1. technology and computing

HEE Mar 15.7
Board Meeting
Meeting Date
24th March 2015
Report Title
Performance: Update on Information Portfolio
Paper Number
HEE Mar 15.7(ii)
Report Author
Andrew Frith, Interim Chief Information Officer
Lead Director
Nicki Latham
FOI Status
Applicable
Report Summary
The purpose of this paper is to update the Board on the work
that the Performance and Development Directorate is
undertaking to improve our approach to systems and data.
As a highlight distributed enterprise, evolving over a number of
years, our systems, processes and data have simply evolved
alongside, without formal governance or management to
ensure alignment and efficiency.
We are now at the point where it is critically important to
manage our data much more effectively, and to coordinate the
delivery of systems, maximising the utility of existing
investments where we can, and working out what we need to
support our enterprise in the future.
As a distributed enterprise, we must also find ways of aligning
our operational/delivery teams, so that they can transform our
ways of working with systems and data to maximum effect.
Purpose
(tick one only)
Approval
To Note
Decision
⬜
✓
⬜
Recommendation
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HEE Mar 15.7
Strategic Objective This paper sets out how we intend to improve our management
Links
and delivery of information systems and data, so that as a
corporate entity we can be more assured that our decisions are
based on sound information, and that our investment in
computer systems is cost effective and beneficial to the delivery
of our mandate commitments.
Identified risks and The programme of work on systems and data now under the
risk management
responsibility of the Performance and Development directorate
actions
is likely to carry both operational and reputational risks;
however we are presently defining our programme of work, and
will identify and plan to mitigate those risks accordingly.
Resource
implications
There are likely to be resource implications as the programme
of work establishes the roadmap for each of the key
components of delivery / improvement, but at this point in time
we are still formulating the detailed plans for subsequent Board
consideration.
Support to NHS
Constitution
This paper supports the NHS commitment to providing best
value for taxpayers money and the most effective, fair and
sustainable use of finite resources
The paper also recognises that HEE is an organisation
accountable to the public, communities and patients that it
serves, and as a result our decisions and actions must be
evidenced and transparent, and underpinned by reliable and
consistent data.
Legal implications
including equality
and diversity
assessment
Failure to put in place effective data and information
management systems could lead to breaches of the Data
Protection Act.
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HEE Mar 15.7
HEE Chief Information Officer Report on Progress
March 2015
Introduction
The purpose of this paper is to update the Board on actions we are undertaking to
improve the ways by which HEE captures, controls and uses information to underpin
its critical business activities.
Background
In January 2015 we appointed HEE’s first Interim Chief Information Officer to take
charge of the diverse portfolio of business information systems and data collection
and reporting processes.
Some key-facts to set the context for this paper:
a. Across our national and local teams there are approximately 130 1 staff
who have some sort of responsibility for information, IT, systems or
analysis within their job role, but they are not presently aligned to shared
objectives/responsibilities, nor managed in a consistent way.
b. During a recent assessment of the systems portfolio for the Trainee
Information Management System2 procurement we discovered circa 120
different business systems, and demonstrated a considerable degree of
overlap between business functions which warrants a much more active
approach to managing the portfolio
c. An information flows audit 3 conducted around the same time as the
systems audit identified circa 180 ‘principal’ datasets that flow routinely
between HEE and the various local delivery partners, regulators and
others. It was clear from that review that there was much scope for
rationalising and filling gaps in our data
Since January 2015 we have been establishing the foundations that will enable us to
deliver a programme of improvements across OneHEE, whilst also dealing with
business-as-usual activities around data, systems and reporting.
Developing a Longer Term Strategy
We will of course need to develop a strategy to shape the future of HEE’s
information systems and services. We already know that a future strategy we will
need to address how HEE’s highly distributed organisation:
1
Beyond Transition Consultation/Structures, Health Education England, March 2015
Trainee Information Systems Strategic Outline Case, Robin Marchant, HEE TIS Project, March 2015
3
Information Flows Audit, collaboration between HEE and NWL LETB, February 2015
2
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HEE Mar 15.7
•
Is enabled to be a ‘productive’ organisation; interacting through email, video
conferencing and sharing of calendars, documents, irrespective of location or
organisational form.
