North East and Cumbria (West, North & East) Digital Care ProgrammeDecember 2016This briefing is a summary of information provided by a number of stakeholders involved in the North East and Cumbria (West, North & East) Digital Care Programme. It is not an exhaustive view of everything that is taking place as it is designed to update stakeholders on the key pieces of work where updates are available.

The Digital Care Programmes aim is to share best practice, learn from this and support organisations in delivering the Local Digital Roadmaps (LDRs) and digital elements of the Sustainability and Transformation Plans (STPs).

Regional priorities have been identified and key leads clarified to inform the three regional Sustainability and Transformation Plans. Where costs are available these have been included so that it is clear what resource is needed to progress these.

The following is a high level list of the themes/priorities that have been identified to date, some of which are already being progressed and others require further development:

1. Regional Interoperability/Great North Care Record (Connected Health Cities Programme) Standardised approach to information sharing Information Sharing Gateway Medical Interoperability Gateway (MIG) or equivalent solution for accessing patient records electronic Patient Health Record (PHR)

2. Infrastructure 3. Planning & Decision Support

End of Life Care Scan for Safety (S4S) Child Protection Information Sharing Project

4. Transfers of Care5. Technology Enabled Care Services (TECS)6. Communications, engagement and consent7. Northern England Clinical Networks

Pathology Maternity Mental Health

8. Analytics 9. National initiatives

Online patient access SCR for pharmacies GP Connect SnoMed CT in Primary Care Open Source APIs in Primary Care/Code4health

10. Regional PMO to support the delivery programme/work with STP leads11. Other initiatives

Opportunities for collaboration ie. back office functions Patient kiosks Use of NHS Number

The latest stakeholder event took place on 29th September which was well attended. The attendees discussed the key work areas and contributed to the development of the regional list of priorities that has been fed into the Sustainability and Transformation Plans. The next event is 8th December at the Durham Centre were the focus will be on the key deliverables for areas of the above to ensure we collectively

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progress these and identify any challenges that can be resolved by working with colleagues regionally or nationally.

Further information about the programme can be found at this link http://www.necsu.nhs.uk/digitalcareincluding the latest briefing, regional plans and presentations from the events.

Programme level update provided by Deborah Bowden. Please direct any queries to Deborah.bowden1@nhs.net

Great North Care Record (GNCR)

“By 2021 the Great North Care Record will make a lasting contribution to the health and well-being of our population through the sharing of information securely and effectively.

The Great North Care Record will make information more widely available and accessible to support frontline care, individual self-management, planning and research.

enabling:Professionals and carers to have legitimate access to the right information at the point of need, ensuring our population get better, safer care regardless of setting or organization.

Improved access to information, allowing individuals to better understand and manage their own wellbeing and care.

Improved data access and analytics, allowing better population health planning based on demand, and enabling the development and deployment of more innovative treatments.”

The following sections provide an overview of progress from across the region, further details will be available from individual workstream reports and leads:

Connected Health Cities (CHC)A Connected Health Cities (CHC)/Great North Care Record (GNCR) event took place on 4 th November in Newcastle.

5 CHC ‘care pathway’ projects were scoped towards formalising in Collaboration Agreement with Newcastle University. The following 3 are progressing towards approval in 2016:

County Durham/Darlington/Tees (Durham University Lead): development of analytical tools for unplanned care forecasting, to support demand management and service planning in relevant health and social care services. The project will also focus on unplanned care for alcohol and dementia related attendances. Northumbria Healthcare, North Tees and South Tyneside Trusts are both now also collaborators.

Newcastle/North Tyneside/other tbc (Newcastle University Lead): increased sharing of information between local authorities and healthcare organisations to better coordinate and plan services for families with multiple risk factors, as part of the ‘Troubled Families’ programme.

North Tyneside/Northumbria/NEAS (North Tyneside CCG Lead): development of current ‘End of Life’ standards, processes and documentation; assessment of electronic solutions and trial across locality;

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sustain EoL network as regional body.

Two further projects are continuing to be scoped for North Cumbria and South Tyneside/Sunderland.A Patient Involvement work package description has been completed and is being further discussed with stakeholders from the University.

CHC-NENC is providing support to the North East ‘Strategic Information Governance Network’ (SIGN), which started in September. The SIGN provides a strategic regional forum for Information Governance, initially for health and social care, and is overseeing development of regional Information Sharing Agreements amongst other activities.

