
Relevant Documentation ............................................................................................................7
2
Executive Summary .....................................................................................................................8
3
Scope .........................................................................................................................................11
4
General ......................................................................................................................................12
4.1
Identify who has endorsed the roadmap (Section 6.2) ............................................................12
4.2
Identify which organisations have made significant contributions in the development
process (Section 6.2) .................................................................................................................12
4.3
Summarise the process through which the roadmap has been developed (Section 6.3)........13
5
Vision .........................................................................................................................................16
5.1
Vision for digitally enabled transformation (Section 6.4 – 6.7) ................................................16
5.1.1 Background ......................................................................................................................16
5.2
Our Vision ..................................................................................................................................17
5.3
Our Principles ............................................................................................................................18
6
Baseline Position .......................................................................................................................19
6.1
Overview of digital maturity of key primary, secondary and social care providers (Section
6.8) ............................................................................................................................................19
Figure 1 - Secondary Care Current Capabilities in Relation to National Average .....................21
Figure 2- Secondary Care Provider Capability Projection for 2020 ..........................................22
7.
Identification of rate limiting factors (Section 6.9) ...................................................................23
8.
Readiness ..................................................................................................................................25
8.1
Set out leadership, clinical engagement and governance arrangements (Section 6.10) .........25
Figure 3 – Governance Arrangements ......................................................................................26
8.2
Cornwall ....................................................................................................................................27
8.3
Devon ........................................................................................................................................27
8.4
Identification of change management approach(es) / model(s) to be followed (Section
6.11) ..........................................................................................................................................28
8.5
Identification of approach to benefits management and measurement (Section 6.12) .........30
8.6
Identification of known, anticipated and target sources of investment (Section 6.13) ...........31
8.7
Overview of programme / project structure for 16/17 (Section 6.14) .....................................32
8.8
Outline of how resources can be utilised more effectively (Section 6.15) ...............................32
Figure 4 – Key Principles for our Peninsula Approach ..............................................................33
9
Capability Deployment ..............................................................................................................34
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9.1
Identification of current maturity for each of the 7 Paper Free at the Point of Care
(PF@PoC capabilities) (Section 6.16) ........................................................................................34
9.2
Capability deployment schedule (Sections 6.17- 6.18).............................................................34
9.3
Capability deployment trajectory (secondary care) (Section 6.23) ..........................................38
Figure 5 – The Roadmap and Information Sharing and Standards Trajectory .........................40
10
Universal Priorities Delivery Plan ..............................................................................................41
Figure 6 – Current Assessment of Progress towards Universal Priorities ................................41
11
Information Sharing ..................................................................................................................43
11.1 Information Sharing Approach (Section 6.32) ..........................................................................43
11.2 Plans for a common information sharing agreement with all providers signed up (Section
6.34) ..........................................................................................................................................44
11.3 Current status of adoption of NHS number / steps to address gaps / gaps that will persist
into 17/18 (Section 6.35) ..........................................................................................................44
11.4 Plans and milestones for adoption of information sharing standards (Section 6.36) ..............45
12
Infrastructure ............................................................................................................................46
12.1 Current status of the mobile working infrastructure (Section 6.39) ........................................46
12.2 Confirmation that individual providers have plans to develop their mobile working
infrastructure (Section 6.40) .....................................................................................................46
12.3 Description of system- wide initiatives to develop the mobile working infrastructure
(Section 6.40) ............................................................................................................................47
12.4 Current status and future plans to improve collaboration between professionals from
different organisations (Section 6.42) ......................................................................................47
12.5 Summary of current or planned initiatives to share infrastructure (Section 6.43) ..................48
13
Minimising risks arising from technology .................................................................................50
13.1 Confirmation that robust plans, policies and procedures in place across the system to
minimise risks / steps to address gaps (Section 6.45) ..............................................................50
13.2 Confirmation that individual providers are moving forward with GS1 adoption (Section
6.46) ..........................................................................................................................................51
Appendix A - Detailed Gap Analysis and Local Provider Plans ....................................................................52
Appendix B - Annex 2 Capability Deployment Schedule Illustration ...........................................................52
Appendix C - Ready to Deliver Change Feedback ........................................................................................52
Appendix D - New Projects Details ..............................................................................................................52
Appendix E - DMA Trajectory Results ..........................................................................................................52
Appendix F - Universal Priorities Forms for each CCG .................................................................................52
Appendix G - SNOMED-CT / DM+D / NHS Numbers / Mobile Working Infrastructure / GS1 Standards
(Barcode) Survey Results ..........................................................................................................52
Appendix H – J2 Interoperability Architecture Specification.......................................................................53
Appendix I – HSCIC Feedback on J2 Interoperability Architecture Specification ........................................53
Appendix J - Roadmap Process Meeting Representation Details ................................................................53
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Appendix K - Patient Safety and Reputational Risk Survey .........................................................................53
Appendix L - Achievements..........................................................................................................................53
Appendix M – Current Initiatives .................................................................................................................53
Appendix N – Outcome to Project Mapping................................................................................................53
Glossary
...................................................................................................................................................54
** Please note the Sections in brackets refer to the Roadmap Guidance Sections
Page 4 of 55
1 Review and Approval
1.1 Reviewers
This document must be reviewed by the following:
Name
Title / Responsibility
Date
Version
Annette Benny
CCG Lead - NEW Devon
9/5/2016
11/5/2016
Draft v0.1
Draft v0.2
Vanessa Dunn
CCG Lead - Torbay
9/5/2016
11/5/2016
Draft v0.1
Draft v0.2
Paul Hayes
CCG Lead and IT Lead - Cornwall/Kernow
9/5/2016
11/5/2016
Draft v0.1
Draft v0.2
Matthew Boulter Clinical Lead - Cornwall/Kernow
9/5/2016
11/5/2016
Draft v0.1
Draft v0.2
John McCormick Clinical Lead - Torbay
9/5/2016
11/5/2016
Draft v0.1
Draft v0.2
Paul Hardy
Clinical Lead - NEW Devon
9/5/2016
11/5/2016
Draft v0.1
Draft v0.2
Jim Goodwin
IT Lead – NEW Devon
9/5/2016
11/5/2016
Draft v0.1
Draft v0.2
1.2 Approvals
This document must be approved by the following:
Name
Title / Responsibility
Date
Version
Annette Benny
CCG Lead – NEW Devon
25/05/2016
v1.0
Andrew Abbott
CCG Lead - Cornwall/Kernow
28/06/2016
v1.0
Vanessa Dunn
CCG Lead - South Devon and Torbay
31/05/2016
v1.0
Nick Roberts
Chief Clinical Officer - NHS South Devon and Torbay
CCG
28/06/2016
v1.0
Jackie Pendleton
Interim Managing Director - NHS Kernow CCG
28/06/2016
v1.0
Rebecca Harriott
Chief Officer - NEW Devon CCG
28/06/2016
v1.0
Page 5 of 55
Date of
Approval
Version
South Western Ambulance Service NHS Foundation Trust (SWAST)
15/06/2016
1.0
South Devon and Torbay CCG Governing Body
31/05/2016
1.0
Torbay & South Devon NHS Foundation Trust Executive Directors Board
10/06/2016
1.0
Torbay Council Approval – held at Children’s and Adults Directors Meeting
01/06/2016
1.0
Devon Partnership NHS Trust Senior Management Board
16/06/2016
1.0
Devon County Council Delivery Board Meeting
24/06/2016
1.0
Devon Doctors Board Meeting
16/06/2016
1.0
Virgin Care - Children’s Services Approvals Board
10/06/2016
1.0
Ramsay Health Care (Mount Stuart, Duchy and Bodmin Hospitals) Approvals
15/06/2016
Board
1.0
Rowcroft Hospice Approvals Board
08/06/2016
1.0
Plymouth City Council IHWB Programme Board
15/06 2016
1.0
Royal Devon & Exeter NHS Foundation Trust Approvals - Trust Executive
Group
14/06/2016
Plymouth Hospitals NHS Trust Digital Care Record Portfolio Meeting
22/02/2016
1.0
Livewell Southwest (CIC) ET Board
02/06/2016
1.0
Northern Devon Healthcare NHS Trust- Exec Committee
01/06/2016
1.0
Northern Devon Healthcare NHS Trust- Trust Board Meeting
07/06/2016
1.0
Devon Doctors Board Meeting
16/6/2016
1.0
Devon County Council People’s Leadership Team
07/06/2016
1.0
Health & Wellbeing Board - Devon
09/06/2016
1.0
Health & Wellbeing Board - Plymouth
30/06/2016
1.0
Cornwall STP Transformation Board
29/06/2016
1.0
Partners Governance Approval Boards
1.0
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Our approval process and associated dates is summarised below:
29 April 2016
9 May 2016
11-17 May 2016
17 May 2016
24 May 2016
15 June 2016
21 June 2016
30 June 2016
– New Roadmap Guidelines Published (Final Version)
– 1st Draft Roadmap Published to CIOs for engagement with their Organisations
– CIOs to Review for accuracy, omissions, and completeness for funding requirements
– 1st Draft Feedback must be submitted
– Final Draft Published and Start Governance Process for CIOs
– Sign Off by All Partner Organisations Required
– Cornwall STP Transformation Board Sign off
– Roadmap Submission to NHS England
1.3 Document Status
This is a controlled document.
Whilst this document may be printed, the electronic version maintained in SharePoint is the controlled
copy. Any printed copies of the document are not controlled.
1.4 Relevant Documentation
These documents provide additional information.
Title
Version
Digital Maturity Assessments
N/A
Sustainability & Transformation Plans Devon
v3.0
Sustainability & Transformation Plans - Cornwall/Kernow
April Submission
South West Region - Integration of IT Systems Strategy
v2
NHS England Roadmap Guidelines (FINAL)
1.0
Cornwall CCG Information Technology Strategy and Implementation Plan
v1.7
SD&T CCG Information Technology Strategy
v1.0
NEW Devon IMT Strategic Vision Statement
Draft v10
Page 7 of 55
‘One Person, One Digital Record’
2
Executive Summary
Data and digital technology has the power to support people to live healthier lives and be less reliant on
care services, as well as ensuring the provision of health and care is both high quality and sustainable.
