Michael Curtis, DCH Transformation Programme Lead, NHS England Phil Graham, Digital Programme Lead, Lancashirs and South Cumbria STP

Digital Child Health Programme iLinks

Liverpool – 5 July 2017

•  Provide a brief on the DCH Programme. •  To share lessons learned from the 16/17 discovery work and

implications for future commissioning of s7a CHIS •  To discuss next steps and plans for early adopter sites •  Provide update on DCH transformation programme work to date

and plans for implementation outlining the outputs from NHS Digital •  Provide an approach to a local implementation (LEMS)

Objectives

Digital Child Health

3

2017 PCHR still on paper

No capability to manage children unregistered to GP practices

Healthcare professionals don’t have access to relevant health information

Services still very paper driven and manually intensive

Child Health Information Services Unchanged For 20 Years

Longitudinal child health record fragmenting (public health risk)

Population inaccuracies and tracking of children has worsened since NIT report

Interoperability layer for digital PCHRS (market enablement)

Standards for exchanging Healthy Child Programme information

Interoperability starts to replace paper processes

Core child record dataset available in professional systems

National Failsafe Management identifies when children are outside the care of the usual agencies and when they are missing preventative programmes of care

2018

2019+

Digital Child Health–Service Transformation The Vision

“As a parent and carer I am informed and can

make choices that best meet my child’s health

and care needs.”

I have access to information that enables me to make the best health and care choices for my child

•  Online record of their child’s health and development.

•  Can share my own health and

wellbeing information with professionals.

•  Can set their own preferences for information sharing and can see who subscribes to their information.

•  Can access online peer support networks or health promotion support more easily

“As a HCP I can provide the best care options to

children and young people as information is real time and available at

the point of care ”

I have access to real time information at the point of care that helps me to provide a better care experience for children and their families •  Core view of child health

information at the point of care.

•  Record information about a child/young person and publish automatically to those in the extended network of care.

•  Up to date health events will be available in their own health record systems, they will not need to access other systems.

•  Failsafe management service will alert preventative programmes of care when an intervention is due or has been missed.

“As a commissioner I can access he right information to understand the health and care needs of children and young people”

I know that children under my care have received the appropriate health interventions to keep them healthy

•  Failsafe management services will give assurance for safeguarding children.

•  Commissioners can

analyse data and intelligence to make service improvements and modifications

“As a provider I have access to IT systems of Choice that meet national data and technical standards”

I can provide an information service that underpins the needs of health and care services

•  Can offer digital services to parents, children and young people which allow them to take ownership of their own care

•  Have a choice of IT

systems that will enable information exchange across extended network of care.

Its proposed the DCH transformation programme operating model is redesigned to create a commissioning and provider function to drive system change and realign its approach with NHS England changing operating model.

DCH Programme Operating Model

DCH Transformation Team

Medical Directorate s7a Commissioner

NHS Digital (Digital design and implementation)

Developing new concepts to support a changing landscape and business needs. This function is commissioning-led providing the thought leadership to the DCH Transformation team and NHS Digital. This will test initiatives and support transition into business implementation. Collaborating with partners (PHE,LAs)

Contracting Operating model that sets the commissioning specification, accountabilities, finance and levers to embed standards into service delivery and hold providers to account.

Implementation support team that supports transformation initiatives across NHS England to setup drive change at pace and scale. This will also be support by NHS Digital but will need to be integrated with NHS England organisational operating model.

Designing the Future (discovery / concepts

Domain F

GPFV

Other

Domain E

Domain G

Tranf initiaties

Domain A

Domain C

National Programmes of Work (NIB)

co-create joint work plan Digital Child Health Programme

Driving Business Change through STPs /ACSs

Operations and Information (Business change)

National implementation team commissioned to support new digital requirements.

Business Sponsor, CHIS strategic commissioner and delivering commitments on s7a

Implementation team to support change management across a changing landscape.

