ICT Strategy - rdash.nhs.uk · the Trust including IT management and governance, applications, infrastructure (networks, servers, storage and end user devices), service management

Information Communication & Technology Strategy

ICT Strategy

ICT Strategy

ICT Strategy

“Towards a Digitally Integrated Healthcare Environment”

April 2016

Health Informatics Directorate

Health Informatics Directorate

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Distribution

Organisation Name Organisation Address

Rotherham Doncaster and South Humber NHS Foundation Trust

Trust Headquarters Woodfield House Tickhill Road Site Weston Road Doncaster DN4 8QN

Channel 3 Consulting Manor House 1 The Crescent Leatherhead Surrey KT22 8DH

Document Control

Approval Sign-off (For formal issue)

Owner Role Signature Date Version

Richard Banks Executive Director Health Informatics

Signature Date Version

Jessica Bradshaw Channel 3 Executive Lead

Review Panel

Name Role

Julie Waters Deputy Director Business Intelligence & Information

Lee Isle

Dave Coney

Change History

Version Status Date Author / Editor Details of Change

0.1 Draft 18/03/16 J Tyacke Initial draft for client review

0.2 Draft 08/04/16 J Tyacke Second draft incorporating comments

1.0 Final 18/04/16 J Tyacke Final version including finance table approved by Jenny Marsh

1.1 Final 28/04/16 J Tyacke Including addendum to section 7.2.1 requested by Finance & Performance Committee

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Table of Contents

1. EXECUTIVE SUMMARY ................................................................................... 4

2. INTRODUCTION ............................................................................................. 7

3. BACKGROUND TO THE TRUST ........................................................................ 8

4. STRATEGIC CONTEXT ..................................................................................... 9

4.1. National Drivers ................................................................................................................. 9 4.1.1. NHS Digital Roadmaps .............................................................................................................9 4.1.2 Digital Maturity Self-Assessment .......................................................................................... 12

4.2. Local Drivers ..................................................................................................................... 13

5. STAKEHOLDER REQUIREMENTS ................................................................... 15

5.1. Patients and the Public .................................................................................................... 15

5.2. Clinicians .......................................................................................................................... 16

5.3. Managers/Decision Makers ............................................................................................. 17

5.4. Administrators ................................................................................................................. 18

6. ICT VISION ................................................................................................... 20

6.1. Improving Patient Experience ......................................................................................... 20

6.2. Supporting Agile Working ................................................................................................ 20

6.3. Enabling Paper-Free Care Delivery .................................................................................. 21

6.4. Reducing Administrative Overheads ............................................................................... 22

7. IT ENVIRONMENT REVIEW ........................................................................... 24

7.1. Scope of the ICT Review .................................................................................................. 24

7.2. Summary of Findings and Recommendations ................................................................. 24 7.2.1. IT Governance, Programme Management & Organisation .................................................. 24 7.2.2. Infrastructure & Service Management ................................................................................. 25

7.3. Impact of the Unity EPR Programme ............................................................................... 27

8. DELIVERING THE ICT STRATEGY ................................................................... 28

8.1. ICT Strategic Work Programme ....................................................................................... 28

8.2. RDaSH ICT Investment Plan ............................................................................................. 28 8.2.1. Additional Sources of Funding .............................................................................................. 28

Figure 1 - RDaSH ICT Work Programme Schedule ........................................................................ 29

Figure 2 - RDaSH ICT Investment Plan .......................................................................................... 31

APPENDIX 1 RISKS ......................................................................................... 33

APPENDIX 2 REFERENCES .............................................................................. 35

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1. Executive Summary

This document presents the future strategic vision for ICT at Rotherham, Doncaster and South

Humber NHS Foundation Trust (RDaSH) over a five year period commencing April 2016. It

should be viewed as a refresh of the previous IT strategy, 2012-2017. It builds upon work

already delivered that has improved infrastructure provision in key service delivery areas. The

reason the strategy is now being refreshed is to ensure that the Trust’s IT infrastructure and

services are ready to support the recently launched Unity EPR Programme which will procure

and implement a single Electronic Patient Record (EPR) across the Trust.

Through information gathered from key stakeholders and reference to a number of NHS and

Trust publications, the high level information needs of clinicians, managers, patients and public

have been identified and an analysis performed to highlight the gaps in current IT provision. The

strategy has been developed to articulate a vision for ICT that will support the Trust’s

development of health services. Section 4 of the document highlights the ways in which this ICT

Strategy will enable the Trust to deliver each of its five strategic goals:

Rotherham, Doncaster and South Humber NHS Foundation Trust – Strategic Goals:

1. To strive for Clinical Excellence

2. To attract, grow and engage our people

3. To deliver excellent services through sound financial management

4. To work flexibly with partners to offer and deliver market-leading services

5. To underpin high quality care with good governance and leadership

The Vision for ICT

The vision statement describes the movement ‘Towards a Digitally Integrated Healthcare

Environment’ that will provide technology to improve patient experience, enable agile working,

eliminate paper, support service transformation, reduce administrative overheads. The following

tables summarises the key components of the vision and how these areas link to the Trusts

strategic objectives:

Key Components of Vision Supports

Objectives

Improving Patient Experience – The Trust will work to expand the channels

of communications in use to include SMS, email and social media. Patients

will be given access to a summary of their own health record, which they will

be able to share with other health professionals involved in their care.

1,2,4,5

Supporting Agile Working – based on a secure and resilient IT infrastructure

service and using modern and relevant IT systems that will support clinicians

and enable them to provide a homogenous service of high quality to patients

regardless of the location in which they are treated. Agile working will be

underpinned by mobile, wireless technology to improve timeliness, patient

safety and efficiency.

1,2,3,4,5

Enabling Paper-Free Care Delivery - The Trust will strive to become a paper 1,2,3,4,5

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free organisation. The patient’s care record will be held electronically and this

will be accessible regardless of the patient’s or the Clinician’s location.

Clinicians will be supported by holistic patient information at the point of

care to enable timely and clinically safe decision-making.

Reducing Administrative Overheads – Both clinical documentation and

management information will be produced as a by-product of clinical and

operational processes.

1,2,4

The Trust is undergoing a transformational change programme, and ICT is an essential enabler to

support extensive integration of clinical and corporate services and the achievement of associated

qualitative and productivity-based performance improvement across the organisation.

Delivering the Strategy

This strategy will be implemented via five strategic workstreams, summarised below. These

strategic themes are consistent with – and indeed are incorporated into the Work Programme

shown in section 8, which sets out the key deployment projects planned for the short and

medium term to deliver the vision, ‘Towards a Digitally Integrated Healthcare Environment’

described above.

1. ICT Governance, Programme Management & Organisation - The profile and structure of

the existing Health Informatics resources is being revised to ensure there is sufficient

quantity and quality of resource available before, during and after the implementation of the

Unity EPR Programme.

2. Infrastructure & Service Management – The Trust will deliver infrastructure

improvements including expansion of wi-fi, end user devices replacement programme, single

sign-on for clinicians to ensure adequacy of support for a more mobile, agile workforce.

