MEETING IN COMMON OF NHS MANSFIELD AND ASHFIELD

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/MEETING IN COMMON OF NHS MANSFIELD AND ASHFIELD CCGAND NHS NEWARK AND SHERWOOD CCG GOVERNING BODIESTITLE:Information Governance, Management and Technology Strategy – version4.6DATE OF MEETING:AUTHOR:7 February 2019Andy Hall, Director ofOutcomes and InformationPAPER REF:PRESENTER:GB/19/25Michael Cawley, Director ofFinancePURPOSE OF REPORT:To present for approval of the Governing Bodies the refreshed version of the CCGs five yearInformation Governance, Management and Technology Strategy.RECOMMENDATION: To endorseTo approveTo receive the recommendation (see details below)To discussThe Governing Bodies are asked to approve version 4.6 of the IGMT Strategy.EXECUTIVE SUMMARY (OVERVIEW):The Information Governance, Management and Technology Strategy (IGMT) Strategy sets outthe five year strategic intent of the six Nottinghamshire CCGs in respect to developments ininformation governance, information management, and information technology and associatedservices.Version 4.6 relates specifically to the strategic intent for the final year of the five year deliverytimescale, April 2019 to March 2020.The Strategy was received by the IGMT Committee in December 2018 and was endorsed forsubmission to the Governing Bodies for approval.The IGMT Committee has requested that a paper is submitted to the March 2019 meetingdetailing areas of delivery over the last four years and the priority areas up to and includingMarch 2020.REPORT:QIPP Assurance and connectionN/AFinancial Impact and RisksN/ALegal ImpactN/ARisk Implications, Assessment and MitigationsRisks to delivery of the strategy will be managed via the IGM&T and reported to the GoverningBodies via highlight reporting

Consultation, Involvement and EngagementN/AEquality ImpactN/AEvidence and Research (include where this informs why the paper is presented toGoverning BodiesHOW DOES THIS CONTRIBUTE TO THE OUTCOMES AND OBJECTIVES OF THE CCG: Quality Health Financial Clinical Performance (tick as appropriate)CONFLICTS OF INTEREST:This is a recommended action to be agreed by the Chair at the beginning of the item. No conflict identifiedConflict noted, conflicted party can participate in discussion but not decision (see below)Conflict noted, conflicted party can remain but not participate (see below)Conflicted party is excluded from discussion (see below)Please state rationale for decisionCONFIDENTIALITY:Is the information in this paper confidential? No Yes

The Nottinghamshire Forward Viewinto ActionAn Information Governance, InformationManagement and Technology (IGM&T) Strategyfor Nottinghamshire led by NHS ClinicalCommissioning Groups

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Nottinghamshire CCGsIGM&T StrategyContentsVersion Control . 2Executive Summary . 4Nottinghamshire IM&T Road Map . 6Introduction . 7Strategy relationships . 8Where Are We Now? . 9What will Nottinghamshire deliver by 2020? . 101.Information sharing . 102.Infrastructure. 143.Improving Citizen Access to Information and Care Records . 174.Digital Maturity . 205.Assistive Technology . 23How will this strategy support the System-wide Delivery Programmes of the STP? . 26System-wide Delivery Programmes . 26Supporting and Enabling Work streams . 28How will we deliver this strategy? . 29Appendix A: Current position of the delivery work streams . 34Information sharing . 34Infrastructure . 36Improving Citizen Access to Information and Care Records . 37Digital Maturity. 37Assistive Technology . 38Appendix B: Glossary. 392015-20Page 1Version 4.6