In September 2015 a Government initiative was launched requiring local health and care systems to
produce Digital Roadmaps setting out the ambition of being paper-free at the point of care by 2020.
This document is the response to that initiative and has been developed through the collaboration of the
three clinical commissioning groups, local authorities and providers covering the Devon and Cornwall
Peninsula. The collaboration on the journey towards developing this Roadmap marks a sea of change in
our organisational attitudes towards the delivery of Information Technology (IT) in health and care and as
such this document sets out the shared vision, goals and plan required to deliver integrated Health and
Social Care IT solutions across the Peninsula. These solutions will be driven by the appetite for
transformation in our services as we deepen the level of integration to provide a more seamless and
person centred experience for people using health and care services. The resulting IT solutions will in
turn facilitate and accelerate the cultural changes which will be necessary in delivering these reforms.
This roadmap builds upon the progress of our local work and identifies how the three CCGs (South Devon
and Torbay, Kernow and NEW Devon) in the Peninsula will work together to make best effect of skills and
resources for the population we serve.
Every local health and care system will be expected to make early progress on 10 Universal Priorities
between now and March 2017.
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In order to achieve this ambition locally there are four key areas of focus namely:




Build the foundations: Health and care organisations need to reach digital maturity
Leverage the capability: Connect all the digitally mature organisations
Leverage existing capabilities: Identify what can be achieved ahead of the 2020
Exploit the opportunities: Enable citizen access
These are illustrated and mapped in the diagram below:
This roadmap outlines how digital technology will support the delivery of the Sustainability and
Transformation Plans for Devon and Cornwall, addressing solutions to close the care and quality gap,
finance and efficiency gap and the health and wellbeing gap.
Whilst further work is required to clarify the costs of delivering the digital vision during the summer 2016,
it is clear that the overall capital programme, across 22 organisations, and across five years will be at least
£150m, with ongoing revenue consequences of £15m. At this stage not all providers provided
information so the costs are likely to increase.
This excludes specific Peninsula wide projects, which would cost between £12m and £22m depending on
clarification of a number of issues. Furthermore, response from most organisations for the initial costing
Page 9 of 55
for the implementation of digital related patient safety initiatives has revealed at least a further £5.9m
cost. There is a clear piece of work required to ensure that there is a consistent data collection and to
identify where funding is already sourced.
And in addition we take into account a number of the 10 Sustainability and Transformation Plan big
questions which include:
Q2 How are you engaging patients, communities and NHS staff?
Q3 How will you support, invest in and improve general practice?
Q4 How will you implement new care models that address local challenges?
Q8 How will you deploy technology to accelerate change?
This roadmap should be considered as a living document; it is both aspirational and ambitious and is
expected to evolve over the coming months and years.
By supporting this document organisations are signing up to the following commitments:








Our vision for ‘One Person, One Digital Record’
That all organisations within the Peninsula work to common standards for data structures,
technology and information sharing
That we commence a period of scoping to produce project mandates for the programme of work
identified
That an updated and more detailed roadmap is produced in September 2016.
Optimise and make best use of any funding sources to ensure that we maximise income within this
programme of work
Work collaboratively and apply our “Do it Once” methodology across the Peninsula
Make the best use of national systems
Make best use of our combined procurement power to ensure financial sustainability
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3
Scope
The scope of this Roadmap includes our population of 1.7 million patients, supported by 3 CCGs (Kernow,
South Devon & Torbay and Northern, Eastern & Western Devon), 9 NHS Trusts, 4 Local Authorities, 245
GP Practices, and private providers.
The Peninsula
The scope of this Roadmap encompasses how we will enable:
(i)
(ii)
(iii)
(iv)
(v)
(vi)
Paper-free at the Point of Care
Digitally enabled self-care
Real-time data analytics at the point of care
Whole systems intelligence to support population health and social care management and effective
commissioning, clinical surveillance and research
Sustainability and Transformation Plans across Cornwall and Devon
5 Year Forward View objectives
We recognise that there are a number of NHS funded care providers who (due to their small size and
localised nature) have not been actively involved to date i.e. RISE (Drug and Alcohol Services) and CHIME
(Audiology). We recognise their importance and will engage with these colleagues at a future point in the
programme.
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4
General
4.1 Identify who has endorsed the roadmap (Section 6.2)
There are a total of 22 Partners within the combined footprint declared by the three CCGs all of which have
input and supported the Roadmap, they are detailed as follows:
Kernow /Cornwall CCG
Cornwall Council
Cornwall Health Out of Hours
Cornwall Partnership Foundation Trust
Council of the Isles of Scilly
Kernow Health CIC (GP Consortium)
Kernow Primary Care
Northern Devon Healthcare NHS Trust
Plymouth Hospitals NHS Trust
Ramsay Health Care approvals board (Duchy and
Bodmin hospitals)
Royal Cornwall Hospitals NHS Trust
South Western Ambulance Service NHS Foundation
Trust
NEW Devon CCG
Devon County Council
Devon Doctors
Devon Partnership NHS Trust
Livewell Southwest (CIC)
Northern Devon Healthcare NHS Trust
Plymouth City Council
Plymouth Hospitals NHS Trust
Royal Devon and Exeter NHS Foundation Trust
South Western Ambulance Service NHS Foundation
Trust
Virgin Care – Devon Children’s Services
South Devon & Torbay CCG
Devon County Council
Devon Doctors
Devon Partnership NHS Trust
Haytor Health GP Consortium (for 34 practices)
Ramsay Health Care UK (Mount Stuart Hospital)
Rowcroft Hospice
Torbay Council
Torbay and South Devon NHS Foundation Trust
South Western Ambulance Service NHS Foundation
Trust
Virgin Care – Devon Children’s Services
4.2 Identify which organisations have made significant contributions in the
development process (Section 6.2)
The majority of the organisations (detailed in Section 4.1) have made significant contributions to the
development process and are acknowledged for their support and contribution. We also acknowledge
the South West Academic Health Science Network (SWAHSN) for their contribution and support.
Our early work included organisations within the Somerset CCG Footprint. As work progressed Somerset
made the decision on the 15th March 2016 to work separately, but are still engaged at CCG level to
ensure we share progress as required.
Page 12 of 55
4.3 Summarise the process through which the roadmap has been developed (Section
6.3)
Since the inception of Clinical Commissioning Groups in 2013, each CCG has either had a clear or evolving
Information and Communications Strategy (“Living Well” - Kernow, “Joined Up” - South Devon and Torbay
“IM&T Strategic Vision” - NEW Devon). During 2014/2015, the South West Academic Health Science
Network (SW AHSN) surveyed the Health and Social Care Organisations across the South West in terms of
digital capability and opportunities to work together were identified.
In order to move forward from this position and create an environment where organisations could work
together and co-ordinate their efforts in achieving a joined up approach, a number of Senior Executives
across the Cornwall and Devon (and Somerset initially) agreed that an IM&T Strategy group should be
established, to build upon the work already underway at individual CCG levels
This IM&T Strategy Group has been meeting on a regular basis since June 2015 – membership of this
group is made up of many of the organisations listed in Section 4.1.
The IM&T Strategy Group along with all of its members has focused efforts on the development and
creation of a joined up and co-ordinated Digital Roadmap Plan for our population. A small sub group of
this meeting / project team has been established, to work with all partner organisations. The initial remit
was to produce a single roadmap plan for the area that incorporates all organisations’ individual IT
strategies and plans, show where collaborative working could be achieved (such as joint procurements),
and help organisations prioritise and cost out the how much investment would be required.
A significant amount of discussion and collaboration took place during 2015, this included a level of
partnership working and all organisations agreeing that a single approach to an Integrated Digital Care
Record should be the recommended way forward as part of approving the Digital Roadmap. All partners
co-funded a technical piece of work to identify the shared standards for adoption across the Peninsula.
In order to pull a project of this complexity and size together, and produce a meaningful digital roadmap
plan that all organisations could sign up to, (as well as meeting all the NHS England requirements) the
project team set out the following programme of work commencing in January 2016.
January 2016
o
o
Clinical and Professional Stakeholder Event, which provided feedback on the vision and outcomes
that would add value to clinical practice.
Presentation to the NEW Devon CCG Executive Committee
Page 13 of 55
February 2016
o
o
o
o
Initial 1-2-1 meetings with each CCG Leads were arranged by the Roadmap Programme Lead to
discuss data gathering and each CCG’s requirements.
A consultancy firm (J2) were appointed to produce a technical architecture document, with the aim
of setting out a technical piece of work to identify the shared standards for adoption across the
Peninsula. A workshop attended by IT technical leads was organised to start this work
The IM&T Strategy Group met monthly to discuss the roadmap guidance context and approach,
fielding questions and clarifying current status within the landscape
Work was started to ascertain the baseline position of all organisations (gap analysis) with the aim
of giving us a clear and accurate picture of the current state, above and beyond the information
contained within the Digital Maturity Assessment.
March 2016
A number of meetings and workshops were held to:
o
o
o
o
Gain greater understanding of the CCG environment
Provide feedback to the IM&T Strategy Group on the Roadmap and discuss what’s next, information
requirements and timescales
Presentation given at the South Devon & Torbay Joined Up IT Group to provide an update on the
Roadmap and discuss what’s next, information requirements and timescales
Presentation to private meeting of the NEW Devon CCG Governing Body
April 2016
o
o
o
o
o
o
o
o
o
o
Attendance at the NHS England South Regional Digital Strategy - "Working Together" Event –
presented South West approach
LMC Liaison Meeting for Cornwall and NEW Devon CCGs to update on the Roadmap and discuss
next steps and timescales
First 2020 Digital Roadmap Priorities Workshop with key service providers to discuss priority
outcomes in addition to the Universal Priorities (62 outcomes identified)
The IM&T Strategy Group to provide an update on the Roadmap and discuss what’s next,
information requirements and timescales
Second 2020 Digital Roadmap Priorities Workshop with key service providers to plan the projects
required to meet the 62 outcomes and 10 Universal Priorities and agree what is done at Local level
and what will be done across all 3 CCGs (majority of new projects will be at 3 CCG level)
Planning Day with Kernow CCG to ensure their requirements/key differences detailed
Planning Day with South Devon & Torbay CCG to ensure their requirements/key differences
detailed
Planning Day with New Devon CCG to ensure their requirements/key differences detailed
Three CCG planning meetings to agree approach and timelines for new projects
Presentation to Private Meeting of the NEW Devon CCG Governing Body
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May 2016
o
o
o
o
o
o
Three CCG Costing workshops to agree cost estimates and funding requirements
5th May all Partners Roadmap Workshop to discuss and gain consensus of the newly defined
Projects and approach of a shared procurement.
