Change & Benefits Management Connecting for Health NE Cluster & SYSHA

SYSHA Connecting for Health Slide 1

Rose Hand

Clinical Director (NPfIT) SYSHA

Change & Benefits ManagementConnecting for HealthNE Cluster & SYSHA


Context

The NHS serves over 50 million people in England.

In 2003-2004 there were:

• 325 million consultations with GPs or nurses in primary care

• 13.3 million outpatient consultations

• over 5.4 million people admitted to hospital for planned treatment

• 13.9 million people attended A&E

• 4.2 million emergency admissions

• 649 million prescription items issued

• 6.4 million calls made to NHS Direct

• 6.5 million hits to the NHS Direct Online website.


Context

Acute Trusts•Most systems do not support the movement of information between buildings and departments

•Several records often created for the same patient


Context

Primary Care

•Most individual practices have their own IT applications and databases

•Patient records are not easily transferred to other practices or care providers

•Developmental and effective implementation of care pathways is inhibited

•Paper-based records delay modernisation and the delivery of National Service Frameworks


Connecting for Health

• NHS Care Records Service– Every patient's medical and care records will be held

electronically and will eventually be available securely online. The information will be safely and easily accessible to healthcare professionals and patients, whenever and wherever it is needed.

• Choose and Book – GPs and other primary care staff will be able to book

initial hospital appointments electronically, at a convenient date, time and place for patients, without sending referral letters to hospitals and waiting for a reply.



• Electronic Transmission of Prescriptions– A new service making it easier and more convenient for

GPs to issue prescriptions and for patients to collect medicines.

• New National Network – N3– A national network with sufficient connectivity and

broadband capacity to meet current and future NHS needs.

• Picture Archiving and Communications Systems (PACS)– Systems to capture, store, distribute and display static or

moving digital medical images, supporting improvements to the patient's NHS journey.



• QMAS - supporting GP practices– QMAS (the Quality Management and Analysis System) gives GP practices

feedback on the quality of care delivered to patients measured against national achievement targets detailed in the GMS (General Medical Services) contract, which sets out the way GPs work and the way they are financially rewarded.

• Contact– A centrally managed email, directory and calendar service provided free

of charge to NHS organisations in England.


High Level Benefits

Better IT to:

• Improve patient centred care

• Improve choice and patient experience

• Give greater support for frontline clinicians

• Improve healthcare process efficiency

• Make better use of existing assets


High Level Benefits

• Patients will benefit from greater involvement in decisions about their care and greater access to and ownership of their records

• Clinicians will benefit from less administration and faster, more efficient access to information and services

• The NHS will benefit from time and cost savings brought about by reduced administration and improved output from the baseline IT spend


Approach To Change Management

• Driven by benefits, avoiding duplication – wide number of change programmes & projects involved in the system reform agenda

• Avoid double counting of benefits through an integrated approach with Modernisation, Workforce Development & Connecting for Health Teams

• Flexibility of approach suitable methodology now may require modification & adaptation as the programme develops

• Work on benefits will be utilised to highlight the positive impact of the Solutions

• Clinical & Stakeholder engagement & leadership to drive out benefits, plus LHC / Project Change & Benefits Leads


Reform Agenda

Improving the patient

experience. Patient centred

services

System Reform

Choice -at six months -at point of referral -choice in primary care

Patient and Public Involvement -Patient Forums - PALS

Contestability -Foundation Trusts -New diagnostic providers -Independent treatment centres

Governance Planning & Performance Inspection & Assessment Standards & Targets

Connecting for Health -Care Records Service -Choose and Book

Incentives -payment by results -Fee for service

Agenda for Change -GP contracts -Consultant contracts

National Service Frameworks -Single Assessment Process

Better Care without Delay Lean Thinking Evidence based care Equity of Access Care-pathways


Advantages of LHC Change & Benefits Leads

• The ability to pull together all the workstreams from an IT and strategic view point and at operational level

• Present the facts in everyday language to end users• Understand which triggers to use to get the interest and

support from key people in the organisations• Ability to ‘infiltrate’ the clinical areas to become part of

the ‘team’

• Produce change management & benefit plans for local ownership which run beyond project boundaries


LHC Service Implementations

Performance management

Comms& Stakeholder Engagement

LeadershipEducationTraining

BenefitsManagement

IntegratedNPfIT

Solutions(LSP)

NPfITService

Implementation

NPfITNational solutions,

Implementation

Strategic Health Authority

Cluster Cluster

programme manager

Pilot programme manager

Department of Health

Knowledge &InformationSolutions

Cluster Cluster

-ordinator

Local Health Community

AmbulanceTrust

MentalHealth

PCTPCTs ATAcuteTrusts

Shared agenda and plan

Users: patients, clinicians, nurses…

PBRPbR

Performance management

CommsStakeholder Engagement

LeadershipEducationTraining

BenefitsManagement

IntegratedNPfIT

Solutions(LSP)

