1 / 43

NPFIT The Strategic Health Authority Perspective

sibley
Download Presentation

NPFIT The Strategic Health Authority Perspective

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

    1. September 2004 SOUTHERN INSTITUTE OF HEALTH INFORMATICS 1 NPFIT – The Strategic Health Authority Perspective

    2. September 2004 SOUTHERN INSTITUTE OF HEALTH INFORMATICS 2 Agenda NPFIT National Cluster Local SHA Roles & Responsibilities How ICT & NPFIT Can Help SHAs Local and Community Organisation Recommendations / Actions

    3. September 2004 SOUTHERN INSTITUTE OF HEALTH INFORMATICS 3

    4. September 2004 SOUTHERN INSTITUTE OF HEALTH INFORMATICS 4

    5. September 2004 SOUTHERN INSTITUTE OF HEALTH INFORMATICS 5 Outline - NPFIT National Systems and Services Spine E-Booking PACS E-Prescribing Local Care Record Service not System (LSP plus) Community Wide (Deployment Families) Modular / Bundles Cluster-wide data centre model Includes non-NHS (Social Care, Hospices, Prisons etc)

    6. September 2004 SOUTHERN INSTITUTE OF HEALTH INFORMATICS Ages of mankind

    8. September 2004 SOUTHERN INSTITUTE OF HEALTH INFORMATICS 8

    9. September 2004 SOUTHERN INSTITUTE OF HEALTH INFORMATICS 9 Investment (SMART) Objectives Improve Patient Experience Improve the Quality of Care Enable Effective Access to Clinical and Administrative Information Reduce Fragmentation of Care Improve Policy Development and Health Research

    10. Scope and roles

    11. September 2004 SOUTHERN INSTITUTE OF HEALTH INFORMATICS 11 National Care Record Service (NCRS) Foundation for entire system Single point of information Informs care decisions Increased safety Better information for national planning

    12. September 2004 SOUTHERN INSTITUTE OF HEALTH INFORMATICS 12

    13. September 2004 SOUTHERN INSTITUTE OF HEALTH INFORMATICS 13

    14. September 2004 SOUTHERN INSTITUTE OF HEALTH INFORMATICS 14 Bundles Core (Funded) Bundles ICRS Portal 2 PAS 3 Enterprise Architecture 1 4 Clinicals 5 Maternity 6 Theatre 7 Alternative GP Solution 8 Advanced PAS 9 Orders 11 Advanced Clinicals 12 Enterprise Architecture 2 14 Prescribing 15 Ambulance 16 Complex Clinicals 17 Advanced Scheduling 18 Enterprise Architecture 3 19 Advanced Maternity Additional (Local Funded) Bundles 20 PACS 21 Pathology 22 Financial Payments 23 eHealth 24 Document Management 25 Dental 26 RIS (Radiology) 27 Pharmacy Stock Control 28 Social Care 29 eBooking to Primary Care 30 Decision Support Advanced 31 Long Term Medical Conditions 32 Early delivery PSS (Bundle 52) 33 Upgrade of early PSS (Bundle 53) 34 Early delivery Prescribing (Bundle 50) 35 Upgrade of early Prescribing (Bundle 51)

    15. September 2004 SOUTHERN INSTITUTE OF HEALTH INFORMATICS 15

    16. September 2004 SOUTHERN INSTITUTE OF HEALTH INFORMATICS 16 Cluster Roles, Organisation and Issues FJA / CCA/ IDX - Common Solutions Board Detail Implementation Plan (DIP) (2006 – 2009) Cluster and London Collaboration Groups Technical Architecture; Information Architecture; Legacy Management; E-Booking; Benefits; .. Clinical Advisory Group(s) Requirements and Design Integral with London (Common Solutions Board) Special Cross-Cluster Initiatives Interim Solutions for NSFs Data Warehouse / Repository Data Cleansing and Migration