3. Unity EPR Programme – This programme will procure, implement and exploit a single

clinical system across all the Trust’s community and mental health services. It will provide

functionality including single sign-on, paperless working and improved integration with

external organisations to provide a better service to clinicians and patients

4. Information Management – The Trust is currently reviewing its options for the future of

the data warehouse (a separate paper will be going to the Board). Based on early successes

with IAPT reporting, the Trust is looking to stabilise, build and enhance current reporting.

Solutions will ensure people will have access to the right information (fit for purpose), at the

right time, in a format that they can readily understand.

5. Corporate Systems – Facilities/features offered by back office systems including office

applications, email and electronic document management solutions 1that will be fully

exploited to maximise their value for money.

1 An electronic document management system (EDMS) is a software system for organizing and storing

different kinds of documents. It is a storage system that helps users to organize and store paper or digital

documents

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The majority of the projects, whilst containing significant ICT elements are fundamentally

transformational in nature. The introduction of technology will involve changes to ways of

working and the delivery of patient care, resulting in more effective, efficient and clinically safe

practice. The Unity EPR Programme will work in tandem with the Trust’s wider Transformation

Programme to enable and support operational changes such as the delivery of an all age service.

Investment Programme

The 5 year investment programme required to deliver the strategy is outlined. This incorporates:

new areas of investment - required to ensure provision of a suitably resilient supporting

technical infrastructure and addresses the need to put in place a rolling replacement

programme for end-user devices, continuing to increase the ratio of mobile workstations

to desktops.

funding already allocated - for the consolidation and re-procurement of the Trust’s

clinical systems.

Full details of the proposed investment programme can be found in section 8.

Where capital funding is required to progress the workstreams, business cases will be developed

to support investment decisions. This will provide the Board with assurance that appropriate

options appraisals have been completed and that the most economically advantageous options

are those taken forward.

Governance Process

The ICT Strategy will be presented to the Health Informatics Sub Committee for comments and

then to the Finance and Performance Committee for approval.

Next Steps

This ICT strategy represents an opportunity for the Trust to deliver ICT systems and services that

will enable service transformation that will keep pace with requirements for increasingly

integrated clinical practice.

The Board is asked to approve this strategy and commence the work programme outlined. The

following actions should be considered as early priorities:

Progress with the Unity EPR Programme to procure and implement a single clinical

system across all of RDaSH’s services;

Develop a business case for the completion of implementation of Wi-Fi across RDaSH’s

estate where clinical and other services will be delivered.

Develop a business case to assess the benefits for Electronic Document Management.

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2. Introduction

This ICT Strategy examines the strategic ambitions of the Trust both as a provider of patient care

and as a business and sets out a vision in which these objectives are supported and enabled

through the innovative use of ICT. Many service improvements and changes that are required

over the coming years will depend on a modern and robust IT infrastructure and good quality

and relevant information provision.

It should be viewed as a refresh of the previous IT strategy, 2012-2017. It builds upon work

already delivered that has improved infrastructure provision in key service delivery areas. The

reason the strategy is now being refreshed is to ensure that the Trust’s IT infrastructure and

services are ready to support the recently launched Unity EPR Programme which will procure

and implement a single Electronic Patient Record (EPR) across the Trust.

The ICT Strategy includes within its scope all aspects of information technology provision for

the Trust including IT management and governance, applications, infrastructure (networks,

servers, storage and end user devices), service management. Information Management is out of

scope for this strategy and will be addressed via a parent document, (Information Management

paper) which is currently in development. The ICT Strategy will enable the Trust to put in place

the IT resources, infrastructure and services to enable delivery of the more detailed vision for

business intelligence laid out in the IM paper.

Through a series of interviews with key stakeholders and reference to a number of reports made

available by the Trust, the high level information needs of clinicians, managers, patients and the

public were identified and an analysis performed to highlight the gaps in current ICT provision.

The strategy articulates a vision for ICT that will support the Trust’s strategic vision for the

transformation of healthcare services.

This document aims to support the Trust’s business strategy and operations by;

• ensuring that information and information technology is used to support Trust staff in giving

patients the highest quality care and experience regardless of their physical location;

• enabling the Trust to support effective management and develop clinical practice that

furthers the Trust’s ambitions for service provision and improvement.

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3. Background to the Trust

RDaSH operates services in over 200 locations across Rotherham, Doncaster, North

Lincolnshire, North-East Lincolnshire and Manchester. The Trust employs over 4,300 staff

equating to 3,700 WTE’s and has more than 200 committed volunteers. Operating expenditure

on health and social care in 2014/15 was £152.37 million and the Trust has achieved its financial

planning targets every year as a Foundation Trust.

The Trust has diversified from mental health and learning disability services to include

community services, such as district nursing and health visiting, and around 115,000 people now

access the Trust’s services each year.

It is important to note that the Trust is committed to working with its health and social care

partners across Doncaster, Rotherham and North Lincolnshire to deliver integrated care

initiatives that will improve the health of local residents. This is evidenced by the ongoing work

to develop Local Digital Roadmaps (LDR) which forms a key part of this ICT strategy as it will

provide the means to deliver integrated health and social care records.

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4. Strategic Context

4.1. National Drivers

The ICT Strategy takes into account a number of national initiatives, expectations and mandates

that have an effect on the ICT agenda:

• NHS Five Year Forward View for Mental Health (2016)

– This recent publication calls for ‘good quality care for all 7 days a week – right

care, right time, right quality’. Focuses on integrating physical and mental health

care, breaking down barriers to accessing healthcare. Recognises the need for

integrated records and heralds a data and transparency revolution

• NHS Five Year Forward View (2014)

– The NHS Five Year Forward View sets out the national direction to upgrade

prevention and public health, give people greater control over their own care and

remove the barriers in the provision of care across providers.

• Personalised Health and Care 2020 – A Framework for Action (National

Information Board November 2014)

– This framework details the progress made by the health and care system in

exploiting technology and sets out a series of proposals to deliver change to

improve health and provide better, sustainable care for all.

• The Power of Information (2012)

– The Power of Information (NHS England) set out a ten year framework for

transforming information for health and care by harnessing the value of

information and new technologies to achieve higher quality care and improve

outcomes for patients and service users.

These publications emphasis similar key themes, including partnership working across NHS

providers, creating new relationships with patients and co-creating new models of care to meet

the challenges of increasing demand within resource constraints.

They seek to establish a more responsive NHS system that allows NHS Commissioners to

commission enhanced service delivery models for their local population. This is to be

underpinned by a significant increase in the use of technology to enable seamless information

flows across the patient journey, helping patients engage with their care plan, and health and

service providers to better manage outcomes.

The national agenda is for integrated working - requiring effective sharing and joint use of

information by those working together in teams that are organised on a scale that can provide

more complex and specialist services than at present.

4.1.1. NHS Digital Roadmaps

The ‘Five Year Forward View’ identified harnessing the information revolution as a key enabler

to securing a sustainable NHS and made a commitment that, by 2020, all electronic health

records would be fully interoperable so that patient records are paperless.

