Health and Social Care Integration

ASSIST

Wrightington

08/10/09

Qu

alit

y, In

no

vati

on

, Pro

du

ctiv

ity

and

Pre

ven

tio

n.

Health Care Drivers and Informatics Responses

Healthier Horizons

Record Systems

High quality Care for All

Quality

TransformingCommunity

Services

WCC Community Provider

Community

Provider Social Care

Mental Health Trusts

FTs

FTs

NHS Ts

ISPs

3rd Sector

Independent Provider

FTs ICOs

ICOs

OrganisationalChanges

The Economic Downturn

World ClassCommissioning

Information, Clinical Leadership, Partnerships, Health, Populations, Personalised, Quality, Cost effective, Safety, Publish, Feedback, Excellence awards, Knowledge, Care Quality, Commission, Observatory, Innovate, Integrate,Interoperate, Community Services, People

Leadership, partners, intelligence, public Engagement, clinical engagement, knowledge Management, Needs assessments, investment, Markets, data flows, continuous improvement, Quality, procurement, contracts, management of systems, transitions and interoperation

Advancing quality, CQUINS, patient reported outcome measures, clinical audit, NICE, NHS evidence, Care Quality Commission, Assurance, Patient Safety

Modern, responsive, seamless, mobile, strengthen commissioning role, clear data flows, IT infrastructure and assets, business-like, leadership, capability and capacity, confidence and competence, business continuity, assuring the process

Flexibility, innovation, enterprise, social care Foundation Trust status, Local Government, Private Sector, Independent, Voluntary Sector Integrated Care, Pathways, Interoperability, CATS, ISTCs, Diagnostics, Contracts, Public,Person centred

Save to Invest, Zero Growth from 11/12, Start Now, Innovation, Quality, Productivity, Prevention, Cost efficiencies, shared services Economies of Scale, Linking finance, HR and Activity Data, Incentives, Effectiveness, NewProcesses, Infrastructure, Waste, Green

Case for change, 10 compelling reasons, Scenario planning, new relationship between public and NHS, Clinical Pathway Groups, 7 Strategic enablers, collaboration, raising game Leadership, listening understanding, Innovate,Partner, manage systems, 10 TouchstonesI will…., Equality and Diversity

Working With Partners

A New Relationship

Innovation

Data to Intelligence

Supporting Concepts

Regional Care Record

PACS

Interim Solutions

Community

Hospitals

UnScheduled Care

Primary Care

National Programme

Mental Health

Shared records

Health Care Health Informatics Themes and Topics

Leadership

Requirements & Content

Interoperability

Workforce

InfrastructureService Management

Information Governance

KnowledgeManagement

The National Perspective

Global Review

£

Working with Partners

Partners

• PATIENTS/SERVICE USERS• SHA• Commissioner• Providers• Social Care• Wider local government - NWEGG• Private Sector• Third Sector

Informatics Objectives for Working with Partners

• Develop membership and contacts with Association of Directors of Adult Social Services and North West Electronic Government Group

• PCTs/LHCs to either confirm that they have appropriate connection between networks at a local level or have enabled/sponsored Councils to achieve N3 connection or to have firm plans in place to complete that by March 2011.

• PCTs/LHCs to have a plan for interoperability with partners which may be through National and Regional Care Records (CFH) solutions or more specific local initiatives

• PCTs/LHCs to assist their local government partners with the introduction of the NHS Number and to be actively achieving that or have a firm managed plan.

• PCTs/LHCs have a programme of process changes which aims to release the type of benefits described in some LHCs, Wigan for example claim benefits in the area of bed management, Hospital Discharge, Managing Long Term Conditions in the community, Unscheduled Care/ Intermediate Care and Hospital at Home Initiatives, Multidisciplinary working and Safeguarding

• PCTs understand and can work with partners on their responsibilities under Contact Point for Children

• PCTs to have a partnership plan in place to explore opportunities to share resources with Local Authorities (wider public sector) in the pursuit of efficiencies

• To find out if there is an appropriate forum/mechanism to discuss working with private and third sector organisations

