N3 / Help the Hospices - Connecting Hospices Workshop

N3 / Help the Hospices - Connecting Hospices Workshop

John HemsleyBusiness Leader N3 Self Funding Customers

Domestics

Objectives of the day

The objectives of today are to:

•Provide a description and background to N3

•Benefits to a Hospice of being connected to N3 •Present the options available to a Hospice

•Overview and detailed

•Provide an opportunity for questions and answers

•Outline the next steps for up you to gain access to N3

Agenda

Time Speaker

10:30 Welcome and objectives of the day John Hemsley, N3SP

10:35 Hospice Connect and the current state of play Dr Steve Plenderleith, Help the Hospices

11:55 Hospice Connect/ICT Hub Survey 2008 Jacquie Wakeford, Miriona

11.35 Coffee break

11:55 N3 Service and options for hospices John Hemsley, N3SP

12:15 Set-up & configuration of N3 connection Kaushik Roy, N3SP

12:45 Lunch & networking on 34th floor

13.45 CFH Information Governance – Statement of Compliance

David Stone, CFH & Dr Kevin King, CFH

14.45 A hospice experience Dr David Butler, Consultant in Palliative MedicineCountess Mountbatten House, Southampton

15.15 Next steps John Ellis, N3SP

15.35 Q & A

16.05 Finish

Gossip, Rumour and Salacious Tittle Tattle

Dr Steve Plenderleith

March 2008

Possibly !!

THEN

“The Magnificent 7 10 and me”

• Northern Cluster MeetingJason Coleman Cluster Lead [email protected] Julia Riley Cluster Clinical Lead [email protected]

• Southern ClusterSouth East Region - - South West Region - Peter Thomson Peter.Thomson@rowcroft-

hospice.org.uk- Chris Halling-Brown

[email protected]

• Northern ClusterNorth West Region - Liam McCarthy [email protected] East Region - Darren Harvey [email protected] Region - Tony Colson [email protected] Region - Darren Holmes [email protected]

• Steering GroupDr Steve Plenderleith [email protected]

Proposed Meetings

• Annual National Meeting – September/October– Organised by Help the Hospices– National speakers on new areas of interest– Followed by Steering Group Meeting

• Cluster Group meeting – March/April– Formal in part, summary produced, may be followed by informal session– London– Southern– Northern

• Regional Meetings – November/December - June/July

– Informal, mentoring/networking group – SE, SW– NW, NE, Midlands, Eastern– London

I am writing to ask for your help in addressing some of the barriers that hospices, as key voluntary sector providers of palliative and end of life care, are encountering in gaining connection to the NHS IT network.

Help the Hospices is the national membership body for hospice care, representing almost 200 independent hospices across the UK. We work to help our members to deliver the very best care for patients and their families through education, training

and support, as well as providing a national voice for the hospice movement. I enclose, for your information, a list of hospices within your region.

Hospices play a major role in the delivery of local services to those approaching the end of life. They provide holistic support to people facing a terminal diagnosis, and supply over 75 per cent of specialist palliative inpatient capacity

within the healthcare system, by working closely in collaboration with NHS clinicians.

Many hospices have been trying to establish a connection with the NHS network since the National Programme for IT began. Their success has been variable, depending often on the interest and good will of local IT professionals within the NHS.

Others have faced significant barriers where professionals have either lacked interest in working with organisations outside the NHS or have been unsure whether they have the permission to develop such links.

The latest guidance from the Department of Health on information management (Guidance on Preparation of Local IM&T Plans for 2008/09) clearly articulates an expectation that localities will work with NHS organisations on these issues . It stated that in developing local IT plans there is a need to “develop information sharing arrangements with independent sector providers of NHS funded care”. We hope that this unambiguous reminder will encourage greater local dialogue

and progress in all areas.

Palliative and end of life care is also receiving increasing attention from Government, with the development of a national End of Life Care Strategy, and recognition within the NHS Operating Framework and the emerging NHS Next Stage Review. A key part of improving and developing end of life care in all communities will be the technological infrastructure which supports the

process. The availability of up-to-date patient information for all providers of palliative and end of life care is crucial to delivering service improvements.

I hope that you will be able to clarify with those working to implement the roll out of the NHS IT network in your region, including PCTs in your area, that they can and must engage with hospices and ensure connection to the

network.

