Securing excellence in GP IT Services

Transcription

1 Securing excellence in GP IT Services Operating Model December 2012

2 Table of Contents 01 Glossary of terms 02 Preface 03 Introduction Background Purpose 04 GP IT services commissioning GP IT scope and definition of services Core and mandated service provision Local strategic and discretionary service provision General Practice Business Systems service provision Commissioning and accountability Summary of commissioning relationships Commissioning responsibilities Accountability who holds who to account Commissioning and Accountability process Tasks and functions core and mandated service provision Local strategic and discretionary service provision General Practice Business Systems service provision 08 Finance 09 Activity to date and next steps 10 Appendix A Core and mandated services Appendix B - Discretionary services 11 References

3 01 Glossary of terms Term Clinical Commissioning Group Commissioning Support Unit GP Extraction Service GP Systems of Choice Health and Social Care Information Centre Information Governance Toolkit Interoperability Toolkit Local Service Provider National Application System Provider National Infrastructure Service Provider NHS Commissioning Board NHS Commissioning Board Local Area Team NHS Commissioning Board Patients and Information Directorate An individual, partnership or corporate body that holds a GMS, PMS or APMS contract Acronym CCG CSU GPES GPSoC HSCIC IGT ITK LSP NASP NISP NHS CB NHS CB LAT NHS CB P&I GP Practice 3

4 02 Preface Data and information are at the heart of improvement for our patients. Put to good use - openly and transparently high quality data will support our focus on the individual, improve productivity and empower patients and clinicians to transform local services. To achieve this we need world-class IT and technology systems right across the NHS, but especially in primary care, where there are millions of interactions with patients every week. And we need to connect data and information across pathways, seamlessly integrating across organisations and systems. Today, data usually exists for a single purpose, but linking all of those separate sources together will give us a completely new picture about the total effectiveness of interventions. We know that one size does not fit all in the provision of information and technology. When the NHS CB becomes accountable for delivery of primary care information services on 1 April 2013, it will delegate responsibility for operational management of GP IT and associated funding to CCGs. That will include: provision of clinical systems and associated hardware and network services; and provision of support services to GP practices, such as training. CCGs will commission these services locally. The NHS CB will support CCGs by setting overall vision and strategy, establishing a single set of standards and maintaining overall budgetary oversight. This includes maintaining the national infrastructure and managing the GP Systems of Choice contract. Through this arrangement, primary care providers will continue to have a choice of high quality solutions, tailored to local need, underpinned by a commitment from the NHS Commissioning Board to support the development of a world-class information and technology infrastructure across health and care. 4

5 03 Introduction Background GP clinical systems and their IT provision are essential and both clinically and business-critical enablers to assuring quality and innovation in primary care. To date primary care trusts (PCTs) have led on the provision and support of GP IT systems and therefore the safe transfer into the new commissioning system is highly important to ensure that GP Practices continue to have a choice of quality solutions which meet local needs. GP IT services relate to those contractors specified in the GMS and PMS and APMS contracts to provide IT support services for GP Practices as set out in existing local IT agreements between PCTs and practices complying with Modernising Information management and Technology in General Practice guidance, plus implementation and support for all appropriate nationally mandated systems. They also include discretionary, locally determined IT support services. The NHS Commissioning Board (NHS CB) will be accountable for these services until the development of a single operating model between NHS CB and CCGs. The NHS CB will continue to set overall direction, standards, strategy, budgets and maintain national infrastructure. CCGs are best placed to plan the use of IT systems to support service delivery and service change to enable better patient care across local health communities. The NHS CB will, through robust formal agreements, discharge its operational responsibilities for GP IT services (along with associated funding to provide local support) to CCGs who will then commission these services locally. IT support for other primary care contractors will be incorporated into the NHS CB s operating arrangements. The proposal is that the NHS CB, through local area teams (LATs), will be the registration authority for all primary care contractors (administration of access to clinical and business systems) and will be responsible for clinical safety and assurance (adherence to dataset change notices). Support will be provided from NHS CB Regional Teams as appropriate. We anticipate that NHS CB through its Regional/LATs will arrange for commissioning support units or other IT providers to provide these services. Purpose This document has been produced to support CCGs in understanding the arrangements for GP IT transferring from PCTs into the new health system. It is aimed at those who will have responsibility for GP IT in CCGs. A key principle on which these arrangements are based is the safe transfer to ensure continuity of support for these important services. The document does not address any human resource implications associated with these changes, nor does it cover IT support for the commissioning functions of CCGs. The document describes: Scope of operational GP IT services Accountabilities and responsibilities for service delivery Tasks and functions to support service delivery Financial support 5