•
Delivers systems which support key business activities like recruitment,
trainee management, commissioning, and helps align business processes
across local and national teams
•
Uses information more actively and constructively to underpin all of our
decisions and actions, with clearer accountability and transparency in
everything that we do.
To formulate that strategy we will need to discuss ‘requirements’ with colleagues
across HEE, and we expect to involve the Board in that process. We will start that
process shortly, with the aim of producing a strategy for Board consideration in early
summer 2015.
Information Programme
In January 2015 we outlined a programme of activities to 'stocktake' the information
challenges we face, and put in place the essential building blocks for delivery. In
summary, the themes of the programme are:
•
Manage the portfolio of systems more actively; rationalising the estate,
and ensuring that we take a more considered view of investment in any new
information systems
•
Using information more effectively; increasing the reliability of our data,
and making sure we use it to understand what is happening, and therefore
underpin more of our decision and actions
•
Aligning teams and delivery approaches; ensuring that our distributed
informatics workforce are working to common objectives, and our approach to
suppliers and delivery is more consistent
We have made good progress on a number of these areas already, and some of
these are outlined below.
Managing The Portfolio of Systems
We have established an initial inventory of business systems used across HEE, and
that is now informing our decisions about where we have significant overlaps, gaps
or weaknesses that need to be addressed. Some tactical early actions that we have
already taken include:
•
eWorkforce: with agreement of the Commissioners Network, and support
from the Head of Workforce Strategy, we are presently rolling out the
Yorkshire and Humber eWorkforce tool across all local teams; this will
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HEE Mar 15.7
standardise and improve the process of collecting demand data from
Providers, and make it easier to collate the data for national purposes.
•
Consolidated Contracts: we have just aggregated all of the individual
contracts between local teams and HICOM, the supplier of the “Intrepid”
Trainee Management System used by a large number of local teams, into a
single national contract with performance payment built-in for the first time.
This will increase our leverage with the supplier and enable us to drive
forward the migration from the old version of the system.
•
Investment Guidance: investment in technology is a cross-government
concern, and usually we have to seek external approval from Department of
Health, Cabinet Office and/or the Government Digital Service, depending
upon the type of solution we are implementing. However the guidance is
extremely confusing and sometimes contradictory, so we have just produced
a HEE guide to systems investment that we are now promoting across HEE
local teams. That guide mandates the involvement of HEE’s Chief Information
Officer, and Chief Technology Officer to help govern any investment, and
inclusion in national registers for systems and technology so that we can
continue to manage the portfolio effectively.
•
Trainee Management System: closely coupled to the work on migration from
the older version of the “Intrepid” system we have started work on the
procurement which is necessary because existing contractual cover will expire
in two years time, and we are already beyond the point at which EU legislation
allows. However contract/legality aside, there are many benefits in bringing
together all trainee data into a single national system, but it is a complex
endeavour and needs a formal Business Case and managed procurement to
deliver effectively. There is already a Steering Team in place, chaired by Nicki
Latham as Senior Responsible Owner (SRO), and work is progressing well on
producing the Business Case, which we intend to bring to the Board in April
for review and sign-off.
Using Information More Effectively
The Information Flows Audit confirmed the complexity of data collection across the
landscape of HEE both at national and local level. Annexe II summarises the main
findings. It highlights the difficulty in forming a coherent picture of ‘what is going on’
across the organisation, which is of course important for accountability and proper
governance. With that in mind, some key early steps we have taken are:
•
Information Assurance: we have issued clear instructions to local teams that
we expect all key data to be validated and assured at the point of collection,
and importantly signed-off but the local director, before it is used for any
analytical, reporting or decision-making purposes. Nationally, we are
reinforcing this important principle by ‘playing back’ aggregated performance
and/or monitoring data to local teams, to challenge and question, before it is
used for decision-making and action. For example, in the last EDCOM round
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HEE Mar 15.7
we ran a ‘webinar’ with local teams, which proved extremely informative and
valuable in highlighting different commissioning practice across local teams.