    17. September 2004 SOUTHERN INSTITUTE OF HEALTH INFORMATICS 17 LSP Deployment Approach – Initial Overview

    18. September 2004 SOUTHERN INSTITUTE OF HEALTH INFORMATICS 18 Health Service & SHA Pressure& Roles

    19. September 2004 SOUTHERN INSTITUTE OF HEALTH INFORMATICS 19

    20. September 2004 SOUTHERN INSTITUTE OF HEALTH INFORMATICS 20 Challenges to be Tackled Access targets Emergency care system Mental health Integrated working Chronic disease management Workforce Capital stock, estate and capacity Social Care market IM&T Finance We have undertaken a stocktake on how well we measure up against key clinical and service priority areas. Common emerging themes include: Some access targets (particularly A&E) continue to cause significant problems for many of our acute trusts. Strategically, the large number of A&E depts and the whole organisation of em care needs to be redesigned There are weaknesses in the ability to integrate commissioning and provision of care across organisational and professional boundaries. Care pathways and clinical networks need to be supported and developed There is no consistent approach to chronic disease management, and there is a need for more proactive management in the community, patient tailored plans with key workers, and support for increased self-management In order to support integrated working, there is a need to promote the best use of scarce staffing resources, prioritise multidisciplinary working and employ more sophisticated approaches to providing and developing leadership in an increasingly complex environment There are a number of structural issues that need to be addressed, including the: Significant difficulties faced in recruitment and retention of many staff groups Shortfall in overall capacity to achieve access targets, but combined with a large number of relatively small acute hospitals and variable use of our large number of community units Need to make up a good deal of ground in investing in IM&T, as well as the associated need for culture change, skills development and process redesign Extreme difficulties in sustaining a stable and affordable social care market in Surrey and Sussex, with significant knock-on effect to delayed transfers of care We have undertaken a stocktake on how well we measure up against key clinical and service priority areas. Common emerging themes include: Some access targets (particularly A&E) continue to cause significant problems for many of our acute trusts. Strategically, the large number of A&E depts and the whole organisation of em care needs to be redesigned There are weaknesses in the ability to integrate commissioning and provision of care across organisational and professional boundaries. Care pathways and clinical networks need to be supported and developed There is no consistent approach to chronic disease management, and there is a need for more proactive management in the community, patient tailored plans with key workers, and support for increased self-management In order to support integrated working, there is a need to promote the best use of scarce staffing resources, prioritise multidisciplinary working and employ more sophisticated approaches to providing and developing leadership in an increasingly complex environment There are a number of structural issues that need to be addressed, including the: Significant difficulties faced in recruitment and retention of many staff groups Shortfall in overall capacity to achieve access targets, but combined with a large number of relatively small acute hospitals and variable use of our large number of community units Need to make up a good deal of ground in investing in IM&T, as well as the associated need for culture change, skills development and process redesign Extreme difficulties in sustaining a stable and affordable social care market in Surrey and Sussex, with significant knock-on effect to delayed transfers of care

