ETD National Conference Making IT Happen Through Learning

1
ETD National ConferenceMaking IT Happen Through
Learning
Good Morning Welcome

• Birmingham NEC 18 January 2006

2
ETD National ConferenceMaking IT Happen Through
Learning
Welcome Address Philip Candy, Director of ETD,
NHS, Connecting for Health

• Birmingham NEC 18 January 2006

3
The ETD TeamSupporting a Safely Managed
Revolution

• ETD National Conference
• NEC Birmingham
• 17 January 2006
• Philip Candy
• Director of ETD

4
Overview of the Presentation

• Introduction
• Background to the ETD Workstream
• How we are organising ourselves
• A distributed national ETD Team
• Conclusion A vision for the future

5
The application of what we know already will have
a bigger impact on health and disease than any
drug or technology likely to be introduced in the
next decadeDr Sir Muir Gray (Director of
Knowledge Process and Safety)Knowledge is the
Enemy of Disease
Why the National Programme is Vital
6
NHS Connecting for Health Better information for
health, where and when it's needed

• NHS Connecting for Health is an Agency of the
  Department of Health. It is tasked with
  delivering the National Programme for IT in the
  NHS, which will provide an integrated IT
  infrastructure and systems for the NHS in
  England. It aims to connect over 30,000 GPs to
  almost 300 hospitals and give patients access to
  their personal health and care information,
  transforming the way the NHS works.

7
The vision for the National Programme
8
Major purposes of Connecting for Health

• To connect delivery of the NHS Plan with the
  capabilities of modern information technologies
  and, in particular, to
• Support the patient and the delivery of services
  designed around the patient, quickly,
  conveniently and seamlessly.
• Improve management and delivery of services by
  providing good quality data to support National
  Service Frameworks, clinical audit, governance
  and management information.
• Support staff through effective electronic
  communications, better learning and knowledge
  management, cut time to find essential
  information and make specialised expertise more
  accessible (emphasis added).
• (Department of Health (June 2002) Delivering 21st
  century IT, Support for the NHS)

9
Service Implementation Mission

• Realise the benefits and achieve real performance
  improvement through synergy with other change
  programmes and system reform
• Enable local change through effective Education,
  Training and Development
• Optimise the use of technology to manage
  knowledge and information to improve care and
  treatment, safety and clinical governance
• Re-design processes supported by appropriate IT
  to improve patient, clinician and managerial
  satisfaction
• Equip patients and clinicians to make best use of
  new processes, systems and knowledge
• Actively contribute to system development and
  implementation activities

10
Scope of Programme

• NHS Care Records Service (NHS CRS) - an
  electronic care record for all (approximately 50
  million records)
• Choose and Book - an electronic booking service
• Electronic Transmission of Prescriptions (ETP)
  GP to Pharmacy link
• N3 a new national broadband IT network for the
  NHS
• Picture Archiving and Communications Systems
  (PACS) to capture, store, distribute and view
  static and moving medical digital images
• Contact a central email and directory service
  for the NHS
• GP IT support including the Quality Management
  and Analysis System (QMAS), support for the
  Quality and Outcomes Framework and a system for
  GP to GP record transfer.

11
Education Training and DevelopmentCurrent
situation

• In support of the National Programme, there is a
  diverse mix of education and training activities
• Local, Cluster and National levels
• Both taught (face to face and elearning) and
  self-directed
• Driven by the rollout of the National Programme
  Applications
• Each National Application has its own Education
  Training and Development strategy
• However actual implementation is a shared
  responsibility with Local Service Providers

12
Core purpose of CfH Education Training and
Development

• To encourage and accelerate the uptake, spread
  and creative use of information and communication
  technologies in support of high-quality
  patient-centred healthcare.

13
National ETD

• Primary objectives
• To support, enable and harmonise National and
  local provision of education and training
  programmes, interventions and approaches, to
  maximise impact and minimise confusion and
  duplication at the frontline
• To strengthen the capacity for learning and
  enhance the readiness for implementation by all
  staff at the frontline
• To provide high quality, evidence-based advice
  and information about educational interventions
  across the service, and collaborate with those
  engaged in similar research activities
• To support the development and networking of
  informatics specialists, education and training
  practitioners, clinicians and leaders seeking to
  implement IT solutions
• To manage the workstream efficiently and
  coordinate all aspects of the workstream, ensure
  its alignment with major strategic goals and
  priorities, and facilitate the mainstreaming of
  its work over time.