Nottinghamshire CCGsIGM&T StrategyVersion ControlReferenceCCG IGMT Strategy v4.6.docxDocument PurposeThis document lays out the strategic intent of the sixNottinghamshire CCGs in respect to developments ininformation governance, information management, andinformation technology and associated servicesVersionStatusTitleAuthors4.6DRAFTIGM&T Strategy 2015 – 2020Jason Mather, NHS Nottingham City CCGAndy Evans, Connected NottinghamshireAlexis Farrow, Connected NottinghamshireIan Trimble, Connected NottinghamshireSteven Murdock, NHS Rushcliffe CCGContributorsLoretta Bradley, NHS Greater Nottinghamshire CCGsThilan Bartholomeuz, NHS Newark and Sherwood CCGAndy Hall, NHS Rushcliffe CCGJeremy Lewis, Nottingham University HospitalsCaron Swinscoe, Nottingham University HospitalsMark Simmonds, Nottingham University HospitalsTracy Tyrrell, Nottingham City Care PartnershipAnna Simpson, Nottingham City Care PartnershipChris Packham, Nottinghamshire Healthcare NHSFoundation TrustSusan Clarke, Nottingham University HospitalsGavin Lunn, GPDebbie Pallant, Nottinghamshire Health InformaticsServiceApproval Date[To be inserted once approved by CCG internal process]Approving BodiesCCG IGM&T/ICT Committees for all publishing CCGsReview DateApril 2019Target audienceAll Nottinghamshire Health and Care providersPublic domainAll Nottinghamshire Health and Care providersPublic domainThe following documents are the key influences for thisstrategy but it should be noted that many more areinterlinked or related:Clinical Commissioning Groups strategy documents;GMS Contract;GP IT Operating Framework 2018/19;The Caldicott 2 Review: To Share or Not To Share 2013;National Data Guardian for Health and Care Review ofData Security, Consent and Opt-Outs 2016;CCG vision for 2020;NIB Personalised Health and Care 2020;Circulation listAssociated documents2015-20Page 2Version 4.6

Nottinghamshire CCGsIGM&T StrategyUsing Data and Technology to Transform Outcomes forPatients and Citizens: A Framework for Action;The Forward view into action;Nottinghamshire Local Digital Roadmap (LDR);Nottinghamshire Sustainability and Transformation Plan(STP);CCG Data Management Strategy;Better Together Transformation Plan;Greater Nottingham Partnership Transformation Plan;Superseded documents2015-20CCG IGM&T Strategy version 4.4CCG IGM&T Strategy version 3.1CCG IGM&T Strategy version 2.1CCG IGM&T Strategy version 2.0CCG IGM&T Strategy version 1.0Page 3Version 4.6

Nottinghamshire CCGsIGM&T StrategyExecutive SummaryWith an increasingly challenging financial environment, cost savings and efficiencies areaffecting the whole health and care economy. The NHS has been tasked by NHS Englandto change the way that it delivers care in order to reduce cost whilst continuing to improvethe quality of care. Whilst it is recognised that there is an increasing financial burden onhealth and care organisations, through being innovative in how current and newtechnologies are utilised to support process redesign and transformation, efficiencies can bedriven not only in primary care but also by commissioners across the wider health and careeconomy.Information and technology can bring enormous benefits by making the delivery of caremore integrated and efficient; however this cannot be undertaken in isolation and will onlydeliver the required benefits through effective change management. It is vital in supportingimprovements in health and wellbeing, organisational efficiencies and quality care. Inutilising high quality information and technology the CCG can help patients to understandhow to improve their own health, to know what their care and treatment choices are and toassess for themselves the quality of services available to them.This Information Governance Management and Technology (IGM&T) strategy sets out thekey deliverables and the Governance required delivering the following work streams:1.2.3.4.5.Information sharingInfrastructureImproving Citizen Access to Information and Care RecordsDigital MaturityAssistive TechnologyThe delivery of this strategy directly supports the ambitions of the NottinghamshireSustainability and Transformation Plan (STP), the Integrated Care System (ICS) and theIntegrated Care Partnerships (ICP) that will mature in the coming months and years. It doesthis by providing the tools to support Nottinghamshire in reducing the Health and Wellbeing,Care and Quality and Finance and Efficiency gaps. This strategy sets out how Informationand Technology will support NHS Nottinghamshire Clinical Commissioning Group’s futurevision for a digitally mature health and care system. It identifies the importance ofInformation Management and Technology (IM&T) within the health and social carecommunity and how IM&T will support the links between health and social care providersand commissioners, which will be essential in delivering the STP.In order to deliver the ambitions of this strategy a true system-wide approach is required inorder to meet both the clinical and operational demands across the health and careeconomy. To achieve this, a close multi-professional collaboration between all systempartners, both across the primary/community/secondary care sectors and into the MentalHealth and Social Care is required. These partnerships will be clinically led and will helpsteer the direction of travel for system wide Information Governance, InformationManagement and Technology developments. Working in this way will ensure that jointambitions are aligned to the collective requirements of each organisation, and importantlylinked to clinically meaningful changes and outcomes using established best practicewherever evidence is available.It is recognised that in order to successfully implement and drive the necessary change inpace to support new models of care, Nottinghamshire must remain agile in the use of localand national funding. Good progress has been made across Nottinghamshire’s health andsocial care system improving infrastructure and systems, and improving integration and2015-20Page 4Version 4.6