12 May IM&T Strategy Group to identify Current Initiatives and Achievements
Engagement and sign off process for all stakeholders
Presentation of Roadmap to the Executive Committee of the CCGs
Presentation of Roadmap to the Governing Body of the CCGs
The sign off process for the final version is detailed in Section 1.2 and details of each meetings attendee
can be found in Appendix J
Work is also progressing on a single Information Sharing Agreement across all CCGs Footprints, with all
stakeholders in favour of adopting a single Information Sharing Charter.
Page 15 of 55
5
Vision
5.1 Vision for digitally enabled transformation (Section 6.4 – 6.7)
5.1.1 Background
Kernow, South Devon and Torbay and NEW Devon Clinical Commissioning Groups and the stakeholders
within these footprints, serve a total population 1.7 million. Our populations and their needs are similar
and we have similar aspirations for our future model of delivery.
The local Joint Strategic Needs Assessments (JSNA) identifies current and future health and wellbeing
challenges across Cornwall and Devon include:
•
•
•
•
•
•
•
•
•
•
An ageing and growing population
Rurality and access to services
Complex patterns of deprivation linked to earlier onset of health and social care problems in more
deprived areas (10-15 year gap)
Housing issues (low incomes / high costs)
Giving every child the best start in life and ensuring children are ready for school
Poor mental health and wellbeing, social isolation and loneliness for both adults and children
Poor health outcomes caused by modifiable behaviours
Pressures on services (especially unplanned care) caused by increasing long-term conditions, multimorbidity and frailty
Unpaid care and associated health and social care outcomes
Shifting to a prevention focus
Our population is already older than in many parts of the country and this will continue to increase (for
example, currently in Cornwall 60-70% of patients over 70 years old have co-morbidity and the
complexity and cost of hospital care increases with co-morbidities). The challenge is to redesign care and
meet the needs of these people, improving their outcomes and reducing the risk of them being admitted
to hospital.
Deprivation is a significant issue with complex patterns of deprivation linked to earlier onset of health and
social care problems in more deprived areas (10-15 year gap in life expectancy).
We have a fragmented system with multiple access points, which everyone finds difficult to navigate.
Different organisations have different boundaries (e.g. CCGs, Local Authorities, Hospital footprints) that
overlap in complex ways. We can make more effective use of the capacity we have and stop people
waiting too long to get care and support, and spending longer than medically needed in bed based care
settings. Enabling partners to identify the risks to children and share these with other professions when
making safeguarding decisions is also an important factor in our work.
A key focus of the two Sustainability and Transformation Plans (2016 – 2021) covering Devon and
Cornwall is the need to radically change services delivery to improve population health, the experience of
care and the cost per head of the population. The implementation and take up of technology will enable
and accelerate this process as long as it is intrinsically aligned to transforming the whole system.
Page 16 of 55
Local people have told us how they would like to experience care, they have described how they wish to
take greater responsibility for staying well and independent and are able to plan their own care with
people who understand them. With access to information, they want the help and support to make
decisions about their own care.
They want to tell their own story once, know who is coordinating their care and receive joined up,
seamless care across organisational and team boundaries.
Across the whole Peninsula there are IT Information and Communications Strategies, which set out the
local ambition in terms of achieving (NHS England Five Year Forward View (2014) and Personalised Health
and Care: a framework for action (National Information Board, 2014):
(i)
Paper-free at the Point of Care
(ii)
Digitally enabled self-care
(iii)
Real-time data analytics at the point of care
(iv)
Whole systems intelligence to support population health management and effective
commissioning, clinical surveillance and research
During the process of developing the digital roadmap over the last eight months, the work plans and
priorities have been amalgamated into one programme of work to effectively enable the delivery of the
above transformation in relation to the health and wellbeing challenges across Cornwall and Devon. A
key aim is to work together wherever it makes sense to do so and we have a unique opportunity to work
together in order to deliver a single, sustainable and affordable solution delivering and sharing digital
clinical information at the point of care (at the bedside, in the clinic, in the patient's home and including
virtual consultations), revolutionising the way patients are cared for and treated across the South West
Peninsula.
5.2 Our Vision
One Person, One Digital Record
We will (with the correct information governance and information and data sharing agreements in place)
safely and securely bring together the information we already hold in many different organisations to
enable health and social care professionals to provide better and safer care for our population. It will be
a key enabler to our commissioning priorities and the health and care needs of our population and is in
line with the requirements of the NHS England 5 year Forward View and Personalised Health and Care
2020, where all Patient and Care records are required to be digital, interoperable and real time by 2020.
To do this we will need to:
•
•
Build the foundations: Health and care organisations need to reach digital maturity - ensure plans
are in place for all the health and social care organisations across the patch to reach digital maturity
at the earliest possible point in time, i.e. they are able to capture information digitally at the point
of care and are interoperable (compliant with international standards which enable sharing of
information).
Leverage the capability: Connect all the digitally mature organisations– procure and deploy the
infrastructure which enables information exchange between organisations to assimilate and create
a consolidated view of the records held for a person.
Page 17 of 55
•
•
Leverage existing capabilities: Identify what can be achieved ahead of the 2020 deadline –
establish a programme of works that ensures that the information that can be shared and will
deliver value, is routinely exchanged by organisations in the quickest possible timeframe. These
include the nationally mandated “universal priorities” by 2018 and a range of other locally identified
projects.
Exploit the opportunities: Enable citizen access – create a single view of the records held for a
person and provide citizens and patients with the ability to access and upload information to their
integrated digital record.
5.3 Our Principles
The establishment of the Integrated Digital Care Record (IDCR) will enable the vision of ‘One Person, One
Digital Record’. The scope of the work includes paper-free at the point of care, digitally enabled self-care,
real-time data analytics at the point of care, whole systems intelligence to support population health
management and commissioning informed by local priorities.
The way that we work will reflect the following principles to ensure a sustainable health and care system
for the future:
o
o
o
o
o
Optimise and make best use of any funding sources to ensure that we maximise income within this
programme of work
That all organisations within the Peninsula work to common standards for data structures,
technology and information sharing
Work collaboratively and apply our “Do it Once” methodology across the Peninsula
Make the best use of national systems
Make best use of our combined procurement power to ensure financial sustainability
Page 18 of 55
6
Baseline Position
6.1 Overview of digital maturity of key primary, secondary and social care providers
(Section 6.8)
We have undertaken a detailed survey of all partner organisations listed in Section 4.1 in order establish a
baseline position of digital maturity across the CCG catchment areas.
The results of this survey provide us with intelligence of the current position of each organisation with
regards to their IT strategies and delivery plans. This survey also provides us with details of delivery
timeframes, costs and prioritisation each organisation is working to.
The Digital Maturity Assessments for our Local Authority Areas and Primary Care are currently being
collated at a national level. Once published these will be used to further inform our Digital Roadmap,
including the timescales and cost impact.
By using this intelligence, it is possible to analyse the data to show areas where a number of different
organisations are looking to find technology solutions to similar challenges. By working together, we will
be able to procure software solutions that will meet the requirements of a number of different
organisations, this could potentially see either the procurement of single systems across multiple
organisations or further adoption of an existing system across other areas, where this is appropriate. This
will save resources in the form of time money and effort, and also allow a co-ordinated approach to
applying for National Funding when it becomes available.
Our approach will be to work collaboratively across all organisations to ensure that we can meet the
requirements of the 2020 vision.
Figure 1 illustrates the current position for each of our Secondary Care Providers in relation to the
National Average which shows that although good progress has been made within individual organisation
for different Capabilities, we still are below the National Average for Medicines Managements and
Optimisation and Decision Support in many areas together with low ranking in the league table for the
Digital Maturity Assessment for many of our Secondary Care Providers, as detailed below:
League Table Rank
42
61
70
71
100
141
154
239
Trust
Plymouth Hospitals NHS Trust
Cornwall Partnership NHS Foundation Trust
Torbay and Southern Devon Health and Care NHS Trust
South Western Ambulance Service NHS Trust
Royal Devon and Exeter NHS Foundation Trust
Northern Devon Healthcare NHS Trust
Royal Cornwall Hospitals NHS Trust
Devon Partnership NHS Trust
Average score
72.3
68.0
66.7
66.3
63.0
58.3
56.0
26.0
We have also run an analysis on the current projections within each Secondary Care organisation to
becoming be ‘Paper Free at the Point of Care’ by 2020, from this we now understand that will not reach
the required targets without substantial funding. As part of the Roadmap we have looked at the
requirements for each Capability and the outcomes we have decided are a priority. A number of projects
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have been identified to fill these gaps and these are detailed in Section 9.2. Evidence of the current
projection for ‘Paper Free at the Point of Care’ is detailed in Figure 2.
Providers have identified the levels of funding they would need to move their current systems to become
paper free and interoperable.
They have identified £150m over 5 years (2021) required to achieve this and currently advise that this is
additional funding over and above their capital programmes. It may be possible to bring some of this
work forward with additional funding to achieve the requirements by 2020 HOWEVER it is important that
further diligence takes place over the summer to clearly identify:
•
•
•
What is deliverable within their capital programme and by when (i.e. with no additional funding)
What additional funding would deliver the paper free at the point of delivery by 2020
What additional funding would achieve a pragmatic outcome somewhere between 2020 and any
projections set out in their capital programmes.