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‘Personalised Health and Care 2020 – A Framework for Action’ established the National

Information Board and laid out its vision to transform the health and care digital landscape. A

key proposal outlined in this document, and later adopted as government policy, was to invite

local areas to produce Local Digital Roadmaps (LDR) detailing the steps they will take, and

when, in their progress towards a fully interoperable way of working. LDR will generate

momentum across local health economies, inform local investment prioritisation and support

local benefit realisation strategies. RDasH is part of three LDR footprint areas:

LDR Footprint

Lead CCG Providers Local Authority

Doncaster NHS

Doncaster Doncaster and Bassetlaw Hospitals NHS

Foundation Trust

FCMS (Not for profit care provider, awarded

Doncaster Urgent Care contract in Dec 2015)

Rotherham Doncaster and South Humber

NHS Foundation Trust

Doncaster

Metropolitan

Borough

Council

North

Lincolnshire

NHS North

Lincolnshire Core Care Lincolnshire

East Midlands Ambulance Service NHS

Trust

GP Federation

Hull and East Yorkshire Hospitals NHS Trust

Lindsey Lodge Hospice

Northern Lincolnshire and Goole NHS

Foundation Trust

Rotherham Doncaster and South Humber


Virgin Care

North

Lincolnshire

Council

Rotherham

NHS

Rotherham Rotherham, Doncaster and South Humber


Rotherham Hospice

The Rotherham NHS Foundation Trust

35 General Practices

Rotherham

Metropolitan

Borough

Council

By June 2016, every local footprint area will submit their local digital roadmap detailing how

they will achieve the ambition of being paper-free at the point of care by 2020.

The Guidance document for development of LDR was published in April 2016 and has

introduced 10 universal capabilities Every local health and care system will be expected to make

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early progress on these universal capabilities, demonstrating clear momentum between now and

the end of March 2017 and substantive delivery by end-March 2018.

The universal capabilities are:

1. Professionals across care settings can access GP-held information on GP-prescribed

medications, patient allergies and adverse reactions

2. Clinicians in urgent and emergency care settings can access key GP-held information for

those patients previously identified by GPs as most likely to present (in U&EC)

3. Patients can access their GP record

4. GPs can refer electronically to secondary care

5. GPs receive timely electronic discharge summaries from secondary care

6. Social care receives timely electronic Assessment, Discharge and Withdrawal Notices

from acute care

7. Clinicians in unscheduled care settings can access child protection information with

social care professionals notified accordingly

8. Professionals across care settings made aware of end-of-life preference information

9. GPs and community pharmacists can utilise electronic prescriptions

10. Patients can book appointments and order repeat prescriptions from their GP practice.

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4.1.2 Digital Maturity Self-Assessment The Digital Maturity Assessment provides a framework for assessing care and the extent to

which healthcare services in England are supported by the effective use of digital technology. It

has been developed to help identify key strengths and gaps in healthcare providers’ provision of

digital services at the point of care and to develop an initial view of the current baseline position

across the country. In doing so it supports the National Information Board’s commitment to

achieving a fully interoperable health and care system by 2020 that is paper-free at the point of

care.

For 2015/16, the following five objectives were identified for the Digital Maturity Self-

Assessment process:

To identify key strengths and gaps in provider’ ability to operate paper-free at the point of

care;

To support internal planning, prioritisation and investment decisions within providers

towards operating paper-free;

To support planning and prioritization of investment decisions within commissioner led

footprints to move local health and care economies towards operating paper-free;

To provide a means of baselining / benchmarking nationally the current ability of providers

to operate paper-free;

To identify the capacity and capability gaps in local economies to transform services and

operate paper-free.

The first iteration of the digital maturity index was published in March 2016. Moving forwards,

it will become part of the CQC inspection regime and NHS Improvement will play a key role in

supporting providers to make progress.

The Trust completed its inaugural Digital Maturity Self-Assessment return in January 2016. The

table below summarises the areas highlighted the further action and aligns these with the

associated ICT work programme element defined by this strategy:

Area Highlighted for Action Related ICT Strategy Work Programme Elements

Leadership IM&T Governance and Organisation

Records Assessments and Plans Unity EPR Programme

Orders and Results Management Unity EPR Programme

Remote and Assistive Care Unity EPR Programme

Enabling Infrastructure Infrastructure and Service Management

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Area Highlighted for Action Related ICT Strategy Work Programme Elements

Information Governance IM&T Governance and Organisation

Transfers of Care Unity EPR Programme

Medicines Management and Organisation Unity EPR Programme

Standards IM&T Governance and Organisation

Unity EPR Programme

4.2. Local Drivers

The Board of Directors has explored what impact new models of care might have on the

organisation within each of the local health and social care economies that the Trust operates in.

Rotherham and Doncaster CCG’s have requested that RDaSH undertake further work to provide

service models which are all age (initially Adult and Older People’s services but to eventually

include CAMHS).

An all age model is a model which will bring together clinical pathways for patients of any age

into one integrated team which would cover a locally defined area, potentially linked to GP

practices. These would take referrals from hub based single points of access for all mental and

physical health services.

This will require a whole system approach to transformation covering all business divisions, it

requires a review of current service provision identifying where services from a number of

divisions would come together to create all age teams.

Over the past two years the trust has been working with Rotherham and Doncaster Clinical

Commissioning Group’s (CCG) to review our service provision. Both CCG’s commissioned

Attain to undertake a review of mental health services and DCCG undertook a review of its

community provision provided by DCIS.

The outcome of these reviews has resulted in a number of service transformation programmes

being undertaken across the Trust which will support the delivery of future QIPP savings and

meet the challenge of the ‘Five Year Forward View’.

There are a number of key themes identified within RDaSH, and by partner agencies, which act

as drivers for change within the Transformation Programme which focus around service delivery

for the future. These are encompassed in the following:

Provision of co-ordinated integrated care which is patient focused and needs based;

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Improved access to and responsiveness of services particularly out of hours and in times

of crisis – 24/7 access;

All Age services and pathways of care;

Improve patient experience of poor transitions between teams;

Improved multi-disciplinary and multi-agency working, including working with third

sector organisations;

Improved liaison and joint working with primary care, with a preference for locality

based models of care;

Review of specialist services, including inpatient beds;

Silo working of current divisional structure;

Deliver transformation QIPP savings;

CCG and LA requests for more locally managed services;

Parity of esteem.

The overarching intent is to wrap services around the individual patient rather than the patient

around the services and this is central to the Transformation Programme.

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5. Stakeholder Requirements

In this section, the information requirements of each stakeholder group are identified and a brief

analysis of the current situation and opportunities for the future given. This analysis has been

developed based on the following sources of information:

Stakeholder interviews (through Clinical Systems Review and ongoing Unity

engagement work)

Analysis of reports made available by the Trust including recent CQC inspection

feedback and the Digital Maturity Self-Assessment

ICT Review to identify gaps in current provision.

5.1. Patients and the Public

In line with the national and local strategic drivers outlined in the previous section, patients will

be placed at the centre of their care. The expectation is that they will be active participants and in

control of their care.