6 04 GP IT services commissioning GP IT support services comprise: Core and mandated services: IT support services for GP Practices as set out in existing local IT PCT GP Practice service agreements complying with Modernising Information management and Technology in General Practice guidance. Plus implementation and support for all appropriate nationally mandated systems. Discretionary services: Locally determined strategic and discretionary IT support services. General Practice business support systems: IT support services required for a General Practice business. These are at the discretion of local general practices with responsibilities for funding and delivery. The necessary approvals will be required for software installed on GP networks that may have an impact on core IT operations. The operating arrangements in this document apply to core, mandated and discretionary services. The NHS CB will remain accountable for these services as well as the responsibility for all GP IT assets transferred from PCTs until the development of a single operating model between the NHS CB and CCGs. The NHS CB will discharge responsibility and associated funding to CCGs for service delivery. GP business support systems are funded entirely by the GP Practices concerned and therefore are not covered by these arrangements. CCGs on behalf of NHS CB will then commission these services (including the management of the associated assets) from appropriate providers, for example CSUs or other IT providers, or may choose to deliver these services themselves). In addition, national systems will continue to be developed and delivered by the Health and Social Care Information Centre (HSCIC) for local implementation. Any appointed GP IT service provider will have to deliver to a set of quality standards, including compliance with Information Governance Toolkit (IGT), determined by the NHS CB in conjunction with CCGs. NHS CB will have responsibility for compliance monitoring and ensuring that all parties comply with their contractual obligations. The CCGs (or through their nominated management function) will therefore require the expertise to monitor performance of local suppliers and practices in using the IT services to enable them to be held to account. Where a situation may arise that cannot be resolved, the CCG will pass to the NHS CB to take contractual action. 6

7 04 GP IT services commissioning NHS CB Holds accountability and provides funding for GP IT Services CCGs GP IT provision to support local strategic initiatives to improve service delivery and support local commissioning objectives Commission GP IT Services (on behalf of the NHS CB) Discretionary Services Core and Mandated Service Provision GP IT support services as set out in existing local PCT GP Practice service agreements, plus appropriate nationally mandated systems. General Practice business support systems GP IT funded by the general practice to support corporate business delivery functions GP IT Services Service Delivery Organisations Deliver GP IT services (on behalf of CCGs) CCG In house Service CSU Any other provider HSCIC National systems 7

8 05 GP IT services Scope and definition of services Core and Mandated Services (Refer to Appendix A) Functional Scope Description 1.1 IT maintenance and Service Desk Providing support services to ensure continued availability of all hardware and software which includes: Desktop support, hardware configuration management, file management and data storage services for the clinical system, local and hosted servers, scanners, smartcard readers, data backup and disaster recovery, business continuity planning support, Service Desk and Technical Support. 1.2 GP Clinical Systems Ensuring the provision of an approved GP Clinical system provided by GP Systems of Choice (GPSoC) or Local Service Provider (LSP) contracts including planned implementation, system updates, clinical safety assurance, training and associated project management. This also includes all services to support any migration from one system to another. 1.3 Networking Services Ensuring continued connection to national broadband services eg N3 and the provision of a wide area network or private branch links where necessary. 1.4 Software licenses Ensuring provision of up-to-date licences for all core and mandated systems eg Operating Systems, anti-virus facilities, MS Office Software, encryption software, internet browser, . Ensuring software licensing legal compliance. 1.5 National System Implementation Planning and local implementation support for nationally mandated systems (eg GP2GP, Summary Care Record, Choose and Book, Map of Medicine, N3, Calculating Quality Reporting Service, Electronic Prescription Service, Interoperability Toolkit (ITK) projects and initiatives). This includes project management, training, data quality programmes, data migration, and some business change. 88

9 05 GP IT services Scope and definition of services Core and Mandated Services Functional Scope Description 1.6 Information Governance Advising and supporting practices in completing the appropriate sections of the Information Governance Toolkit and provide support to Practices on the investigation management of possible information security breaches & incidents. 1.7 GP Extraction Service Providing support for any local responsibilities relating to GPES. 1.8 Hardware Replacement Ensuring all hardware is up-to-date and serviceable including the operation of replacement programmes, and asset management responsibilities such as maintenance of asset registers. Providing a warranted secure hardware disposal service. Insurance will be responsibility of NHS CB. 1.9 Registration Authority Ensuring all service users adhere to Access Security Policy and deliver the management of role-based access control and issuing of smartcards Core Administrative Services Providing administrative support for all mandated services eg) access and Local Officer Administrator support for NHS mail, including migration from local services to NHS Mail, file storage and backup services (on or off site), any relevant active directory services Clinical Safety and Assurance Ensuring that the requirements of DSCN 14(2009) Application of Clinical Risk Management to the manufacture of health software and DSCN 18(2009) Management of Clinical Risk relating to the deployment and use of health software are met. 9