    21. September 2004 SOUTHERN INSTITUTE OF HEALTH INFORMATICS 21 National Drivers for Change Patient & public involvement Plurality of provision/wider choice Integration of health & social care National standards External regulation & performance management Changing workforce IM&T investment Devolution A number of national and local drivers for change provide the context for our service transformation work. The overall backdrop is one where delivery of demonstrable significant improvement to public services is critical, with government determination to achieve that, public and political frustration with current services, significant investment and associated rises in taxation (thereby increasing expectations). Some particular areas I’d like to highlight: PPI – we need greater involvement of local people and patients both at strategy/policy level and at individual patient care level. This involvement will inform development of care pathways and integrated care Plurality and choice – seen to be a major stimulus to more responsive services, challenging existing system, behaviour and practice. We will need to develop the skills to deal with more providers (incl private), and plan for the impact of plurality on care pathways and clinical networks Integration of health and social care – new partnerships will need to be put in place to tackle the challenges faced by LHSCCs, with particular emphasis on the need to put service users (esp older people, children, people with MH problem) at the centre of service planning and provision Changing workforce – taking advantage of the opportunities offered by developments in the use of technology, and integration of the system across traditional organisational boundaries. New roles for nurses, encouragement for GPs to develop special interests, consultants viewed as working across whole systems rather than being based specifically in their employing trusts, making the most of the skills of other professional groups (eg pharmacists, radiographers) IM&T – NHS has historically underfunded its IM&T infrastructure dramatically, and has yet to see the benefits on a large scale of modern and integrated systems. We need to grasp the opportunities offered by electronic records and booking systems, telemedicine, new diagnostic techniques and other changes to health technology. A number of national and local drivers for change provide the context for our service transformation work. The overall backdrop is one where delivery of demonstrable significant improvement to public services is critical, with government determination to achieve that, public and political frustration with current services, significant investment and associated rises in taxation (thereby increasing expectations). Some particular areas I’d like to highlight: PPI – we need greater involvement of local people and patients both at strategy/policy level and at individual patient care level. This involvement will inform development of care pathways and integrated care Plurality and choice – seen to be a major stimulus to more responsive services, challenging existing system, behaviour and practice. We will need to develop the skills to deal with more providers (incl private), and plan for the impact of plurality on care pathways and clinical networks Integration of health and social care – new partnerships will need to be put in place to tackle the challenges faced by LHSCCs, with particular emphasis on the need to put service users (esp older people, children, people with MH problem) at the centre of service planning and provision Changing workforce – taking advantage of the opportunities offered by developments in the use of technology, and integration of the system across traditional organisational boundaries. New roles for nurses, encouragement for GPs to develop special interests, consultants viewed as working across whole systems rather than being based specifically in their employing trusts, making the most of the skills of other professional groups (eg pharmacists, radiographers) IM&T – NHS has historically underfunded its IM&T infrastructure dramatically, and has yet to see the benefits on a large scale of modern and integrated systems. We need to grasp the opportunities offered by electronic records and booking systems, telemedicine, new diagnostic techniques and other changes to health technology.

    22. September 2004 SOUTHERN INSTITUTE OF HEALTH INFORMATICS 22 Local Drivers for Change Developing a culture of Service Improvement Restoring financial health & discipline Expanding physical & workforce capacity Strengthening the capability of LHSCCs to deliver In combination with the national drivers I’ve just mentioned are an additional set of challenges that must be addressed within Surrey and Sussex. The background is formed by a health community that has faced significant challenge over a number of years, not least with the running of a major deficit that has acted as a kind of planning blight on service change. In common with some other parts of the NHS, there are parts of the Surrey and Sussex system that suffer from that well known disease NIH syndrome – not invented here syndrome – and we need to move to a culture of sharing good practice, learning from each other and learning from other parts of the country (and world) We also need to recognise that as a large health authority, we have a significant number of new organisations taking on new responsibilities – in a patch that is facing some of the most difficult challenges in the whole of the NHS. The role of the SHA in supporting and nurturing these new organisations so that they work effectively as the local leaders of the NHS, is criticalIn combination with the national drivers I’ve just mentioned are an additional set of challenges that must be addressed within Surrey and Sussex. The background is formed by a health community that has faced significant challenge over a number of years, not least with the running of a major deficit that has acted as a kind of planning blight on service change. In common with some other parts of the NHS, there are parts of the Surrey and Sussex system that suffer from that well known disease NIH syndrome – not invented here syndrome – and we need to move to a culture of sharing good practice, learning from each other and learning from other parts of the country (and world) We also need to recognise that as a large health authority, we have a significant number of new organisations taking on new responsibilities – in a patch that is facing some of the most difficult challenges in the whole of the NHS. The role of the SHA in supporting and nurturing these new organisations so that they work effectively as the local leaders of the NHS, is critical