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Figure 1 - Secondary Care Current Capabilities in Relation to National Average
100%
90%
80%
70%
60%
Records, Assessments & Plans
Transfers Of Care
50%
Orders & Results Management
40%
Medicines Management & Optimisation
Decision Support
30%
Remote & Assistive Care
Asset & Resource Optimisation
20%
10%
0%
NATIONAL
AVERAGE
Cornwall Royal Cornwall Northern
Livewell
Plymouth
Royal Devon
Partnership Hospitals NHS
Devon
Southwest CIC Hospitals NHS and Exeter
NHS
Trust
Healthcare
Trust
NHS
Foundation
NHS Trust
Foundation
Trust
Trust
SWAST
Devon
Torbay and
Partnership
Southern
NHS Trust Devon Health
and Care NHS
Trust
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Figure 2- Secondary Care Provider Capability Projection for 2020
100%
90%
80%
70%
Records, Assessments & Plans
60%
Transfers of Care
50%
Orders & Results Management
Medicines Mgt & Optimisation
40%
Decision Support
30%
Remote Care
Asset & Resource Optimisation
20%
10%
0%
Cornwall
Partnership NHS
Foundation Trust
Royal Cornwall Northern Devon
Hospitals NHS Healthcare NHS
Trust
Trust
Livewell
Southwest CIC
Plymouth Royal Devon and
Devon
Torbay and
Hospitals NHS Exeter NHS
Partnership NHS Southern Devon
Trust
Foundation Trust
Trust
Health and Care
NHS Trust
* Please note that after further review the baseline results for Torbay and Southern Devon Health and Care NHS Trust have been rebased for Medicines
Management and Optimisation and Asset and Resource Optimisation. The full details of the gap analysis results can be found in Appendix A
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6.2 Summary of key recent achievements (Section 6.8)
At the IM&T Strategy Group held on 12 May 2016, we identified the achievements we are proud of
having achieved to date, these are captured in Appendix L. There is consistent progress across all
organisations in relation to our approach to information sharing and agile working (which give our staff
flexibility and the tools to support effective practice).
6.3 Summary of key current initiatives (Section 6.8)
We have identified the existing initiatives our stakeholders are currently working on and these are
detailed in Appendix M, this together with our gap analysis has identified 12 projects that we will scope
and run at Peninsula level, many of which will leverage the existing capability and provide sharing of
information ahead of 2020. We will also continue to consider and test the full list of initiatives against
our principles which are detailed in Figure 4.
The 12 Projects are as follows:
Project
Number
1
2
3
4
5
6
7
8
9
10
11
12
Project Title
Information Sharing Agreement across the 3 CCG areas
Availability of GP Record in all care settings
Extension of electronic Appointments and Referrals
Child Protection Information System
Secure eMail including care homes
Self-Care (including Patient Held Record and Prevention)
Virtual Consultations
Decision Support for clinicians
Secure Hotspots for Health and Care Workers
Support End of Life Wishes and Shared Care Plans
Bed Management across the “whole system” including care homes
Integrated Digital Health and Care Record in all care settings across the 3 CCG areas
Full details of each of these projects can be found in Appendix D
7.
Identification of rate limiting factors (Section 6.9)
As with all large scale IM&T implementations, we recognise that there will be challenges to delivering this
programme of work. Our surveys and analysis provide us with detailed intelligence of each organisations
plans and timeframes to deliver the 2020 vision. Our challenge will be to pull all these work streams and
organisations together and form a comprehensive and joined up delivery plan. This plan will clearly
identify what is to be delivered and how it is managed and at what level i.e. at a Peninsula level, CCG level
or by individual organisations the governance of the work will then reflect this.
We have listed below areas that we know we will need to address and resolve in order to successfully
manage and co-ordinate a programme of work of this size.
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As we move from the detailed planning stage to deployment, a central project team will be established to
manage all aspects of the delivery of the strategy, and address and resolve the Rate Limiting Factors
described below:





The complex landscape with varying digital maturity
Aligning the governance and decision making across partners (Minimum of 22 partners)
Limitations on accessing Funding/Finance to deliver these projects
Internal pressures on each organisation to implement their internal electronic patient record in
parallel to contributing the Peninsula wide workstreams
Staff resourcing for the key stages of all workstreams including design, build, implementation and
exploit
This is not an exhaustive list, and we anticipate undertaking further detailed planning work as we move
into the deployment stages of the programme.
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8.
Readiness
8.1 Set out leadership, clinical engagement and governance arrangements (Section
6.10)
Strong managerial and clinical leadership is key to the successful delivery of this programme of work.
With strong leadership and the sign up and commitment of all organisations, we will build on work and
plans already in place and underway at many of our partner organisations, to ensure that we can
successfully deliver our vision of ‘One person, One Digital Record’. Each CCG has a CCIO and a number of
organisations have the same or similar positions with clinical leaders for IT. They are fully engaged in this
process and have an active leading role.
This digital programme is an essential enabler to both Kernow and Devon’s STPs and success regime
where applicable; therefore it must be an integral part of the governance arrangements required for the
delivery of the STPs overall.
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Figure 3 – Governance Arrangements
Cornwall STP
Devon STP
*Further work is required to define the local programme structure and to align with the STP
arrangements which start at the Peninsula Digital Health and Care Steering Group
**This is based on the assumption that the existing STP PMO will be used.
The arrangements above in Figure 3 are aligned with both the Cornwall and Devon Sustainability and
Transformation Plan governance arrangements and these are detailed below:
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8.2 Cornwall
NHS England requires that each planning footprint area produces a Sustainability and Transformation
Plan (STP) in order to access the Sustainability and Transformation Fund. The STP will provide a local
strategic plan that will deliver an improved, more sustainable health and care system and the Local Digital
Roadmap (LDR) will be one of its key enablers. NHS Kernow CCG, CFT, RCHT, Cornwall Council, the Council
of the Isles of Scilly and Kernow Health CIC will be principle signatories in acknowledgement of the key
roles these organisations play within the wider system.
The strategic leadership for the STP will be provided by the Joint Strategic Executive Committee (JSEC),
jointly chaired by the Chair of the CCG and the Portfolio Holder for Adult Care. The JSEC reports into the
Cornwall Health and Well-Being Board (CH&WBB) and is attended by Chief Officers of all the key health
provider organisations in Cornwall and the Isles of Scilly, the two Council portfolio holders for adults and
children’ services, and the Chair of the CH&WBB. The Board of Directors / Governing Body of each of the
Health institutions have provided delegated authority to their Chief Executive attendee at JSEC to
approve the STP and the LDR on behalf of their organisation. It is also proposed that the STP and the LDR
are presented to Cornwall Council’s Informal Portfolio Holder Briefing, rather than to Cabinet for formal
approval. Each project board member will take responsibility for presenting the STP and LDR to their own
institution’s Executive Management Team / Corporate Directors Team, as and when they deem
appropriate.
Leadership and oversight for the STP is provided by a project board made up of the Executive Planning
Leads from each of the institutional partners, chaired by the Chief Executive of Cornwall Foundation
Trust. Programme Direction for the STP and underpinning LDR is from the NHS Kernow CCG Director of
Strategy, supported by a project team with representatives from each of the institutions. The programme
governance described here does not yet reflect changes in corporate governance, which remains with the
individual institutions. There has been a high turnover of System Leaders within the footprint over recent
time and we are currently out to advert for additional leadership capacity to act as substantive Senior
Responsible Owner for the work.
8.3 Devon
The two communities already have robust and inclusive governance arrangements in place to support
development and delivery of the success regime (NEW Devon) and the ICO transformation plan and
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urgent care Vanguard (South Devon & Torbay). However, the two CCG areas are coming together under
an integrated set of governance arrangements for the delivery of the Sustainability and Transformation
Plan. The success regime is already working in a system inclusive way to develop transformation plans for
NEW Devon, as are the ICO transformation plans in South Devon & Torbay as the ICO is by far the largest
provider in SD&T and plans have been jointly developed. Angela Pedder has been appointed as the
Sustainability and Transformation Plan Nominated Lead. Laura Nicholas is the Sustainability and
Transformation Plan Programme Director and Interim Joint Director of Strategy across the two CCGs. A
number of support posts are currently being recruited. An external provider - Carnall Farrar are providing
Diagnostic and Planning Development Support also as part of the success regime and in South Devon and
Torbay.
The communities of NEW Devon and South Devon & Torbay already undertake a wide range of planning
and commissioning together. We will continue to build on these areas and we plan to engage with
stakeholders in developing new joint strategic content as part of the Sustainability and Transformation
Plan under which our transformation plans will sit. This will consist of joint narrative covering public
health needs assessment, system vision, strategic objectives and a high level prioritised delivery plan to
include extended joint planning arrangements for, for example, workforce, IT, estates, engagement, and
acute and specialised service configuration . This will develop further during 2016/17 as a more detailed
integrated model of care becomes defined and key transformational deliverables clarified.
8.4 Identification of change management approach(es) / model(s) to be followed
(Section 6.11)
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There is much evidence on how major change projects succeed or fail. The NHS Change Model is a
composite of international evidence on enabling successful change. In order for us to assess the
strengths and development opportunities within the Digital Roadmap Programme, Chief Information
Officers stakeholders were asked to complete a questionnaire relating to the domains of the NHS Change
Model on 12th May 2016. The collated information is found at Appendix C and the key themes are
described below
The majority of respondents agreed that we have a clear vision with a shared understanding, however we
need to ensure some stakeholders come to the table and also that we increase the level of clinical
engagement. Whilst there was a sense that many stakeholders were engaged respondents felt that this
could be enhanced with some bigger engagement events and further continued joint working with other
colleagues such as the finance teams.