14
So, how will we organise ourselves

• to deliver these five main goals?

15
(No Transcript)
16
Sic evenit ratio ut componitur The small Book
about Large System Change
Sir John Oldham

• Three essential elements of large system change
• The systematic transfer of knowledge
• The creation of an environment that facilitates
  the uptake of ideas
• A unified policy framework and infrastructure for
  spread

17
National ETD programme areas

• Principal Programmes and Platforms (PPP)
• The systematic transfer of knowledge
• Frontline Readiness for Implementation (FRI)
• The creation of an environment that facilitates
  the uptake of ideas
• Evaluation Research and Dissemination (ERD)
• A unified policy framework and infrastructure
  for spread
• Professional Development and Support (PDaS)

18
(No Transcript)
19
But these arent our only objectives

• There are other vital aspects to support our work

20
National ETD

• To establish, manage and maintain relationships
  with other significant stakeholders and
  contributors with an interest in the learning and
  knowledge programmes of NHS CfH.
• Relationships Management
• To ensure the professional currency of our staff
  and enhance their credibility amongst colleagues
  in the service as leaders of their field
• Internal Staff Development
• To ensure that knowledge and insights generated
  in the ETD domain are captured appropriately and
  made available for use by members of the ETD
  community nationally and locally
• Manage and Mobilise Knowledge
• To communicate the values, activities, outputs
  and collaborative work of ETD in a systematic way
  using multiple channels and approaches
• Communications and Stakeholder Engagement

21
Strategy and Standards, Relationships Management,
Knowledge Management, Communications and
Engagement, Professional and Staff Development
within ETD
22
(No Transcript)
23
(No Transcript)
24
(No Transcript)
25
(No Transcript)
26
(No Transcript)
27
(No Transcript)
28
(No Transcript)
29
Plus, one more cross-cutting theme

• Managed by the Director
• To even up the workload
• Because of its central importance
• Relationships Management

30
Relationships Management
31
(No Transcript)
32
(No Transcript)
33
Relationships Management Nancy Bavin
34
Relationships ManagementNancy Bavin
35
How does this relate to our Strategic Plan?

• Each work team has a Primary Goal
• Each Primary Goal has a number of Strategic
  Objectives (4 or 5)
• Each Strategic Objective has a number of
  Activities
• Some of these Activities are higher priority than
  others
• Our Business Plan distinguishes Activities
  according to their priority
• Our Budget and Staffing need to reflect the
  highest priority activities

36
Objective 1, Activity 2 would be a High Priority
activity
37
The immediate priorities

• in the longer term context

38
1. Cultural change creating comfort with new
technology
2. Technical proficiency with specific
applications
3. Ability to use technologies for learning
4. Ability to use technologies for other
knowledge applications
39
In conclusion

• We are all working together
• What does this mean for ETD at the Cluster level?
• We are working to create a shared team

40
An integrated ETD Team
2
3
Nationallybased
Locally (cluster)based
1
4
Locally focussed
Nationally focussed
41
Four different kinds of work one purpose

• To encourage and accelerate the uptake, spread
  and creative use of information and communication
  technologies in support of high-quality
  patient-centred healthcare
• or
• To support a Safely Managed Revolution

42
ETD National ConferenceMaking IT Happen Through
Learning
The Training Story Declan Hadley Tracey
Handley,Lancashire NHS Mental Health Care Trust

• Birmingham NEC 18 January 2006

43
Lancashire Care NHS Trust NHS Care Record
Service

• The deployment experience

44
About the Trust

• Specialist Mental Health Trust
• Size average acute trust
• 68 sites across 200Sq Miles
• 11 hospital sites, 750 beds
• 6 legacy PAS, not much else
• 9 PCTs, 3 Local Authorities
• 4 COINs (Good infrastructure)

45
Topics for discussion

• Project planning
• Deployment
• Where are we now
• Lessons Learnt

46
Why go live first?

• 6 PAS with little or no access
• LTH switching off
• Risks no worse
• Greenfield site
• Organisation up for it
• Support of SHA CSCA