10 05 GP IT services Scope and definition of services Discretionary Services (refer to Appendix B) Functional Scope 2.1 Local strategic initiatives to improve service delivery across local community and support commissioning plans possibly in collaboration with other providers at the discretion of the CCG. Description Providing hardware, software and support services (including clinical safety and assurance, project management, business change, training and service desk) for : Local shared systems or interoperability initiatives (eg INRStar, Scriptswitch and ICE) Shared local infrastructure (eg Public Sector Networks, COIN/VPN, VOIP, WiFi,) Systems that link into other services (eg web portal, Order Communications, Local Data warehouse and Patient Indexes) Primary care data quality and PRIMIS support services, Asset management, disposal and replacement programmes Local Enhanced Services and GP Specialist Interest schemes agreed by the CCG. 2.2 Discretionary developments in individual general practices at the discretion of the CCG. Providing hardware, software and support services (including clinical safety and assurance, project management, business change, training and service desk) for: Add-on applications to Clinical Systems eg) patient arrival, appointment and calling systems, kiosks and websites and enhanced use of active directory services. services other than NHS Mail. Remote access facilities to practice and clinical systems. Asset management, disposal and replacement programmes. Providing advice and support for any business case relating to IT services in the development of GP Practice premises. 10

11 05 GP IT services Scope and definition of services General Practice Business Support Systems Functional Scope 3.1 Systems to support individual general practices as a business and which are not funded nationally or by the CCG. Description Managing and maintaining systems that support the practice as a business eg) payroll, HR systems, telephony systems, photocopiers, faxes. Providing hardware, software, support and disposal/replacement and assurance for all practice funded systems and equipment. PAT Testing and consumables for all IT equipment used by the practice. Clinical Safety and assurance to comply with ISB 0160 (DSCN 18/2009) and ISB 0129 (14/2009) for manufacture and use of healthcare software purchased by the Practice. Insurance for practice owned IT equipment and cover for consequences of loss. 11

12 Contractor IT Service Delivery Commissioning 06 Commissioning and accountability Summary of commissioning relationships Core and Mandated Services NHS CB Accountable for ensuring the delivery of all core, mandated and discretionary GP IT services CCG in house service CCG Responsibility for commissioning delivery of local IT services CSU Any other provider Responsibility for delivery of IT services Commissioning and management of contracts for GP Clinical Systems and National Systems HSCIC Advice on national contracts and ensuring adherence to contractual conditions. Management of supplier performance LSP GP Provider GPSoC suppliers National Services August Draft for testing General Practices 12 12

13 06 Commissioning and accountability Commissioning responsibilities Commissioner Service being commissioned Commissioned from NHS CB Accountable for ensuring the delivery of all core, mandated and discretionary GP IT services through its Regional/LATs through its Regional/LATs through P&I Directorate (working with GP Practices and CCGs) Registration Authority services Clinical safety and assurance for the deployment and use of health software ISB 0160 (DSCN 18/2009) Contracts for GP Clinical Systems (and associated support services) eg GPSoC and LSP Contracts and management of contracts. Clinical Safety and assurance of health software ISB 0129 (DSCN 14/2009) CSUs or other providers CSUs or other providers HSCIC through P&I Directorate National Systems and Interoperability Toolkit (ITK) initiatives (with associated support services) and management of contracts HSCIC through its Regional/ LATs Advice on IT requirements to any proposed changes to premises CCGs 13

14 06 Commissioning and accountability Commissioning responsibilities Commissioner Service being commissioned Commissioned from CCGs Responsible for commissioning delivery of IT services (on behalf of NHS CB) Core and mandated services (except RA and clinical safety and assurance) Discretionary Services Clinical safety and assurance compliance with supplier requirements of DSCN 14(2009) and use of health software DSCN 18(2009) for clinical software procured as a discretionary service. Planning and Implementation Services for GP Clinical Systems Planning and Implementation Services for National Systems and ITK initiatives Signatories to CCG-Practice and local GPSoC Call Off Agreements and ongoing maintenance and management of these agreements (for GPSoC and LSP) Asset management and disposal services Provision of advice to NHS LATs on the IT requirements for any proposed changes to premises CSUs or other providers CSUs or other providers CSUs or other providers CSUs or other providers CSUs or other providers CSUs or other providers CSUs or other providers CSUs or other providers HSCIC Responsible for commissioning national systems and establishing national contracts (on behalf of NHS CB) GP Clinical Systems and associated support services for GPSoC and LSP contracts National Systems and ITK initiatives with associated support services GP Clinical System Providers System Providers 14