There was a clear sense that we have leaders that bring together all parts of the health and care system
and collaborate, however clinical engagement continued to be acknowledged as a gap, as well as the
need to extend the work to smaller providers (such as care homes) as the programme progresses. One of
the proposals we will explore as we move into the next phase is how we use technology to enable
clinicians to participate effectively and efficiently in spite of our geographical spread.
Given that both STP processes will include patient and public engagement, we will use the outcomes of
this work to provide the context for the people we serve. However, we recognise the importance of
patient and public engagement in the Digital Roadmap programme and will ensure this is a key
component of the design as projects are scoped during summer 2016.
The level of transparency in the process has enabled some sharing and learning, however it was
acknowledged that this was an area where we could further develop and accelerate good practice.
The majority of respondents identified that we were unclear about the “Change Methodology” for each
programme/project and it was noted that this is an area for future development during the summer as
the work is scoped.
Respondents considered that our approach to delivery (through programme and project management
techniques) could be enhanced by ensuring that we have a detailed methodology, to which everyone
signs up, and that there is proper funding of programme/project resources.
A gap in our current approach is the clarity about how we will measure the success of our
programmes/projects. There was an optimism that this would become clearer as we move to the next
stages and this is an important element of the work planned throughout the summer.
Respondents felt there was a clear gap in terms of aligning other system drivers, such as contracting, to
enable this work. Whilst there are elements in the national contract and a service delivery and
improvement plan has been agreed with major providers, there could be a more coordinated approach to
maximise system drivers, including accessing national funding.
Finally there was overwhelming feedback from respondents that there is a good balance between the
things that motivate them in the programmes/projects and the level of performance
management/accountability. A continued focus on ensuring this balance will help motivate us all as we
progress this major work.
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8.5 Identification of approach to benefits management and measurement (Section
6.12)
Potential benefits will be identified for each project and held at a steering group level to prevent double
counting and to monitor against the defined metrics and project delivery objectives. We will clarify and
agree a consistent approach to benefits realisation across the peninsula as part of our work throughout
the summer 2016. It is our intention to measure our current state in relation to each of our projects for
our benefits to be realised.
As part of the Benefits Realisation approach we are also incorporating a mapping to the 3 challenges
defined in the Sustainability and Transformation Plan:
Care and Quality Gap
By linking and integrating IT systems across multiple organisations, the care that our health and social
care professionals provide will be significantly improved. For the first time information will be available
to be shared across all our partner organisations, which will allow front line health and social care
professionals to be able to provide the most appropriate care and services based on detailed knowledge
of the individual.
Finance and Efficiency Gap
Patients will be treated with the most appropriate care based on their medical history, this will improve
patient flow in the clinical environment, reduce unnecessary diagnostic tests (as they may have already
been completed by the GP recently), and improve patient care. In the social care setting for example, the
ability to know when a patient is either admitted to hospital or discharged will allow packages of care to
be stopped and started at the correct time.
By working together in a co-ordinated and joined up way, additional savings could be realised – for
example, having one procurement process for implementing one of the many IT systems that will be
required as part of this programme of work, and by having a central team with responsibility for the
delivery of the programme.
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Health and Well Being Gap
Sharing of information is key to driving out efficiencies, and improving patient care. All aspects of this
programme of work will play a part in closing the financial gap, the care and quality gap and also the
health and wellbeing gap.
By working together we improve the Care and Quality Gaps, Finance and Efficiency Gaps and the Health
and Well Being Gaps and an illustration of this can be seen in the example below:
Example: Clinicians in urgent and emergency care settings will be able view information held by GPs for
patients presenting at A&E departments. Clinicians will be able to make more informed decisions based
on clinical history, and save time and effort contacting GP Practices to get copies of medical records and
therefore this will enable better care
8.6 Identification of known, anticipated and target sources of investment (Section 6.13)
Following an initial enquiry to all providers, it is clear that further work is required to clarify the future
costs of delivering the digital vision.
The information collated from providers is of differing quality and status. It is unclear if these are funded
within provider capital programmes, or additional costs. If additional costs, it is unclear what is the
intended source of funds.
What is clear is that the overall capital programme, across 22 organisations, and across 5 years will be at
least £150m, with ongoing annual revenue consequences of £15m. Please note some providers did not
provide this information so the costs are likely to increase.
This excludes the specific Peninsula wide projects set out in the roadmap, which would cost between
£12m and £22m. This would be dependent on clarification of a number of issues including:
•
•
•
•
The consent model
The capital cost of implementation
The phasing of implementation
Concurrent or sequential implementation
Furthermore, response from most organisations for the initial costing for the implementation of patient
safety initiatives has revealed at least a £5.9m cost. These initiatives include:
•
•
•
•
•
•
•
Cyber Security
Clinical Safety
Data Quality
Data Protection and Privacy
Meeting Accessible Information Standards
Business Continuity and Disaster Recovery
Unwarranted or Unlicensed Software
Not all organisations have responded to this, nor has any diligence or challenge been provided on these
numbers. There is a clear piece of work required to ensure that there is a consistent data collection that
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is meaningful and this will take some time and will be part of the work programme over the summer
2016.
8.7 Overview of programme / project structure for 16/17 (Section 6.14)
The defined and recommended programme structure to deliver the Digital Transformation across the
three CCGs is made up of 12 Projects which will be scoped and managed at a Peninsula level supporting
the collaborative model we have chosen to adopt together, these 12 projects address the 62 Outcomes
and 10 Universal Priorities.
Where progress has already been made within a CCG, consideration will be given to extending this project
to the other CCGs, if this is deemed the most appropriate approach.
In addition to the 12 new Projects, each CCG has a number of projects in progress that will continue as is,
with individual providers also delivering their own programme of work which will work toward the
‘Paperless at the Point of Care’ and Interoperable model.
Support End of Life Wishes and Shared Bed Management across the “whole
Care Plans
system” including care homes
Integrated Digital Health & Care
Information Sharing Agreement across
Decision Support for clinicians
Record in all care settings across the 3
the 3 CCG areas
CCG areas
Self-Care (including Patient Held
Extension of electronic Appointments
Virtual Consultations
Record and Prevention)
and Referrals
Secure Hotspots for Health and Care
Availability of GP Record in all care
Secure eMail including care homes
Workers
settings
Child Protection Information System
3CCG Wide
12 New Projects
CCG Projects
Local Implementation
of a National System
Local Projects
Individual Partner
Projects
Kernow
NEW Devon
South Devon & Torbay
National 111
Patient Online
National 111
Patient Online
National 111
Patient Online
Secondary Care EPR
Secondary Care EPR
Secondary Care EPR
eDischarge
eDischarge
eDischarge
National eReferals
National eReferals
National eReferals
National ePrescribing
National ePrescribing
National ePrescribing
GURU & SCR
MIG
MIG & SCR
Care Plan & EoL
EPR
EPR
GPIT Projects
Integrated Commissioning Programme
(under the Cornwall Deal)
Integrated Early Help Hub
One Public Estate Programme
delivering Cloud Printing and Faster
Wireless for Health and Council
GPIT Projects
GPIT Projects
Full Details can be found in Appendix A
We will also continue to consider and test these projects against our principles and look at them in
greater detail during summer 2016.
8.8 Outline of how resources can be utilised more effectively (Section 6.15)
To ensure that resources in the form of staffing and finances can be utilised efficiently, a Peninsula wide
project team will be established with responsibility for the overarching management, co-ordination and
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delivery of the Digital Roadmap plan. This team will engage with and work alongside local organisational
delivery and project teams in a supportive and co-ordinated way and ensuring that priorities and delivery
is aligned with the requirements set out in the STPs.
With this approach, organisations will be able to focus on their own local delivery of the plan, whilst the
overarching programme team would manage and co-ordinate multiple workstreams where appropriate,
for example, procurement of a medicines management system may need to undertaken across more than
one organisation. With an overarching approach savings should be made around the procurement
process i.e. only one process needed, and additional savings may be realised if expertise around
implementation of the systems should be shared amongst organisations.
There is a track record of joint working between organisations in the Peninsula and this approach builds
on the foundation that exists. We have the motivation from all organisations to “Do it once” and through
the sign up to this document an explicit commitment to continue working this way (See Figure 4 below).
This will save time, money and resources by not procuring and implementing numerous different systems
across multiple organisations.
Figure 4 – Key Principles for our Peninsula Approach
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9
Capability Deployment
9.1 Identification of current maturity for each of the 7 Paper Free at the Point of Care
(PF@PoC capabilities) (Section 6.16)
The surveys and analysis we have undertaken (as mentioned in Section 6.1) allow us to identify the
current maturity positions for each of the 7 capabilities across our Secondary Care partner organisations.
These organisations have completed detailed analysis for each of the capabilities, showing which of their
IT programmes of work meet each requirement. The analysis also shows the current status of each
project (In progress / deployed etc.) as well as which supplier is delivering the solution. The analysis is
further enhanced as a planned timeline to deploy information is also included.
All our Secondary Care organisations are below the national average for a number of capabilities as
defined by the Digital Maturity Index and this is illustrated in the ‘Secondary Care Current Capabilities in
Relation to National Average’ Graph in Section 6.1.
The Social Care and Primary Care Digital Maturity Assessments were not available at the time of
publishing this roadmap, but will form a fundamental part of our digital transformation planning moving
forward.
A detailed breakdown of all the outcomes and the progress against the Universal Priorities can be found
in Appendix B. In addition to this the specific projects these have been allocated to can be found in
Appendix N.
9.2 Capability deployment schedule (Sections 6.17- 6.18)
Following the Gap Analysis exercise and the identification of the required outcomes by 2020, we were
then able to pull together a number of layers of planning.
1.
2.
3.
4.
Build the foundations: Health and care organisations need to reach digital maturity - ensure plans
are in place for all the health and social care organisations across the patch to reach digital maturity
at the earliest possible point in time, i.e. they are able to capture information digitally at the point
of care and are interoperable (compliant with international standards which enable sharing of
information).
Leverage the capability: Connect all the digitally mature organisations – procure and deploy the
infrastructure which enables information exchange between organisations to assimilate and create
a consolidated view of the records held for a person.
