Change & Benefits Management Connecting for Health NE Cluster & SYSHA

1. Change & Benefits ManagementConnecting for HealthNE Cluster & SYSHA Rose Hand Clinical Director (NPfIT) SYSHA

2. Context The NHS serves over 50 million people in England. In 2003-2004 there were: • 325 million consultations with GPs or nurses in primary care • 13.3 million outpatient consultations • over 5.4 million people admitted to hospital for planned treatment • 13.9 million people attended A&E • 4.2 million emergency admissions • 649 million prescription items issued • 6.4 million calls made to NHS Direct • 6.5 million hits to the NHS Direct Online website.

3. Context • Acute Trusts • Most systems do not support the movement of information between buildings and departments • Several records often created for the same patient

4. Context • Primary Care • Most individual practices have their own IT applications and databases • Patient records are not easily transferred to other practices or care providers • Developmental and effective implementation of care pathways is inhibited • Paper-based records delay modernisation and the delivery of National Service Frameworks

5. Connecting for Health • NHS Care Records Service • Every patient's medical and care records will be held electronically and will eventually be available securely online. The information will be safely and easily accessible to healthcare professionals and patients, whenever and wherever it is needed. • Choose and Book • GPs and other primary care staff will be able to book initial hospital appointments electronically, at a convenient date, time and place for patients, without sending referral letters to hospitals and waiting for a reply.

6. Connecting for Health • Electronic Transmission of Prescriptions • A new service making it easier and more convenient for GPs to issue prescriptions and for patients to collect medicines. • New National Network – N3 • A national network with sufficient connectivity and broadband capacity to meet current and future NHS needs. • Picture Archiving and Communications Systems (PACS) • Systems to capture, store, distribute and display static or moving digital medical images, supporting improvements to the patient's NHS journey.

7. Connecting for Health • QMAS - supporting GP practices • QMAS (the Quality Management and Analysis System) gives GP practices feedback on the quality of care delivered to patients measured against national achievement targets detailed in the GMS (General Medical Services) contract, which sets out the way GPs work and the way they are financially rewarded. • Contact • A centrally managed email, directory and calendar service provided free of charge to NHS organisations in England.

8. High Level Benefits Better IT to: • Improve patient centred care • Improve choice and patient experience • Give greater support for frontline clinicians • Improve healthcare process efficiency • Make better use of existing assets

9. High Level Benefits • Patients will benefit from greater involvement in decisions about their care and greater access to and ownership of their records • Clinicians will benefit from less administration and faster, more efficient access to information and services • The NHS will benefit from time and cost savings brought about by reduced administration and improved output from the baseline IT spend

10. Approach To Change Management • Driven by benefits, avoiding duplication – wide number of change programmes & projects involved in the system reform agenda • Avoid double counting of benefits through an integrated approach with Modernisation, Workforce Development & Connecting for Health Teams • Flexibility of approach suitable methodology now may require modification & adaptation as the programme develops • Work on benefits will be utilised to highlight the positive impact of the Solutions • Clinical & Stakeholder engagement & leadership to drive out benefits, plus LHC / Project Change & Benefits Leads

11. Reform Agenda

12. Advantages of LHC Change & Benefits Leads • The ability to pull together all the workstreams from an IT and strategic view point and at operational level • Present the facts in everyday language to end users • Understand which triggers to use to get the interest and support from key people in the organisations • Ability to ‘infiltrate’ the clinical areas to become part of the ‘team’ • Produce change management & benefit plans for local ownership which run beyond project boundaries

