London Programme for IT The Story so Far

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London Programme for ITThe Story so Far

• Kevin Jarrold
• Chief Information Officer
• NHS London

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Overview

• National Programme for IT a quick recap
• Progress with national infrastructure
• Progress with the Care Records Service
• The London Programme for IT
• What we are planning to deliver
• Progress so far
• Key elements of the approach
• The future

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Quick re-cap on background

• 2002 National Programme for IT (NPfIT) launched
• Procurement Strategy
• Vision of an integrated electronic patient record
• IT Tsar for the NHS
• 2005 NHS Connecting for Health
• Set up as an arms length body of the Dept of
  Health
• Charged with the implementation of the National
  Programme for IT
• 2006 National Audit Office Review
• 2007 NPfIT Local Ownership Programme (NLOP)
• Transfers responsibility for the implementation
  of the National Programme to Strategic Health
  Authorities

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Procurement Strategy

• National Applications
• Spine (national summary record)
• N3 (NHS-wide network)
• Choose and Book
• NHS Mail (email system for the whole NHS)
• GP2GP records transfer
• Electronic transfer of prescriptions

• Local Applications
• Implemented by Local Service Provider (LSP)
• Delivers the electronic patient record
• Aka the Care Records Service
• PACS (digital Xrays)

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National Applications

• Spine
• 470,000 smartcard users
• 150,000 summary records
• N3
• 32,000 connections
• 1.2m staff have access
• Largest VPN in the world
• Choose and Book
• Used for 50 of GP referrals to Outpatients

• NHSmail
• 100,000 messages a day
• 360,000 registered users
• GP2GP
• Over 151,000 records transferred
• Electronic Prescriptions
• Used for 17 of prescriptions issued by GPs

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Progress with Care Records Service

• Suppliers have struggled to deliver the Care
  Records Service
• Country now divided into 3 regions
• North, Midlands and East (6 SHAs)
• Local Service Provider CSC
• Software provider iSOFT
• South (3 SHAs)
• Local Service Provider Fujitsu have now exited
• Software provider Cerner
• London
• Local Service Provider BT
• Software provider best of breed approach

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Progress in London

• 2003 Contract signed with BT to deploy IDX
  across all care settings.
• 2005 CCN1 brings in interim solutions for GPs
  community services and mental health
• 2007 CCN2 removes IDX and replaces them with
  best of breed
• Acute Hospitals Cerner Millennium
• Mental Health CSE Servelec RiO
• Community CSE Servelec RiO
• GPs INPS (plus EMIS)
• Shared Patient Record - BT

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London Care Records Service
National Summary Care Record
London Shared Patient Record
Acute System (Cerner)
Mental health System (RiO)
Primary care System (INPS and EMIS)
Community System (RiO)
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Deployment Progress - Acute

• Planned Cerner Millennium LC1
• Royal Free
• Imperial (St Marys)
• Kingston and QMR
• St Georges
• Imperial Phase 2 (Hammersmith)

• Pre-existing Cerner deployments
• Homerton
• Newham
• Cerner Millennium LC0
• Barnet and Chase Farm
• Queen Marys Sidcup
• Barts and the London

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Deployment Progress - Acute

• PACS (digital Xray)
• live in 21 trusts
• Interim Order Communications
• live in 8 trusts
• Interim Theatres
• live in 7 trusts

• iSOFT sites supported by CSC
• Guys and St Thomass
• Kings College
• Lewisham
• Great Ormond Street
• Epsom and St Helier

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• RiO V4 Community Deployments in London

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RiO Mental Health
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Key elements of the approach

• Pragmatic rather than dogmatic about the route to
  the original vision
• Recognise that change impacts across the whole
  organisation
• NHS trusts need to choose to do it rather than
  have it imposed
• Large releases of software designed in a
  laboratory environment dont work
• The users need to have control over the future
  development path for the systems that they use

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London Programme Board and Care Setting
London Programme Board

• Expand scope to include
• Whole IMT agenda
• Strategic perspective for London

• New Body - Role to include
• resolution of multi-care setting issues (e.g.
  shared patient record)
• coordination of innovations across care settings
  (e.g. with HfL projects such as Unscheduled Care)
• integration coordination of IM
  requirements/delivery

Acute Programme Board
MH Programme Board
Primary Care Community Care Prog. Board
Shared Patient Record and Integration Board

• Scope to include
• set strategy and agenda provide leadership for
  wider IMT agenda
• link IMT to national and local strategic
  priorities
• focus on LPfIT deployment
• set direction/agenda for strategic stakeholder
  group
• escalation route for Trusts
• set benefits expectations
• communicate to wider NHS
• Lift membership to ensure CEO leadership and
  mandate to act on behalf of represented
  organisations

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Generic sub-structure for each Care Programme
Boards
Care Programme Board

• Role of QA Group
• QA throughout the DBT lifecycle
• Scope covers full range of stakeholder
  perspectives

Strategic Stakeholder Group (nee User Group)
Quality Assurance Group

• Strategic Stakeholder Group
• Translate strategic priorities into IMT / LPfIT
  priorities development plans (inc. LSP
  solutions)
• Prioritise work packages to the Design Group
• Approve LPfIT project scope and release strategy
• Assure cross-setting requirements
  incorporated into care setting
  plans/requirements
• Collate/structure performance information for
  the Care Setting Board
• Make recommendations to Care Setting Board
• Champion benefits realisation / service
  transformation
• Ensure information management requirements
  are reflected in delivered solutions

Performance Management
User Design Group

• Performance Management Function
• Track key issues/risks resolution
• Track solution delivery
• Track LPfIT deployment against contract
• Track and report benefits realised
• Track NHS readiness for deployment

• Role of Design Group
• Deliver agreed scope and design configuration
• Work within remit set by operational group

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The Future.

• By the end of 2008/9 a large proportion of the
  NHS in London will be on systems supported by the
  programme
• 29 of 31 PCTs
• 8 of 10 Mental Health Trusts
• 15 of 32 acute hospitals
• 100 of GPs (under GP Systems of Choice)

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Key Challenges are going to be

• Standardisation vs localisation
• Improving the functionality
• Delivering the shared patient record
• Improving the interface with social care
• Enhancing governance
• Understanding the impact of changes in the South
  on London
• Responding to the wider changes in the NHS
• World Class Commissioning
• Healthcare for London

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• Any Questions