Leverage existing capabilities: Identify what can be achieved ahead of the 2020 deadline –
establish a programme of works that ensures that the information that can be shared and will
deliver value, is routinely exchanged by organisations in the quickest possible timeframe. These
include the nationally mandated “universal priorities” by 2018 and a range of other locally identified
projects.
Exploit the opportunities: Enable citizen access – create a single view of the records held for a
person and provide citizens and patients with the ability to access and upload information to their
integrated digital record.
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Build the foundations: Health and care organisations need to reach digital maturity
Digital innovation delivers considerable benefits in terms of driving efficiencies in day to day working and
continued progress in key patient’s safety areas (National Information Board 2015). Before we can
connect all organisations and enable information exchange between them we have to ensure that each
organisation has the capability/digital maturity to enable the sharing to take place. Each health and care
provider has their own digital roadmap which identifies how they might achieve this digital maturity.
Further work is required during summer 2016 to understand the detailed plans, the costs of these plans
and whether funding has been allocated.
The graphs in Figure 1 and Figure 2 in Section 6.1 show the current and projected capabilities to 2020.
Leverage the capability: Connect all the digitally mature organisations
We have identified the need for an Integrated Digital Health and Care Record (IDCR) that covers all
elements of a person’s health and care record. This project is one of 12 that we will scope, procure and
deliver at a Peninsula level.
The Scope will include:
o
o
o
Clinical Portal
Patient Portal
Analytics Functionality (further consideration will be given to the inclusion of analytics in the scope
of this project during the Summer 2016 planning exercise)
Leverage existing capabilities: Identify what can be achieved ahead of the 2020 deadline
There are ten Universal Priorities in areas where we are required by NHS England to make significant
progress by 2018. These are listed below:
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Professionals across care settings can access GP-held information on GP-prescribed medications,
patient allergies and adverse reactions
Clinicians in urgent and emergency care settings can access key GP-held information for those
patients previously identified by GPs as most likely to present (in U&EC)
Patients can access their GP record
GPs can refer electronically to secondary care
GPs receive timely electronic discharge summaries from secondary care
Social care receive timely electronic Assessment, Discharge and Withdrawal Notices from acute care
Clinicians in unscheduled care settings can access child protection information with social care
professionals notified accordingly
Professionals across care settings made aware of end-of-life preference information
GPs and community pharmacists can utilise electronic prescriptions
Patients can book appointments and order repeat prescriptions from their GP practice
These expectations together with opportunities identified from analysing the gap analysis have resulted
12 projects being identified for scoping and delivery at a Peninsula level. There are also a number of
other projects relevant only to a specific area (CCG or provider).
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These projects will be scoped in detail, costed and prioritised during the summer 2016 with the road map
updated in September 2016. All progress will be monitored through a single Programme Management
Office, currently being set up to support the STP processes and the Peninsula Digital Health and Care
Steering Group will provide recommendations and assurance on delivery to the Joint Strategic Executive
Committee and the Programme Delivery Executive Group (for Cornwall and Devon respectively).
Details of each of the 12 new projects are as follows:
Project 1: Information Sharing Agreement across the 3 CCG areas
Narrative: A Peninsula Information Sharing Charter will be established and would aim to provide Devon
and Cornwall health and care organisations with a robust foundation for the lawful, secure and
confidential sharing of personal information between themselves and other public, private or voluntary
sector organisations that they work, or wish to work in partnership with.
Project 2: Availability of GP Record in all care settings
Capability: Records, Assessments and Plans
Universal Priority: Professionals across care settings can access GP-held information on GP-prescribed
medications, patient allergies and adverse reactions
Narrative: Health and Social Care professionals across all organisations will be able to access GP patient
records at the point of care. This will allow Health and Social Care professionals to make informed
decisions on the most appropriate care for their patients - GP practices will no longer have to be
contacted to fax / send information to where the patient is being treated, therefore saving time and
resources.
Project 3: Extension of electronic Appointments and Referrals



GP Referral to Secondary Care
Online booking for GP by Patients
Online booking and changes to Secondary Care appointments by Patients
Capability: Records, Assessments and Plans
Narrative: Online booking and changes to secondary-care appointments by Patients. This is a national
requirement and is the first phase of a much wider scope of work that could include appointments for
example: mental health, learning disability and health visitor services.
Project 4: Child Protection Information System
Capability: Decision Support
Universal Priority: Clinicians in unscheduled care settings can access child protection information with
social care professionals notified accordingly
Narrative: Functionality will exist that will allow clinicians to be made aware of child protection issues or
concerns when a patient presents at an out of hours or emergency care setting (possibly a child
protection flag within their clinical system). This will then allow clinicians and other health and social care
professionals to co-ordinate the care, or flag up to other clinicians any concerns they may have.
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Project 5: Secure eMail including care homes
Narrative: We can communicate easily and effectively using a secure mechanism with other health and
care professionals including care homes, reablement services, domiciliary care providers.
Project 6: Self-Care (including Patient Held Record and Prevention)
Capability: Remote and Assistive Care
Narrative: The use of telecare and telehealth equipment will be utilised to improve patient care, and
allow patients to take control and responsibility of their conditions. For example, remote diabetic
equipment could be used for patients to self-monitor; intervention could then be made if their results fall
outside of pre-set limits.
Project 7: Virtual Consultations
Capability: Remote and Assistive Care
Narrative: By utilising technology such as secure video conferencing, patients could initially be consulted
remotely, before a decision on the correct treatment pathway - this would reduce travel from the
patient’s side, and allow clinicians to only see patients that really needed to be seen. Patients could be
signposted to the most appropriate care setting. There are also uses in the Multi-Disciplinary Team
setting where video conferencing across health and social care can provide benefits to both professional
and service user.
In applying both remote consultations and telehealth technologies, reductions in GP attendance at
nursing homes could be achieved, as well as face to face hospital appointments could be reduced.
Instead appointments could be utilised by patients needing high levels of intervention.
Advances in security around video conferencing will allow clinicians to carry out consultations directly
with patients on their own IT equipment.
Project 8: Decision Support for clinicians
Capability: Decision Support
Narrative: Implementation of intelligent software that would show conflicts and contraindications of
drugs to assist clinicians with their prescribing decisions.
Shortcuts and hyperlinks to be embedded within software solutions that will provide links to up to date
guidelines and information for clinicians, to include analysis of real time data to assist with clinician
decision making process.
Project 9: Secure Hotspots for Health and Care Workers in all health and council locations
Narrative: Allow any care professional, with an enabled device, the capability to access their applications
and data over the WLAN network throughout the Peninsula. Set up secure hotspots to allow staff from
different organisations to use each other’s Wi-Fi securely and is likely to take the form of a Peninsula
HealthRoam.
Page 37 of 55
Project 10: Support End of Life Wishes and Shared Care Plans
Capability: Decision Support
Narrative: Ensuring that end of life wishes of patients is incorporated within the data sets that are
available to clinicians within the out of hours services.
Project 11: Bed Management across the “whole system” including care homes
Capability: Asset and Resource Optimisation
Narrative: All organisations in the care system will have a real time view of bed base and occupancy
across the complete system (including Care Homes etc.)
Project 12: Integrated Digital Health and Care Record in all care settings across the 3 CCG areas
Capability: Asset and Resource Optimisation, Records, Assessments and Plans, Medicines Management
and Optimisation and Decision Support
Universal Priority: Professionals across care settings made aware of end-of-life preference information
Scope: Clinical Portal, Patient Portal and Analytics Functionality (further consideration will be given to the
inclusion of analytics in the scope of this project during the Summer 2016 planning exercise).
Full details of all these projects including an initial review by our providers and the themes of their
feedback can be found in Appendix D
9.3 Capability deployment trajectory (secondary care) (Section 6.23)
The Digital Maturity Assessment results for each of the Secondary Care Providers in the Peninsula has
been provided as the baseline for each of the 7 capabilities and projected progress detailed in the
attached spreadsheet (Appendix E) for 2016/2017, 2017/2018 and 2018/2019. Given that this was the
first time providers completed the Digital Maturity Assessment and further validation is needed, they
have taken a more prudent approach to increasing capability during the first year (2016/17). As we work
through the detail in the next three months we will have greater clarity and consistency in the approach
taken.
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The Digital Maturity Assessments for our Local Authority Areas and Primary Care are currently being at a
national level, once published these will be used to further inform our Digital Roadmap, including the
timescales and cost impact.
Illustrated in Figure 5 below is the projected enabling of each of the capabilities by the information
sharing agreement and data flow across the peninsula. As we have yet to confirm the scheduled delivery
of our 12 new projects the grid below reflects the local projects provides an indicative view of the
roadmap progress and an updated grid will be provided in September 2016 following more detailed
analysis.
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Figure 5 – The Roadmap and Information Sharing and Standards Trajectory
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10
Universal Priorities Delivery Plan
The following information will be found in detail in Appendix F
•
•
•
•
Current baseline (for each universal priority) (Section 6.27)
Ambition (for each universal priority) (Section 6.28)
Key activities (for each universal priority) (Section 6.29)
Rationale for using alternatives to national services / infrastructure / standards (for each universal
priority) (Section 6.29)
• Proposals for evidencing progress towards the defined aims (for each universal priority) (Section 6.30)
Surveys for each CCG have been undertaken to establish the baseline position, ambition, key activities,
and rationale for using alternatives to national services / infrastructure / standards and the proposals for
evidencing progress towards the defined aims with regards to the delivery of the Universal Priorities
targets.