A letter to the SHA’s

NHS Operating Framework 2008 -09

NOW

CfHDigital Information Governance Team

Hospice Requirements

• Information Governance Management 101, 102, 103, 105, 106 107, 109 (if applic.), 110, 111, 112, 113

• Confidentiality and Data Protection Assurance 201, 202, 203, 204, 205, 206, 208, 210, 214 (if applic.)

• Information Security Assurance 301, 303 (smart cards if applic.), 305, 306, 307, 308, 313, 314 (if applic.),

• Clinical Information Assurance 401, 403, 405

• Not 603 FOIA

• Tie in with Healthcare Commission standards?

THANKS - Policies

• St Catharine’s Hospice• Saint Francis Hospice• St Mary’s Hospice• St Oswald’s Hospice• Farleigh Hospice• Rowcroft Hospice

• Katharine House Hospice• N London Hospice• Southport & Ormskirk• St Peter’s Hospice• Pasque Hospice

More Needed

Library

Software Review

• RiO – A good work in progress.• Infoflex – update needs writing up.• SystmONE & Crosscare – need updating.• Palcare – Struggling with new MDS.

G:\18th\Hospice Software Review RiO.doc

IGSoC – Information Governance ToolkitHELP !

• LPfIT London IG Group meets every 2 months 3.4.08, 29.5.08, 31.7.08 @ 14:00 - to attend please contact [email protected] Invite from Stephen Elgar

• Others – by the time these slides go out.

mailto:[email protected]

NEXT

HospitalSystems

PACSINFO

Prescrip-tions

CommunitySystems

Secure NHS e-

mail

ClinicBooking

NELH

N3

SpineN3

Spine

ActivityData

30IGSoC

Requirements Hospice Specific

e -Prescribing

LaboratoryResults

EPR SNoMed

CTe - Staff

Record

ESR

• Electronic Staff Record

• Do hospices need it ?

• Can we have it?

• Education, Training and Development (ETD) series replaces ECDL

NHS ELITE (eLearning IT Essentials)

NHS Health (eLearning for Health Information Systems)

NHS National Learning Management System (NLMS), linked to the Electronic Staff Record (ESR).

• Electronic Staff Record http://www.esrsolution.co.uk/

• Microsoft NHS Resource Centre

Secure NHS e-mail

PACS

CommunitySystems

LaboratoryResults

ActivityData

EPR SNoMed

CT

e -Prescribing

INFO Prescrip

-tions

•Northern ClustersLorenzo by another name

Part of the LSP contract ?

•LondonRiO being rolled out to PCT’s & Mental Health Trusts

Is it available for hospices?

•SouthernMillennium for all!

ACSS

ACSS

• Set up to cover specialities and areas of NHS IT need, not covered in the original LSP contracts.

• Tendering has just closed for companies applying for eligibility to supply to specialities within Lot 2.

• Long list of companies involved available on their website.– TPP not there

– CSE Servelec are.

-Additional Supply Capability & Capacity Framework

Lot 2 Clinical Information Technology Services

Service Category Hospice Care: (2.8)

Objective of this Service Category:

This Service Category encompasses the requirements for hospice services

Details removed as document not available for publication – yet.

ACSS

• Further Info needed• Potential for bulk buys• Who negotiates for hospices and who pays

• SHA ? - SHA ?• LSP ? - LSP ?• HtH ? -

Hospice ?• Clusters ?

Freedom of Information Act 2000: Designation of additional public

authorities

• Consultation document• Cost implication or just another requirement• 603

THE FUTUREMore Ideas Welcome

!

Help the Hospices/ICT HubHelp the Hospices/ICT HubIT Survey 2008IT Survey 2008Seminar 18 March 08

AgendaAgendaIntroductionThe survey results

◦ Basic hospice demographics

◦ The IT team

◦ IT governance

◦ IT infrastructure

◦ Business and system applications

◦ Security

◦ Hot topics

◦ Skills, training and supportNext steps

IT Survey 2008 ObjectivesIT Survey 2008 Objectives

To enable HtH and its Hospice Connect cluster groups to focus on those areas where hospices most need help

To enable HtH to establish which common services and suppliers are being used, to apply leverage and gain value