Nottinghamshire CCGsIGM&T Strategydigital records. Despite these positive steps forward there is much work left to do in order toachieve the transformational transition of this strategy into business as usual.This document is an enabling strategy to support Health and care transformation and shouldbe read alongside other key strategic documents identified later in this strategy. Itsupersedes the CCG IGM&T Strategy version 4.4 for 2017/18 and sets the strategicdirection up to March 2020 (in alignment with the current national strategy drivers) and insome areas beyond. Driven by the National Information Boards (NIB) paper in support of theNHS Five Year Forward View and clarity on the digital maturity framework, it informs not justthe local requirements but also takes into consideration the organisational attributesexpected from external authorities such as NHS England, NHS Improvement, NHS Digital,Local Government Association and the Care Quality Commission.2015-20Page 5Version 4.6

Nottinghamshire CCGsIGM&T StrategyNottinghamshire IM&T Road Map2015-20Page 6Version 4.6

Nottinghamshire CCGsIGM&T StrategyIntroductionRapidly advancing technologies have revolutionised the way we interact with each other ineveryday life. Industry and the commercial sector have changed profoundly and technologynow has the ability to enable a similar change in health and care services, shifting therelationships between patient, clinician and care professional towards one of shareddecision-making. These changes are also influencing the behaviours between commissionerand provider towards one that is beneficial in delivery of health and care as a business whilstfocused on working in partnership or alliance as a system.A critical element of the National Information Board’s national vision is local design anddelivery against the identified national objectives. Clinical Commissioning Groups (CCGs)became accountable on 1st April 2016 for the production of Local Digital Roadmaps (LDR)working with local authorities, local providers, and other local stakeholders such as housingand education to set the direction for fully interoperable digital records. This is the fifthrevision of the Information Governance, Information Management and Technology (IGM&T)Strategy for Nottinghamshire and it is anticipate that it will continue to evolve.Achieving interoperability and the integration of systems within Nottinghamshire is critical toenable successful communication and information sharing between clinical teams and thewider health and care economy including; primary, community, secondary, mental health,social, housing, education and third sector services. Where possible information should berecorded once, utilising every contact and shared securely with those professionals with a‘legitimate’ patient relationship in providing care. Information is a service in its own right, andlocal digital maturity will be closely monitored by the CCGs following national guidance, toolsand standards set out within the NHS England Interoperability Handbook.The Five Year Forward View made a commitment that, by 2020, there would be “fullyinteroperable electronic health records so that patient’s records are paperless”. This wassupported by a Government commitment in Personalised Health and Care 2020 that “allpatient and care records will be digital, interoperable and real-time by 2020”. Radically newcare delivery models supported by new payment arrangements which are value andoutcome based are driving the need for change. This requires information to flow moreeffectively across health and care to support the delivery of direct care to patients/citizens.2015-20Page 7Version 4.6