CHC-NENC has committed funding for the Information Sharing Gateway (ISG) to October 31st 2019 for the region (up to 100 organisations.) The licence is signed and hosted by Newcastle University, as the NENC lead organisation for CHC. Use of the ISG is mandatory for all CHC-NENC projects, and it has been approved for use across the other 3 CHC regions.

A tender for a report to scope options and recommend a solution for a common regional ‘interoperable’ architecture for the NENC closes 23/11. The contract is planned to be awarded in w/b 5 th December with the report complete 10th February 2017.

A work package to progress a common consent model for the NENC population is being defined.

Key deliverables next period: 3 ‘care pathway’ projects formalised in Collaboration Agreement, approval to start. Contract for ‘Interoperability’ work package awarded. Public Engagement work package description complete for contract award. Consent model work package description complete.

Update provided by Mark Walsh. Please direct any queries to mark.walsh@connectedhealthcities.org.

Urgent and Emergency Care Vanguard - Information Sharing Gateway (ISG) & Medical Interoperability Gateway (MIG)MIG & ISG Delivery Team MeetingA Delivery Team meeting, led by Maria Williams (alignment of regional MIG Delivery Teams) was held on 8 th

November.

MIG Comms Meeting A dedicated MIG communications meeting group has been brought together to discuss the MIG

communications plan. Weekly meetings (face to face & webex) have been set up and require representations (if possible) from

each delivery team involved. This is to ensure a consistent message is sent out with regards to the region-wide MIG delivery and to enable tailoring of communications to make the messages relevant to the differing positions in the delivery team areas.

MIG Comms Meeting was held on 15th November.

Delivery Teams Proposals have been received and agreed for regionwide tasks (Info Sharing Agreement & Technical

Scoping, Engagement and MIG Technical Roll-out); Roll-out of the DDT, Sunderland and South Tyneside areas. A joint proposal from NHCT & NTW has been received for the Newcastle Gateshead (NTW),

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Northumberland & North Tyneside (NHCT) areas. This is currently being revised in line with information discussed at the recent delivery meeting and this will be provided shortly.

CCG MIG DCR Licencing Costs (Healthcare Gateway)Some CCGs have already paid for a Detailed Care Record (MIG DCR). For the remaining CCG areas, Healthcare Gateway (HCG) outlined DCR costs (costs are based on population size) and contracts have been drawn up for those areas to proceed.

Technical Engagement with Receiving OrganisationsMaria Williams (NECS IT) has already carried out region wide technical scoping of the viewing organisation systems, compatibility, licence requirements, key contacts (receiving organisations & clinical provider organisations) and incorporating timeframes & scheduling into the project timeline.

Discussions have included:• Individual requirements of MIG viewing• SRV / integration options (linking in with NTW etc.)

Advice will be given on:• Clarification of costs & licencing arrangements of viewing options • Resource commitment requirements• Staff training requirements• Business change activities to embed use of MIG

Work will continue with both viewing organisations & Primary Care Enablement Delivery teams to draft high-level timeline for proposed activities to implement; Maria will co-ordinate viewing organisations technical kick-off.

Information Sharing Gateway The MIG provides a ‘window’ through which GP patient records and other information can be viewed by U&EC providers and other authorised NHS personnel. This process requires information governance compliance and formalised regional Data Sharing Agreements that are held electronically on the IS Gateway (signed Memorandum of Understanding & individual Data Flows).

Receiving organisations – All north east GP Practices, All north east Acute Trusts, All north east Mental Health Trusts, North East Ambulance service (NEAS), All north east Out of Hours Providers

Type of information viewed – Patient summary, Problems, Diagnoses, Medication (current, past and issues), Risks and warnings, allergies, Procedures, Investigations, Blood pressure measurements, Encounters, admissions & referrals, Patient demographics

Region wide DSA – Memorandum of Understanding (MOU)The new version of the Region wide DSA MOU, which the IG task and finish group (Liane Cotterill, Tracey Best and Lisa Wilson) have agreed upon, takes into account all the feedback received and their own IG views. The ISG Change Control Board decided that by conducting a wider consultation on the terms of the MOU would reduce the chances of others raising further suggestions. Once that exercise is complete, the ISG Change Control Board intends to review the MOU on a fixed schedule (12 monthly was suggested) to avoid inundating signatories with changes. This will delay the implementation of the change by a month or so but should mean a more sensible approach to handling these changes longer term. When the MOU receives final approval, it will be submitted to the regional LMC and local LMCs.

