ISB
Appraiser Training
Contents
• Information Standards Board
• Development methodology
• Appraisal process
• Conducting an appraisal
• Further information
Information Standards Board
The Information Standards Board for Health and Social Care in England (ISB) is tasked with the independent approval,
assurance and governance of information standards for adoption by the NHS and Adult Social Care. The scope of ISB
includes all information standards within the DH, NHS and Adult Social Care. This scope extends to those required to
support approved sharing and communication with other agencies where NHS infrastructure and systems are used.
The ISB:
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Ensures that information standards are fit for purpose, can be implemented, support the exchange of information
between systems, such that sending and receiving people derive the same meanings, and reduce clinical risk, while
ensuring stability or improvements in patient safety.
Reviews DH, NHS and Social Care information standards to ensure that they are still appropriate and consistent
(including those approved by its predecessor, CRIR - the Committee for Regulation of Information Requirements).
Identifies the need for future standards and, where necessary, the development of additions or subtractions to
existing DH, NHS and Social Care standards. This may include producing a case for change.
Provides input into policy implications for information standards and into informatics policy itself to ensure it can be
delivered by the informatics community, i.e. ISB will express the burden that policy decisions may have to support the
decision making process.
Undertakes from time to time a review of the scope of the ISB remit in the light of changes to service delivery, e.g.
the establishment of care trusts.
What is an Information Standard?
An information standard is a formal document approved and issued by the Information Standards Board for health and
social care. It defines technical criteria, content, methods, processes and practices for mandatory implementation across
health and social care in England.
Clinical Information Standards
Clinical information standards build upon existing national clinical practice, ideally set down by a national body such as the
National Institute of Health and Clinical Excellence (NICE). The benefits are clear. If every clinician is expected to record
information in a specified way then all IT systems should accept it in this format.
Example of clinical information standards are data sets used for record-keeping or information standards underpinning
National Patient Safety Agency safer practice notices.
Social Care Information Standards
Social care has information requirements distinctly different from health. Strictly speaking the ISB covers adult social care,
with the childrens' social care being managed by the Department of Education.
In practice, setting social care information standards is a new area for the ISB. More work is required to deliver concrete
examples of whether standards can deliver in this area.
Secondary Uses Information Standards
Secondary uses describes the use of patient data outside that of delivering direct care. This could be for the management
and audit of the Trust or the NHS as a whole; medical research or public health protection.
National secondary uses requires that Trusts provide data in a common format in a specified way. This makes them ideal
candidates for information standards. Examples include the information standards underpinning commissioning and the
National Service Frameworks.
Development Methodology
Developing an information standard normally takes between 9 and 12 months. Implementation can take 1 – 3 years. The
assurance and approval by the ISB is conducted alongside this. Due to the investment required it is only suitable where
the scope of the change will occur nationally and where there is a clear consensus on how to achieve the change.
Developing an information standard involves:
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Identifying the business need and agreeing it with those impacted by the information standard. This is normally
underpinned by a business case.
Developing a precise definition of what is required in order that there is no ambiguity or confusion. This includes
considering information governance, how it is to be implemented, burden and clinical safety.
Testing the information standard to ensure that it works as expected.
Implementing the information standard into health and social care and then maintaining it until it is no longer required.
Managing the retirement of the information standard.
Approval of the information standard by the information standards board for health and social care (ISB) unfortunately
does not remove the need to manage its implementation.
The development methodology is hosted on the ISB website.
Development Stages
The development of each information standard will normally be
managed through the following stages:
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Need – an information deficit or gap within the existing
national or international portfolio or product suite that is
planned to be remedied by the proposed development.
Requirement – the requirements for the information
standard are identified.
Draft – the technology elements of the standard are
defined and assured. Development testing has identified
any technical issues and mitigations are in place.
Full – there is evidence that the standard is
implementable, interoperable and safe and is supported
by an ongoing maintenance and update process. This is
normally gathered through implementation testing or pilot.
Implementation – the information standard is being
implemented in health and social care.
Maintenance – the information standard is used in
operation.
Retirement – the standard is deprecated and then
withdrawn.
Why do we need a
methodology?
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Transparency – Everyone needs to understand the rules of
the game. This stops surprises.
Choice – There are other ways of implementing change
rather than making a new standard. Developers need to
understand there is a choice.
Learn from mistakes – Many people have developed
information standards. It is right that we learn from their
mistakes to make the process easier.
Increase success / reduce costs & time – Ultimately this
is about reducing the costs and time to achieve the goal of
the standard. Note that the standard is a means to an end.