15 06 Commissioning and accountability Accountability who holds who to account Organisational Body Accountable for management Service accountable for Accountable for delivery NHS CB through its Finance Directorate Management of devolved revenue and capital budgets for core, mandated and discretionary services CCGs NHS CB through it Regional/LATs Registration Authority Services - delivery of service CSUs or other providers NHS CB through its Regional/LATs Registration Authority Services- adherence to RA Policies GP Practices NHS CB through its Regional/LATs Clinical Safety and Assurance delivery of service for core and mandated clinical software CSUs or other providers NHS CB through its Regional/LATs Clinical Safety and Assurance compliance with ISB 0160 (DSCN 18/2009) governing implementation and safe use of systems for core and mandated clinical software CSUs or other providers NHS CB through its P&I Directorate GP Clinical Systems and support services procuring contracts for GPSoC and LSP Systems HSCIC NHS CB through its P&I Directorate HSCIC Ensuring adherence to contracts for GPSoC and LSP Systems, including the requirements for clinical assurance and safety for ISB 0129 (DSCN 14/2009) Suppliers NHS CB through its Regional/LATs Provision of GP Clinical Systems to General Practices CCGs 15

16 06 Commissioning and accountability Accountability who holds who to account Organisational Body Accountable for management Service accountable for Accountable for delivery NHS CB through its Regional/LATs HSCIC Signatories to CCG-Practice and local GPSoC Call Off Agreements and ongoing maintenance and management of these agreements (for GPSoC and LSP) CCGs NHS CB through its Regional/LATs CSUs with advice from HSCIC Compliance with CCG-practice agreements and LSP terms and conditions GP Practices NHS CB through its P&I Directorate National systems, ITK initiatives and support services for delivery and management of contracts commissioned by NHS CB HSCIC NHS CB through its Regional/LATs HSCIC Ensuring adherence to National System contracts including the requirements for clinical assurance and safety for ISB 0129 (DSCN 14/2009) Suppliers NHS CB through its Regional/LATs CSUs with advice from HSCIC Compliance with any terms and conditions for National Systems that apply to end users GP Practices NHS CB through its Regional/LATs Asset management and disposal services CCGs NHS CB through its Regional/LATs Advice on IT requirements to any proposed changes to premises CCGs 16

17 06 Commissioning and accountability Accountability who holds who to account Organisational Body Service accountable for Accountable for delivery GP Practices Provision of GP IT services set out in existing local PCT GP Practice service agreements in accordance with Modernising Information management and Technology in General Practice guidance and provision of nationally mandated services NHS CB CCGs (on behalf of NHS CB) Provision of Core, mandated and discretionary Services and oversee the overall performance management of local delivery providers Planning, Implementation and delivery of support services for GP Clinical, National Systems and adoption of national ITK initiatives Clinical safety and assurance compliance with the requirements of DSCN 14(2009) and DSCN 18(2009) for clinical software procured as a discretionary service Signatories to CCG-Practice and Local GPSoC Call Off Agreements and ongoing maintenance and management of these agreements (for GPSoC and LSP) Designing IT specification and establishing business case requirements for IT services to support approval in principles for GP Practice expansion, changes or mergers. Asset management and disposal services Provision of advice to NHS LATs on the IT requirements for any proposed changes to premises CSUs or other providers CSUs or other providers CSUs or other providers CSUs or other providers CSUs or other providers CSUs or other providers CSUs or other providers CSUs or other providers Services required to support delivery of core, mandated and discretionary services Suppliers 17