    23. September 2004 SOUTHERN INSTITUTE OF HEALTH INFORMATICS 23 Two Major Areas of Constraint Capacity Physical Workforce IM&T Culture Partnership working Person centred care Primary care Using IM&T Modernising the workforce Finance Although this analysis does not pull its punches, we do need to recognise that there are areas of good practice across Surrey & Sussex. But, as a generalisation: There has been a historical failure to get high quality partnership working in place This has led to poor coordination of care and underdeveloped care pathways and clinical networks Relationships with local communities are varied, and in some places obstructive to achieving proposed changes Primary care is of high quality but traditional, and there has been an underdevelopment in the non acute sector generally in terms of structure and practice The willingness to use IT to its full advantage is variable and implementation of better systems will need to be accompanied by significant change to some working practices Slow progress has been made in modernising the workforce, including the adoption of new roles and addressing skill mix. For many staff there has been a tendency to work in traditional ways that are not patient centred, and do not liberate or enable high trained staff to use their skills to best advantage. A varied record on financial performance and culture of poor financial control mean that some areas have significant historical deficits and will be challenged to achieve in-year balance In terms of physical capacity, the patch is characterised by a large number of small acute trusts which lack the critical mass to deliver the highest quality acute care. This is further exacerbated by a particularly pressured social care market, and need for significant reconfiguration of mental health services Recruitment and retention difficulties mean that workforce capacity is a significant concern – and one that will be exacerbated by the need for further expansion to meet future service requirements IM&T capacity is weak, and technical opportunities offered by modern systems have yet to be fully exploitedAlthough this analysis does not pull its punches, we do need to recognise that there are areas of good practice across Surrey & Sussex. But, as a generalisation: There has been a historical failure to get high quality partnership working in place This has led to poor coordination of care and underdeveloped care pathways and clinical networks Relationships with local communities are varied, and in some places obstructive to achieving proposed changes Primary care is of high quality but traditional, and there has been an underdevelopment in the non acute sector generally in terms of structure and practice The willingness to use IT to its full advantage is variable and implementation of better systems will need to be accompanied by significant change to some working practices Slow progress has been made in modernising the workforce, including the adoption of new roles and addressing skill mix. For many staff there has been a tendency to work in traditional ways that are not patient centred, and do not liberate or enable high trained staff to use their skills to best advantage. A varied record on financial performance and culture of poor financial control mean that some areas have significant historical deficits and will be challenged to achieve in-year balance In terms of physical capacity, the patch is characterised by a large number of small acute trusts which lack the critical mass to deliver the highest quality acute care. This is further exacerbated by a particularly pressured social care market, and need for significant reconfiguration of mental health services Recruitment and retention difficulties mean that workforce capacity is a significant concern – and one that will be exacerbated by the need for further expansion to meet future service requirements IM&T capacity is weak, and technical opportunities offered by modern systems have yet to be fully exploited

    24. September 2004 SOUTHERN INSTITUTE OF HEALTH INFORMATICS 24 This model has been developed by the SHA and discussed with a number of audiences across Surrey and Sussex It can be used to describe the way that services are currently organised, but has the potential to change depending upon investment in physical and human capacity, modernisation and service reconfiguration. REMEMBER – THIS SLIDE BUILDS UP WITH EACH CLICK OF THE MOUSE!This model has been developed by the SHA and discussed with a number of audiences across Surrey and Sussex It can be used to describe the way that services are currently organised, but has the potential to change depending upon investment in physical and human capacity, modernisation and service reconfiguration. REMEMBER – THIS SLIDE BUILDS UP WITH EACH CLICK OF THE MOUSE!

    25. September 2004 SOUTHERN INSTITUTE OF HEALTH INFORMATICS 25 Reasonably self explanatory diagram NB – THIS SLIDE BUILD UP WITH EACH MOUSE CLICK!Reasonably self explanatory diagram NB – THIS SLIDE BUILD UP WITH EACH MOUSE CLICK!