A great example is reducing the cost of change. The cost of
change rises considerably throughout the lifecycle. It is therefore
absolutely key that the feedback from the ISB is prompt, relevant
and early enough to allow it to be implemented without significant
cost.
Appraisal Process
Quality
criteria
Fit for
purpose
Risks and
issues
Appraisal
Each information standard goes through a rigorous appraisal process based on the identification of risks and issues. The
standard is appraised by subject matter experts (known as appraisers) recruited from the NHS and supplier
communities. It is led through the process by a domain lead and standards manager to ensure that the process is as
seamless as possible.
The aim of the appraisal process is to ensure that all risks and issues are identified; and then resolved or mitigated such
that an information standard meets the ISB quality criteria for approval. The acceptance and management of risks and
issues by the sponsor and developer of the standard is critical to an information standard being approved by ISB.
Standard Quality Criteria
Any standards must meet the following criteria. The appraisal process ensures that their is evidence that the criteria are
met:
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Is within the legal and information governance framework of the DH and NHS
National (England) in scope.
Fit for purpose.
Of overall benefit to health and social care particularly for health IT.
Capable of being implemented in organisations and health IT systems (where appropriate).
Supports interoperability between machines (functional) and people (semantic).
Compatible with existing standards, professional practice and DH policy.
Clinically and organisationally safe.
Does not impose an unanticipated cost burden on organisations.
Approved by a sponsor who commits that:
• A strategic outline case exists for the business change proposed by the standard. This will normally have been
approved by the Informatics Professional Network Group (IPNG).
• The prospective information standard has a defined purpose and scope.
• There is sufficient funding and resources allocated to complete the development, implementation and
maintenance of the standard within health and social care.
Examples of Quality Criteria
Product
• Individual product quality criteria. These are given as part of the product
descriptions in the method. For example, a quality criteria for the Statement of
Need product is "There is a clear, measurable need for the information standard
where benefits outweigh cost plus risk."
Stage
• The appraisal criteria for the stage. For example, one of the Requirements stage
quality criteria is "The requirements for the information standard are clearly
understood with no ambiguity and accepted by the stakeholders. They meet the
identified need and are consistent with the stated purpose and scope."
Standard
• An overarching set of standards quality criteria. An example is that the standard
must be "Of overall benefit to health and social care particularly for health IT."
Appraisal Roles
Domain Lead
The domain lead is an ISB board member responsible for the strategic development of a specific area of information
standards. They bring a broad understanding of health and social care and a national reputation and network of contacts in a
specific domain area.
The domain lead manages the assurance of prospective and approved information standards from proposal through to
implementation, maintenance and retirement. They manage the resolution of significant issues identified during the appraisal
process, including briefing the ISB as required.
Appraiser
The appraiser is a subject matter expert in a specific area impacted by an information standard. They are independent of the
ISB. Their purpose is to ensure that the prospective information standard is fit for purpose for the NHS and social care based
upon the ISB quality criteria. Appraisers give constructive, structured advice to the developers of standards in line with ISB
guidance. The advice explains how to improve their standard submissions to meet the standards criteria along with any
associated implementation and user guidance.
Information Standards Manager
The information standards manager is responsible for co-ordinating the assurance of information standards through a
process of formal appraisal including the proposals for implementation, maintenance and retirement. In general, the output
of this process will result in a recommendation being made to the Information Standards Board for that standard.
What Makes a Good Appraiser?
Follows the development methodology
Understands risk and issue management
Can see the big picture and the details together
Identifies quality defects and problems and suggests solutions
Clearly communicates back to the developer
Provides feedback promptly
Respects all involved in standards development
Conducting an Appraisal
Read
• Check the products have been provided
• Read the submission from cover to cover
Review
• Identify any general risks and issues
• Check each product meets the quality criteria
• Consider if the standard is sensible, fit for purpose and useful
Respond
• Document problems as risks or issues
• Record detailed comments on the specification on the comment sheet
• Upload to SharePoint and notify Standards Manager
Structure of a Submission
The appraiser will be provided with the following
documents from the developer:
•Submission – guidance for the appraisers and ISB on
what they are reviewing and why. The overview will be
written for the specific submission stage (Requirement /
Draft / Full).
•Mandatory products – those documents required by
ISB for approval of a standard. These are marked with a
Y in the ISB column of the product list at each stage
•Other supporting products – any other
documentation that the ISB will find useful in
understanding the standard.
•Risks and issues log - this is absolutely crucial to
demonstrating that risks are being managed
appropriately
•Glossary of terms
Mandatory
products
Supporting
products
Submission
Risk and issues
logs
Glossary of terms
Further Information
 Development Methodology
 ISB website
 SharePoint Appraiser Area
 Don’t Panic
 ISB mailbox