To provide Hospice IT teams with useful sector data to benchmark against

HOSPICE HOSPICE DEMOGRAPHICSDEMOGRAPHICS

Hospice IncomeHospice Income

52

17156

Total replies = 90

Number of IT UsersNumber of IT Users

3028

20

812

Total replies = 98

IT TEAMIT TEAM

Team SizeTeam Size Of those with an in-house team, about 70% have 2 or less IT staff. Average number of staff increases in line with number of users:

8

Total replies = 85

Managed ServicesManaged Services

Type of Managed Service# who use this

(total replies = 90)Desktop maintenance/fault fixing 46 (52%)

Printer/copier maintenance/fault fixing 59 (66%)

Server/network maintenance/fault fixing 69 (77%)

Hosted applications 31 (34%)

Helpdesk/Service desk 41 (46%)Specialist help for projects on an ad-hoc basis

59 (66%)

Consultancy when no in-house expertise 2 (2%)

Managing User RequestsManaging User Requests

Activity# who use this

(total replies = 87)We have a Helpdesk/Service Desk 30 (35%)

Users just email, phone or visit the IT team 64 (74%)

We log all issues to resolution 33 (38%)

We can do remote IT support for fault fixing 50 (58%)We can do remote software installations/upgrades

31 (36%)

We have a Service Level Agreement for user requests/issues

19 (22%)

IT GOVERNANCEIT GOVERNANCE

IT BudgetsIT Budgets

Operating Budget

Capital Budget

15 13

26 24

5

8

44

1911

1

Total replies for both = 83

IT Decision MakingIT Decision Making

48 40

57

9 6

Total replies = 75

IT StrategyIT Strategy

2421

25 13

Total replies = 83

Policies and AgreementsPolicies and AgreementsTop 3 in place

◦Data Protection: 79 (95%)◦Use of Internet/Email: 69 (83%)◦Information Security Policy: 59 (71%)

Top 3 planned◦Communications Policy: 20 (25%)◦Information Security Policy: 18 (22%)◦Internal Service Level Agreement: 17 (21%)

Total replies = 83

ComplianceCompliance

Top ‘aware and compliant’ = Data Protection: 71 (87%)

Top ‘aware and planning response’ = Freedom of Information: 29 (35%)

Top ‘unaware’ = Email Retention: 26 (32%)

Total replies = 82

Management ProcessesManagement Processes

Top ‘have in place’ = incident/problem management: 47 (59%)

Top ‘planning’ = asset management: 22 (28%)

Top ‘no and not planning’ = change management: 28 (35%)

Total replies = 80

IT INFRASTRUCTUREIT INFRASTRUCTURE

HardwareHardware

ServersDesktopsLaptopsPDAsPrinters/copiersNetwork equipment

SuppliersSuppliers

The Top 4 (total replies = 76)

Dell 30 (21%)

HP 25 (17%)

Local 16 (10%)

Misco 8 (5%)

Reason for using current suppliers response (total = 78)

Price 66 (85%)

Quality 65 (83%)

Good customer service 55 (71%)

We’ve used this supplier for a long time 28 (36%)

Hospice Connect Cluster GroupsHospice Connect Cluster Groups

Total replies = 52

Northern Southern London

Already involved 16 (31%)

13 (25%)

9 (17%)

Intend to be involved

8 (15%)

3 (6%)

6 (12%)

BUSINESS AND SYSTEM BUSINESS AND SYSTEM APPLICATIONSAPPLICATIONS

Most Common ApplicationsMost Common ApplicationsDesktop = XP: 71 /77Server = Server 2005: 63 /70Email = Exchange 2003: 44 /71 Human Resource = bespoke: 13 /74Payroll = Sage: 36 /75Finance = Sage: 52 /74Fundraising = Donorflex: 35 /75Patient & Family Info = Palware: 30 /77Lottery = Sterling Members: 26 /73

SECURITYSECURITY

DR/Business ContinuityDR/Business ContinuityResponse

%Response

count

Our critical business applications have a ‘warm start’ backup (eg mirrored, clustered, replicated servers)

51% 36

We keep spare equipment so that we can quickly rebuild if necessary

28% 20

Our users have agreed that there will be no formal business continuity/DR measures

0% 0

We have a documented Disaster Recovery IT Plan 32% 23

We have an alternate location available for IT if our main location is lost

27% 19

We have a UPS to cover at least our critical systems 82% 58

Total replies = 71

Data Back-upsData Back-upsResponse

%Response

count

We have a process of daily/weekly/monthly back-ups

88% 68

Our back-ups are automated 66% 51

We back-up to tape only 44% 34

We backup to hard drive (instead of or as well as tape)

