Update on Progress with the National Programme for IT in London

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Update on Progress with the National Programme
for IT in London

• Kevin Jarrold
• Regional Implementation Director NHS CFH
• Chief Information Officer NHS London

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Agenda

• Progress with deployment
• Update on CCN2 re-setting the contract with BT
• National Programme for IT (NPfIT)
  Local Ownership Plan
• Looking ahead key challenges in 2007/8

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Deployment Progress
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Planning for Cerner

• Cerner R0
• Barnet and Chase Farm
• Queen Marys Sidcup
• Barts and the London
• Cerner LC1
• St Marys Paddington
• St Georges
• Royal Free
• Kingston

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CCN2
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Purpose of CCN2

• Address two main concerns
• Delivery of systems for acute trusts
• Resolve uncertainty around interim GP, mental
  health and community solutions.
• Achieve original vision of shared patient record
  across all care settings

• Work within existing contractual framework
• Retain existing contract value of 966m
• Provide a robust commercial framework for going
  forwards
• Improve confidence in supplier delivery
  capability

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CCN2 Proposal

• Replace GE (previously IDX) with Cerner for Acute
• Mental Health and Community will deploy the RiO
  product from CSE Servelec
• The primary care solution will be Vision 4 from
  INPS
• An integration layer will facilitate data sharing
  across care settings

• Recognises
• Ambitious plans for a single instance database
  have not been delivered (anywhere)
• Key issue is the ability to share information
  irrespective of the care setting
• Interim solutions are providing a pragmatic way
  forwards in community and mental health

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NHS Engagement

• CCN2 workshops held with Acute, Mental Health and
  Primary Community groups at outset
• Three levels of input
• NHS participation in detailed evaluation
• Overview and assurance from care setting
  programme boards, clinical and reference groups
• Governance final sign off by this London
  Programme Board
• The NHS input has had a significant impact on the
  outcome

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2007/8 Detailed Implementation Plan

• Wraps up 2006/7 CCN1 deployments
• Identifies slots for
• Go live of new system in 2007/8
• Upgrade of existing system in 2007/8
• Commence planning for new system or upgrade in
  2008/9

• Risks
• Failure to fill slots
• Aborted deployment
• Failure to deploy full functionality
• Delay has domino effect
• Mitigation
• More detailed engagement process

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Issues to highlight

• Integration
• Primary Care direction of travel
• Cerner London configuration

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Benefits expected from integrated solution

• Access to all relevant information
• Integrated view across care-settings
• Information up to date at all times
• Data integrity
• Common look and feel across applications
• Single Sign On
• Integrated decision support
• Minimise hand-offs and re-entry of data

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Acute Issues

• London Configuration of the Cerner product
• More flexibility to meet the needs of the NHS in
  London
• Avoids cumbersome joint process across the 4 SHAs
  in London and the South
• Enables Homerton and Newham experience to be
  exploited

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Primary Care

• Key issues
• Progress made by PCTs with legacy suppliers
• Impact of GP Systems of Choice
• Ability to reach agreement with suppliers
• Financial constraints

• Outline proposal
• Achieve 100 coverage but with 2 suppliers
• Anticipate 40/60 split between INPS/EMIS
• Only INPS would be fully integrated
• Plan 120 day period to negotiate

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National Programme for ITLocal Ownership
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Established October 2002
Established April 2005
June 2002
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Main drivers for change

• National Audit Office Report and Public Accounts
  Committee Review
• David Nicholson wants to see change
• Negative feedback from within the NHS about
  delays to the realisation of benefits
• Continuing bad press
• Changes to LSPs in North Midlands and East that
  means clusters need to change

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NAO Report

• Two and half years into the 10 year programme the
  report recommends the procurement strategy for
• Speed of contract closure
• Success in transfer of cost of delay to suppliers
• But raises concerns about
• Impact of delay in delivery from key suppliers
• NHS ownership and commitment to deployment
• Clinical engagement

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NPfIT Local Ownership Project Context

• London
• 1 SHA
• 1 NHS CFH Cluster
• 1 LSP (Circa 1bn)

• North/Midlands/East
• 6 SHAs
• 3 NHS CFH Clusters
• 1 LSP and 1 software supplier (circa 3bn)
• Southern
• 3 SHAs
• 1 NHS CFH Cluster
• 1 LSP (Circa 1bn)

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Main Projects

• Mainstreaming IMT
• Benefits Realisation
• IMT Strategy and Policy
• IMT Planning and Performance Management
• NPfIT Local Ownership Programme
• NHS CFH Structural Transition
• London, South, NME Projects
• Capability and Capacity
• Clinical Availability and Mobilisation

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London Objectives.

• Achieve improved local ownership and better
  delivery of NPfIT solutions
• Quantify and manage any risks falling on local
  NHS
• Minimise disruption for staff
• Outcome at the very least is no worse than
  current arrangements

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London deliverables

• Fit for purpose governance arrangements
• New organisational design that places the London
  NHS CFH team with the Strategic Health Authority

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Governance

• A range of tasks have to be carried out by the
  SHA in partnership with Trusts and PCTs
• Process needs participation of all NHS
  organisations in London
• Two options
• Retain existing arrangements with modifications
• Develop new governance arrangements

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Existing governance

• London Programme Board with sub-groups for
• Mental Health
• Primary and Community
• Acute
• Recently introduced
• Already moving in direction of Local Ownership

• But may need to
• Strengthen boards
• Have key decisions signed off by London-wide
  chief execs groups
• Place greater emphasis on clinical and reference
  groups in which all organisations are invited to
  participate

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Organisational Design deliverables

• Describing the Organisational Design
• Operating Model
• Detailed costed resource model with job
  descriptions
• Managing the Transition
• Transition Plan including HR arrangements
• Financial Framework

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Looking ahead

• NPfIT Local Ownership is consistent with the
  overall direction of travel in London
• Track record of successful deployments is
  providing a credible base on which to build
• Roll out plans are ambitious and limiting factor
  in 2007/8 may be NHS capacity