Patients will need:

To know how to access NHS services, find their way and contact those involved in their

care;

To learn about their condition, treatment and outcomes;

Online access to their health records including: clinical letters; laboratory results;

centrally held patient-identifiable data; community and mental health services

information; personal care plans for people with long terms conditions; and needs

assessments and care plans relating to social care services;

Access to patient information sources including trusted internet sites containing

information on health and lifestyle to help them take care of their own health;

To make informed decisions about their treatment, appointments and admission dates etc;

To have confidence in those caring for them and reassurance that they are fully informed

about their history, condition and treatment to date;

Information about them to be accurate, complete, secure and shared as appropriate;

To know where they are in the healthcare journey and have full knowledge and

transparency about timescales for next steps and to be able to make informed choices

about their care options.

Current Situation:

Information regarding Trust services and signposting to patient information is available

to patients via the Trust web site;

The Trust communicates with patients using a mixture of communication channels

consisting mainly of appointment letters and associated paper based correspondence

although there is some evidence of email and SMS messaging;

There is a need to improve patients awareness of their healthcare journey so that they

understand the care pathway they are following and are empowered to participate in their

own care;

There is no provision for patients to routinely access their own health records.

Opportunities for Enhancement:

The volume of patient letter templates which should be reviewed and standardised to

ensure the quality and consistency of communication messages.

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The quality of information sent out with patient letters should be reviewed and

standardised to ensure that this is of high quality.

Improve communication between patients and their relatives and those caring for them by

providing email addresses and direct telephone numbers for relevant healthcare services

and professionals.

Information systems need to enable communications with patients via the

communications media that they prefer e.g. capturing patient email addresses, enabling

telephone auto-dial facilities, supporting text messaging, use of social media.

Real-time capture of the patient experience during their healthcare journey.

Increase the patient’s level of knowledge of their care pathway, ensure transparency in

their patient journey and enable greater levels of patient participation.

Support for patient access of the own care records.

5.2. Clinicians

Clinicians Want:

To be able to log in quickly with a single sign-on for all clinical systems and similarly, to be

able to leave the PC/laptop quickly to attend to urgent clinical matters whilst maintaining the

security of confidential patient information;

Access to a single, integrated electronic patient centric record giving accurate, complete and

immediately available information on patient history, attendances, clinical correspondence,

investigations and interventions that is available regardless of the patient’s location or the

clinician’s location

Access to real time bed management information so that a bed for a patient requiring

inpatient care can be quickly and easily located;

Access to guidelines and knowledge which will support decision making about patients

treatment and care and to support life-long learning including best-practice, evidence and

access to on-line databases;

To be able to pro-actively identify and treat patients with increasing healthcare needs using

recognised industry standard risk stratification tools;

To be able to communicate rapidly with each other across RDaSH’s various sites and across

organisational boundaries. This includes the ability to securely share patient images, results

or documents with clinical or social care colleagues for advice or an opinion.

Current Situation:

The introduction of mobile working has highlighted connectivity issues and the need for

integrated electronic patient records.

RDaSH operates multiple clinical systems which are not integrated. The two core systems

are:

o TPP SystmOne: supporting Community (Learning Disabilities service also using

community module) and Palliative Care supplied by CSC via the NPfIT. Two

additional modules, EPR Core and Drug Rehab modules have been purchased by the

Trust and not as part of the LSP contract.

o SilverLink: supporting Mental Health services and community inpatient services and

Forensic Services.

Paper assessments still in use across most clinical services, with only some services using

clinical systems to record clinical notes. Paper notes are still in use across most clinical

services, including those where SystmOne is used for clinical noting.

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There is a confusing array of assessments and letters available within the existing clinical

systems.

There are many home grown Excel spreadsheets still in use for recording of patient

information and delivering operational reporting for staff, service managers and in some

cases outside agencies.


Further investment in mobile working will enable the Trust to develop a more agile

workforce capable of delivering services of a homogeneous quality regardless of the patient’s

location. However there are several enabling factors that will need to be in place to fully

realise the benefits of mobile working. These include:

o Improve provision of Wi-Fi and connectivity solutions to ensure a consistent service

in all RDaSH clinical locations.

o Development of single sign-on for clinical systems that will enable swift log-in and

log-out and enable clinicians to resume a system based activity from the point at

which it was left;

o Provision of end user devices (desktop PCs, laptops, tablets, smartphones) that are

suitable to the user’s role type e.g. office based, fully mobile, partially mobile.

o The Transformation Programme and the Unity EPR Programme will work together to

address:

The deployment of a single EPR across all clinical services (Unity EPR

Programme);

The replacement of existing Excel workarounds;

Develop standards for the use of electronic patient records including

improving the timeliness of data entry and a review of existing clinical

assessments and letters;

o Implement an electronic document management solution for legacy case notes and

other shared clinical and corporate documentation;

Introduce technical solutions to enable clinicians to work seamlessly with staff from external

organisations to deliver care in multi-disciplinary teams.

5.3. Managers/Decision Makers

Managers / Decision Makers Want:

To work with commissioners to develop innovative healthcare services that will improve the

health of the local population;

GPs and other referrers to be able to book direct access services via the national eReferral

Service;

Access to dashboard style information for monitoring and managing performance of the

Trust;

Real-time, high quality data regarding each clinician’s caseload to enhance efficiency,

improve standards of care and assist caseload management;

Support for flexible, agile working, e.g. remote access to clinical systems, word-processing,

email, scheduling applications, document sharing and workflow.

Facilities for the electronic storage of documents to reduce paper and hence the cost of

storage and processing;

Current Situation:

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The Trust is starting to recognise the data capture and recording issues it has within the

service, with its current clinical systems through the recent ‘Task and Finish Groups’ on

IAPT and now CAMHS. More is likely to be identified by the Unity EPR Programme Data

Migration Workstream ‘Data Healthcheck’.

The Trust recognises the need to improve its information management (IM) provision and

work is ongoing to develop an IM plan to facilitate this.

The timeliness and quality of data entry into clinical and corporate systems is variable: in

some cases, data is entered retrospectively; in some cases not at all. Clear definitions of what

constitutes say an “indirect contact” and how to record these on the clinical system are not

uniformly communicated and implemented.

Some performance and operational information is generated directly from clinical source

systems.

The Trust informatics staff have to perform many manual extracts of data to obtain

information required for reporting purposes. This is time consuming and prone to human

error.


Improving the timeliness and quality of data entry into clinical and corporate systems is

essential to the delivery of improved business intelligence. Having someone who owns data

quality monitoring within the service is key to addressing this;

The Trust needs to invest in its data warehouse. This is an opportunity for the Trust to invest

in a business intelligence solution that is capable of delivering a dashboard style drill-down

reporting system that will highlight issues and alert managers to areas that require attention.

o Invest in the Informatics team appropriately and ensure that the team are

implementing good practice database and report design.

o Integrate new data feeds from various Trust clinical and corporate systems into the

data warehouse to enable delivery of service line reporting (SLR).

o Work with the service to improve standardised definition, appropriate clinical system

configuration and meaningful information insight.

Provision of training and support to improve managers’ understanding of information and to

enable them to use a business intelligence system effectively to fulfil some of their own

reporting needs.

