Latest Update on NPfIT in the Northwest
Alan Spours
Chief Information Officer
9th October 2007
Structure of Presentation
• Position in the North West
• Update on the NPfIT Local Ownership Programme
• Governance Arrangements
• Delivery of the Lorenzo Solution
Position in the North West
•
Deployments to Date
– Heavily focused on PAS in community & secondary care
– Main focus PAS – difficult in acutes….still a lack of confidence
•
National Pilot of Summary Care Record in Bolton
•
Morecambe Bay Strategic Partner with CSC
•
Primary care not well supported in the original contract.
•
Detailed Implementation Plan (DIP) for 2007/8 in NW
– Large scale programme compared to other SHA’s
– 93 CSC projects planned for delivery in 7/8
– Remaining 5 PACS systems to go live by end of ‘07
• PACS next steps
– Ensuring the Independent Sector is bound in
– Options for sharing the Image, can we reach agreement on
‘Broadview’ ?
– Northwest wide PACS/Imaging strategy
Solutions Delivered to Date
Enablement of NPfIT Solutions Across NW SHA
Total when at 100%
1327
28
7
7
24
7
28
26
1327
1569
1327
100%
19
90%
80%
41
43
51
58
70%
68
60%
86
% Remaining
11
100
50%
93
% at Technical Go Live
93
% at Business Go Live
12
81
40%
30%
57
48
20%
17
42
37
10%
14
16
0%
GP
% GP
Practices Referrals
Live with Using C&B
C&B
Acute
Trusts
Directly
Booking
PCT PAS
(iPM)
Mental
Acute
Digital
EPS- GP
EPSE-Transfer
Health
Trust PAS Imaging
Practice Pharmacy
of GP
Trust PAS
(iPM)
(PACS Ref Release 1 Release 1 Records
(iPM)
Soln)
2007/8 Delivery of CSC Solutions up to end
of Sept
Overview Progress Against 07/08 Plan as @ 1st April Base
Planned
Live
R
A
G
PACs
18
13
0
2
3
PAS - Acute
7
0
4
1
2
PAS - Community
3
3
0
0
0
PAS - Mental Health
3
2
0
0
1
iCM
19
0
3
16
0
Child Health
13
0
12
1
0
Departmental Systems
29
6
9
5
9
Map of Medicine (MoM)
1
0
0
1
0
Total
93
24
28
26
15
NLOP
• Openness, Transparency and NHS control & influence
• Access to the Contract
– Main Project Agreement & 36 Schedules attached.
• 3000 pages of complex legal documentation….need
support from CfH to translate!
• Implied Confidentiality agreement linked to this access
• Financial Schedules particularly sensitive
• Financial Risks & Issues
– ‘The entity (Trust, SHA, CfH, CSC) that causes a contractual
delay event will be responsible and accountable for the
consequences’
– For discussion at NW DoF’s, and at SHA & NME Programme
Boards
Governance
• Establish governance arrangements that reflect the new
accountabilities
– Pan SHA (NME) Management Board
– SHA NPfIT Board
– Patch IM&T Boards
• Re-establish Cheshire & Merseyside & Cumbria & Lancashire
Boards
• Lead CEO for each patch
• Review of local governance arrangements in the light of the
above
Delivery of Lorenzo 3.5/4.0
• Lack of Confidence in the NHS in the Delivery of Lorenzo
– Timing & Quality
• Current Dates:
– 3.5 End of June 08
– 4.0 End of June 09
• Focus on how do we ensure CSC deliver quality products
to time
• CSC have taken control over the delivery of Lorenzo
• External review of CSC/iSoft by EDS and Mastec
– Lorenzo 3.5, 2 months behind schedule
• Options for the NHS?
– Is there an alternative release and deployment strategy that
would benefit the NHS and also reduce risk?
The ‘Penfield’ Project
Lorenzo New Release Strategy
Release 4
Release 3
Release 2
Release 1
GP
Commissioning
Document
Management
Integration
Protocols
Integrated Care Pathways
Screening
Mobility
Device Integration
Interactive Charting
Tray Management
Stock Management
Non -Patient Requests
Inpatient
Prescribing
Theatres
Maternity
Medication Administration
Enhanced PSIS
Multi -Resource Scheduling
Advanced Bed Management
Consent for Treatment
Emergency Care
Patient
Confidentiality
Mental Health Administration Act
Mental Health Reviews & Tribunals
TTO/OPD Prescribing
Care Plans
Contract Management
PSIS View & Initial PoC
Referrals
Access Planning
Inpatient
Patient Identity including PDS
Outpatient
Document Tracking
Requests and Results
Task Management
EPR Views
Clinical Documentation
SNOMED
Core LORENZO Framework
Contact Management
Day Care Management
Caseload Management
LRS
Multi -Campus
Inbound ADT Messages
Lorenzo Release Dates from CSC
Available to Early Adopters
Production Ready
RKM
Release 1
1st March 2008 – 31st May 2008
1st June 2008 - 31st Aug 2008
Release 2
1st Oct 2008 – 30th Nov 2008
15th Dec 2008 - 28th Feb 2009
Release 3
1st July 2009
1st October 2009
Release 4
1st March 2010
1st June 2010
Lorenzo Issues Requiring Clarification &
Agreement
• What is the Instance Strategy?
– During Transition
– Long Term
• Deployment Approach & Number of CSC Engagements
• Lead time & Project Duration (9 -12 months)
• Configuration Approach
– NME wide configuration
– SHA wide level?
– Local health community defined configuration
• Content Approach
– In certain areas Lorenzo allows total flexibility eg Clinical
Documentation
– National/NME wide standards ?
– Do we allow some local ability to add clinical data items ?
Re-planning & Timelines
• Additional Contract Requirements linked to CSC’s late
delivery
• Way forward for Primary Care
– TPP and Lorenzo GP options still there
• CSC Capacity over time, under discussion for R1 for
NME
– May 08: 3 Early Adopters
– July/August 08: Further 3 deployments?
– September to March 09: ‘2 per week’…circa 25-30?
• Implies around average of 6 per SHA by March ’09
– Urgent need to identify early implementers of R1
• iCM still an important stepping stone from end of ’07
• Creation of an Outline Implementation Plan (OIP)
– Contract Value
We need your help, input and drive to ensure
that the NHS and CSC deliver Lorenzo
successfully.
Alan.spours@northwest.nhs.uk
Thank You
Alan Spours
Chief Information Officer
9th October 2007