18 06 Service Commissioning and accountability Commissioning and Accountability Process Process Registration Authority NHS CB through its Region/LATs commission CSUs (or any other provider) to deliver Registration Authority Services. CSUs (or any other provider) deliver service and assure adherence. If assurance cannot be obtained, then the issue is passed to NHS CB LATs to resolve. Clinical Safety and Assurance NHS CB through its Region/LATs commission CSUs (or any other provider) to deliver a clinical safety and assurance service (i.e. to ensure all systems are deployed and used safely in accordance in DSCN18/2009 ) for core and mandated systems. CSUs (or any other provider), deliver service and ensure compliance in accordance with ISB 0160 (DSCN 18/2009). If assurance cannot be obtained, then the issue is passed to NHS CB LATs to resolve. CCGs commission CSUs (or any other provider) to deliver a clinical safety and assurance service (i.e. to ensure all systems are deployed and used safely in accordance in DSCN18/2009 and suppliers manufacture health software in accordance with ISB 0129 (DSCN 14/2009) for discretionary systems. CSUs (or any other provider), deliver service and ensure compliance in accordance with ISB 0160 (DSCN 18/2009) and ISB 0129 (DSCN 14/2009). If assurance cannot be obtained, then the issue is passed to CCGs to resolve. 18

19 06 Service Commissioning and accountability Commissioning and Accountability Process Process GP Clinical Systems NHS CB through its P&I Directorate commissions HSCIC to procure clinical systems (and some support services) from GP System Suppliers and to provide oversight and advice on the discharge of contracts. HSCIC procure systems (and some support services) and puts in place contract management and advice arrangements and informs CCGs of contracts and these arrangements. CCGs commission CSUs (or any other provider) to manage the delivery plan and ensure all GP Practices are supplied with appropriate clinical system using these contracts including any system migration and implementation and operational support. This includes signatories to CCG-Practice and local GPSoC Call Off Agreements and ongoing maintenance and management of these agreements (for GPSoC and LSP). CSUs (or any other provider) ensure practices are supplied with appropriate clinical systems and deliver implementation and operational support services in accordance with delivery plan. Ensure suppliers and practices meet their obligations. Where suppliers do not meet their obligations, they escalate to HSCIC to resolve the issue with the suppliers concerned. Where practices do not meet their obligations, they try and resolve with advice from HSCIC but if unable they escalate to NHS CB LATs to resolve. 19

20 06 Service Commissioning and accountability Commissioning and Accountability Process Process National Systems NHS CB through its P&I Directorate commissions HSCIC to procure national systems and solutions for ITK initiatives (with appropriate support services) from system suppliers and to provide oversight and advice on the discharge of contracts. HSCIC procure systems (and some support services) and puts in place contract management and advice arrangements and informs CCGs of contracts and these arrangements. CCGs commission CSUs (or any other provider) to manage the delivery plan and implementation of national systems and ITK initiatives to support local strategy in conjunction with GP Practices. CSUs (or any other provider) ensure planning and implementation of national systems and ITK initiatives. They ensure suppliers and practices meet their obligations under the HSCIC contracts. Where suppliers do not meet their obligations, the issue is raised with HSCIC to resolve with the suppliers concerned. If practices do not meet their obligations, they try and resolve with advice from HSCIC prior to escalating to NHS CB LATs to resolve. Changes to Premises NHS CB through its Region/LATs advice CCGs of any proposed changes to premises. CCGs commission CSUs (or IT Provider) to provide the appropriate IT planning advice and support to Region/LATs for the development of the relevant business cases. CSUs (or any other provider) advice the NHS CB LATs on IT design in conjunction with the GP Practice.

21 06 Service Commissioning and accountability Commissioning and Accountability Process Process Core, Mandated and Discretionary Services CCGs commission CSUs (or any other provider) to provide the full range of core and mandated services plus any discretionary services. This includes asset management, hardware replacement and disposal programmes. Performance management of the contract delivery will be the responsibility of the CCG. CSUs (or any other provider) deliver services including asset management, hardware replacement and disposal programmes and ensure GP Practices and suppliers adhere to the appropriate service standards, mandatory/contractual requirements. Supplier performance issues are raised with the suppliers concerned and if GP Practices adherence issues are encountered and unable to resolve, these are escalated to NHS LATs. 21

