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The NIMM – Local benefits and experience
Am I providing a good service?
Is it a cost effective service?If you don’t have measures in place how will you know?
All NHS Trusts are subjected to measurement and comparison, whether by SHA or Monitor
Information on Trusts’ performance is made public
Most clinical services are measured and accredited already
All start with fairly simplistic measures and develop
Why should IT/HIS services be any different, since IT enabled developments like PACS underpin clinical services 24/7
Provider of a shared service, but could not provide evidence of best practice performance or cost effectiveness
Undertaken unofficial benchmarking with other local HISs
Some pockets of good practice – Health Records and Clinical coding accreditation
What have the Roman’s done for us? How Much!&*!! If you don’t improve we will take our business
elsewhere Need to take the heat out of the system The question of a Value for Money HIS was fast
becoming an unanswerable taboo
If we can’t prove we are any good, or cost effective, at least provide transparency
Provided customers with a break down of individual service costs and their share of that service
Started by using simplistic metrics, such as:◦ The number of PCs◦ The number of end users
Proposed share of HIS funding for Financial Year 2009/10
Budget Centre NameSource of evidence for the share of
serviceBudget centre code Budget Value
HIS valuation of work carried out for each Organisation
South Devon Healthcare FT Torbay Care Trust Devon PCT Devon Partnership Trust
% Value % Value % Value % Value
HIS Baseline Costs 2009/10
Clinical Records Health Records Tab 16400 £768,378 94% £719,048.13 2% £13,984.48 5% £35,268.55 0% £0.00
Clinical Records Management Health Records Tab 58100 £224,899 94% £210,460.48 2% £4,093.16 5% £10,322.86 0% £0.00
HIS Graphics Not Shared 74630 £39,373 0% £0.00 0% £0.00 100% £39,373.00 0% £0.00
Informatics Support Core Admin systems users 75320 £227,120 81% £183,285.84 11% £25,664.56 7% £16,352.64 1% £1,589.84
Web Support Not Shared 74609 £24,429 100% £24,429.00 0% £0.00 0% £0.00 0% £0.00
Clinical Coding Health Records Tab 19300 £204,209 94% £191,098.78 2% £3,716.60 5% £9,373.19 0% £0.00
Information Information Team Tab 19000 £318,511 83% £263,090.09 9% £28,347.48 7% £23,251.30 1% £4,140.64
General IT Contracts Actual IT Invoices 75319 £1,017,366 58% £593,938.27 13% £136,428.78 23% £234,299.39 5% £52,699.56
IT Operations Non Pay IT Operations Summary Tab 74601 £80,61570% £56,430.50 16% £12,898.40 11% £8,867.65 3% £2,418.45
IT Operations Projects IT Operations Summary Tab 75113 £41,38073% £30,207.40 12% £4,965.60 10% £4,138.00 5% £2,069.00
Desktop Operations Team IT Operations Summary Tab 75110 £593,78864% £380,024.32 19% £112,819.72 13% £77,192.44 4% £23,751.52
Servers Team IT Operations Summary Tab 75111 £429,23379% £339,094.07 15% £64,384.95 5% £21,461.65 1% £4,292.33
Networks Team IT Operations Summary Tab 75112 £202,84770% £141,992.90 11% £22,313.17 18% £36,512.46 1% £2,028.47
HIS Corporate team & Services Core Admin systems users 74603 £379,387 81% £306,165.31 11% £42,870.73 7% £27,315.86 1% £2,655.71
HIS Projects & Training Core Admin systems users 75340 £279,77581% £225,778.43 11% £31,614.58 7% £20,143.80 1% £1,958.43
Actual HIS Budget figures as of July 2008 £4,831,310 75.9% £3,665,044 10.4% £504,102 11.7% £563,873 2.0% £97,604
Add Pay Inflation & A4C Banding Adjustments ESR System
£226,382 80.4% £182,011 9.8% £22,118 8.6% £19,559 1.2% £2,694
HIS Baseline for 2009/10 Pre LDP £5,057,692 76.1% £3,847,055 10.4% £526,220 11.5% £583,432 2.0% £100,298
Acute 3% CRES See CRES 2009/10 Tab
£144,365 100.0% £144,365.00 0.0% £0 0.0% £0 0.0% £0
Add Pay Inflation & A4C Banding Adjustments ESR System
£226,382 80.4% £182,011 9.8% £22,118 8.6% £19,559 1.2% £2,694
Add Trust applied overheads at an agreed 20% South Devon Healthcare Ledger
£966,262 20.0% £733,009 20.0% £100,820 20.0% £112,775 20.0% £19,521
New Baseline for 2009/10 - Post LDP £6,105,971 75.6% £4,617,709 10.6% £649,158 11.7% £715,766 2.0% £122,513
Microsoft Office Excel Worksheet
◦ Health and Social Care Information Centre◦ Monitor ◦ Healthcare Commission◦ ATOS ◦ National Computing Centre◦ SOCITIM◦ Gartner◦ NIMM◦ FIMM◦ Microsoft
◦ ASSIST / UK CHIP◦ BCS (HIF)◦ UKAS◦ National Computing Centre◦ SOCITIM◦ NHS HIS - Clinical coding & Health records
model already exists
Can we agree on one standard tool It should enable meaningful comparison
with Industry wide tools, not just the NHS Can we start simply and develop
incrementally Don’t mandate it until the pilot sites are
happy it is fit for purpose Can the newly created Benchmarking club
be the forum for developing the tool
PC Operating system & patch management PC Operating system platform
standardisation Single Sign On Software Asset Management On the above we scored 3 to 4, depending
on the customer
Organisations receive assurance of good performance, best practice and VfM
HIS/IT providers can address areas in need of improvement and have sources of evidence to help
We, the internal IT providers, can demonstrate our ability to provide world class IT services, as good as any other sector (the grass is not always greener on the private sector side, but can we prove it?)
We have evidence to demonstrate our service is fit for purpose
Benchmarking and accreditation will support local cases for IT investment
Integration of health and social care is where the big patient benefits will come
CfH/Spine are looking to develop the interoperability of software
We should look to enable the NHS to get best value out of the vast NHS infrastructure and enable all NHS employees to work flexibly
Accreditation of Infrastructure to common standards should provide organisations with assurance that it can provide open access to all NHS employees who happen to be working on their site
Any Questions?
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