47
Project planning

• Developed good working relationship with CSCA
• Strong project management
• Spent time on brief and PID
• Trust keen to get full bundle functionality
• Little or no external validation by NHS
• Lots of scrutiny by CSCA
• Didnt spend long enough on the training plan

48
Developing IT competency

• Training Needs Analysis
• 40 of staff with little or no IT Skills
• Set up training courses
• ECDL, CLAIT Etc..
• Established partnerships with local college
• Keep pushing IT training

49
Business change

• The role of clinical specialist

50
Why have clinical specialist?

• Lots of relevant experience
• Help colleagues understand the techies
• Patient centred approach not IT centred
• Dedicated time
• Were committed (or should be)
• We have to go back to the service!

51
Business change

• The role of clinical specialist

• Better ways of working
• Workshops looking at the way we work
• Understanding how the application will support
  this
• New Admin and Clinical processes
• Communication
• MORE communication

52
Pre-deployment work

• Training
• Good master training
• Didnt cover full scope
• Time lag between training and live
• Unstable training environments
• Different builds training vs live
• No spine access (PDS Postcoder)
• Use E-learning NWVLE

53
Pre-deployment work

• Training Continued
• No time to configure environments
• Local confusion over modules
• No time to customise to local operation
• Registration Authority
• Changes to RA software build
• Linking role to real job role (AfC)
• Use SMS to deploy.

54
Pre-deployment work

• No visibility of application
• Lack of knowledge - Trust CSCA
• Data migration
• PMI and Casenote details in house work
• Lots of testing, but no resolution to health
  records problem until night before!

55
Pre-deployment work

• Configuration
• Lack of understanding (more Trust than CSCA)
• Dubious I-Config
• Consequences of coding on application
• Impact on future reporting
• Shared sites
• Impact on strategic instance
• How codes appeared to users (order etc)

56
Going Live 29th March 2005

• Long days and nights
• 100 commitment from CSCA
• Technical bridges worked well
• Lots of configuration problems
• Unstable at first
• Trainers and project staff on-hand to support
  users

57
Where are we now?

• Over 10 months live
• Deployed in all hospital areas
• First community sites deployed
• Psychology in progress
• Over 500 staff trained
• 8 training rooms set up
• Most staff are positive.

58
Where are we now?

• More stable recently
• lots of undocumented features
• Greater understanding of the product
• Many problems fixed in Erlanger
• Upgrading could be better
• Erlanger still a mystery
• Not signed Deployment Verification Document

59
(No Transcript)
60
What the users think

• Janet Shelmerdine-Administration Manager
• NCRS gives me a better overview of the work
  being carried out in remote clinics without
  interrupting the staff during their busy periods.
  This in turn feeds performance management
  requirements
• Vicki Greenwood-Office Supervisor
• Using NCRS saves time in dealing with patient
  enquiries you know that the information you are
  looking at is correct and up to date
• Sue Fielding-Administration Lead Officer
• The ability to be able to check bed occupancy a
  the click of a button makes better use of time in
  situations that need immediate answers

61
What the users think

• Michelle Knowles-Medical Secretary
• Information is requested regarding a patient
  stay in hospital this can easily be found now in
  patient view without disturbing others or
  trawling through notes
• Alwyn Savage-Outpatients Department Supervisor
• Communication can be improved between
  professionals as all areas of the system become
  live
• Val Baldwin-Ward Clerk
• Being able to transfer a patients details in
  full with the click of a button is far better
  than our previous reliance on photocopied details
  of paperwork that could at times be unfamiliar

62
Things that didnt go well

• Product Knowledge
• Testing / configuration
• Access to the live environment
• TOO Many Faults
• Not tested properly!
• Lack of understanding
• The Authority CSCA
• Product

63
Recommendations

• Spend time on your PID
• Insist on access to the software ASAP
• Make it real
• Training, Training, Training
• Establish post go-live support
• Formalise handover of project to operations
• Be patient!