34% 26

Our backups are securely stored off-site 68% 52

We regularly practice data restores 39% 30

Total replies = 77

Security MeasuresSecurity MeasuresIn Place Planning

Anti-virus protection on desktops and servers 76 (100%) 0 (0%)

Malware checking for external emails 53 (70%) 3 (4%)

Malware checking for internal emails 36 (47%) 5 (7%)

Hardware firewall(s) 62 (82%) 1 (1%)

Software firewall(s) 56 (74%) 2 (3%)

Website filtering/restrictions 44 (58%) 5 (7%)Management of portable memory units (Eg memory sticks, iPods) 14 (18%) 17 (22%)

Anti-spam 64 (84%) 2 (3%)

Total replies = 76

HOT TOPICSHOT TOPICS

The Top Five Planned...The Top Five Planned...

Already have/use

Will implement in next 12 months

Will trial/pilot in next 12 months

NHS Connect 14 (21%) 15 (22%) 18 (27%)

Application implementation/ major upgrades

11 (16%) 28 (41%) 2 (3%)

DR/BC 22 (32%) 21 (31%) 4 (6%)

VoIP/IP telephony 10 (15%) 2 (3%) 16 (24%)

Remote working 30 (44%) 10 (15%) 7 (10%)

Total replies = 68

SKILLS, TRAINING AND SKILLS, TRAINING AND SUPPORTSUPPORT

User Competence and TrainingUser Competence and Training

Competence:◦Most are ‘Reasonably competent’: 36 /77

(47%)

Training:◦Most done by the IT Team: 36 /75 (48%)

IT Staff IT Staff Training:

◦Most common: reading/self-study: 50 /58 (86%)

Formal qualifications:◦Most common: technical: 27 /64 (42%)◦ ‘None’ is the same...

Pressure of work◦Most common: ‘Busy’: 37 /62 (60%)

Support for IT TeamSupport for IT Team

some lotswould like

to haveInternal support 25 10 8

Local PCT 8 3 17Umbrella groups (such as Help the Hospices)

14 2 10

IT groups (such as British Computer Society)

9 0 5

Mentoring (from internal person) 5 1 1Mentoring (from external person)

9 2 4

Total replies = 53

WHAT NEXT?WHAT NEXT?

Next StepsNext Steps

Complete the summary results report and issue to responders

Complete recommendations reportAgree an action planImplement actions!

A similar survey may be done in 2009

N3 Introduction & Background

What is N3?

• New National Network for the NHS

• N3 connects all NHS locations to allow digital sharing and exchange of information.

• NPfIT – February ‘04 – BT awarded contract as network integrator.– Live for 4 years now.

• Probably the largest network in Europe.

• Coverage for England & Scotland.

NPfIT contracts

LSP

LSP

LSP

LSP

LSP

NISP N3

NASP EBS

NASP NCRS

The Value of N3

• Metcalfe's law states that the value of a telecommunications network is proportional to the square of the number of users of the system (n²).

• N3 has >34,000 sites with over 500,000 users.

Savings from N3

• NAO report 14th March 08

– The Department of Health said that of savings totalling £208m, N3 generated £192m, with digital imaging and scanning saving a further £14m and software licensing and hardware maintenance contributing £617,000.

N3 Service options for Hospices

• The question of resilience

N3 Hospice Configuration

Local Network

N3 Customer Router

Backup via ISDN

N3 Core Network

DSLNetwork

ISDN

IPstream CentralPrimary via

IPstream Max Premium

N3 Service options for Hospices

GPRS

MobileCommunity network

256K to 1G sites (GP to Hospital)

8M to 1G data centre (LSP, NASP)

N3 core

Hospice

Internet

ISP and remote VPN (Home working) VPN

Gateway

Hospice Catalogue Services

N3-9-6IPstream primary

+ 128kb/s ISDN backup line

N3-2-53IPstream primary

+ 256kb/s ISDN backup lines

N3-2-542Mb/s Private Circuit primary

+ IPstream backup

N3-9-5IPstream primaryNo backup line

N3-9-6

Prices (subject to site survey and vat)

Installation Monthly Rental

• £ 1,220 £ 31 (£2,336 3 yr)