Liane Cotterill, NECS Senior Governance Manager, confirmed that the change to the MoU was not a key dependency on regional roll-out and that the ISG teams can roll-out regionally without changes to the MoU. The key dependencies are the data summary and data flows which specify the actual data sharing situations.

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If the MoU changes following the consultation this is fine and it will not prevent regional roll-out. It just means that the practices will have to re-sign at a later date (and taken to the LMCs) and so the existing MOU is being used in order to meet the MIG technical roll-out timeframe.

At the time of this report, the revised MoU has not yet been finalised and this is with the Change Control Board, Information Sharing Gateway, Morecambe Bay FT.

Letter to previously opted-out patientsThe final version of the opt out letter, per the discussions at the September MIG ISG Project Board (and subsequent email exchanges), was circulated to the group for information in October.

The discussion: If a patient chooses to opt out, then it may also mean that information about that patient will no longer available to other community services. The patient should be made aware of this so that they can make an informed decision re opt out. The group discussed how to word this in the letter while at the same time keeping the message simple. The letter also directs patients to the helpline, email & website if they have any concerns.

Feedback from Lisa Sewell, Northumbria Healthcare Trust, re patients contacting the helpline – they are mainly seeking assurance and a lot have now chosen to opt in.

ISG Super AdministratorsCurrently in place there is a designated ‘Super Administrator’ for each delivery area and they are in the process of receiving (or will have received already) training. Super Administrators have capacity to support users of the ISG with queries. More technical queries which require additional support are directed via the Super Administrator to the Central ISG Admin Team for action.

Update provided by Janine Howarth. Please direct any queries to janine.howorth@nhs.net.

The Better Health ProgrammeThe Better Health Programme (BHP) that has been in place for over a year, and is now aligning with the emergent Sustainability and Transformation Plan (STP) footprint within the Durham, Darlington, Teesside, Hambleton, Richmondshire and Whitby (DDTHRW) region.

The BHP/STP governance is now forming and roles, responsibilities and accountability frameworks are developing. The following illustration describes the latest governance structure.

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BHP/STP Governance StructureWithin the above framework, it can be see that a Digital Transformation Workstream (DTW) has been established as part of the formal governance arrangements, whilst the DTW is classified as a key enabler, this is increasingly becoming a strategic programme that will be expected to “enable” a range of transformational changes across the STP footprint.

The key areas of focus/transformation themes within the DTW include: In-hospital – increase digital maturity to enable digitally service delivery, within and across

providers. Out of Hospital (AKA Neighbourhoods and Communities) – identify and implement cost effective

digital solutions to shift the care paradigm to a new form of delivery (i.e. closer to home and more citizen self-serviced).

Back-Office review, resource and digital collaboration.

A DTW delivery group has been established and an inaugural meeting taken place, however this requires further refinement to confirm the membership, key areas of focus and designated leads for the specific delivery themes are in place and are appropriate.

Early conversations are taking place between the three acute provider organisations within the STP footprint regarding broader back-office collaboration in a number of key areas, including but not limited to Information and Technology Services.

From a PAN North East North Cumbria (NENC) STP perspective, there is an ambition to collaborate and strengthen the regional approach in the development of shared care record, and the concept of the Great North Care Records (GNCR), is fundamental and critical to achieving this ambition.

Furthermore, we are fully supportive of collaborative approaches to enhancing the “out of hospital” services via the opportunities and technologies available within the telehealth and telecare environment, especially those digital services in current use within the local health and care economy and delivering benefit that can be adopted and scaled-up to a broader STP delivery model.

The next BHP/STP DTW meeting is scheduled for week commencing 5th December 2016.

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Scan for Safety (S4S)The Scan4Safety Programme commenced on the 1st January 2016. NT&HFT is now nearing the end of Phase 2 (13th January 2017).

The programme is led by the Trust Head of Procurement - Jane Hawkes, the programme is technically supported by the Associate Director ICT Operations - Tony Naylor and championed by Deputy Medical Director and Orthopaedic Surgeon Mr Chris Tulloch, who is leading cross organisational collaboration with our neighbouring trusts.