Nottinghamshire CCGsIGM&T StrategyStrategy relationshipsNottinghamshire’s STP identifies Technology Enabled Care as one of its high impact workstreams to support the delivery of the ambition set out in a number of national policydocuments. The digital vision is to gain a number of ‘quick wins’ where digital enablementhas already made progress whilst continuing to develop strategic information systems andmake improvements in the system wide infrastructure.2015-20Page 8Version 4.6

Nottinghamshire CCGsIGM&T StrategyNottinghamshire’s vision for supporting the STP, the five year forward plan and 2020objectives is to provide the capability for paper free at the point of care through the digitalprovision of; The Right InformationTo be available at the Right PlaceFor the Right PersonTo make the Right DecisionsAt the Right Time AlwaysNottinghamshire’s focus on existing ICP level transformation programmes and projectssupports the vision that Nottinghamshire should always be one step ahead in providing thedigital enablers so that transformation can happen without waiting for technology delivery.This work will ensure that Nottinghamshire is able to achieve the National Informatics Boardmilestones.This five-year strategy shows how IGM&T will support the ICS and ICPs in the delivery of theambitions set out in the STP. The objectives within this document depend on stakeholdershaving an up-to-date and robust IT infrastructure combined with modern, optimised systemswhich provide good quality and relevant data and information. For this reason the DigitalMaturity of all providers across Nottinghamshire will be monitored through the DigitalMaturity Framework – a national requirement for providers to submit details of their digitalreadiness.Technology enables the use of information when and where required for the best clinical,operationally effective delivery of care. The key elements of IM&T investment covered inthis strategy are: Infrastructure and security (the physical hardware and software used to interconnectcomputers, users and services);Systems (the clinical applications that provide staff, managers, clinicians and careprofessionals with the tools and information to perform their tasks safely andefficiently. Alongside the professionally used systems those that allow patients tohave improved access to services and support self-care)Accessibility (improving patient/citizen, clinician and care professional access toinformation)Support (needed for all organisations involved including CCGs; Primary care;community care, acute, mental health and Social Care);Change Management (the management of change and development needed withinHealth and Care organisations to realise the benefits of IM&T);Transitional Management (necessary in managing an institutional investment andenable the merging of funds and pooled resources e.g. NHSE and local funds).Where Are We Now?Nottinghamshire, through the Connected Nottinghamshire Programme of work, delivers thedigital agenda by bringing together outcomes from both the STP and Local Digital Roadmap(LDR) to inform the strategic direction. Across Nottinghamshire Health and Local Authorityorganisations along with third sector partners have helped deliver an exemplar LDRdocument, in which the joint ambitions to achieve the 2020 vision have been documented. Itis anticipated that as the Integrated Care System and Integrated Care Partnerships developthe CCG IGM&T strategy and LDR will become one document.2015-20Page 9Version 4.6

Nottinghamshire CCGsIGM&T StrategyNottinghamshire has identified five key work stream areas (information sharing,infrastructure, patient access to information and care records, digital maturity and assistivetechnology). Each of these work streams has an executive lead that ensures oversight ofkey projects identified to enable development and delivery against the objectives of the LDR.A number of key projects are already well into the delivery phase and Appendix A providesan overview of the current position of the five key work stream areas.What will Nottinghamshire deliver by 2020?1. Information sharingSummary: This chapter outlines plans for integrating health and care systems acrossall organisations and providers as well as between individual GP Practices.ProjectsTemplate Alignment and Standardisation (F12 / Ardens)Key MilestonesApril 2019 (transition toBAU)Medical Interoperability Gateway (MIG) phase 3June 2018GP Repository for Clinical Care (GPRCC) Phase 3October 2018Nottinghamshire Health and Care Portal (CareCentric) Phase May 20181Nottinghamshire Health and Care Portal (CareCentric) Phase April 20192Use of NHS number including PDS

strong The /strong Nottinghamshire Forward View into Action . An Information Governance, Information Management and Technology (IGM&T) Strategy for Nottinghamshire led by NHS Clinical Commissioning Groups . This page intentionally left blank . Nottinghamshire CCGs IGM&T Strategy . Contents .

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