The NIMM – Local benefits and experience
 Am
I providing a good
service?
 Is it a cost effective service?
 If you don’t have measures
in place how will you know?
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All NHS Trusts are subjected to measurement
and comparison, whether by SHA or Monitor
Information on Trusts’ performance is made
public
Most clinical services are measured and
accredited already
All start with fairly simplistic measures and
develop
Why should IT/HIS services be any different,
since IT enabled developments like PACS
underpin clinical services 24/7
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Provider of a shared service, but could not provide
evidence of best practice performance or cost
effectiveness
Undertaken unofficial benchmarking with other local
HISs
Some pockets of good practice – Health Records and
Clinical coding accreditation
What have the Roman’s done for us?
How Much!&*!!
If you don’t improve we will take our business
elsewhere
Need to take the heat out of the system
The question of a Value for Money HIS was fast
becoming an unanswerable taboo
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If we can’t prove we are any good, or cost
effective, at least provide transparency
Provided customers with a break down of
individual service costs and their share of that
service
Started by using simplistic metrics, such as:
◦ The number of PCs
◦ The number of end users
Proposed share of HIS funding for Financial Year 2009/10
HIS valuation of work carried out for each Organisation
Budget Centre Name
Source of evidence for the share of
service
Budget centre code
South Devon Healthcare FT
Budget Value
%
Value
Torbay Care Trust
%
Devon PCT
Value
%
Devon Partnership Trust
Value
%
Value
HIS Baseline Costs 2009/10
Clinical Records
Health Records Tab
16400
£768,378
94%
£719,048.13
2%
£13,984.48
Clinical Records Management
Health Records Tab
58100
£224,899
94%
£210,460.48
2%
Not Shared
74630
£39,373
0%
£0.00
0%
Core Admin systems users
75320
£227,120
81%
£183,285.84
Not Shared
74609
£24,429
100%
£24,429.00
Health Records Tab
19300
£204,209
94%
Information Team Tab
19000
£318,511
Actual IT Invoices
75319
£1,017,366
HIS Graphics
Informatics Support
Web Support
Clinical Coding
Information
General IT Contracts
IT Operations Non Pay
IT Operations Summary Tab
74601
5%
£35,268.55
0%
£0.00
£4,093.16
5%
£10,322.86
0%
£0.00
£0.00
100%
£39,373.00
0%
£0.00
11%
£25,664.56
7%
£16,352.64
1%
£1,589.84
0%
£0.00
0%
£0.00
0%
£0.00
£191,098.78
2%
£3,716.60
5%
£9,373.19
0%
£0.00
83%
58%
£263,090.09
£28,347.48
£234,299.39
1%
5%
£4,140.64
£136,428.78
7%
23%
£23,251.30
£593,938.27
9%
13%
£52,699.56
70%
£56,430.50
16%
£12,898.40
11%
£8,867.65
3%
£2,418.45
73%
£30,207.40
12%
£4,965.60
10%
£4,138.00
5%
£2,069.00
64%
£380,024.32
19%
£112,819.72
13%
£77,192.44
4%
£23,751.52
79%
£339,094.07
15%
£64,384.95
5%
£21,461.65
1%
£4,292.33
70%
£141,992.90
11%
£22,313.17
18%
£36,512.46
1%
£2,028.47
81%
£306,165.31
11%
£42,870.73
7%
£27,315.86
1%
£2,655.71
81%
£225,778.43
11%
£31,614.58
7%
£20,143.80
1%
£1,958.43
£4,831,310
75.9%
£3,665,044
10.4%
£504,102
11.7%
£563,873
2.0%
£97,604
£226,382
80.4%
£182,011
9.8%
£22,118
8.6%
£19,559
1.2%
£2,694
£5,057,692
76.1%
£3,847,055
10.4%
£526,220
11.5%
£583,432
2.0%
£100,298
£144,365
100.0%
£144,365.00
0.0%
£0
0.0%
£0
0.0%
£0
£226,382
80.4%
£182,011
9.8%
£22,118
8.6%
£19,559
1.2%
£2,694
£966,262
20.0%
£733,009
20.0%
£100,820
20.0%
£112,775
20.0%
£19,521
£6,105,971
75.6%
£4,617,709
10.6%
£649,158
11.7%
£715,766
2.0%
£122,513
£80,615
IT Operations Projects
IT Operations Summary Tab
75113
£41,380
Desktop Operations Team
IT Operations Summary Tab
75110
£593,788
Servers Team
IT Operations Summary Tab
75111
£429,233
Networks Team
IT Operations Summary Tab
75112
£202,847
Core Admin systems users
74603
£379,387
HIS Corporate team & Services
HIS Projects & Training
Core Admin systems users
75340
£279,775
Actual HIS Budget figures as of July 2008
Add Pay Inflation & A4C Banding
Adjustments
ESR System
HIS Baseline for 2009/10 Pre LDP
Acute 3% CRES
Add Pay Inflation & A4C Banding
Adjustments
Add Trust applied overheads at an agreed
20%
New Baseline for 2009/10 - Post LDP
See CRES 2009/10 Tab
ESR System
South Devon Healthcare Ledger
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Health and Social Care Information Centre
Monitor
Healthcare Commission
ATOS
National Computing Centre
SOCITIM
Gartner
NIMM
FIMM
Microsoft
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ASSIST / UK CHIP
BCS (HIF)
UKAS
National Computing Centre
SOCITIM
NHS HIS - Clinical coding & Health records model
already exists
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Can we agree on one standard tool
It should enable meaningful comparison with
Industry wide tools, not just the NHS
Can we start simply and develop
incrementally
Don’t mandate it until the pilot sites are
happy it is fit for purpose
Can the newly created Benchmarking club be
the forum for developing the tool
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PC Operating system & patch management
PC Operating system platform
standardisation
Single Sign On
Software Asset Management
On the above we scored 3 to 4, depending on
the customer
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Organisations receive assurance of good
performance, best practice and VfM
HIS/IT providers can address areas in need of
improvement and have sources of evidence to help
We, the internal IT providers, can demonstrate our
ability to provide world class IT services, as good as
any other sector (the grass is not always greener on
the private sector side, but can we prove it?)
We have evidence to demonstrate our service is fit for
purpose
Benchmarking and accreditation will support local
cases for IT investment
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Integration of health and social care is where the
big patient benefits will come
CfH/Spine are looking to develop the
interoperability of software
We should look to enable the NHS to get best
value out of the vast NHS infrastructure and
enable all NHS employees to work flexibly
Accreditation of Infrastructure to common
standards should provide organisations with
assurance that it can provide open access to all
NHS employees who happen to be working on
their site
Any Questions?