The current project status is as follows:- Patient ID – 100% in-patients now have GS1 compliant wristbands & a trial of POC scanning has

commenced in day case theatres. Product Recall – New policy currently being drafted and technical development pathway in design. Catalogue Management – Catalogue solution contract awarded to Virtual Stock for the Edge. Cardea

(P2P) now able to hold GTIN’s and GLN’s. Over 50% of products purchased are currently catalogued. P2P – Policy in development and the technical development path has been agreed for current

systems. Currently reviewing new PEPPOL provider’s framework. Inventory Management – contract already in place with Genesis for a stock management system.

Sustainable structure for managing inventory in place for the whole Trust. Web requisition reductions commenced.

Location ID – GLN policy finalised but requires approval, Trust registry 90% populated. Commenced placing GS1 bar codes on walls on 2 sites.

Technical FocusS4S requires the capture of real time data across a multitude of systems and processes, underpinned by robust technical solutions. We require solutions that allow us to fulfil the requirements of the agreed milestones but without triggering excessive third party supplier costs; extension to timeline or major workflow interruptions.

Whilst the technical requirements were already anticipated to be a significant undertaking, the scale and scope of this increased dramatically once we began to work with core service representatives to map out the full patient journey from a complete scanning perspective.

Working directly with numerous suppliers, will inevitably extrapolate costs and time across the NHS and does not therefore represent a viable approach to fulfilling our goals.

NT&HFT have proposed an alternative solution [and with support from GS1] are the principal architects of a new Open Interoperability Standards Architecture designed to meet our joint requirements. The NT&HFT design has received backing from our demonstrator peers and is recognised by the NHS England Open Standards Team.

Following a successful workshop 17 November, NT&HFT are aiming to work with Open Source providers recommended by the NHS Code4Health Team to develop a proof of concept comprising the following five key component areas:• Reporting services• Scanning services• Data distillation • Scan validation • Scan trigger

Ultimately the aim is to work collaboratively to meet the requirements using open source products; whilst this may been seen as a bold departure from procuring direct solutions from suppliers, it presents a far better prospect in terms of delivering a standardised, scalable and future proof output that will benefit all who adopt it. These benefits are expected to extend far beyond the demonstrator sites into the NHS secondary and wider care settings.

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Update provided by Graham Evans. Please direct any queries to dr.gevans@nth.nhs.uk.

Planning and Decision SupportStandardised referral forms have been developed (where needed) as a means to standardise and improve referrals from primary care and secondary care. Recently this has been refreshed to ensure forms are compatible with the eReferral System (avoiding the duplication that occurred with prior to then). As a proof of concept for regional working, the 2 week wait forms have been designed (the content itself being designed by the Cancer network, form created electronically for EMIS; then converted them into a SystMOne version)

Developments are taking place with EMIS to develop a system of distributing these forms, and other resources such as clinical templates and protocols, to practices within Newcastle and Gateshead, which can be used to act as a central library across the region. This work can complement the decision support group work from South Tyneside (ie resources developed elsewhere can be added to the EMIS library and be immediately available to practices.) This can also be applied to SystmOne.

A standard set of resources are being developed to support End of Life Care planning building on the work from Derwentside and Gateshead.

There are papers that have been produced that provide further detail on the above. Dr Jonathan Harness and Dr Gareth Forbes are working to develop this work further. Contact Deborah.bowden1@nhs.net for further information.

Northern England Clinical Networks (NECN)End of Life (Adrienne Moffett)EPaCCS update:

Palliative & End of Life Care lead for EPACCS, Dr Kathryn Hall has brought together representatives from across the region forming a scoping/working group. Membership includes representatives of both clinical and IT specialist representing all localities across the Network region, NEAS and the Digital Care Programme.

The group will continue the work defined at the inaugural meeting: o Ways to ensure Palliative & EoL Read Codes are used consistently across the region.o Collaborative working with Digital Care Programme to establish current data set and it’s

suitability for use.o Collation of a proforma to establishing what data is being recorded within the region for

palliative & end of life care patients. Establishing a collaborative working relationship with Connected Health Cities to design and

implement a solution that meets the requirements of patients, carers and professionals.