Figure 6 – Current Assessment of Progress towards Universal Priorities
Universal Priorities
Professionals across care settings can access GP-held
information on GP-prescribed medications, patient allergies
and adverse reactions
Clinicians in urgent and emergency care settings can access
key GP-held information for those patients previously
identified by GPs as most likely to present (in U&EC)
Patients can access their GP record
GPs can refer electronically to secondary care
GPs receive timely electronic discharge summaries from
secondary care
Social care receive timely electronic Assessment, Discharge
and Withdrawal Notices from acute care
Clinicians in unscheduled care settings can access child
protection information with social care professionals
notified accordingly
Professionals across care settings made aware of end-of-life
preference information
GPs and community pharmacists can utilise electronic
prescriptions
Patients can book appointments and order repeat
prescriptions from their GP practice
NEW Devon
South Devon &
Torbay
Kernow
Plan in place, on
track
Plan in place, on
track
Plan in place,
on track
Plan in place, on
track
Plan in place, on
track
Plan in place,
on track
Complete,
increase in
uptake req’d
Complete,
increase in
uptake req’d
Plan in place risk
to delivery
Plan in place, on
track
Plan in place, on
track
Plan in place risk
to delivery
Complete,
increase in
uptake req’d
Complete,
increase in
uptake req’d
Plan in place
risk to delivery
To be scoped
To be scoped
To be scoped
To be scoped
To be scoped
To be scoped
To be scoped
To be scoped
To be scoped
Plan in place risk
to delivery
Complete,
increase in
uptake req’d
Plan in place risk
to delivery
Plan in place, on
track
Plan in place
risk to delivery
Complete,
increase in
uptake req’d
Page 41 of 55
Each of the Universal Priorities have plans detailing how we intend to progress these and a summary of
the target completion dates are reflected in the table below.
Scheduled
Completion
Date
TBC
April 2017
April 2017
April 2017
April 2017
October 2017
TBC
TBC
August 2017
April 2017
Universal Priority
Professionals across care settings can access GP-held information on GP-prescribed
medications, patient allergies and adverse reactions
Clinicians in urgent and emergency care settings can access key GP-held information for
those patients previously identified by GPs as most likely to present (in U&EC)
Patients can access their GP record
GPs can refer electronically to secondary care
GPs receive timely electronic discharge summaries from secondary care
Social care receive timely electronic Assessment, Discharge and Withdrawal Notices
from acute care
Clinicians in unscheduled care settings can access child protection information with
social care professionals notified accordingly
Professionals across care settings made aware of end-of-life preference information
GPs and community pharmacists can utilise electronic prescriptions
Patients can book appointments and order repeat prescriptions from their GP practice
Full details of these plans can be found in Appendix F.
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11
Information Sharing
11.1 Information Sharing Approach (Section 6.32)
A Peninsula Information Sharing Charter will be established and provide Devon and Cornwall health and
care organisations with a robust foundation for the lawful, secure and confidential sharing of personal
information between themselves and other public, private or voluntary sector organisations that they
work, or wish to work in partnership with. It will enable all organisations that they work, or wish to work,
with in partnership to meet their statutory obligations and share information safely to enable integrated
service provision across the Peninsula and better care outcome for individuals.
The principles of this Charter will be to:
a)
b)
c)
d)
e)
f)
g)
h)
identify the lawful basis for information sharing;
provide the framework to ensure that information is kept secure and meets the legal requirements
associated with confidentiality and information sharing;
address the need to develop and manage the use of Information Sharing Agreements (ISA);
encourage the flow of personal data and develop good practice across partners and integrated
teams;
provide the basis for Peninsula wide processes which will monitor and review data flows and
information sharing between partners;
protect partners from unlawful use of personal data;
reduce the need for individuals to repeat their story when receiving an integrated service;
support the development of the Local Digital Roadmap.
The information governance professionals from across Devon and Cornwall have a track record of
working together to find solutions to the challenges similar to those presented by the Digital Roadmap.
They will continue to support the development of appropriate systems and processes to ensure that all
organisations involved in integrated care meet their responsibilities under the data protection act. They
will work closely with other Information Governance Networks both locally and nationally.
In terms of the Information Sharing Governance, the information governance professional will act as a
mechanism for generating expert advice and guidance, but cannot govern. A suitable forum will be
required to discharge the responsibilities relating to information governance and data sharing for the
Peninsula.
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11.2 Plans for a common information sharing agreement with all providers signed up
(Section 6.34)
Development of High Level Information Sharing Charter
(In Progress) Completion Due - Q3 2016
Development of Consent Model with Public and
Organisational Agreements
Completion Due - Q2 2017
All Partners Sign Off
Completion Due - Q3 2017
Detailed Mapping and Data Flow
Completion Due - Q4 2017
Governance Board Set Up
Q4 2017
11.3 Current status of adoption of NHS number / steps to address gaps / gaps that will
persist into 17/18 (Section 6.35)
Our analysis of the adoption of NHS Numbers shows that all partner organisations have a 100% for the
adoption of NHS numbers, those that are robust plans in place and they are as follows:




South Western Ambulance Service NHS Trust - DMA Result 51-75%, Full implementation by Q4
2016/17
Isles of Scilly Council – DMA not applicable, Deployment planned for Summer 2016
Cornwall Council – DMA not applicable, Deployment planned for Summer 2017 (TBC)
Torbay Council - (Children's services only) – DMA not applicable, Deployment Full implementation
by Q4 2017-18
We recognise that the adoption and continued use of NHS numbers is key to our overarching plans and
strategy, to link and share information across our CCG catchment areas. As the programme moves into
the deployment stages, this area of work will be revisited to ensure continued compliance and use of NHS
numbers as the prime identifier is still being achieved.
The use of NHS number is affected by national guidelines. Social care (especially children's services) relies
on partnership with Education and Police. The NHS Number is not currently supported in these areas
however it is the obvious identifier across agencies where there is a duty of care and the management of
safeguarding. It is an area in which we would value national support in achieving widespread roll out of
the NHS number across multi-agencies.
The full details of the survey results can be found in Appendix G
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11.4 Plans and milestones for adoption of information sharing standards (Section 6.36)
Additional surveys have been carried out to ascertain our position with regards to information sharing
standards and technical architecture standards. We know that this area of work will be key to enabling
the linking and integration of IT systems as we progress with the delivery of our programme of work. All
partner organisations are aware that consideration will need to be given on integration functionality of all
systems either being or planned to be procured over the coming months and years. We will ensure that
only systems that meet the required standards and needs of the health and care system will be procured.
In addition to the surveys carried out, we commissioned a consultancy firm (J2), to make
recommendations on what the technical architecture could look like when we get to the point of linking
and integrating IT systems. Discussions with technical infrastructure colleagues will continue in order for
us to form an agreed way forward that will not only meet the requirements of individual organisations,
but also ensure that systems can be linked together in the future.
In order to support the vision of “One Person, One Digital Record”, enterprise architectures and systems
must hold data in a structured format and be able to support interoperability by sharing and exchanging
information directly between different systems and disparate organisations. This is will be achieved by
having common technical standards and protocols which include a single information sharing model
across the Peninsula, the adoption of common open standards for data structures and technology, an
integrated network backbone and Role Based Access Control (RBAC).
Examples of these are as follows:
•
•
•
•
•
Implementation of a full-featured Enterprise Master Patient Index (EMPI) solution
Adoption by participating organisations of the following IHE interoperability standards:
o Patient Identity: PIX, PDQ, and XPD
o Document Sharing: XDR, XDM, XDS.b, XCA, and HPD
o Security and Privacy: ATNA, BPPC, XUA
o Notifications: DSUB
Two options for sharing data across the community using XDS affinity domains
Adoption of a Health Service Bus design to integrate legacy systems and support present and future
interoperability requirements
Implementation of a full-featured interoperability / HIE platform that supports our recommended IHE
profiles
The full J2 Interoperability Architecture Specification document can be found in Appendix H, and
following a review by HSCIC their feedback can be found in Appendix I, which will be taken into
consideration going forward.
A survey of the adoption of the Dictionary of Medicines and Devices (dm+d) has shown a relatively low
update to date, however plans from the relevant partners are in place to transition over to these
standards over the next 2 years. In terms of the current position with regard to SNOMED-CT, this mirrors
the position with DM+D with plans in place within each of the applicable provider organisations to
improve this position across the landscape.
The detailed results of the SNOMED-CT and DM+D Surveys have been included in Appendix G.
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12 Infrastructure
12.1 Current status of the mobile working infrastructure (Section 6.39)
A survey of the current status of the mobile working infrastructure across all of our partner organisations
was conducted for the purposes of the Roadmap and it shows that considerable progress has been made
to develop the mobile working infrastructure; the main themes are as follows:




NHS Mail is used across all providers
19 out of 22 organisations support Wi-Fi to enable staff to work from any office in the workplace
18 out of 22 organisations support secure remote access (via home or public networks) to enable
staff to work from "anywhere" i.e. in a client’s / supplier property
13 out of 22 organisation have single-sign-on to allow staff easy access to (authorised) applications
A full breakdown of the survey results can be found in Appendix G.
12.2 Confirmation that individual providers have plans to develop their mobile working
infrastructure (Section 6.40)
We can confirm that robust plans are in place for each organisation to develop and roll out mobile
working functionality across our catchment area. Part of our programme management approach for the
delivery of the 2020 vision, will be to include this as one of the key workstreams to ensure that progress
continues to be made and that the output of this work will complement the overarching delivery of
strategy.
Please see the completed survey in Appendix G for the consolidated survey results and plan details for
each partner.
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12.3 Description of system- wide initiatives to develop the mobile working infrastructure
(Section 6.40)
Cornwall
NEW Devon
Mobile working infrastructure is now in all major health locations; a rolling programme
is underway to deploy Wi-Fi in all GP Practices. N3 connections were refreshed in 201314 throughout Cornwall and the current agreement for the N3 Wide Area Network
comes to an end in March 2017 and will be replaced by a single Health and Social Care
Network (HSCN). This is a key opportunity for joining up access and sharing across
health and care settings as well as addressing the bandwidth and resilience challenges
due to the increased roll out to branch surgeries, together with the move to cloud
based systems.
Mobile working is in place for some parts of the health and social care system in NEW
Devon but it has not been planned at a system-wide scale. NEW Devon CCG is currently
planning to increase the mobile access for GP Practices by providing tablet devices
loaded with the right clinical system to allow GPs to have ‘Access at the Point of Care’
and we have submitted a bid to the Primary Care Transformation fund for capital to
enable this.