• £ 1,620 £ 75 (£ 4,320 3yr)

• £ 4,220 £ 155 (£ 9,800 3yr)

• £ 9,580 £ 705 (£34,960 3yr)

N3-9-6

N3-2-53

N3-2-54

N3-9-5

Set-up & Configuration of N3 Connection

Name Kaushik RoyTitle Technical Consultant

NOT TO BE SHOWN OUTSIDE OF N3SP

British Telecommunications plcRegistered office: 81 Newgate Street, London EC1A 7AJ

Registered in England No. 1800000www.n3.nhs.uk

Topics for Today

•N3 Network Overview

•Connectivity Options

•An Example Solution Design

•Questions & Comments



Access: N3 / Internet

Care History Care Plans Care Services

NHS CRS

CRS Spine CAB

ETPPACS

CRS = Care Records Service

CAB = Choose and Book

ETP = Electronic Transfer of Prescriptions

PACS = Picture Archiving Communication System

N3 Network Overview



N3 Network Overview

•Access to the following applications: NHS Email, CAB, PACS, ETP, Clinical Records, etc.

•Access to local community applications - through your local PCT

•Internet Access

What does the access to the N3 network give you:



N3 Network Overview

•The N3 network is based on 58 PoP locations throughout England & Scotland

•Each PoP location is an interconnection of thousands of individual connections

•Each PoP is connected to the BT MPLS network to provide a private network with any-to-any connectivity



N3 Network Overview



Connectivity Options

•Most connectivity options are based on a catalogue system

•This offers various bandwidths and different levels of redundancy

•Bandwidths options range from ADSL to Gigabit Ethernet

•Bespoke designs are also available



Connectivity IPStream

•Typical Consumer Broadband but for Business Use

•Downstream bandwidth between 288kbps and 8128kbps

•Upstream Bandwidth between 64kbps and 832kbps

ADSL Router BT Exchange

BT Wholesale Network N3 Network

Downstream Bandwidth

Upstream Bandwidth



Connectivity IPStream

•Based on Max Premium service from BT Wholesale

•Rate Adaptive – bandwidth related to distance from nearest BT Exchange

•No QoS guarantees – QoS can be applied to packets

•However no guarantee that packets will not be dropped within BT Wholesales network

•However Max Premium will be prioritised over residential broadband



Connectivity: N3-9-5

•Non-Resilient Connectivity

•Single Cisco 1801 Router at Customer Site

•Single IPStream Connection to N3

N3 Network

Single non-resilient IPStream circuit

ADSL Router




•Resilient Connectivity


•Primary IPStream Connection to N3

•Secondary ISDN at 128kbps

N3 Network

Primary: IPStream

Secondary: ISDN






•Primary IPStream Connection to N3

•Secondary ISDN at 256kbpsN3

Network

Primary: IPStream

Secondary: ISDN

ADSL Router






•Primary 2Mbps private circuit Connection to N3

•Secondary IPStreamN3

Network

Primary: 2Mbps Private Circuit

Secondary: IPStream

Router






•Primary 10Mbps Ethernet Connection to N3

•Secondary IPStreamN3

Network

Primary: 10Mbps Ethernet

Secondary: IPStream

Router



Connectivity – What You Get

•Managed Service

•N3 Operations 0800 085 0503

•HSCR Bandwidth utilisation Reporting

•N3 Portal Access

•Full Access to N3 - Internet and Applications



Connectivity – What we need

•Power – 240V AC 24 x 365

•Rack Space – eg., Cisco 1801 1RU

•Space and Power for Access Circuits: IPStream/PSTN, ISDN, Private Circuit or Ethernet

•Physical Security of equipment

•LAN port to connect N3 router



Solutions Design

•Thanks to Darren Holmes, Head of ITC for St Barnabas Lincolnshire Hospice

•St. Barnabas consists of a 7 smaller sites and 1 main site

•Solutions Design uses both non-resilient IPStream and Private Circuit connectivity