The Northern Cancer Alliance (Adrienne Moffett)The newly formed Northern Cancer Alliance will be tasked with satisfying a number of recommendations in line with Achieving World Class Cancer Outcomes: A Strategy for England 2015-2020. There is a national ambition for all cancer patients to be able to access test results and communications online by enabling IT to share information with those along the care pathway and for all patients living with and beyond cancer to have a holistic needs assessment (HNA). The Alliance team is building on the experience of a Macmillan lead project connecting hospital based HNA with patient held iPad. The Alliance team is benchmarking the uptake of this service to enable promotion across the region.

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Pathology has achieved CEO and commissioner support for investment into Digital Imaging and the creation of an Academy of Pathologists that will in future review tissues through a consortium based approach. This will improve both the quality, productivity and sustainability of the service in the face of mounting workload and a diminishing Pathologist workforce. Funding streams are under investigation after an unsuccessful bid to the Cancer Capacity Fund.

In line with new NICE NG12 clinical guideline for suspected cancer the 2 week wait referral forms have been revised for regional adoption and integration into the regional GP systems.

The integration of the forms in the GP clinical systems will: Improve the quality of the clinical information provided on the referral Reduce chance of delay for patients by : prompting clinicians to do blood tests if required and, pulling

through relevant required information on to the referral so secondary care can direct patients straight to test where appropriate

Provide a clear audit trail without additional work to scan completed paper referrals Reduce risk of a referral being rejected because it is not on the correct form

It is hoped this will be the forerunner for other integrated forms across the region.

Deciding Right App – this app has been designed to facilitate appropriate decision making in line with the Mental Capacity Act. Discussions are ongoing to for the incorporation of the planned national ReSPECT form.

In our recent research bid to CRUK, which is looking at GP direct access to tests for suspected cancer, we proposed including digital applications in the qualitative part of the study, to see what could improve communications between primary and secondary care. The following examples may be relevant: E-referral software to enable GPs to electronically refer and receive data, such as the STRATA e-referral

package in Cumbria, and ICE, which is more commonly used across the north east Telemedicine, telehealth and telecare Electronic patient record management systems, particularly elements that are (or could be)

interoperable between acute and primary care services Shared access to high definition images in MDTs, through a dedicated video link, for example, as used for

breast cancer services between Newcastle and Cumbria Decision support tools integrated with GP clinical systems such as Map of Medicine and the DCS decision

support tool in SystmOne.

GP surgeries have digital applications to help in patient consultations – typically in suspected cancer consultations GPs are able to access decision support tools (or risk assessment tools such as QCancer) to assist them in evaluating symptoms, usually in EMISweb and SystmOne, before they decide whether to refer a patient for urgent diagnostic tests. Use of these tools varies, but primary care increasingly uses the ICE system for electronic referrals to radiology and pathology, and for receiving alerts about test results and reports. Some of these applications can also prompt for tests such as BP, bloods etc. at regular intervals, so can assist in stratification and surveillance of higher risk patients. Contact Julie Owens for more information.

Dementia (David Newman)Information sharing at point of careCoding issues have been identified around information passed back to GPs after diagnosis - NECN developed a paper version however a barrier to uptake was the existing systems already in place.Recent work with memory services revealed that there are standard letters which include ICD10 codes. However, Read codes were not known about or being communicated as suggested by NHS England best practice document https://www.england.nhs.uk/wp-content/uploads/2014/12/memory-clinics-final.pdfPopulation data

Information that is likely to become important but is currently not well understood and published are:

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National comparable annual dementia review data for GPs (already collected) National comparable access and waiting times data for memory services National digital workstreams Work is being done on addressing the national data needs described above and increasing accuracy

on diagnosis rates.

Public and Patient Involvement (Michelle Wren)The Cumbria and the North East Transforming Participation Partnership collectively provides leadership in implementing ‘Transforming Participation in Health and Care’ (Sept 2013), including individual participation, public participation and insight and feedback. Due to the project funding ending and participants being keen to keep the forum running the Nursing and Quality Directorate Team, NHS England North (Cumbria and North East) are developing a share point site to enable greater networking and sharing. The aim of the collaborative workspace is to bring together a range of perspectives from across the system to provide collaborative leadership for transforming participation and thereby improve health outcomes for local citizens.

Maternity (Vicci McGurk)The recently published National Maternity Review, Better Births (2016), has a number of digital aspirations summarised specifically as:

To support sharing of data and information between professionals and organisations, use of an electronic maternity record should be rolled out nationally. Providers should ensure the woman shares and can input the information that is important to her.