5.4. Administrators

Administrators Want:

Rapid access to accurate and complete patient documentation.

The ability to respond to patient queries in a professional manner.

Access to technology and tools to maximise their time and skills, freeing up time from

routine tasks and to be able to spend more time talking to patients.

Current Situation:

Existing clinical systems are not routinely being updated in real time and therefore do not

always accurately capture the patient journey.

Information is fragmented, causing administrative staff to waste time re-keying manually

recorded information, searching for notes and looking up information in multiple systems.

Patient records are still largely paper based and can be fragmented into service specific

records.

Page 19 of 35


The administration service should be smooth and almost unseen by the patient as it facilitates

their journey through their healthcare experience.

The Transformation Programme and the Unity EPR Programme will work together to

address standardisation of patient communications and associated patient information sources

will improve the quality of communication.

The Trust should identify opportunities to utilise additional communication channels to

communicate with patients e.g. mobile apps, social networking, email etc.

Use of a document management solution would centralise document storage and enable

online access to a patient’s correspondence history. A project should be initiated to review

options for technology solutions and make a case for investment.

Page 20 of 35

6. ICT Vision

The Trust will develop its ICT service provision ‘Towards a Digitally Integrated Healthcare

Environment’, capable of supporting its staff, patients and partners as it works to deliver high

quality, patient led services across Rotherham, Doncaster and South Humber. Delivery of this

vision for ICT will support staff, patients and partners as the Trust works to deliver new models

of efficient patient-led services.

This Digitally Integrated Healthcare Environment will exploit technology to:

Improve patient experience

Support agile working;

Enable paper-free care delivery;

Reduce administrative overheads;

6.1. Improving Patient Experience

Patients will be given access to a summary of their own health record, which they will be

able to share with other health professionals involved in their care.

Standardised high quality patient communications will be available via a variety of

channels including mobile apps, SMS messaging, email and social networking.

Use of mobile technology including handheld tablets will facilitate discussions with

patients and capture of patient feedback.

High quality, timely information will be provided to support commissioners of Trust

services and enable development of innovative services to meet the needs of the local

population. Links will be developed with local Clinical Commissioning Groups, enabling

secure sharing of information where appropriate to improve access to services, patient

experiences and outcomes.

The Trust will work with partner organisations, particularly GP practices, social care

services and third sector services, to ensure that IT supports seamless care across

organisational boundaries. This will include support for Local Digital Roadmaps (LDRs).

Communication with GPs will be electronic by transmission of information directly into

GP systems where appropriate.

Links to the following Trust strategic goals:

1 To strive for Clinical Excellence

2 To attract, grow and engage our people

4 To work flexibly with partners to offer and deliver market-leading services

5 To underpin high quality care with good governance and leadership

6.2. Supporting Agile Working

A secure and resilient IT infrastructure will be available to all staff. This will incorporate:

o Stable, supported network operating platforms (hardware and software)

o A robust wireless network infrastructure supporting mobile devices

o Access to Trust systems by an agile and mobile workforce that spans all locations

where patient care is delivered.

Page 21 of 35

Modern and relevant IT systems and devices will be provided that support clinicians and

enable them to provide a homogenous service of high quality to patients regardless of the

location in which they are treated.

Clinicians will have access to all clinical systems via a single login. Contextual log-ins

will ensure that clinicians will only need to log in once and thereafter relevant patient

information will be available to them in a clear and logical presentation format.

Devices such as tablets, smart phones and laptops will be deployed where this improves

timeliness of data entry, patient safety and efficiency.




3 To deliver excellent services through sound financial management



6.3. Enabling Paper-Free Care Delivery

The Trust will strive to become a paper free organisation.

The Trust will procure and implement a single integrated electronic patient record system

(EPR).

The patient’s complete care record will be held electronically, with the majority of it

made up from information collected through the clinical process in a single dedicated

clinical system. The electronic patient record will be accessible in all locations where

care is provided.

Real time data entry will streamline patient flow and enable more effective

communication regarding patient care across the organisation.

Appropriate technologies that enable alternate means of communication with patients and

colleagues such as email, SMS messaging and social networking will be used to replace

traditional paper based communication flows.

A document management solution will provide secure access to clinical and corporate

documentation that cannot be maintained within the Trusts strategic systems.

The Trust will work with its local partners to support the development of Local Digital

Roadmaps which will enable development of a single logical view of information about

the patient and associated care activity and pathways, enabling integration across the

wider health and social care community.




3 To deliver excellent services through sound financial management



Page 22 of 35

6.4. Reducing Administrative Overheads

Clinical, operational and administrative processes will be designed and digitised to

enable collection of management information as a by-product of operational activity.

Systems will be integrated to facilitate intra and inter-departmental and organisational

working.

A centralised Business Intelligence solution will be underpinned by a data warehouse, fed

from clinical and corporate systems.





Page 23 of 35

Towards a Digitally Integrated Healthcare Environment

Exploiting technology to support care pathway improvements, enable new integrated care models, support agile working, eliminate paper, reduce administrative overheads and improve patient experience and outcomes.

Patients Clinicians Managers Staff CommissionersReview Bodies

Other Stakeholders

Unity EPR Programme

Clinician Single Sign-On

ePrescribing

Video Conferencing Digital Telephony /

VOIP

Robust IT Infrastructure

Business Intelligence Solution

ENABLING TECHNOLOGIESElectronic Document Management

CORPORATESERVICES

CLINICAL RECORDS

PARTNERS & EXTERNAL AGENCIES

EMPLOYEE MANAGEMENT

ESR

Job Planning

Expenses

Attendance Management

FinancialsInventory

Meetings Management

Records

Management

Risk Management

Quality Management

FacilitiesManagement

AssetManagement

Business Intelligence

Communications

Inpatient ServicesLocality Based

All Age Services

Bed Management

Diagnostics

Commissioners

Tertiary Providers

Social Care

Review Bodies

Unified Communications

Virtualised Services

Third Sector Organisations

Pharmacy

Specialist Services

Prison Health Services

Drug & Alcohol Services

CAHMS

Local Digital Roadmaps

NHS e-Referral Service

GPs

Page 24 of 35

7. IT Environment Review

7.1. Scope of the ICT Review

A review of the current IT infrastructure environment at RDaSH has been carried out. The

objective of conducting the review is to inform the strategic objectives for IT over the next five

years, and to determine the level to which the Trust’s current IT environment is able to support

mobile/agile working, and implementation and deployment of an EPR, confirming the level of

readiness or identifying areas where additional investment may be required. The review covers

infrastructure aspects such as physical data centres, server

rooms, networks, servers, storage and the security aspects of

these and also assesses other elements of technology,

applications and processes which relate to the core elements

of the review.

For the purpose of this review the overall IT environment is

broken down into ‘layers’ as depicted in the diagram on the

right. The layers outlined by the dotted lines are the primary

focus for this review (infrastructure), including the associated

process elements. However, the elements within the other

layers will have a bearing upon the infrastructure in terms of

requirements and dependencies as well.