TechnicalImplementation

SupportImplementation

NPfITService

Implementation

NPfITNational solutions,

Implementation

Strategic Health Authority

programme manager

SI programme manager

Department of Health

Knowledge &InformationSolutions

ChoiceChoiceHRAgenda for

Change

SI co-ordinatorLocal Health Community

AmbulanceTrust

MentalHealth




Local Health Community

AmbulanceTrust

MentalHealth


AmbulanceTrust

MentalHealth

PCTPCTsPCTPCTs ATAcuteTrustsATAcuteTrusts



CDMMA: 10 Changes


Benefits Categorisation

Benefit Categories

SafetyClinical and

Cost Effectiveness

Governance Patient FocusAccessible and

Responsive care

Care Environment

and AmenitiesPublic Health

Patient SafetyHealth Care

Benefits

Managerial & Clinical

Leadership

Partnership with Patients

Responsiveness to patient

needsStaff Well-being

Cross NHS Collaboration

Clinical Efficiency

Reduced Expenditure

Capital Effectiveness

Management Information

Quality

Organisational Flexibility

Systems and Working Practices

Partnership with Other

OrganisationsPatient Choice

Patient Satisfaction

Privacy and data Security

Learning and Research

Benefit Sub-Categories

Process Change

Information Availability

Cost SavingOutcome

Categories

Management Clinical Staff Administrators PatientsStudents,

Teachers and Researchers

IT StaffStakeholders


Benefits Realisation Framework

Benefits Identification

• National Team assembles generic Benefits Register (National Project Focus) and Benefits Measurement Work Packages

• National Team and Clusters define contents of Cluster-specific Benefits Menus (Cluster/LSP Focus) & update Benefits Register

Benefits Prioritisation

• LHC alignment process• LHC selects NPfIT benefits/initiatives (using Benefits Menu)

• LHC identifies additional ‘local’ benefits (using Benefits Menu Format)

Benefits Planning

• LHC defines Benefits Plan (using Benefits Menu)

• National Team captures LHC Benefit Plans (using Benefits Data Warehouse)

• LHC defines Benefits Measurement Plan (using Benefits Measurement Work Packages)

Benefits Reviews

• Held when evidence is available that the benefits in the Benefits Plan should have become measurable. More than one review may be needed (using Benefits Measurement Plan)

• National level review will also take place to assess benefits realisation

Benefits Measurement

• LHC manages benefits realisation• LHC measures subset of benefits (using Benefits Measurement Plan)

• National Team/Other organisations (e.g. HC) measure remaining realised benefits and capture all benefits measurement (using Benefits Data Warehouse)


Success Factors of Local Project

• Benefits Realisation is dependent on changes to working practices and training & education to be successful

• Detailed Benefits Plans, Business Change Plans & Training Plans are an essential part of the Project Plans (PID)

• Projects assign ownership to Business Change & Benefits• Learn the lessons from earlier projects


North East Cluster Achievements To Date

• At the forefront of implementation• Developing processes• Choose and Book

– Barnsley and Harrogate Early Adopters– 270 bookings

• N3 – 584 connections – 775 work in progress• RA – 3201 smartcards issued to staff• 30 Projects mobilised• PACS

– Cluster business case– Plans for first wave delivery completed


North East Cluster Achievements To Date

• Training– NHS trained in a variety of areas– End users trained

– Learning Management System

• Benefits– Leads in each SHA– Close working with national team

• Single Assessment Process– Live in 5 PCTs

• Primary Care – First practice in England – Dr Lee

10,000 patients are already benefiting from Connecting for Health


Current Deployment Profile for 2005

• ETP– Keighley Wave 1 implementer site live– 2 practices in Grimsby go-live imminent

• Choose & Book compliant systems roll-out– Primary Care - 70%– PAS – 60%

• Secondary Uses Service – SHA’s mobilised to establish RA’s by 31 March

• Additional Service Request’s– Many including some tactical core e.g. Airedale and Leeds A&E


Current Deployment Profile for 2005/06

LSP Core First Site/s Total GP Dr Lee 121 practices

Mental Health South of Tyne & Wearside

5 Trusts

Acute Scarborough & NE Yorkshire

9 Trusts + 1 Ambulance Trust

Child Health / Community

Community Care Trust, CDTV

26 PCTs

Ambulance South Yorkshire 1 Trust

Map of Medicine Gateshead, Barnsley, Harrogate & Doncaster

Initially 4 pilots

SAP 3 North of Tyne PCTs 16 PCTs


Summary

• 2004– Built the foundations– Much implementation work in progress– Delivered to 8 Trusts– Benefits to 10,000 patients

• 2005– Delivery to all 98 Trusts– Benefits to approx. 4 million people

Documents

Change & Benefits Management Connecting for Health NE Cluster & SYSHA