The Maternity Network is linked in with the national team. A region-wide indicator dashboard is a Maternity Network business plan deliverable and a national team is developing agreement over common indicators at the moment. There is also a notable surge in the use of apps by women and health professionals which is recognised in the Better Births document.

There is interest in mapping current systems, skills and capacity in local services, and to consider the information sharing requirements (both point of care and population) for locality footprints.The PHE Mental Health Intelligence Network has published a data catalogue and data profiles, and NHS Digital have a published Maternity Services Dataset.

Fetal Ultrasound Telemedicine ServiceThe complexity of fetal medicine referrals that can be managed in a district general hospital (DGH) is dependent on the availability of specialist ultrasound expertise. Telemedicine can effectively transfer real-time ultrasound images via video-conferencing and provide specialist fetal medicine consultations to women in their local unit.

The fetal ultrasound telemedicine project was funded by Academic Health Science Network (North east and North Cumbria) and undertaken by team of clinicians and researchers from The Newcastle Hospitals NHS Foundation Trust, North Cumbria University Hospitals, University of Cumbria and Newcastle University. It was demonstrated that high quality ultrasound images could be successfully transferred and that women and staff value the service.

A weekly telemedicine clinic has been established as part of standard care provision, linking the Fetal Medicine Unit in Newcastle with West Cumberland Hospital. The service provides ultrasound examinations, diagnosis and multidisciplinary consultations to women and their families and has resulted in reduced travel times and family costs. In addition, the telemedicine link has facilitated advanced training of qualified sonographers and support for clinicians based in the DGH.

NESCN Maternity DashboardFollowing discussions through the Maternity Clinical Advisory group, the NE Maternity Network have recently introduced a maternity dashboard, which incorporates 19 collectively agreed maternity indicators

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and definitions. The indicators include birth outcomes, intervention rates, stillbirth rates and public health outcomes. It is anticipated that the number of indicators may increase as the dashboard evolves to meet the needs of providers.

The dashboard is designed to highlight variation in maternity outcomes across the Northern England Maternity network and facilitate discussions between providers. This will result in sharing of information to explore differences, highlight best practice and innovative approaches and further build on the collaborative approach within the Maternity Network to the provision of high quality maternity services.

Mental Health (Jo Phillipson)To assist Mental Health Trusts’ knowledge sharing, a paper has been compiled to provide a broad overview of the existing and planned linkages between Mental Health Trusts and their associated primary, secondary and social care partners. This paper also takes into account other ongoing work in relation to Vanguards, AHSN and sub-regional initiatives. It also highlights other National best-practice information sharing models. The paper is in final draft form and for those interested in viewing the final version contact should be made via j.phillipson@nhs.net.

Communications (Jenny Hicken)The Clinical Networks will be launching a newly redeveloped website in early 2017, which will enable us to highlight our projects in a more engaging way, and will be more user friendly for stakeholders to access information. We will be compiling regular case studies to showcase our project work using written and video content, and have completely redesigned the look of the site to modernise the feel and functionality of it.In line with the launch of the new website, NECN will be implementing a full comms and engagement strategy to encompass increased social media activity, primarily Twitter, and regular external communications with all parties interested in the work of the Networks. The new website will become the ‘hub’ of NECN activity and will develop into a comprehensive resource for our clinicians and other stakeholders.

Learning Disability Network (Julie Tucker)Cancer/learning disability project digital themes:

Bowel cancer screening flagging project flags people with a learning disability on a the Bowel Cancer Screening Programmes computer system and uses the flag to offer reasonable adjustments

Development of the cervical screening sample takers digital resource pack, currently being developed

Use of RAIDR to look at screening uptake data, currently awaiting permissions.

Update provided by Louise Wilson. Please direct any queries to lou.wilson@nhs.net.

Analytics (also see Connected Health Cities update)

RAIDRBuilding further on the intelligence available via RAIDR, expanding from current access by all CCGs and GP practices, to include other organisation e.g. Foundation Trusts. RAIDR is used across the NE&C – within CCGs and GP practices. It’s also in use in CCGs and practices elsewhere in the country, in the North West, Yorkshire, Humberside, and Suffolk. RAIDR provides powerful and intuitive business intelligence to these users, and is being expanded to provide a BI offer to other organisations. It is hoped that the NE&C will remain RAIDR’s core customer base with Trusts, Local Authorities and other organisations using the system. This will help realise the vision of a single version of the truth across health economies with associated efficiencies, and providing insight for benchmarking, decision making, service improvement, and cost-effectiveness.