It should be noted that at the time of the review the new EPR

solution is in the process of being procured. The assessment

is based on generic criteria related to procurement and

implementation of an EPR, with a stated preference for an off-premises hosted and managed

solution provided by a third party, working closely with the existing IT teams across all stages of

the lifecycle. The review was conducted through interviews with a set of selected individuals

from across the IT teams, in combination with a review of some documented materials.

Overall, the review found that the Trust has made a good level of investment in the infrastructure

technologies to date, including networks, storage and servers.

7.2. Summary of Findings and Recommendations

The main body of the report highlights a number of aspects within each of the areas (or layers) of

the technology environment. The following is a summary of the ICT Review’s key findings and

recommendations in each of the areas:

7.2.1. IT Governance, Programme Management & Organisation

Programme Management and Governance

The capacity with the IT team itself should be reviewed before, during and after the

implementation phase of the Unity EPR Programme to ensure that they are not only able

to take on and manage new technologies and services, and support larger programmes of

work, but that they continue to be able to cope with the day to day activities of a

demanding healthcare business environment.

The IT team should strengthen its approach to assessment, prioritisation, initiation and

management of technology delivery programmes of work. It is also likely to be necessary

to be stricter on prioritisation of projects, potentially even putting some initiatives on

hold, to ensure EPR implementation is not impacted.

Page 25 of 35

IT Support

The IT department currently provides ICT support to RDaSH, Doncaster CCG, the

associated Doncaster GP practices (52 of them) and four Doncaster prisons (in terms of

supporting the healthcare staff that visit those prisons).

There is a formal service level agreement (SLA) in place with Doncaster CCG and with

Notts Healthcare for staff based at Doncaster prisons, but no such agreement is in place

covering internal RDaSH services. Discussions are ongoing about replicating the

Doncaster CCG SLA for RDaSH services.

Self-service features should be enabled within the TrackIT service management system

for aspects such as password reset, which will reduce the volume of contacts received by

the service desk.

Information Governance and Security

A good level of investment has been put into the technical security measures in place,

and a recent review has recommended that the Trust carry out regular penetration testing,

which is being arranged, together with a broader cyber security review. Cyber Security

and ISO27001 accreditation will be an important differentiator in future SLAs with third

party organisations.

Now that both groups fall under the Health Informatics remit, the IT team should

strengthen the relationship with the IG team. The IG team provide support and guidance

but IT ‘own’ the development and implementation of the IT suite of policies.

Training

Consideration should be given to the likely volume of training that will need to be

delivered when implementing a new EPR solution, including number of staff, training

locations, training systems and data, duration of training courses and delivery methods

(classroom, online, self-service, etc.).

7.2.2. Infrastructure & Service Management

Network and Supporting Services

Work should continue on improvements to the connectivity to remote sites that fall

within the remit of the IT support contracts and which are likely to be used by staff

accessing the primary clinical and business systems of the Trust. This will include mobile

telephony for both voice and data connections.

Improved coverage of the wireless network across the whole site, and in significant

remote working locations, should be a priority. Where possible this should be centrally

funded to ensure full coverage across all areas where records are to be accessed

electronically.

A reduction in use of two SIM cards for staff that have a mobile phone and a SIM-

enabled Trust laptop should be explored, utilising tethering from the mobile phone with

an appropriate data package included in the contract.

A review should be undertaken of the telephony environment and a roadmap developed

to converge voice and data communications, dispensing with the old Siemens telephony

system, which will be unsupported within the period of the five-year IT Strategy. Further

usage of the existing NEC IP telephony solution should be explored in the first instance.

Data Centres

Management processes for the existing data centre environments should be improved, to

avoid using them as additional storage space. The data centre environment should be kept

Page 26 of 35

‘sterile’ in this respect, only containing equipment necessary to run the Trust’s

operations.

Investment in the data centre environments should continue to further improve the

standard of those environments, to bring them up to a more ‘industry standard’

specification.

The relatively close proximity of the two data centres is a concern. Options for a

relocation of one of the data centres should be considered, and this could be tied into a

move out of Chestnut View if this is part of the Estates plans, including consideration of

off-site co-location facilities.

Alternative options for provision of data centre services may also be considered in

addressing the preceding two bullet points.

The disaster recovery (DR) and business continuity plan (BCP) should be reviewed in

light of the recent investment in technologies, the refresh of the IT Strategy, and the

increased reliance on the technology services once a new EPR is implemented and the

Trust becomes increasingly paperless.

Storage

Further work should be carried out on capacity planning, to encompass an improved level

of monitoring and forecasting of storage needs, as well as consideration of an archiving

solution and alternate provision for backups.

The data retention policy for the Trust, and IT’s support for it, should be reviewed,

updated and appropriate technical measures put in place.

Servers

Further work should be carried out on capacity planning, to encompass an improved level

of monitoring and forecasting of server needs.

Work should continue to convert existing physical servers to virtual servers wherever

possible, recognising that some servers will need to remain as physical servers.

Applications (including licensing)

The initiatives underway to upgrade System Centre Configuration Manager (SCCM)

should be completed as a priority.

In the context of the replacement email solution, it is worth reconsidering Office365 as an

option. This would not only provide an email solution, but would also deliver:

o an integrated collaborative working solution;

o information on staff presence - presence is a combination of availability and

willingness to meet, and is a feature that works across many Office 365

applications;

o video conferencing capability via Skype for Business;

o features that support lone worker situations;

o the latest Microsoft Office 2016 suite of tools, enabling the Trust to remove the

current constraint of Office 2010 (an aspect that may also be a constraint of the

new EPR solution).

A broader review of the current licensing agreements and management process should be

undertaken in light of future plans for the Trust, including implications of deployment of

a new EPR solution.

Integration

An appropriate level of skilled technical resource should be established, together with a

technical integration platform, to cope with the integration demands of a new EPR

solution, the information management platform, and other systems that may require it.

Page 27 of 35

Presentation

Revisit the possibility of implementing virtual desktop technology for certain end user

devices and environments, where this would improve accessibility, usability and reduce

maintenance and support costs.

End User Devices

The aging desktop estate is a primary cause for concern, especially in conjunction with

the lack of a central refresh budget. A more centralised and planned approach is likely to

be required as part of the strategic roadmap going forward.

It will be important to define a standard mobile device or set of devices that are fit for

purpose, and that the Trust is able to procure and support in a cost effective manner,

especially as demand increases with a reduction in use of paper and introduction of a new

EPR solution.

The existing security measures for laptop devices are good, and something equivalent or

better should be implemented for other forms of mobile devices used for access to

patients’ clinical, or other sensitive, information.

A roadmap for the desktop operating system should also be determined, including

consideration of Windows 10.

7.3. Impact of the Unity EPR Programme

The expectation is that all clinical services will use the Trust’s new clinical (EPR) system. This

will have implications for Informatics in terms of new groups of staff who will be located in

different (possibly new) buildings, need to be trained, setup as users on the Trust’s systems,

receive Trust equipment (such as laptops and mobile phones), require remote access to those

systems, migration of existing patient data to the Trust’s systems, and so forth.