22 07 Tasks and functions Service: Core and Mandated service provision There is a responsibility to deliver locally IT support services for GP contractors (specified in GMS, PMS and APMS contracts) as set out in existing local PCT GP Practice service agreements, plus implementation and support for all appropriate nationally mandated systems. In addition, there are also local obligations under the GPSOC and LSP contracts which need to be met in the deployment and support of practice clinical systems. Whereas there is national funding to develop and deliver GPSoC, LSP, NASP and NISP solutions there are still significant local costs in deploying and supporting these systems and the infrastructure on which they operate locally. The standardised funding for these local obligations will be provided through NHS CB to the CCGs to allow them to commission these services. *CSU or any other IT Service Provider includes those CCGs providing in-house support arrangements. Function NHS CB CCGs *CSU or any other IT Service Provider HSCIC GP Practices Suppliers 1.1 IT maintenance and Service Desk Will set overall direction of strategy, operating model and budget and assign to CCGs for commissioning core and mandated GP IT Services. Responsibility for commissioning core and mandated GP IT services from CSUs or any other service providers. Will be commissioned to deliver GP IT services (directly or subcontracted) on behalf of CCGs. May be delegated responsibility by NHS CB for setting standards for core and mandated GP IT services where commissioned to do so. Use services and systems in accordance with any national guidance, IG requirements and any contractual responsibilities with suppliers. Meet the standards for supply of core and mandated GP IT services. Deliver obligations set out in the GPSoC service-level performance monitoring specification and comply with accreditation standards. 22

23 07 Tasks and functions Service: Core and Mandated service provision *CSU or any other IT Service Provider includes those CCGs providing in-house support arrangements. Function NHS CB CCGs *CSU or any other IT Service Provider 1.2 GP Clinical Systems Responsible for ensuring all GP Practices have a GP Clinical System (and some support services) through HSCIC who will commission from suppliers. Work with CCGs and GP Practices in developing the specification for clinical systems. Responsible for ensuring all GP Practices have appropriate systems and will commission CSUs or any other service providers, to make those systems available. This includes support for system migrations. Responsible for Signatories to CCG- Practice Agreements, ongoing maintenance and management of GPSoC and LSP GP Clinical Systems, authorise local GPSoC Call Off Agreements. Will be commissioned to implement, provide support, service management and monitor that GP practices comply with their responsibilities around the use of GPSoC and LSP Services. Use National Tracking Systems to order clinical Systems. HSCIC GP Practices Suppliers Responsible to manage the GPSoC Agreements and LSP contracts on behalf of NHS CB and to provide advice and support to CCGS and CSUs. Commission with and contract manage clinical system suppliers to deliver appropriate clinical systems and services. Use services and systems in accordance with any national guidance, IG requirements and any contractual responsibilities with suppliers. Work with CCGs, NHS CB in developing the specification for clinical systems. Deliver GPSoC and LSP Services in line with their contractual obligations. Maintain service catalogue and asset register (eg national tracking database). Work with NHS CB and GP Practices in developing the specification for clinical systems. 23

24 07 Tasks and functions Service: Core and Mandated service provision *CSU or any other IT Service Provider includes those CCGs providing in-house support arrangements. Function NHS CB CCGs *CSU or any other IT Service Provider HSCIC GP Practices Suppliers 1.3 Networking Services 1.4 Software Licenses Will set policy and direction for national services. Ownership of software licences. Responsible for commissioning CSUs to ensure provision of LAN and connection to broadband services. Responsible for commissioning the delivery of service. Maintain practice connections to N3 and implement and support LAN services. Commissioned to manage and install software including compliance management. Commission N3 or alternative national network services and manage suppliers. No direct responsibility Comply in use of practice N3 services with N3 Code of Connection and any local requirements. Ensure compliance with the terms of software licences. Maintain LAN services and ensure compliance with N3. No direct responsibility 1.5 National Systems Implementation 24 Will set overall direction of strategy, operating model and budget and assign to HSCIC for commissioning core and mandated GP IT Services. Responsibility for commissioning CSU to oversee development of programme delivery plan to meet local strategy and deliver implementation service for national systems and ITK initiatives. Will develop and manage the local delivery plan and implementation of national initiatives. Procure Systems, manage Suppliers and provide oversight and guidance to CCGs and CSUs. Adopt and implement national initiatives. Develop and deliver national initiatives in line with contractual obligations. 24

25 07 Tasks and functions Service: Core and Mandated service provision *CSU or any other IT Service Provider includes those CCGs providing in-house support arrangements. Function NHS CB CCGs *CSU or any other IT Service Provider HSCIC GP Practices Suppliers 1.6 Information Governance 1.7 GP Extraction Service Will set policy and ensure GP Practices comply with NHS IG requirements. Will develop the operating model for GPES. Responsible for commissioning service to support Practices in completing Information Governance Toolkit and support investigation and management of possible information security breaches & incidents. Will commission GPES support services from CSUs. Ensure support practices in compliance of IG requirements and completion of appropriate returns, Will support GP Practices with GPES extracts and ensure compliance with conditions of the extracts. No direct responsibility. Set out requirements for extracts and advise CSUs accordingly. Completion of GP IGT and compliance with NHS IG requirements. Will comply with GPES requirements. Completion of Supplier IGT and maintenance of systems which allow general practices to comply with NHS IG requirements. Responsible for ensuring extracts can take place of practice data when requested