64
What goes around, comes around
That it will ever come into general use,
notwithstanding its value, is extremely doubtful
because its beneficial application requires much
time and gives a good bit of trouble, both to the
patient and to the practitioner because its hue
and character are foreign and opposed to all our
habits and associations. The London Times in
1834the stethoscope
65
Questions?
66
ETD National ConferenceMaking IT Happen Through
Learning
Exhibition RefreshmentsGallery Concourse

• Birmingham NEC 18 January 2006

67
ETD National ConferenceMaking IT Happen Through
Learning
Choose BookKate Marshall, Irene Stephenson
Therese Manship,Wakefield North Kirklees
Choose Book Programme

• Birmingham NEC 18 January 2006

68
The Wakefield and North Kirklees Programme

• Implementation Case Study

Presented by Kate Marshall
Date January 18th 2006
69
Objectives

• Programme structure
• The programme story so far
• Programme lessons learnt
• A story of success
• Human Resource Management Framework

70
Wakefield and North Kirklees Local Health
Community

• 3 Primary Care Trusts
• 1 three site Acute Trust
• 1 Mental Health Trust

71
Programme Structure

• SHA Implementation Team
• Programme Board
• Programme Manager
• Implementation Managers and acute trust lead
• Programme Coordinator
• Task Groups
• Organisational Steering Groups

72
Story so far.

• Planthen plan again..then plan again!!!!!
• Stage 1 success
• Roll out begins

73
And now..

• 24 live practices
• 600 bookings
• Practices moving towards integration
• Specialty roll out nearing completion

74
Keep on booking..
75
Lessons so far

• Firm programme structure
• Joint planning
• Know your dependencies and order of events
• Realise the importance of scheduling and
  coordination
• Embed new roles into organisations early
• Clear issue escalation routes
• Do not underestimate the challenge of obtaining
  and maintaining engagement
• Floor walking shows in booking figures

76
Contact details

• Kate Marshall
• Programme Manager
• 01924 213138 or 07768 568285
• kate.marshall_at_wwpct.nhs.uk

77
Choose and Book working

• An Implementation Managers Story

Presented by Irene Stephenson
Date 18th January 2006
78
In the beginning

• The Choose and Book lady arrives!
• Build the foundation of a good relationship
• Identify key staff
• Plan timetable leading to go live
• Gate keep CAB activity at practice

79
Going Live

• Go Live day
• End of go live week
• Contact at end of second week
• Fortnightly review meetings
• Share issues/solutions from review meetings
• Monitor activity lists and weekly reports

80
After going live

• Peer Support
• Updates on any changes to software
• Top up training if required/train new staff
• Set up user group share good practice
• Respond promptly to problems

81
Next Steps

• Keep the plates spinning!
• Work to engage 100 GPs.
• Evaluate gather feedback
• Continue to update and improve!

82
Questions?

• Contact details
• Irene Stephenson
• E-mail irene.stephenson_at_wwpct.nhs.uk
• Mobile [phone]
• Office 01924 213181

83
Human Resource Management Framework

• Supporting the impact of Choice and Choose Book
  on the Workforce

Presented by Therese Manship Project
Co-ordinator
Date 18 January 2006
84
Human Resource Management Framework

• Background of the Framework
• Who should use the Framework
• Role of the Project Co-ordinator

85
Practical Support

• Consider the options for delivery of Choice and
  CaB
• Identify the tasks associated with delivering
  those options
• Identify the people who could undertake those
  tasks
• Identify the training and development that may be
  required by those people

86
Training Development

• IT Training
• Effectively enabling patients to exercise their
  rights
• Identify individual learning and development
  needs

87
In Summary

• Choose Book and Choice go hand-in-hand
• Raise awareness of the Framework

88
ETD National ConferenceMaking IT Happen Through
Learning
Learning from Industry Building Society to
Clearing Bank Joy Milton, Director of Laura Birch
Limited.

• Birmingham NEC 18 January 2006

89
Learning from Industry Building Society to
Clearing Bank

• Joy Milton

90
You may recognise these....
Context

91
...but do you also recognise these?
Context

92
Culture and Traditions
Context

• Ex-Leeds or Ex-Halifax
• Bank and Building Society
• Leading Edge and Assembler
• Vary 1 of 3, Owlcotes
• Central Control, Entrepreneurs
• Plate Glass and Chandeliers
• Change the Programme Manager

Trying is the first step towards failure . (The
Office)
93
Scale
Context
We are either doing something, or we are not.
'Talking about' is a subset of 'not. (The
Office)
94
Clear Vision
Aims
... ..- -.-. -.-. . ... ...?