Due to Devon rural nature coverage plans will need to accept that there will be limits to
the connectivity of front line service being delivered.
South Devon
& Torbay
Remote working is available to all GPs who require it, and currently 75% of the CCG GP
practice staff have access to this technology, which is available on request. SystmOne
Mobile is available to practices that wish to utilise mobile working, as is EMIS Mobile.
Practices can also request access to a laptop for Disaster recovery where required. WiFi is available in 25% of GP practices, with plans being drawn up as to how to deploy to
the rest of the primary care estate. Main to branch site N3 links have been or are in the
process of being upgraded as more pressure is put on these links.
Plans to expand the infrastructure within practices to allow more flexibility in agile
working to include Wi-Fi, telephony and networking.
Peninsula
Wide
In 2016/17 we will work with organisations across the health and social care system
across Devon and Cornwall to enable the sharing of mobile working infrastructure
across the two counties, for example by allowing staff from any accredited health or
social care organisation access to Wi-Fi facilities at partner organisations.
12.4 Current status and future plans to improve collaboration between professionals
from different organisations (Section 6.42)
It is envisaged that as with all the IT plans and strategy set out within this document, that enabling health
and care professionals from different organisations to collaborate through telephony, secure email and
other emerging mechanisms will complement the developing Sustainability and Transformation Plan, is a
key enabler to meeting the requirements for a more flexible and mobile workforce.
We have identified this work as a key priority to scope across the 3 CCG area and aim to extend this
ability to hospices and care homes as part of our solution.
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NEW Devon CCG in collaboration with Plymouth City Council is keen to pilot the new Health and Social
Care Network through its shared IT setup in the form of Delt Shared Services Ltd. The details of the
Secure Email project can be found in Appendix D.
South Devon and Torbay CCG are eager to evolve a whole community network over their footprint to
enable seamless working across the combined estates.
NHS Kernow CCG, health providers and Cornwall Council are actively engaged on a number of
collaborative initiatives and have deployed joint health and social care teams in a number of localities.
Future plans include:
•
•
•
Integrated Commissioning Programme (under the Cornwall Deal);
Integrated Early Help Hub;
One Public Estate (OPE) Programme delivering cloud based printing and faster wireless for Health
and Council staff.
12.5 Summary of current or planned initiatives to share infrastructure (Section 6.43)
The commitment to close joined up working of all partners (as set out in this document), coupled with a
single programme delivery team - will ensure a co-ordinated approach to the implementation of the
infrastructure to support mobile working.
Within each CCG the following shared infrastructure arrangements are in place:
Cornwall /
Kernow
NEW Devon
At an infrastructure level, RCHT's IM&T Directorate Cornwall IT Services (CITS) provides
managed services to the Cornwall Healthcare Community covering the hosting
environment, bulk storage, networking and support for end user devices. During 2015
there was significant investment made in the back-end compute and storage platforms
and these are considered fit for purpose for the next 5 years.
There is a single Community of Interest Network (CoIN) that enables any healthcare
worker to access their systems and data from any health location. Options to extend
this across to Cornwall Council locations to enable healthcare workers to access their
systems from local authority sites and vice versa are currently being explored.
The infrastructure within healthcare and local authorities in NEW Devon is currently
separate for each organisation and does not often allow sharing. NEW Devon CCG has
established a project to run in 2016/17 that will merge the Microsoft Active Directory
domains across the 122 separate GP Practices to allow for easier working for GP staff
across different practices. NEW Devon will explore sharing IT infrastructure across
different organisations through the joint owned vehicle of Delt Shared Services Ltd as
an opportunity. We will investigate ways we can share services such as Wi-Fi between
different organisations to make working across different health and care settings
easier.
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South Devon
& Torbay
In South Devon and Torbay CCG, all GP practice end user devices (PCs/Laptops) are
supported by the South Devon Health Informatics Service, who also support 50% of the
GP Practice Server infrastructure. Access to Acute software for Order Comms and
Radiological Imaging is available from all practices. Where required staff can work on
any N3 connected site. Our vision is to enable an infrastructure (depending on
availability of funding) where any member of staff can securely access all software
required to work effectively from anywhere, including both within and outside of the
NHS N3 network)
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13
Minimising risks arising from technology
13.1 Confirmation that robust plans, policies and procedures in place across the system
to minimise risks / steps to address gaps (Section 6.45)
By having agreements in place to share and work together in the delivery of this programme of work, we
will be able to co-ordinate our approach to the areas set out in the guidance. We will work towards for
example, shared policies and procedures that cover Business Continuity and disaster recovery etc., as
once systems start to be linked together and integrated, having multiple individual processes from
multiple organisations won’t work. We see this programme of work as an opportunity to develop a single
approach to all of the areas set out in this document.
All projects will be assessed for risk including specifically clinical safety and the NHS information Standard
requirements (e.g. ISB 0160).
The results of the survey we have undertaken, show that whilst there is a good level of confidence in the
existing policies and procedures across the landscape, a further significant investment is required which is
currently estimated to be around £5.9 million is needed in order to fully meet the requirements of this
section. It is understood that this is not captured within the capital programmes for each organisation
and further work to understand the detail will completed during summer 2016. A summary of the
confidence levels across the landscape, for each area is detailed below:
By referring to the attached summary, you will see that our partner organisations have set out the details
of funding required for each section. Each of these areas will need to be incorporated into all IT systems
Page 50 of 55
being implemented; the overarching programme management approach will ensure that we have a coordinated approach to this.
In summary the estimated investment for each section is as follows:
Cyber Security
Clinical Safety
Data Quality
Data Protection & Privacy
Meeting Accessible Information Standards
Business Continuity & Disaster Recovery
Unwarranted or Unlicensed Software
£
£
£
£
£
£
£
1,256,000
939,000
1,925,000
605,000
310,000
565,000
387,000
Total Funding Requirement
£
5,987,000
Full details of the survey can be found in Appendix K.
13.2 Confirmation that individual providers are moving forward with GS1 adoption
(Section 6.46)
GS1 standards are a standardised approach to barcoding and are used within the healthcare industry for
Catalogue Management, Patient Identification and Location Numbering.
From the responses received our GS1 Standards adoption survey shows the following results:






Mental Health Trust (Devon Partnership) – need to procure a new system, current plan for
implementation Q4 2017/18
Acute Trust (Torbay & South Devon) – replacement printers required, current plan for replacement
dependant on available funding
Acute Trust (Northern Devon) – planned implementation Q2 2016, no plans to implement Location
Numbering
Acute Trust (Plymouth Hospital) – already implemented
Acute Trust (Royal Devon & Exeter) – patient identification in place, specimen tracking underway,
catalogue management outline plan in place no timeframe for implementation.
Acute Trust (Royal Cornwall) – plan to implement Patient Identification by Q1 2017, and catalogue
management by Q4 2016
Ongoing monitoring of the implementation of the GS1 Standards will be built into the programme
management of the overarching project.
Full details of the survey can be found in Appendix G.
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Appendix A - Detailed Gap Analysis and Local Provider Plans
LDR Plans Consolidated Plans & Gap Analysis.xlsx
Appendix B - Annex 2 Capability Deployment Schedule Illustration
Annex 2 - Capability
Deployment Schedule Illustration.xlsm
Appendix C - Ready to Deliver Change Feedback
Appendix D - New Projects Details
New Projects
Details.xlsx
Appendix E - DMA Trajectory Results
NHS England Capability Trajectory (Secondary Care).xlsx
Appendix F - Universal Priorities Forms for each CCG
SD&TBY - Universal
Priorities Forms.xlsx
NEW Devon Kernow - Universal
Universal Priorities Forms.xlsx Priorities Forms.xlsx
Appendix G - SNOMED-CT / DM+D / NHS Numbers / Mobile Working Infrastructure / GS1
Standards (Barcode) Survey Results
Surveys MASTER.xlsx
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Appendix H – J2 Interoperability Architecture Specification
Appendix I – HSCIC Feedback on J2 Interoperability Architecture Specification
Appendix J - Roadmap Process Meeting Representation Details
Appendix K - Patient Safety and Reputational Risk Survey
Patient Safety and
Reputational Risk Survey - Master.xlsx
Appendix L - Achievements
Appendix M – Current Initiatives
Appendix N – Outcome to Project Mapping
Outcome to Project
Mapping.xlsx
Page 53 of 55
Glossary
A&E
Accident and Emergency
CCG
Clinical Commissioning Group
CCIO
Chief Clinical Information Officers
CFT
Cornwall NHS Foundation Trust
CH & WBB
Cornwall Health and Well Being Board
DM+D
The NHS Dictionary of Medicines and Devices
DMA
Digital Maturity Assessment
eDischarge
Electronic Discharge
EoL
End of Life
EPR
Electronic Patient Record
ePrescribing
Electronic Prescribing
eReferrals
Electronic Referrals
GPIT Projects
General Practice Information Technology
GS1 Standards
(Barcodes)
GURU
Global Standards Barcoding (formerly known as EAN numbers)
ICO
A clinical data-sharing tool that enables remote access to GP patient
records
Information Commissioner's Office
ICT
Information Communication Technology
IDCR
Integrated Digital Care Record
IM&T
Information Management and Technology
IT
Information Technology
JSEC
Joint Strategic Executive Committee
JSNA
Joint Strategic Needs Assessment
Kernow Health CIC
Kernow Health Community Interest Company
LDR
Local Digital Roadmap
LMC
Local Medical Committee
Page 54 of 55
MIG
Medical Interoperability Gateway
NEW Devon
North East and West Devon
PF@POC
Paper Free at the Point of Care
PMO
Project Management Officer
RCHT
Royal Cornwall NHS Hospital Trust
SCR
Summary Care Records
SD&T
South Devon and Torbay
SNOMED-CT
Systematised Nomenclature of Medicine – Clinical Terms
STP
Sustainability and Transformation Plan
SW AHSN
South West Academic Health Science Network
U&EC
Urgent and Emergency Care
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