    26. September 2004 SOUTHERN INSTITUTE OF HEALTH INFORMATICS 26 SHA (NPFIT) Roles Strategy & Planning Integration across SHA roles Manage LSP Contact Manage SHA wide initiatives Coordinate London / Southern Connection Disseminate and Communicate

    27. September 2004 SOUTHERN INSTITUTE OF HEALTH INFORMATICS 27 HEALTH INFORMATICS TRANSFORMATION SHA Inter-working Development Clinical change NSFs Policy Financial Recovery Increasingly delivery of targets

    28. September 2004 SOUTHERN INSTITUTE OF HEALTH INFORMATICS 28 Mapping the LDP to ICRS - Generic Access Sharing Carers Choice Capacity Prevention Pt/Carer Info and Support Pt Admin, Index, Spine Scheduling / Booking RR and OCs Integrated internal Systems Integrated Community System Access to the KB Decision Support Health Promotion Key issues in the LDP are… Map to some very common themes in ICRS – some functionality will need to be there in all areas of the LDP. For each of the key areas of the LDP we have mapped the modules of the ICRS/LCR and NCRKey issues in the LDP are… Map to some very common themes in ICRS – some functionality will need to be there in all areas of the LDP. For each of the key areas of the LDP we have mapped the modules of the ICRS/LCR and NCR

    29. September 2004 SOUTHERN INSTITUTE OF HEALTH INFORMATICS 29 The NHS Plan and LDPs: Plan and Benefits LDP Targets LCR Functional Requirements Investment Objectives Service Targets SMART Targets Benefits Realisation & Management Engagement & Change Management LDP focus for LHCs Need to map to ICRS LDP has structure and plan ICRS has structure and plan – with formal approach to monitoring and ben. Realisation Huge change management agenda .. For both LDP and ICRS How do we get them to meet..LDP focus for LHCs Need to map to ICRS LDP has structure and plan ICRS has structure and plan – with formal approach to monitoring and ben. Realisation Huge change management agenda .. For both LDP and ICRS How do we get them to meet..

    30. September 2004 SOUTHERN INSTITUTE OF HEALTH INFORMATICS 30 Local & Community Organisation

    31. September 2004 SOUTHERN INSTITUTE OF HEALTH INFORMATICS 31 The Future Shape of NHS IT - Services DOH National IT Programme) (RG) NSPs LSPs Cluster Office Modernisation Agency SHA Health Informatics Services NHS

    32. September 2004 SOUTHERN INSTITUTE OF HEALTH INFORMATICS 32 Organisational Structures and Processes

    33. September 2004 SOUTHERN INSTITUTE OF HEALTH INFORMATICS 33 Put SS / other map/ diag in here..Put SS / other map/ diag in here..

    34. September 2004 SOUTHERN INSTITUTE OF HEALTH INFORMATICS 34

    35. September 2004 SOUTHERN INSTITUTE OF HEALTH INFORMATICS 35 OLIT role Strategy & Leadership Communication & Engagement Inteface to Service Needs and Requirement Align and Integrate with Modernisation and Change Management Benefits delivery and realisation External relationship management (SHA, HIS & LSP etc.) Strategy - ensuring Board develop understanding of how NPfIT will underpin strategy and help deliver Business needs. Identifying other ways in which iT can support the Business. Integrating organisational needs into wider community approach. Championing the Programme at Board level. Communication - outlining the vision, and ensuring the right communication at all levels throughout the organisation. Ensure integration with service modernisation, and develop awareness and engagement of the NPFIT role throughout organisation. Lead the change management process and implementation planning. Benefits delivery - Ensure that mechanisms are in place for delivering the benefits and measuring that success. HIS relationship management – ensuring that the HIS fully understands the organisational needs, priorities and plans. Strategy - ensuring Board develop understanding of how NPfIT will underpin strategy and help deliver Business needs. Identifying other ways in which iT can support the Business. Integrating organisational needs into wider community approach. Championing the Programme at Board level. Communication - outlining the vision, and ensuring the right communication at all levels throughout the organisation. Ensure integration with service modernisation, and develop awareness and engagement of the NPFIT role throughout organisation. Lead the change management process and implementation planning. Benefits delivery - Ensure that mechanisms are in place for delivering the benefits and measuring that success. HIS relationship management – ensuring that the HIS fully understands the organisational needs, priorities and plans.