•
Performance Frameworks: working closely with the Performance Leads
Network (PLN) we are revisiting the existing Integrated Performance Report
framework, to seek to make it more relevant to local teams, and provide a
clearer line-of-sight between local activities and national accountability. We
also hope to make the national reporting more understandable and focused
so that Executive team has the key information they need for decision-making
and action.
•
Using Data More Effectively: as the audit showed, we are amassing large
quantities of data across many different themes, however we have difficulties
marshalling that data into suitable repositories for wider use/exploitation. We
have therefore started work on a prototype data repository as the basis for
information collation and exploitation. Rather than develop something in
isolation nationally, we have asked our London and Midlands geographies to
work together to develop this initial prototype, building on work they were both
already undertaking independently.
Aligning Teams and Delivery
One of the major challenges in bringing coherence to the systems and information
portfolio is the highly distributed nature of our organisation. To mirror the
arrangements in place for other national disciplines we have instigated the following:
•
Geographic Information Leads: each area has a lead for all matters
relating to information and systems locally. Annexe III identifies who these are
in each geography. We are now working with these leads as the ‘senior
management team’ for information and systems, professionally linked to the
Chief Information Officer, but managed directly locally.
•
Thematic Collaboration: we cannot hope to deliver our information
programme with just a small national team responsible for everything, so we
have adopted the following approach:
o Geographic Information Leads taking on responsibility for key
operational themes, and working in collaboration with another
geography to maximise the capability and capacity of each geographic
team (see Annexe III for details).
o Leveraging established networks such as performance, workforce,
commissioning, to help define and shape requirements, and make
appropriate choices and manage delivery (see Annexe III).
We are pleased to report that this approach seems to working well so far, as
evidenced by the eWorkforce implementation, and the support being offered
by the performance network in rejuvenating the IPR.
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HEE Mar 15.7
There is much work yet to do in this area, for example establishing our preferred
approach to delivering systems ie is our policy to buy, build, rent or other? We will
need to work closely with colleagues in procurement and finance, as well as
colleagues in Department of Health, Government Digital Service and others to
establish a policy which meets HEE’s needs, whilst remaining compliant with
Government standards and direction of travel for Digital Services.
Supporting Other Teams
With the Chief Information Officer in post, we are, for the first time, able to support
colleagues in other Directorates with professional / technical input to existing
schemes, for example, working closely with the Director of National Programmes in
DEQ advising / supporting:
•
Oriel national recruitment system delivery approaches / issue resolution
•
Dental ePortfolio options for delivery / procurement / issue resolution
•
eLearning programme, supporting the take-on of new / complementary
content from Health and Social Care Information Centre eg Patient Safety,
Summary Care Record
This type of support is an important aspect of our new responsibilities as it provides
a level of professional / technical input to all systems and data schemes irrespective
of the ownership or responsibility for those schemes, and over time this improve their
delivery and alignment with corporate objectives.
National Information Board
NHS England through the National Information Board (NIB) has recently published
the Personalised Health and Care 20204 strategy that sets out how health and care
will be ‘electronically transformed’ over the next 5 – 7 years.
There are various NIB Leadership and Working Groups tasked with delivering
against the 70+ commitments raised by the strategy, organised into seven themed
workstreams, with an eighth enabling workstream to underpin the others.
HEE has been asked to work with the HSCIC, leading workstream 6: “Supporting
care professionals to make the best use of data and technology”, under which there
are seven core tasks. Annexe I sets these commitments out in more detail, but in
summary they cover the following themes:
4
Personalised Health and Care 2020: A Framework for Action, NHS England National Information
Board, November 2014
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HEE Mar 15.7
•
Competency: making data and technology a core part of every professional
training programme and throughout continuous professional development /
careers.