• 2 Becomes 1

When you are a Bear of Very Little Brain, and you
Think of Things, you sometimes find that a Thing
which seemed very Thingish inside you is quite
different when it gets out into the open and has
other people looking at it
If I'd have wanted it for tomorrow, I would have
asked for it tomorrow. (The Office)
95
Simple Transparent Low Cost High Sales
Aims

96
Rationalise
Aims
From
To
"To err is human, to really foul things up
requires a computer. (Anon)
97
The New Force in Banking
Aims
?
Is your work done? Are all pigs fed, watered and
ready to fly....? (The Office)
98
Key Issues
Communication

• Business Cases
• Scale and impact
• Complexity
• Number of Internal Stakeholders..and External
  Stakeholders
• Service is Top Priority, but we also need
• Continue to challenge Big 4
• Customer Proposition

Lack of planning on your part does not
constitute an emergency on my part. (The Office)
99
Champions Deliver Change
Learning

• Clarity of Vision
• Communication, Communication
• Guide, Support and Control
• Humour and Energy
• Celebration Reward
• Area Champions
• Unleashing Potential

Language is important. Normal/Standard - Same
thing! Told one of my staff last week they were
'sub-normal, and they burst into tears?!
100
Learning from Industry Building Society to
Clearing Bank

• THANK YOU
• joy.milton_at_laurabirch.co.uk

101
ETD National ConferenceMaking IT Happen Through
Learning
Question Answer Session Phil Candy, Director of
ETD, NHS Connecting for Health Maeve Smith,
Systems ETD Lead Marion McGowan, Transitional ETD
Lead Di Millen, Head of Informatics

• Birmingham NEC 18 January 2006

102
ETD National ConferenceMaking IT Happen Through
Learning
Plenary ETD The Futures Bright Phil Candy,
Director of ETD, NHS Connecting for Health

• Birmingham NEC 18 January 2006

103
ETD The Futures Bright

• Some quick reflections on todays event

104
Overall reflections

• Today has been a great success lots of support
  for similar events
• Lots of lessons learnt lots of similarities
• Maybe not enough time for informal networking
• We need a mixture of similar sharing events
  geographical applications-based thematic

105
Significant insights

• Dont underestimate the challenges of getting and
  maintaining engagement
• Recognise the close relationship between ETD and
  Business Change
• Start with the Go-Live date and plan backwards
• Planning is repaid many times over in good
  learning outcomes
• Make use of good project management disciplines
• Clarify dependencies both procedural and
  technical
• Involve end-users as early and as often as
  possible

106
More significant insights

• Provide post go-live help and support (floor
  walking) after the initial training
• Keep a sense of humour youll almost certainly
  need it
• Be responsive but also be proactive keep the
  lines of communication with end-users open
• Try to obtain high level buy-in, support and
  advocacy
• Plan to mainstream the learning into business as
  usual post go-live
• Track and show progress on the long journey

107
Areas for collaboration

• Helping users (and especially managers) to
  envisage what the connected future might be
  like
• Helping each other to use elearning in creative
  and inspirational ways
• Sharing practice through virtual as well as real
  communities of practice

108
Three memorable quotes from today

• The simpler the application, the easier the
  training
• If you can get through the headlines and
  deadlines, the harder the process the greater
  the satisfaction
• We are either doing something or we are not.
  Talking about is a subset of not.

109
We may work in different places, and have
different responsibilities, but we have a common
purpose

• To encourage and accelerate the uptake, spread
  and creative use of information and communication
  technologies in support of high-quality
  patient-centred healthcare
• or, in other words, to support
• A Safely Managed Revolution

110
And finally, many thanks to

• Nancy
• Other members of the ETD Team National and
  Cluster-based
• Ruth and the Events Team
• Exhibitors
• Presenters especially Joy
• You all for coming

111
ETD National ConferenceMaking IT Happen Through
Learning
Thank you Goodbye!

• Birmingham NEC 18 January 2006