It will be important to ensure that the Informatics department as a whole is prepared for these

aspects of Trust-level change, alongside the enhancement and transformation work required to

deliver against the refreshed strategic objectives.

Page 28 of 35

8. Delivering the ICT Strategy

The current economic position has impacted negatively on public sector spending and in this

environment the Trust must plan to address inevitable cost reductions. In short, the Trust needs

to eliminate waste, increase efficiency and improve quality. Against this backdrop, and in line

with the QIPP agenda, ICT must now be positioned as a service improvement tool to transform

the organisation, by helping to drive up quality, drive out inefficiency and drive down cost.

8.1. ICT Strategic Work Programme

An indicative high level work programme plan is shown in Figure 1, below. This will be revised

at regular intervals as decisions are made regarding strategic solutions and progress is made

against milestones. Delivery of the ICT work programme will be monitored by the Health

Informatics Sub Committee and the Unity EPR Programme Board which reports to the Board of

Directors.

8.2. RDaSH ICT Investment Plan

To deliver the ICT vision outlined within this strategy, a programme of investment will be

required in addition to the annual ICT budget. This covers the funding required for the

procurement of a new single the Trust-wide clinical system (already approved by the Board of

Directors), plus provision for a suitably resilient supporting technical infrastructure. There is a

need to extend the provision of wireless networking across the Trust estate, to establish a rolling

replacement programme for end-user devices and continue to increase the ratio of mobile

workstations to desktops.

An indicative high level ICT investment plan is shown in Figure 2, below. Where capital funding

is required to progress the work programme, business cases will be developed to support

investment decisions. This will provide the Board with assurance that appropriate options

appraisals have been completed and that the most economically advantageous options are those

taken forward.

8.2.1. Additional Sources of Funding

The Government spending review and autumn statement in November 2015 made available £4.2

billion to deliver the technology revolution promised by the “Five Year Forward View”. While

full details of the funding are yet to be decided by the Department of Health and NHS England, it

is believed that around £1.8 billion has been earmarked for the creation of a paperless healthcare

service, an additional £1 billion to invest in digital security and data consent, and £750 million to

upgrade out-of-hospital care and medicines, and to digitise social and urgent/emergency care

services. A further £400 million will also be invested into improving digital services for

patients- including an updated NHS website and apps- and free Wi-fi across all health service

buildings. The Government is targeting 10% of patients to access GP services online and through

apps by March 2017, and for 25% of patients with chronic conditions such as hypertension,

diabetes and cancer to monitor their symptoms remotely by 2020.

It is unclear how much of this funding will be available to NHS provider organisations or what

mechanism will be used to apportion the central funding between organisations as varying levels

of digital maturity. It is likely that the Lead CCGs for the Local Digital Roadmap footprint

groups will be instrumental in managing and assuring this process. It is important that the Trust

is prepared to submit a credible bid for a share of this additional funding as and when this

becomes available.

Page 29 of 35

Figure 1 - RDaSH ICT Work Programme Schedule

The following high level project sequencing chart depicts the stages in the implementation plan. All the dates shown are subject to further

internal discussion and detailed planning:

Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4

Review priorities, revise project approach

Strengthen IG / IT working relationship

IT Team structure, capacity, capability review & remedy

Review current training provision

Training needs assessment to baseline staff skills

Define & implement strategic training

Network & Telephony

WAN connectivity

Mobile provider review

Enhanced wifi deployment

Telephony options review

Telephony replacement

Data Centres and DR

Improve existing data centre environments

Data centre options review

Data centre solution implementation

DR & BCP review and refresh

Infrastructure (storage & servers)

Physical to virtual (p2v) servers

Capacity planning review and update

Archiving solution

Backup solution revision

Retention policy and implementation

Application, Integration, Licensing

Complete upgrade of SCCM

Review mail options (inc. collaborative working)

Implement email solution

Integration platform options review

Integration platform implementation

Licensing review and tool implementation

Infrastructure & Service

Management

Proposed New Areas of Activity & Investment

IM&T Governance &

Organisation

Training

ICT Work Programme Schedule

Programme Area

Programme Element 2016/17 2017/18 2018/19 2019/20 2020/21

Page 30 of 35

Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4

End User Devices (EUDs)

Review EUD estate; strategic roadmap

Mobile device standardisation

EUD strategic refresh programme

Operational Service Management

TrackIT self service features

Additional ITIL processes

Security

Conduct security review

Revise security processes

IM Solution

IM Solution OBC and Procurement

IM Solution Implementation

IM Solution Enhancement

Electronic Document Management System

OBC / options appraisal

Procurement

Implementation

Existing Clinical Systems Tactical Solution

SystmOne Support Contract 12 months

EPR

EPR System Procurement

EPR Trust Implementation Costs

EPR Supplier Implementation Costs

Contingency

Annual licensing & maintence

Corporate Systems

Programme

Committed Areas of Activity & Investment

Unity EPR Programme


Management (Cont.)


Information

Management Programme

ICT Work Programme Schedule

Programme Area

Programme Element 2016/17 2017/18 2018/19 2019/20 2020/21

Page 31 of 35

Figure 2 - RDaSH ICT Investment Plan

The following investment plan provides a high level view of the expected additional investment required to deliver this ICT Strategy:

Review priorities, revise project approach £0 £0 £0 Interviews, review of current approach, projects, plans, etc.; revised approach

Strengthen IG / IT working relationship £0 £0 £0 Process review and update

IT Team structure, capacity, capability review & remedy £0 £0 £0 £0 All FTE assessment, target operating model definition

Review current training provision £0 £0 £0 Review of existing training environment, systems, processes; revised approach

Training needs assessment to baseline staff skills £0 £0 £0 *Define & implement strategic training £0 £0 £0 £0 * Training needs analysis all IT staff

Network & Telephony

WAN connectivity £650,000 £0 £650,000 * Additional connectivity to sites; capital & revenue

Mobile provider review £0 £0 £0 * Market assessment, tariff options, coverage, innovation, recommendations

Enhanced wifi deployment £180,000 £0 £180,000 * Procure & deploy additional wireless access points

Telephony options review £0 £0 £0 * Including OBC, OBS

Telephony replacement £165,000 £0 £165,000 £995,000 * Procure & deploy new telephony solution (assumed based on existing IP soln)

Data Centres and DR

Improve existing data centre environments £0 £10,000 £10,000 General tidy, review process and procedure, recommendations

Data centre options review £0 £20,000 £20,000 Assess on-premise, co-location, fully hosted options

Data centre solution implementation £200,000 £225,000 £425,000 Includes recurring revenue rental for off site data centre

DR & BCP review and refresh £0 £50,000 £50,000 £505,000 Full review of documentation; interviews across clinical services; update all

Infrastructure (storage & servers)

Physical to virtual (p2v) servers £0 £40,000 £40,000 Continue to port physical servers to virtual servers (assume infrastructure exists)

Capacity planning review and update £0 £35,000 £35,000 Review tools & process; update processes, recommendation for tools

Archiving solution £100,000 £0 £100,000 Review options, procure and implement infrastructure (archive storage) & tool

Backup solution revision £50,000 £0 £50,000 Review options, procure & implement solution (assume no revenue implications)