•
Leadership: ensuring that health and care leaders / decision-makers fully
understand how information and technology can enable efficient, patient /
citizen focused health and care services.
•
Professionalism: turning the specialist informatics community into a
professional cadre, able to support colleagues across the sector to deliver the
aspirations outlined in PHaC20.
•
Collaboration and Cooperation: ensuring that the sector makes the best
use of the knowledge, skills and capabilities acquired by collaborating and cooperating more effectively, and driving data / technological uptake as a result.
We have been quite clear with the NIB Leadership that we support and endorse the
aspirations of the strategy, and will play our part actively, but that we need to take a
considered view about the pace of change that is possible, especially in the context
of consultations like Shape of Training5 and the Shape of Care6 review which may
have a bigger impact on the professional health and care workforce.
In Conclusion
Clearly there is much work presently underway to establish a coherent portfolio of
information and systems. Whilst this paper is a brief update on some of the activities
we are presently doing, it does not yet give the Board details on the timetable,
investment necessary, nor the risks we may encounter. Our plan is to bring all of that
together into a more detailed update for the Board around May/June, in line with our
business plan commitment.
Recommendation
The Board is asked to:
•
Note the updates identified this paper, and provide input/comment for Director
of Performance and Development and Chief Information Officer to take on
board for subsequent
•
Note our intention to bring a more detailed programme / timetable report back
to a subsequent meeting, for due consideration, discussion and approval.ß
5
Securing the future of Excellent Patient Care, Professor David Greenaway, Shape Of Training
review, Autumn 2013
6
Shape of Caring: A Review of the Future Education and Training of Registered Nurses and Care
Assistants, Lord Willis, Chair of the Independent Review Panel, HEE, February 2015
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HEE Mar 15.7
Nicki Latham
Director of Performance and Development
Andrew Frith
Interim Chief Information Officer
Annexe I: NIB Workstream 6 Commitments
1. Introduce a new KSF for all levels of health, care and social care workforce to
embrace information, data and technology, by April 2016
2. A consortia group of NIB members and stakeholders, including the NHS TDA,
HEE, Monitor, the NHS Leadership Academy, the Association of Directors of
Adult Social Services (ADASS), the Society of Local Authority Chief Executives
(SOLACE), NHS Confederation and the Foundation Trust Network, will lead on
the development of a training programme for boards and senior leadership teams
across health and care. This will support executive and non-executive directors in
the development and implementation of technology strategies as part of wider
service redesign and change management.
3. The HSCIC will establish a framework contract and panel of suppliers, including
the best-performing NHS Trusts and Foundation Trusts, to provide easily
accessible support on digital strategies, process reengineering, managing
change, benefits optimisation and systems implementation.
4. By April 2016 the HSCIC will work with national and local partners to agree a
revised definition of the health, care and social care informatics profession.
5. The NIB and its Strategic Clinical Reference Group will, with clinical leaders,
develop proposals to support an emerging federation for the informatics
profession. The longer-term vision involves the development of a Faculty for
Health Informatics for medical practitioners and a Federation for Informatics
Professionals for non-clinicians. The latter will launch an Informatics Career
Framework to support the development and professionalisation of informatics
specialists. The federation will engage with stakeholders to determine whether a
voluntary registration-based model or professional regulation is appropriate.
6. DH, HEE and Skills for Care will work with the professional regulation and
education bodies to ensure that by April 2017 their core curriculum and
associated knowledge frameworks contain the relevant knowledge, skills and
characteristics to enable the workforce to embrace information and technology in
the rapidly changing digital environment.
7. NHS England will develop proposals for Code 4 Health by June 2015
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Annexe II: Information Flows Audit
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Annexe III: Geographic Responsibilities
Geographic Information Leads
London and South East:
South:
Midlands:
North:
John Madsen
Debi Carpanini
Sally Batley
Jonathan Brown
Working Collaboratively on Key Themes
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