Architectures

Lorenzo Release Progression

H

O

C I

G

R

B

LMX

WF

DA

KP

E

T

SNUVJ

Q

H

O

C I

G

R

B

LMX

WF

DA

KP

E

T

SNUVJ

Q

Not known

Paris

Northgate Swift

RAISE

Lancs in house ISIS

OLM Carefirst

Core Logic Frameworki

SAP Social Care

Social Care Systems Across NW

Microsoft Excel Worksheet

Target Solution Model – Lorenzo Everywhere

Different goals – different models

Social and Health Care Integration

NHSLed

Social Care/ LA LedMethod

“Dominance” MIM/ Spine

Local Other e.g. Click Through

NHS A E I

Social Care B F J

Neutral C G K

None D H L

Health Care SystemLorenzo or TPP or Existing

Spine

Health Care SystemLorenzo or TPP or Existing

Spine

Shared Record/Communication Application

Care Trus

t

Potential Roadmaps(Need a similar view for TPP &Lorenzo)

November 2008

NHS - PAS

NHS - EPR

NHS – Lorenzo R1

NHS – Lorenzo R1.9

NHS – Lorenzo R2

NHS – Lorenzo R3

NHS – Lorenzo R4

Social Care?

Neutral System

NHS – Spine TMS

Social Care

Cont

ent/

proc

ess

dev

elop

men

t

Integration Engine

May 2009

November 2009

April 2010

September 2010

NHS – Spine TMS (PDS)

Click Through/context passing (URL) SHA

Portal

An Example Road Map• Regardless of technical solution

– Infrastructure and networks (N3)– PDS enable and connect social care system– Agree joint governance for project, developments and service– Agree overall joint business strategy– Establish Information Governance framework– Agree shared business content and processes– Set Data Quality standards then deliver to them

• Technical solution Road Map– Introduce a shared Integration layer which links health and social care systems– Migrate users to integration layer– Local deployments of LRC R1, R2 – introduce assessments (and produce

outputs)– At LRC3 – develop a joint workflow – Introduce a “click through” process between Lorenzo and Social Care system– Migrate from local integration layer to Spine services

Enablers• Infrastructure and networks (N3)• Business analysis• Content• Integration• Data Quality• Information Governance• Project, Development and Service Governance• Integration at interim stage and longer term

What By Whom By When PCTs/LHCs to either confirm that they have appropriate connection between networks at a local level or have enabled/sponsored Councils to achieve N3 connection by March 2010 or to have firm plans in place to complete that by March 2011.

PCTs March 2010

PCTs/LHCs to have a plan for interoperability which may be through National and Regional Care Records (CFH) solutions or more specific local initiatives

PCTs March 2010

PCTs/LHCs to assist their local government partners with the introduction of the NHS Number and to be actively achieving that or have a firm managed plan.

PCTs March 2010

PCTs/LHCs have a programme of process changes which aims to release the type of benefits described in the Wigan example.

Bed management Hospital Discharge Managing Long Term Conditions in the community Unscheduled Care/ Intermediate Care and Hospital at

Home Initiatives Multidisciplinary working Safeguarding

PCTs March 2010

PCTs to have a partnership plan in place to explore opportunities to share resources with Local Authorities (wider public sector) in the pursuit of efficiencies

PCT March 2010

There is an appropriate forum/mechanism to discuss working with private and third sector organisations on the subject of informatics and information requirements either at national (preferred) or regional level in the North West

SHA March 2010

SMART PROPOSED!!! Not agreed

Example from London

BT Rio Community

Health System

London’s RoadmapHSCI Prototype - Proof of Concept

EMIS GP

System

BT e-SAP System

Internet

NB – these slides from London are not yet finalised and subject to change but included to show their thinking

BT Rio Community

Health System

Newham Whole System Demonstrator

SpineTMS

BT Integration

Engine

OLM Care First

Social Care System

EMIS GP

System

BT e-SAP

System

Existing SystemsBT LSP

SpineServices

?

Later Demonstrators…..

BT Integration

Engine

BTCerner

Millennium System

BT RiO Mental

Health System

BT Rio Community

Health System

BT INPS

GP System

BT e-SAP

System

BT LSP

OLM Care First

Social Care System

Other NHS Compliant

Social Care Systems

EMIS GP

System

Existing Systems

SpineTMS

SpineServices

Core Logic Social Care

System

SpineTMS

SpineServices

Long Term Vision for London

BT Integration

Engine

BTCerner

Millennium System

BT RiO Mental

Health System

BT Rio Community

Health System

BT INPS

GP System

BT

SPR

BT LSP

OLM Care First

Social Care System

Other NHS Compliant

Social Care Systems

EMIS GP

System

Existing Systems

Corelogic Social Care

System

BT e-SAPSystem