Key work streams associated with this programme have been identified and they are:

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The Development of the specification for a provider tool that allows the performance management and benchmarking for FTs. With the ability to compare against wider Trusts across the country (using HES data feed) building on existing performance management tools functionality and access.

Caseload enhancement tool - enabling community teams on the ground to access a wider data set around patients based on primary care data which would include risk strat and potential data linkage mapping functionality

Commissioner development- Inclusion of community data into Patient Activity dashboard initial work would be inclusion in swim lane patient search, basic tabs around community teams for analysis by commissioner

Priorities: Begin the development of the FT performance and benchmarking tool based on the specification

developed in partnership with a local FT. Identify additional FT stakeholders from the region to help with the development of the programme of

work. Start initial scoping of a social care tool and identify key LA stakeholders to include in programme work

stream.

Update provided by Richard Mcleod. Please direct any queries to rm@nhs.net.

Technology Enabled Care Services (TECS)The Academic Health Science Network (AHSN) has produced a proposal for the development of a TECS steering group and approach to strengthen this area of the regional plan for the region. The aim is to have a collaborative approach to deliver an inclusive TECS program by 2020, which supports patients to live longer, healthier lives at home or in a home environment. A paper has been shared with the Digital Care Programme Board that: Proposes the establishment of a steering group and delivery team for Technology Enabled Care

across the three STPs Describes the efforts of The Academic Health Science Network for the North East and North Cumbria

(AHSN NENC) and partners including NECS and the Clinical Networks to support strategic and operational work on TECS across the region

Begins to describe how we might create a delivery plan for TECS across the region to collectively support organisations in delivering their Local Digital Roadmaps, Sustainability and Transformation Plans and other transformation programmes.

For further information please contact Jackie Smart, Programme Lead, Digital Care, AHSN NENC jackie.smart1@nhs.net

CoIN Implementation Have asked HSCN and current network supplier for clarity in three areas

o Is our existing network offer, HSCN complianto Does our existing offer still demonstrate good value for money o Will there be any additional cost to migrating to HSCN further down the line

It was indicated that we will have answers by the end of Dec Continued conversation with NHSD and HSCN on the opportunity of becoming an early adopter but

this national timeline is now slipping and could be as far away as next September Several FTs in the area are now considering their position wrt the HSCN initiative and what it means

for them and have requested a local HSCN workshop to explore the detail - amber

VOIP TelephonyExploiting VOIP Telephony to reduce cost across organisational boundaries

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Working with NHSPS to identify opportunities to include more sites onto the main telephony network

Still awaiting news of business case to NHSE for Telephony upgrade – amber

Wi-Fi Deployment Waiting for outcome of bids to continue with Wi-Fi deployment. These may be delayed as there has

been mention of a national initiative to implement Wi-Fi in all health and social care sites (with separate funding) but with strict guidelines around security and protocols. - amber

Virtual Desktop Infrastructure (VDI) The ETTF bids for VDI implementation have been assigned to cohort two and we are waiting for the

next steps to be announced. TPP SystmOne working in a warranted virtual environment and NECS has partnered with VMware

and EMIS to develop the warranted environment for EMIS Web.. Presentation to the CIO group on the advantages of VDI and NECS involvement with TPP and EMIS

was well received and generated further discussion - green

Update provided by Brian Lonsdale. Please direct any queries to brian.lonsdale@nhs.net.

Primary CareEnabling Patient Access throughout the North EastHigh level benefits:

Improved efficiency in GP practices; increased quality and integrity of patient records; reduction in waste in prescribing budget as patients will select only the medication;

Improved efficiency as patient records will no longer be printed as online access can be granted.

Patient Access : Appointment Statistics

Supplier No. of Practices

No. practices >10%

% of Practices with 10% Enabled

EMIS 202 112 55%TPP 174 117 67%INPS 6 2 33%TOTAL 382 231 60%

Patient Access : Repeat Prescribing

Supplier No. of Practices

No. practices >10%

% of Practices with 10% Enabled

EMIS 202 113 56%TPP 174 117 67%INPS 6 2 33%

TOTAL 382 232 61%

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NB: work has been ongoing with those sites that are not utilising these solutions fully to drive up utilisation further.