There are three phases to the Transformation strategy which outlined below which are required to achieve end to end service transformation for the DCH Programme Phase1: Planning (17/18) Phase 2 : Implementation (18/19) Phase 3 : Evaluation (19/20 dependant on funding)

DCH Transformation Programme Overview

7

National Events Management

Service - (NEMS) Local events management

service (LEMS)

Technical adoption

Business intelligence

Purchasing Frameworks IT Systems

of choice

Service spec

Market Development

Commercial arrangements

Business Intelligence

Datasets Interface

Commissioning and Operating

Model Core service &

contracts

Data Sharing

e-Consent model

Configure national infrastructure to meet technical and data standards enabling local commissioning insight Develop a vibrant,

competitive marketplace with choice of suppliers

Develop commissioning model that promotes proactive health and care commissioning

Collaborate with local service models to make Information accessible at the point of care

e-Personal Child Health

Record proposals

Standards

Develop digital tools to provide choice for parents on access to record and support services

Develop a trusted consent model for patients and professionals

Accreditation

Levers & Incentives

Develop a commercial model to support procurement of local IT systems of choice

Architectural Blueprint

Standards National

Service Design

Interop. National Failsafe

Management Service Eval.

Benefits

Redesign Fail-safe management

services

Test / Discovery

Preventative programmes to monitor the uptake of the Child Health Development Programme Service

Blueprint

Achieving transformation

Programme Scope M

ater

nity

D

atas

et

National Failsafe Management

Service Events Catalogue &

Design Authority

Hub Registration Authority

Domain A

Citizen Identity

Proxy Management

Domain D National Events Management

Service

Core child health data set Connection via national messaging

standards

Phase 2: Maternity Domain H

0d 5d 8d 11d 7w 9w 12m 13m 24m 40m 4y 5y

NIP

E

Blo

odsp

ot

Hea

ring

New

Bab

y R

evie

w

6-8

Wee

k Ex

am

8/12

/16

wk

Imm

s

12 m

th R

evie

w

12/1

3 m

th Im

ms

2/2.

5 yr

Inte

g R

evie

w

3yr 4

mth

Imm

s

4-5y

r eye

sigh

t ch

eck

Scho

ol E

ntry

Chk

Year

6 C

heck

Year

8 H

PV

Boo

ster

Im

ms

Public Health England

Per

sona

l Hea

lth

Pro

fess

iona

l Hea

lth

Pub

lic

Hea

lth

Commissioners Directors of Public Health & Children’s

Services

Delivery of Healthy Child Programme (All Children)

Delivery of all other care services (Some Children)

CHIS / CHRD

CHIS / CHRD

CHIS / CHRD

CHIS / CHRD

CHIS / CHRD

CHIS / CHRD

School Nursing Primary Care Health Visiting Midwifery

Education Services Voluntary Services Mental Health Services

Emergency & Acute Services

Justice Services Social Services Community Services Neonatal Services

Maternity Information Systems

Screening Information Systems

Primary Care Systems

GPES CYP Dataset CAMHs Dataset

PCHR

90 CHRDs

Research & Policy

Maternity Dataset

SCR

National Audit

Interoperability Approach

Events Each message will have one or more uses

Efficiency (savings in time and resource)

Personal

Professional

Public Health

The parents or young person

needs to see it/act on it

Care Professionals need to see it/

act on it

It is an event actively tracked by Public Health

& Commissioners

Events Messages

Electronic data sharing in real time Reduced reliance on paper

Data only ever entered once and then messaged to where it is needed, one message per event, not different

messages for different audiences

Maternity & CYP Data Sets

DCH Transformation overview

Lancashire Project (STP)

STP

STP

STP

STP

17/18 DCH Transformation Team focus working within each STP identified for early transformation

18/19 Update ‘Service’ element of CHIS Service specification based on learnings from 17/18 STPs

1.Lancashire takes lessons learnt from London (Phase 1) and applies to phase 2

2. New Technical standard developed and embedded in 17/18 CHIS service spec

3. STPs identified (5-8) to collaborate to support wider development of LEMs and early service configuration

4. STPs redesign local CHIS supported by DCH Transformation team

5.DCH team co-ordinate engagement across Health and care system within each STP supported by local commissioners and connect with other key programmes to support adoption e.g. Interoperability , Digital Maturity,NEMS,LEMS

Standards

ePCHR Failsafe

Core dataset available

•  Contact us England.healthychildren@nhs.net

How do we keep in touch

@jo_gander

https://www.england.nhs.uk/digitaltechnology/info-revolution/digital-primary-care/child-health/

#healthychildren