Solution – St. BarnabasSite Name Post Code Nearest BT

Wholesale PoPConnectivity Distance (straight

line) in Km

Nettleham Road LN2 1RE Lincoln IPStream w. no backup 1.08

Hawthorn Road LN2 4QX Primary: N3 PoPSecondary: Lincoln

2Mbps private circuit w. IPStream backup

Primary: 6Secondary: 3.2

Cardinal Close LN2 4SY Lincoln IPStream w. no backup 1.92

Boston Day Hospice PE21 9NB Boston IPStream w. no backup 1.76

Gainsborough Day Hospice

DN21 3AD Gainsborough IPStream w. no backup 1.93

Spalding Day Hospice PE11 3GD Spalding IPStream w. no backup 1.28

Sutton-on-Sea Day Hospice

LN12 2LL Sutton On Sea IPStream w. no backup 849m

Boston Welfare Support

PE21 9HH Boston IPStream w. no backup 722m

http://www.samknows.com/broadband/exchange.php?ecode=SLLI



http://www.samknows.com/broadband/exchange.php?ecode=EMBOSTO

http://www.samknows.com/broadband/exchange.php?ecode=SLGB

http://www.samknows.com/broadband/exchange.php?ecode=EMSPDNG

http://www.samknows.com/broadband/exchange.php?ecode=SLSU

http://www.samknows.com/broadband/exchange.php?ecode=EMBOSTO



Solution – St. Barnabas

Lincoln

Nettleham Road

Hawthorn Road

Cardinal Close

Boston Day Hospice

Gainsborough Day Hospice

Spalding Day Hospice

Sutton-on-Sea Day Hospice

Boston Welfare Support

N3

KeyIPStream circuitPrivate circuit



Solution – St. Barnabas

•What kind of bandwidth can you expect from an IPStream connection?

•Quick DIY guide http://www.samknows.com/broadband/

http://www.samknows.com/broadband/



Setup & Configuration

Thank you for your time.

AgendaTime Speaker

13.45 CFH Information Governance – Statement of Compliance

David Stone, CFH & Dr Kevin King, CFH

14.45 A hospice experience Dr David Butler, Consultant in Palliative MedicineCountess Mountbatten House, Southampton

15.15 Next steps John Ellis, N3SP

15.35 Q & A

16.05 Finish

Info

rmat

ion

Gov

erna

nce

Information Governance

Connecting Hospices Workshop

BT Tower

18th March 2008

Info

rmat

ion

Gov

erna

nce

Creating the environment

Organisational Controls

Physical Measures

Personal Behaviour

Info

rmat

ion

Gov

erna

nce

Key stakeholder drivers

Care Record Guarantee

IG Statement of Compliance

IG Toolkit

Info

rmat

ion

Gov

erna

nce

Stakeholder satisfaction - IG

CPNIMI5

SHAs

HealthcareCommission

N3 SPProgrammes

NHS CFHIG

N3SP

PCTCommissioners

NHS CFHN3

DepartmentOf Health

Hospices

Info

rmat

ion

Gov

erna

nce

Contact

David Stone – Communications Manager0113 397 369807947 [email protected]


Info

rmat

ion

Gov

erna

nce

Information GovernanceStatement of Compliance Migration Programme(IGSoC)

Hospice TrainingInformation Governance and IT Security

Dr Kevin J. KingIGSoC Processing ManagerInformation Governance Statement of Compliance Migration Programme

18th March 2008

Info

rmat

ion

Gov

erna

nce

Contents

ObjectivesWhat – Integrating Quality AssuranceWhy – Quality Assurance ViewDocument Details – Quality Assurance ViewInformation GovernanceIT SecurityIGSoC IT Security HeadlinesTypical Specifics (1 to 3)One Computer ModelActions for One ComputerComputer InterchangeContactsHelp! - Information Sources (1 to 12)Help! - Summary

Info

rmat

ion

Gov

erna

nce

Objectives

To focus on: The IGSoC Process Document Set Information Governance IT Security Proposed ‘Single Computer’ Set-Up

To provide: A guide to sourcing information An overview of headline subject areas Some specifics from a QA perspective Discussion on Information Governance Toolkit (IGT)

Requirements (questions and answers at end of day)

Info

rmat

ion

Gov

erna

nce

What – Integrating Quality Assurance

What is the IGSoC Process?

Application Form

NACS Code

Information Governance Toolkit (Acute Hospital Trust)

Sponsorship Letter

Logical Connection Architecture

IGSoC Declaration

Offshore Policy/ISMS

Quality Assurance Process

Audit

Purpose• Starts the Process (Register)• Unique Identifier• Self-Assessment of IG and IT

Security Position• Confirms Validity of Need• Ensuring the Network is Fit for

Purpose• Commitments and Obligations• Patient Identifiable Data

Outside England• Checking Up• Fine Toothcomb

Info

rmat

ion

Gov

erna

nce

Why – Quality Assurance View

Why is the IGSoC needed by NHS CFH?

