Health and Social Care Integration

1. Health and Social Care Integration ASSIST Wrightington 08/10/09

2. High quality Care for All World Class Commissioning Quality Transforming Community Services Primary Care Community Shared records UnScheduled Care PACS Organisational Changes Mental Health Hospitals Interim Solutions Regional Care Record National Programme The Economic Downturn Requirements & Content Interoperability Infrastructure £ Workforce Service Management Health Care Drivers and Informatics Responses Health Care Health Informatics Themes and Topics Information, Clinical Leadership, Partnerships, Health, Populations, Personalised, Quality, Cost effective, Safety, Publish, Feedback, Excellence awards, Knowledge, Care Quality, Commission, Observatory, Innovate, Integrate, Interoperate, Community Services, People Knowledge Management Leadership The National Perspective Information Governance A New Relationship Leadership, partners, intelligence, public Engagement, clinical engagement, knowledge Management, Needs assessments, investment, Markets, data flows, continuous improvement, Quality, procurement, contracts, management of systems, transitions and interoperation Working With Partners Advancing quality, CQUINS, patient reported outcome measures, clinical audit, NICE, NHS evidence, Care Quality Commission, Assurance, Patient Safety Global Review Innovation Data to Intelligence Modern, responsive, seamless, mobile, strengthen commissioning role, clear data flows, IT infrastructure and assets, business-like, leadership, capability and capacity, confidence and competence, business continuity, assuring the process Quality, Innovation, Productivity and Prevention. Record Systems Flexibility, innovation, enterprise, social care Foundation Trust status, Local Government, Private Sector, Independent, Voluntary Sector Integrated Care, Pathways, Interoperability, CATS, ISTCs, Diagnostics, Contracts, Public, Person centred Save to Invest, Zero Growth from 11/12, Start Now, Innovation, Quality, Productivity, Prevention, Cost efficiencies, shared services Economies of Scale, Linking finance, HR and Activity Data, Incentives, Effectiveness, New Processes, Infrastructure, Waste, Green Supporting Concepts Case for change, 10 compelling reasons, Scenario planning, new relationship between public and NHS, Clinical Pathway Groups, 7 Strategic enablers, collaboration, raising game Leadership, listening understanding, Innovate, Partner, manage systems, 10 Touchstones I will…., Equality and Diversity Healthier Horizons

3. Working with Partners

4. Partners • PATIENTS/SERVICE USERS • SHA • Commissioner • Providers • Social Care • Wider local government - NWEGG • Private Sector • Third Sector

5. Informatics Objectives for Working with Partners • Develop membership and contacts with Association of Directors of Adult Social Services and North West Electronic Government Group • PCTs/LHCs to either confirm that they have appropriate connection between networks at a local level or have enabled/sponsored Councils to achieve N3 connection or to have firm plans in place to complete that by March 2011. • PCTs/LHCs to have a plan for interoperability with partners which may be through National and Regional Care Records (CFH) solutions or more specific local initiatives • PCTs/LHCs to assist their local government partners with the introduction of the NHS Number and to be actively achieving that or have a firm managed plan. • PCTs/LHCs have a programme of process changes which aims to release the type of benefits described in some LHCs, Wigan for example claim benefits in the area of bed management, Hospital Discharge, Managing Long Term Conditions in the community, Unscheduled Care/ Intermediate Care and Hospital at Home Initiatives, Multidisciplinary working and Safeguarding • PCTs understand and can work with partners on their responsibilities under Contact Point for Children • PCTs to have a partnership plan in place to explore opportunities to share resources with Local Authorities (wider public sector) in the pursuit of efficiencies • To find out if there is an appropriate forum/mechanism to discuss working with private and third sector organisations

6. Architectures

7. Lorenzo Release Progression

8. Social Care Systems Across NW H H OLM Carefirst Northgate Swift Paris RAISE Lancs in house ISIS Core Logic Frameworki O O SAP Social Care I I Not known G G C C B B R R K K E E D D P P A A Q Q N N T T J J L L U U V M M V S S X X F F W W

9. Target Solution Model – Lorenzo Everywhere

10. Different goals – different models Social and Health Care Integration Health Care System Lorenzo or TPP or Existing Health Care System Lorenzo or TPP or Existing NHS Led Social Care/ LA Led Spine Care Trust Spine Shared Record/ Communication Application Social Care Systems Social Care Systems

11. Potential Roadmaps(Need a similar view for TPP &Lorenzo) NHS – Lorenzo R4 Social Care? September 2010 NHS – Spine TMS NHS – Lorenzo R3 April 2010 Click Through/ context passing (URL) SHA Portal NHS – Lorenzo R2 November 2009 NHS – Lorenzo R1.9 NHS – Spine TMS (PDS) Content/process development May 2009 NHS – Lorenzo R1 November 2008 Neutral System NHS - EPR Integration Engine Social Care NHS - PAS

12. An Example Road Map • Regardless of technical solution • Infrastructure and networks (N3) • PDS enable and connect social care system • Agree joint governance for project, developments and service • Agree overall joint business strategy • Establish Information Governance framework • Agree shared business content and processes • Set Data Quality standards then deliver to them • Technical solution Road Map • Introduce a shared Integration layer which links health and social care systems • Migrate users to integration layer • Local deployments of LRC R1, R2 – introduce assessments (and produce outputs) • At LRC3 – develop a joint workflow • Introduce a “click through” process between Lorenzo and Social Care system • Migrate from local integration layer to Spine services

13. Enablers Infrastructure and networks (N3) Business analysis Content Integration Data Quality Information Governance Project, Development and Service Governance Integration at interim stage and longer term

14. SMART PROPOSED!!! Not agreed

15. Example from London

16. London’s RoadmapHSCI Prototype - Proof of Concept BT Rio Community Health System EMIS GP System BT e-SAP System Internet NB – these slides from London are not yet finalised and subject to change but included to show their thinking

17. Newham Whole System Demonstrator BT Rio Community Health System EMIS GP System ? BT e-SAP System Spine TMS BT IntegrationEngine OLM Care First Social Care System Spine Services Existing Systems BT LSP

18. Later Demonstrators….. BT Rio Community Health System EMIS GP System BT RiO Mental Health System Other NHS Compliant Social Care Systems BT e-SAP System Spine TMS BT IntegrationEngine BT Cerner Millennium System OLM Care First Social Care System Core Logic Social Care System BT INPS GP System Spine Services Existing Systems BT LSP

19. Long Term Vision for London BT Rio Community Health System EMIS GP System BT e-SAP System BT RiO Mental Health System Spine SCR Other NHS Compliant Social Care Systems BT SPR Spine TMS BT IntegrationEngine BT Cerner Millennium System OLM Care First Social Care System Corelogic Social Care System BT INPS GP System Spine Services Existing Systems BT LSP