Retention policy and implementation £90,000 £0 £90,000 £315,000 Review process, solution options, procure and implement; then annual review

Application, Integration, Licensing

Complete upgrade of SCCM £0 £0 £0 Assume already covered within IT budget

Review mail options (inc. collaborative working) £0 £20,000 £20,000 * Complete full assessment of options and costs, including procure & implement

Implement email solution £1,300,000 £0 £1,300,000 * Procure & implement; assume annual revenue cost per user

Integration platform options review £0 £25,000 £25,000 Review requirements; review options; make recommendation

Integration platform implementation £320,000 £0 £320,000 Procure & implement, including initial & ongoing interface development

Licensing review and tool implementation £0 £30,000 £30,000 £1,695,000 Review process; implement in existing Service Management tool

Totals Per GroupingEnables Agile

WorkingNotesCapital Revenue

IM&T Governance &

Organisation

Training


Management

ICT Investment Plan Ballpark Budget Estimates

Programme Area Programme Element


Page 32 of 35

End User Devices (EUDs)

Review EUD estate; strategic roadmap £0 £15,000 £15,000 * Review of exsiting deployment; produce roadmap based on business drivers

Mobile device standardisation£0 £20,000 £20,000 * Define standard; enable management tools, build image(s) / config (not procurement)

EUD strategic refresh programme £1,250,000 £0 £1,250,000 £1,285,000 * Refresh of 4000 devices @ approx £312 each over 5 year period (not all devices)

Operational Service Management

TrackIT self service features £50,000 £0 £50,000 Includes licensing & implementation

Additional ITIL processes £0 £50,000 £50,000 £100,000 Includes definition of process & config within Service Management tool

Security

Conduct security review £0 £35,000 £35,000 Cyber Security Review by external agency

Revise security processes £0 £55,000 £55,000 £90,000 Initial revision & annual review thereafter

IM Solution

IM Solution OBC and Procurement £0 £45,000 £45,000 Develop OBC, run procurement

IM Solution Implementation £600,000 £0 £600,000 Including cost of solution, implementation, data migration & deployment

IM Solution Enhancement £0 £450,000 £450,000 £1,095,000 Ongoing enhancements

Electronic Document Management System

OBC / options appraisal £0 £40,000 £40,000 Develop OBC with options appraisal

Procurement £30,000 £0 £30,000 Run procurement process

Implementation £1,500,000 £0 £1,500,000 £1,570,000 Includes procurement & implementation

TOTAL £6,485,000 £1,165,000 £7,650,000

Existing Clinical Systems Tactical Solution

SystmOne Support Contract 12 months £246,000 £0 £246,000 £246,000 *EPR

EPR System Procurement £500,000 £0 £500,000 * Taken from FIBD 19Nov15 Draft EPR OBC (combining 2015/16 & 2016/17 costs)

EPR Trust Implementation Costs £1,519,000 £0 £1,519,000 * Taken from FIBD 19Nov15 Draft EPR OBC

EPR Supplier Implementation Costs £998,000 £0 £998,000 * Taken from FIBD 19Nov15 Draft EPR OBC

Contingency £251,700 £0 £251,700 * Taken from FIBD 19Nov15 Draft EPR OBC

Annual licensing & maintence £0 £1,625,000 £1,625,000 £4,893,700 * Taken from FIBD 19Nov15 Draft EPR OBC – 5 yrs annual revenue costs @£325k p.a

TOTAL £3,514,700 £1,625,000 £5,139,700

GRAND TOTAL £9,999,700 £2,790,000 £12,789,700

RevenueCapital

Corporate Systems

Programme

Unity Clinical Systems

Programme


Management (Cont.)

Information

Management Programme

Committed Areas of Activity & Investment

ICT Investment Plan Ballpark Budget Estimates

Programme Area Programme Element


Enables Agile

WorkingNotesPer GroupingTotals

Page 33 of 35

Appendix 1 Risks

The following are the key risks identified during development of the ICT Strategy. These should

be captured on a risk register and a mitigation plan put in place:

Ref Description Impact Mitigation

R001 End user device refresh budget constraints

Inconsistent approach to device replacement, meaning older devices are in use for longer and may not be fit fir purpose in an increasingly electronic record world.

Implement a more centrally coordinated and funded approach to device refresh, aligned to broader business objectives and roadmap.

R002 Chestnut View data centre location and potential need to move

Moving the remaining NHS teams from Chestnut View has a major impact on the data centre environment located there, and therefore the systems and services hosted within it.

If a move is required, review options for establishing a new data centre location and required funding; assess against other options such as off-site / remote / cloud-based third party service provision.

R003 The IT team is insufficiently resourced to cope with delivery and ongoing management of the EPR solution.

Implementation of a new EPR solution will require significant input from the IT team, utilising their knowledge and skills of the existing environment, which will impact day-to-day activities and management of issues that arise.

Ensure the IT team members have time available in their normal daily schedules to support the EPR procurement, with adequate forward planning and additional, possibly backfill, resourcing.

R004 Suitability of technical hosting environment provision within the RDaSH data centre environment(s)

If elements of the new EPR solution are to be hosted within the existing RDaSH data centre environment(s) it will be important to ensure that aspects such as cooling and power provision are suitably robust to avoid unnecessary outages impacting EPR availability.

Once the architecture and hosting requirements of the new EPR solution are understood, review the existing environmental provisions required to host any elements that may be required and plan remediation activities that may be necessary.

R005 The lack of a Trust integration platform impacts support for the requirements of a new EPR solution.

Interoperability and integration of the new EPR solution with other Trust systems and services will be critical to ensuring the success of the EPR.

Establish a view of the EPR

integration requirements

and touchpoints as early as

possible in the procurement

process, as well as selecting

a solution that best supports

Page 34 of 35

Ref Description Impact Mitigation

these integration

requirements.

Also worth ensuring that the team responsible for integration are suitably resourced.

R006 Extended mobile / agile working

Increases in new working practices and demand for supporting technology, combined with new EPR system implementation could overload IT’s service provision and ability to cope with demand.

Ensure a clear statement of requirements is available, together with an understanding of what is required and when in a planned / roadmap form, and align IT-related initiatives to meet demand.

Page 35 of 35

Appendix 2 References

Ref Document Title Description

1 RDaSH EPR OBS …. .docx

The Output Based Specification (OBS) for procurement of a new EPR solution

2 RDash EPR OBC …..docx

The Outline Business Case (OBC) for procurement of a new EPR solution

3 Systems Linkage Narrative.xlsx

List of applications, systems and services in use across RDASH (still work in progress)

4 Assessing the Cyber-Risk Self-Assessment

RDaSH baseline self-assessment of security developed using the HM Government Cyber Essentials Scheme

5 Digital Maturity Self-Assessment

RDaSH baseline self-assessment of digital maturity required as part of the Local Digital Roadmap initiative

6 RDaSH CQC Quality Report

CQC quality inspection report published on 19/01/16

Documents

ICT Strategy - rdash.nhs.uk · the Trust including IT management and governance, applications, infrastructure (networks, servers, storage and end user devices), service management