Availability

Confidentiality

Integrity

Protect Patient Identifiable Data

Patient Confidence

DPA for employee data

Care Record Guarantee

Why is the IGSoC needed by organisations?

Access to digital services

Service Delivery

Industrial Good Practice

Management of Public Image

Focus on central and local

DH Legal and Professional Obligations

Info

rmat

ion

Gov

erna

nce

Document Details – Quality Assurance View

Simple StuffApplication Form, look out for detailed business need, this helps NHS CFH assess submissionsIGSoC, read carefully, follow all links and complete the obvious like date, signatory name and position, submit from correct mailbox, if IT Outsourcer involved they must also submit an IGSoCSponsorship Letter, complete the obvious like date, NHS organisation name, signatory name and position and IP addresses

More ComplicatedIG Toolkit, n requirements, long

lead time activity, need to understand ISO 27001/2, conduct gap analysis, account for business need

LCA, network topology, show relationship to N3, other networks e.g. corporate, Internet, tell how user and device access to N3 is reduced to a minimum

Offshore Policy, if PID is stored or viewed outside England, includes back-ups

Info

rmat

ion

Gov

erna

nce

Information Governance

Information Governance is a framework providing a consistent way for employees to deal with the many different information handling requirements, including:• Information Quality Assurance• The NHS Confidentiality Code of Practice• Information Security Assurance• The Data Protection Act (1998)• Records Management• The Freedom of Information Act (2000)

It allows organisations and individuals to ensure that personal information is dealt with legally, securely, efficiently and effectively, in order to deliver the best possible care

H. Cayton: IG must “provide sound policy, standard setting, independent oversight, monitoring, arbitration and enforcement”

Info

rmat

ion

Gov

erna

nce

IT Security

All based on:• Availability• Integrity• Confidentiality

Most recognised standard is ISO 27001/2

Other standards such as CobiT and ITIL help as can Basle 2, SOX, PCI

A large part of Information Governance

Info

rmat

ion

Gov

erna

nce

IGSoC IT Security Headlines

Network Access Management

User Access Management

Policies

S/W H/W Maintenance

Asset Management

Audit Controls

Legal Compliance

Stop network intrusion external and internal

Stop unauthorised user activity

N3, PID, Password etc.

Downloads, Hardening

Protecting What/How

Making sure

IGSoC, DPA, NHS Codes and Practices ...

Info

rmat

ion

Gov

erna

nce

Typical Specifics (1)

Do this:


Penetration Testing

Password Policy

Asset Register

Software Updates

Risk Register

Hardening

and this:

• Offshore PID

• Security Incident Log

• Anti-Spyware

• Knowledge of Standards

• Monitoring Systems

• Anonymise PID Data

• IGSoC from Correct Mailbox

• IT Outsourcer (QA & IGSoC)

Info

rmat

ion

Gov

erna

nce


and this:

Logging

Mobile Code

PID Guidelines

Audits

Documentation in General

External Audit

Headline Issues

Policy Expansion

and this:

• Policy Range

• Security Policy

• Vulnerability Scanning

• Anti-Virus Updates

• BCP/DRP

• Devices Connected to N3

• Data Protection Act

• Future Usage

Info

rmat

ion

Gov

erna

nce


and this:

IGT Guidance

LAN Segregation

LCA Update

Legislation

NHS CFH Contact

Policy Deviation Numbers

Policy Training

RA Procedures

and this:

• Review ISO 27001/2

• Send IGSoC

• Software Download

• Sponsorship Letter

• Standards Certification

• Third Party Contracts

• URL Filter

Info

rmat

ion

Gov

erna

nce

One Computer Model

N3

CorporateInternet

Associate

Interchange:•CD•USB•Hard Drive•Hard Copy•Fax•E-mail•Etc.

Actions depend on Interchange

N3 Router

Actions required

Info

rmat

ion

Gov

erna

nce

Actions for One Computer

All the IG Toolkit Requirements are mandatory

Pay attention to:• Anti-virus and anti-spyware updates• Security patch updates• Operating system updates• Productivity product updates (MS Office, Adobe etc.)• Account administration• Account monitoring• Third party access• Screen controls (password timeout, visibility)• Clinical or business application updates

Info

rmat

ion

Gov

erna

nce

Computer Interchange

Is the one computer really standalone?