26 07 Tasks and functions Service: Core and Mandated service provision *CSU or any other IT Service Provider includes those CCGs providing in-house support arrangements. Function NHS CB CCGs *CSU or any other IT Service Provider HSCIC GP Practices Suppliers 1.8 Hardware Management Will commission standards setting from HSCIC and will own the hardware and liabilities for practice based infrastructure. Will commission hardware management, disposal and replacement service from CSUs. Determine local strategy for hardware management. Will be commissioned to support, dispose and replace practice based hardware. Maintain provision of shared / core IT infrastructure (eg off site servers). Set standards for infrastructure (warranted environment) Provision of suitable environment including security, power supplies, PAT testing. Funding local consumables (eg printer ink and paper). Provide unambiguous minimum requirements for hardware and infrastructure required to operate systems in general practice. Ensure these align with the agreed warranted environment. 1.9 Registration Authority Will be responsible for commissioning a Registration Authority Service. No direct responsibility Will be commissioned to deliver the Registration Authority including configuration, issuing and management of smartcards. Will set standards for suppliers. Maintain and publish the National RBAC Database (NRD) GP Practices authorise the issue, revocation and configuration of smartcards for any access by individuals working in their practice to the clinical system. Suppliers will support the Smartcard model and the National RBAC Database in their systems. Ensure adherence to Registration Authority access policy. 26

27 07 Tasks and functions Service: Core and Mandated service provision *CSU or any other IT Service Provider includes those CCGs providing in-house support arrangements. Function NHS CB CCGs *CSU or any other IT Service Provider 1.10 Core Administrative Services No direct responsibility. Responsible to commission support. Commissioned to deliver service to support file management services and services (eg NHS Mail). HSCIC GP Practices Suppliers Provide guidance on any administrative requirements for core and mandated system. No direct responsibility No direct responsibility 1.11 Clinical Safety and Assurance Will commission clinical safety and assurance service required to comply with ISB 0160 (DSCN 18/2009) from CSUs. No direct responsibility Ensure all systems are being used and setup in accordance with ISB 0160 (DSCN 18/2009). Will be responsible for ensuring clinical system supplier compliance with ISB 0129 (DSCN 14/2009). Will support compliance with ISB 0160 (DSCN 18/2009). Will be responsible for compliance with ISB 0129 (DSCN 14/2009.) 27

28 07 Tasks and functions Service: Discretionary Services Prior to April 2013 PCTs may have elected to fund IT systems and services used by general practices and in many cases other local health community stakeholders where a strategic need has been identified. CCGs will be responsible to assess such services based on supporting local commissioning objectives. *CSU or any other IT Service Provider includes those CCGs providing in-house support arrangements. Function NHS CB CCGs *CSU or any other IT Service Provider HSCIC GP Practices Suppliers 2.1 Local strategic initiatives to improve service delivery across local community and support commissioning plans possibly in collaboration with other providers at the discretion of the CCG. Providing strategic support for transformation for Local Health Community-wide Information and Infrastructure. Set operating standards and monitor compliance. Providing oversight of transformation for Local Health Community-wide Information and Infrastructure. Will commission IT services, asset management, hardware replacement/disposal and clinical safety assurance services to support local initiatives for GP Practices to support local objectives. Commissioned to deliver IT services (directly or sub-contracted). (Eg project management, installation, clinical safety assurance, support and training). Will have the responsibility to maintain, promote and develop Interoperability Toolkit standards and implementations. Responsible for infrastructure enabling works (eg accommodation and electrical supply). Supply systems as contracted locally. 2.2 Discretionary developments to support individual general practices at the discretion of CCG. Seek advice of CSUs on the IT requirements of any proposals for changes to GP Practice Premises. CCG local decision on level of discretionary support provided. Budget locally determined by CCG. Will commission IT planning, advice and support for the development of premises business cases through local IT Provider. May be commissioned to deliver IT services (directly or subcontracted). Will advice the NHS LATs on IT design requirements for changes to GP Premises. Will have the responsibility to maintain, promote and develop data quality and interoperability standards to support individual initiatives that aim to work with wider health informatics. GP engagement and input to business cases. Supply systems as contracted locally. 28