    36. September 2004 SOUTHERN INSTITUTE OF HEALTH INFORMATICS 36 Conclusions & Recommendations

    37. September 2004 SOUTHERN INSTITUTE OF HEALTH INFORMATICS 37 HEALTH INFORMATICS TRANSFORMATION – What does the Patient deserve? Change current status: Discontinuities Best practice not integrated Information not available Patient disempowered Need to transform care delivery and clinical work underpinned by effective use of technology Need to function as a single NHS Infers strong hands-on role for the SHA

    38. September 2004 SOUTHERN INSTITUTE OF HEALTH INFORMATICS 38 How Can IT Help ? Common Infrastructure E-mail; NSTS; integrated availability and access to solutions.. Data and Information Flows Demographic (Spine) Core service requirements Sharing Supporting Issues Confidentiality and Security Integral with other Health Information Integral Reporting and Monitoring

    39. September 2004 SOUTHERN INSTITUTE OF HEALTH INFORMATICS 39 Overall Messages Service Improvement Carer/Education Focus MDT / Community wide Patient Based Pt access to record National Programme in fast Different approach to management / benefits realisation True ICRS IM&T core to service IM&T professional needs to understand the service IM&T now a clinical tool A new and radical change to the way we use and manage our IM&T systems A new relationship between SHAs, LHCs and all H&SC organisations .. So not just core to the service, but a part of routine practice in the way that many medical equipment revolutions have become .. So not just core to the service, but a part of routine practice in the way that many medical equipment revolutions have become

    40. September 2004 SOUTHERN INSTITUTE OF HEALTH INFORMATICS 40 Issues for Resolution Terminology Ways of Working Culture and Politics Fit with other service needs and processes Sector targets, performance framework and priorities Governance NPFIT not fully ready and in place for 6,8,10 yrs.. Information Sharing and Ownership Systems Integration Confidentiality E.g. for SAP SS has a different set of performance targets.. -> if health is to manage/deliver integrated care then it needs to understand, rlate to and be able to work with the different perf targetsE.g. for SAP SS has a different set of performance targets.. -> if health is to manage/deliver integrated care then it needs to understand, rlate to and be able to work with the different perf targets

    41. September 2004 SOUTHERN INSTITUTE OF HEALTH INFORMATICS 41 Approaches Citizen / Patient first Centred on service processes not management Operational Services and IT working together Listening & Learning Incremental through joint work and planning Best Practice work springboard to change Risks are part of the agenda – honestly expressed Patience and Persistence Pragmatism - based on patient & citizen need

    42. September 2004 SOUTHERN INSTITUTE OF HEALTH INFORMATICS 42 Immediate Actions & Recommendations Establish joint processes wherever possible Agree Information Sharing Protocols Establish common data definitions and terminology Explore, use and seize immediate opportunities (e.g. Interim SAP) Pilot local schemes to test Governance and boundary issues Connect where possible (NHS net, local networks) Use the NHS number

    43. September 2004 SOUTHERN INSTITUTE OF HEALTH INFORMATICS 43 Core SHA NPFIT Roles Local Alignment with Service Priorities (LDP, Star Indicators etc) & Modernisation Organisational Leads (OLITS) Board Level leadership HIS / IT organisation Benefits Management & Realisation .. all whilst moving to the live use of data and information systems.. & the 7 practices of effective uses of IT systems Immediate Actions & Recommendations .. But we need better and more information and communication from NPFIT and the Cluster…!p.. But we need better and more information and communication from NPFIT and the Cluster…!p

More Related