13. Users: patients, clinicians, nurses… Technical Implementation Implementation Support MA: 10 Changes Agenda for Change HR CDM Choice Choice PBR PbR LHC Service Implementations NPfIT NPfIT NPfIT NPfIT Service Service National solutions, National solutions, Department of Health Department of Health Implementation Implementation Implementation Implementation Cluster Cluster Strategic Health Authority Strategic Health Authority Performance management Performance management Ambulance Ambulance Ambulance Ambulance Mental Mental Mental Mental PCT PCT PCT PCT PCT AT AT AT AT AT Acute Acute Acute Acute Acute PCTs PCTs PCTs PCTs PCTs Trust Trust Trust Trust Health Health Health Health Trusts Trusts Trusts Trusts Trusts Pilot programme SI programme Shared agenda and plan Shared agenda and plan Shared agenda and plan manager manager Users: patients, clinicians, nurses… Users: patients, clinicians, nurses… Local Health Local Health Local Health SI co-ordinator Community Community Community - ordinator programme manager programme manager Integrated Integrated Benefits Benefits Leadership Leadership NPfIT NPfIT Comms Comms & Management Management Knowledge & Knowledge & Education Education Solutions Solutions Stakeholder Stakeholder Information Information Training Training (LSP) (LSP) Engagement Engagement Solutions Solutions Cluster Cluster

14. Benefits Categorisation Benefit Categories Safety Clinical and Cost Effectiveness Governance Patient Focus Accessible and Responsive care Care Environment and Amenities Public Health Benefit Sub-Categories Patient Safety Health Care Benefits Managerial & Clinical Leadership Partnership with Patients Responsiveness to patient needs Staff Well-being Cross NHS Collaboration Clinical Efficiency Management Information Quality Partnership with Other Organisations Patient Choice Privacy and data Security Reduced Expenditure Organisational Flexibility Patient Satisfaction Learning and Research Capital Effectiveness Systems and Working Practices Outcome Categories Process Change Information Availability Cost Saving Stakeholders Management Clinical Staff Administrators Patients Students, Teachers and Researchers IT Staff

15. National Team assembles generic Benefits Register (National Project Focus) and Benefits Measurement Work Packages • National Team and Clusters define contents of Cluster-specific Benefits Menus (Cluster/LSP Focus) & update Benefits Register Benefits Identification Benefits Prioritisation • LHC alignment process • LHC selects NPfIT benefits/initiatives (using Benefits Menu) • LHC identifies additional ‘local’ benefits (using Benefits Menu Format) • LHC defines Benefits Plan(using Benefits Menu) • National Team captures LHC Benefit Plans (usingBenefits Data Warehouse) • LHC defines Benefits Measurement Plan(using Benefits Measurement Work Packages) Benefits Planning • LHC manages benefits realisation • LHC measures subset of benefits (using Benefits Measurement Plan) • National Team/Other organisations (e.g. HC) measure remaining realised benefits and capture all benefits measurement (using Benefits Data Warehouse) Benefits Measurement • Held when evidence is available that the benefits in the Benefits Plan should have become measurable. More than one review may be needed (using Benefits Measurement Plan) • National level review will also take place to assess benefits realisation Benefits Reviews Benefits Realisation Framework

16. Success Factors of Local Project • Benefits Realisation is dependent on changes to working practices and training & education to be successful • Detailed Benefits Plans, Business Change Plans & Training Plans are an essential part of the Project Plans (PID) • Projects assign ownership to Business Change & Benefits • Learn the lessons from earlier projects

17. North East Cluster Achievements To Date • At the forefront of implementation • Developing processes • Choose and Book • Barnsley and Harrogate Early Adopters • 270 bookings • N3 – 584 connections – 775 work in progress • RA – 3201 smartcards issued to staff • 30 Projects mobilised • PACS • Cluster business case • Plans for first wave delivery completed

18. North East Cluster Achievements To Date • Training • NHS trained in a variety of areas • End users trained • Learning Management System • Benefits • Leads in each SHA • Close working with national team • Single Assessment Process • Live in 5 PCTs • Primary Care • First practice in England – Dr Lee 10,000 patients are already benefiting from Connecting for Health

19. Current Deployment Profile for 2005 • ETP • Keighley Wave 1 implementer site live • 2 practices in Grimsby go-live imminent • Choose & Book compliant systems roll-out • Primary Care - 70% • PAS – 60% • Secondary Uses Service • SHA’s mobilised to establish RA’s by 31 March • Additional Service Request’s • Many including some tactical core e.g. Airedale and Leeds A&E

20. Current Deployment Profile for 2005/06

21. Summary • 2004 • Built the foundations • Much implementation work in progress • Delivered to 8 Trusts • Benefits to 10,000 patients • 2005 • Delivery to all 98 Trusts • Benefits to approx. 4 million people