Summary Care Record (SCR) in Pharmacies Currently in delivery to end of March 2017. High level benefits: Improved patient safety with core clinical information at point of care; improved

efficiency and effectiveness in pharmacies reducing need to contact GP’s; average SCR viewings 3 per week with an average saving of 20 minutes per view reducing the need to contact the GP practice

Local Pharmacy Committee Area No of Pharmacies Confirmed Live @ 17/11/16Cumbria LPC 72 80%Darlington LPC 10 40%Durham LPC 79 65%Gateshead LPC 23 61%Tees LPC 65 76%Newcastle LPC 36 76%North Tyneside LPC 25 70%Northumberland LPC 31 65%South Tyneside LPC 27 75%Sunderland LPC 42 76%

GP Connect Current est delivery date 2017/18: keeping a watching brief.

SnoMed CT in Primary Care Migration of practices from READ to SnoMed CT in line with National timeframe. Current est delivery

date 2017/18: a discrete team has been formed to work closely with NHS Digital SnoMed delivery team, to map out potential issues and scope for this project

High level benefit - Standardisation of messages and solution to improve interoperability

Open Source APIs in Primary Care/Code4healthKeeping a watching brief.

Update provided by Jacqueline Fawcett. Please direct any queries to jacqueline@nhs.net.

System Suppliers UpdatesTPP SystmOne UpdateTPP and EMIS Direct Integration:

TPP have recently been informed that EMIS will pilot the HTML views in December. November– the pilot for the national GP Connect programme. The First of Type sites have been

selected in Cornwall. UPDATE – the First of Type pilot has now been moved to December. Early next year – the pilot for bi-direction appointment booking and cross system tasks as part of

GPConnect as well as the direct integration with EMIS. Structured data items to be nationally worked upon in the new year. The GP Connect team at NHS

Digital are looking to send across the draft specifications for structured items by December 2016. UPDATE – the specification for the API to send these structured messages will be available for February 2017.

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TPP SystmOne have shared an update on the organisations they are working with to increase integration:

Out of HoursAdastra – have previously engaged with them and plan to have further discussions. They have received the organisations specifications as part of a piece of work with the West Yorkshire Urgent Care Vanguard. Update – awaiting timescales from Advanced to be able to write to the national specs. UPDATE – previously should have been highlighted that SystmOne currently integrate with Advanced to receive ITK CDA for 111, and also integrate to allow Advanced services to book directly from their call centre module into SystmOne's OOH PCC module.

Acute:Ascribe - eCamis and Symphony – awaiting further engagement from EMIS health to confirm when these solutions will be ready to integrate.

Orion – Awaiting confirmation from Orion to the reciprocity agreement as part of GP Connect and our direct integration arrangement. TPP are happy to be a provider of data as long as consuming systems provide reciprocal information.

Medway – planning to engage with the provider. Update – engaged with the supplier, however they weren’t overly receptive as their main coverage is in Gateshead where there is limited SystmOne coverage.

Cerner – SystmOne sites can currently see information recorded in Cerner’s HIE. Cerner have provided March/April as an indicative timeframe for the capability of the HIE to receive information directly from SystmOne rather than this information being populated by the MIG. UPDATE – Cerner will have access to SystmOne's test environments by the end of November which will enable them to complete development to view SystmOne information directly in their HIE. The HIE is currently populated using the MIG, which won't be required once Cerner have finished this development.

Meditech – An Account Manager contact would be helpful for this supplier – please can someone email me across a contact?

Intersystems – An Account Manager contact would be helpful for this supplier – please can someone email me across a contact?

Mental HealthServelec – they’re part of GPConnect and the national interoperability work. Would be happy to discuss local requirements. They received the GPConnect specifications (minus the SSP component) and will be a fast follower following the pilot with EMIS. Update – awaiting timescales from Servelec for the delivery of the FHIR HTML views.

Paris – An Account Manager contact would be helpful for this supplier – please can someone email me across a contact?

Ambulance TrustCleric – previously hadn’t included this integration in the last update. Cleric are able to book 111 appointments directly into SystmOne OOH PCC.

If provider organisations have key contacts that can be shared with thomas.gausden@tpp-uk.com he will discuss developments further with system suppliers.

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