No, not really, somehow updates are applied.

And the likelihood is that data exchanged with N3 via• The screen• File transfer• NHSMail

may need to be used elsewhere on the corporate LAN, or even

exchanged with other parties, so all the IG Toolkit requirements

for the one computer apply to the Corporate LAN.

An N3 or PID policy, signed by the relevant staff, is a good way to

address some of the IG Toolkit requirements.

Info

rmat

ion

Gov

erna

nce

Contacts

Dr Kevin J. King – IGSoC Processing Manager

0113 397 3666

07891 151304

[email protected]

IGSoC Team

0113 397 3646

[email protected]

Info

rmat

ion

Gov

erna

nce

Help! – Information Sources (1)

Info

rmat

ion

Gov

erna

nce


Info

rmat

ion

Gov

erna

nce


Info

rmat

ion

Gov

erna

nce


Info

rmat

ion

Gov

erna

nce


Info

rmat

ion

Gov

erna

nce


Info

rmat

ion

Gov

erna

nce


Info

rmat

ion

Gov

erna

nce


Info

rmat

ion

Gov

erna

nce


Info

rmat

ion

Gov

erna

nce


Info

rmat

ion

Gov

erna

nce


Info

rmat

ion

Gov

erna

nce


Info

rmat

ion

Gov

erna

nce

Everything you need is on www.connectingforhealth.nhs.uk

Like an Intranet the HOME tab contains current articles e.g. IGSoC

Afterwards moved to SYSTEMS and SERVICES tab

Multiple links of interest on SYSTEMS and SERVICES tab

Information Governance, NHS Number, NHSMail more…

NHS Codes of Practice

Records Storage


Knowledge Base

Remember RHS menus and contact details

Help! - Summary

http://www.connectingforhealth.nhs.uk/

IT Issues – an NHS View

Dr David ButlerMacmillan Consultant in Palliative Medicine

Countess Mountbatten House

Southampton University Hospitals NHS Trust

Setting the Scene

• SUHT main base - SGH

• Unscheduled Care Division

• Cancer Care Group

Setting the Scene

Setting the Scene

• Specialist Palliative Care Service

• Based mainly at Moorgreen Hospital

• IT links via Southampton City PCT

Setting the Scene

Setting the Scene

• SPC Service

• Catchment approx 710,000

• 2 PCTs (previously 5)

• In patient unit

• Day Care

• Community Service

• Hospital Palliative Care Team (SGH)

• Education

Setting the Scene

IT for SPC

• Pallicare (1999)

• Clinisys CIS Healthcare

• Linked to PAS / Chemocare / RTcare

• Terminals all areas and Winchester Hospital and SGH Chaplains

• Runs on Citrix

A patient

• Referral from GP on Friday 29th Feb.

• Not known to me but had been in SGH.

• Discharged previous day

• Would it be appropriate to admit?

Pallicare System

• Link to PAS

• Possible use for Commissioning purposes

Conclusion

• Information on the hospital system enabled me to discuss the patient and agree admission was appropriate.

• Then provided information prior to admission and before notes arrived.

The Next Steps

John EllisN3 SFC Manager

Hospice Trial

• 4 Hospice’s

• Bespoke

• Different Solutions

• Results

• Product availability

Stand Alone Site

Multi-Site

Hosted SiteMulti Solution

N3 Helpdesk Introduction

• 0800 085 0503 , Option 3• Mike Atrill• [email protected]• [email protected]• 01977 595760• Connectivity Process:

IG SOC Access Agreement



Calling Plan

• Product Options

• Set Pricing Options

• Advice on process

• Placing orders

• Advice on Implementation and timelines

Support

• IG SOC Team

• N3 Helpdesk

Option 1 In Life Faults

Option 2 Delivery

Option 3 Helpdesk

CRM and Service Portal

Review

The objectives of today were to:

•Provide a description and background to N3

•Benefits to a Hospice of being connected to N3 •Present options available to a Hospice

•Overview and detailed

•Provide an opportunity for questions and answers

•Outline the next steps for up you to gain access to N3

Question Time

Thank you for your time today

Documents

N3 / Help the Hospices - Connecting Hospices Workshop