29 07 Tasks and functions Service: General Practice Business Systems General Practitioners may and should be allowed to use/install agreed/approved software on systems provided by CCG/CSU. Availability of remote access should be granted to Business systems. Function NHS CB CCGs CSU or any other Primary Care IT Service Provider HSCIC GP Practices Suppliers 3.1 Systems to support individual general practices as businesses and which are not funded nationally or by the CCG. No direct responsibility Authorise practice-based software to operate on GP Networks. Enable GP corporate systems to operate in the managed IT infrastructure subject to security and performance limitations and capacity of infrastructure. If required contract with GP practices to provide additional IT services to support GP corporate systems. Will have the responsibility to maintain, promote and develop data quality and interoperability standards to support individual initiatives that aim to work with wider health informatics. Commission systems and services from Suppliers Comply with security and technical requirements of Primary Care IT Service provider (eg CSU). Fund additional infrastructure and support needed to support these systems if not already in place under 1 or 2. Seek approval from CCG to install practice-based software on GP networks that may have an impact on core IT operations. Supply systems as contracted locally by general practices. 29

30 08 Finance Financial arrangements for core, mandated and discretionary services: Core, mandated and discretionary services The NHS CB will continue to provide national funding direct to CCGs to cover local costs for the provision of core, mandated and some discretionary services transferred from PCTs in 2013/14. The funding will be divided across commissioners for the service provision described in section 5 and will be based on 2012/13 expenditure levels. Overall funding will not exceed 2012/13 flat cash expenditure. CCGs in partnership with providers will fund and contract for these services. CCGs in conjunction with GP practices will prioritise spending of discretionary programmes. The procurement for GP Clinical Systems through GPSoC and LSPs, or any national systems, will continued to be supported nationally. IT Assets IT assets owned by PCTs, irrespective of number or value, will transfer from PCTs to the NHS CB as the Receiver Organisation for the relevant primary medical care IM&T equipment. NHS CB will direct CCGs to manage the assets on its behalf and delegate appropriate financial resources for this. IT Asset Replacement Programmes The funding provided to commissioners will include provision for agreed asset replacement programme costs. Property management Funding to support new, expansion, mergers and any changes to premises including closures is the responsibility of the General Practice to seek authorisation from NHS CB. Funding for IT elements for changes to GP Practice Premises will be provided by NHS CB LATs, subject to an approved business case, as part of their overall funding for approved property schemes. (Further information will be provided as part of the NHS CB s financial allocations to CCGs) 30

31 09 Activity to date and next steps September to October 2012 Test the operating model with primary stakeholders. Autumn Publish Operating Model By end of December 2012 CCG commissioned services with CSUs or any other Primary Care IT Provider By end of March 2013 Responsibilities transitioned to new state Service live 31

32 10 Appendix A Core services A comprehensive list of core and mandated services for GP IT Requirement Hardware Software Services Accredited GP Clinical System (through GPSOC or LSP contract) PCs and printers including dual bin feed printers for consulting rooms. Smartcard readers. Local clinical servers including UPS, DDS, Spoke servers and backup hardware (as required). Local Area Network including switches and UPS. Hardware replacement / reinvestment programme. GP Clinical System licences. Desktop and server operating systems. Desktop and server anti-virus software. Backup software (if required). Use of LSP reporting unit for configuration and aggregated reporting. Desktop Support, including service desk, field support, remote desktop support and management including patch management, software upgrades etc, anti virus protection services etc. Clinical Application support, including back up and data verification support for those sites still on LAN based clinical systems. Deployment of new clinical system and migration to alternative clinical systems. N3 connections to Main and branch practice sites as per national entitlement. Clinical system backup tape validation. Hosted clinical systems. Use of national contract management/monitoring system (tracking database) for GPSoC and LSP systems. Access to DTS (data Transfer Services) for monitoring messaging faults and issues. 32

33 10 Appendix A Core services A comprehensive list of core and mandated services for GP IT Requirement Hardware Software Services Planned implementation/support for functional updates/releases to GP Clinical System from GPSoC or LSP (eg updates are via GP system suppliers). Training, Business Change and associated project management for migration to GP Clinical System (GPSoC/LSP). This also includes all services to support any migration from one system to another as per local policy, relocate, separate or merge GP lists / clinical systems and maintain links to other services, eg) Pathology / Radiology links, ongoing new starter training for GP Clinical System. Advising and supporting Practices in completing Information Governance Toolkit and provide support to Practices on the investigation management of possible information security breaches & incidents. Registration Authority service including policing Access Policy and the management of role-based or position-based access control and issuing of smartcards. Training of RA Sponsors. 33 Clinical assurance and safety: Ensuring that the requirements of DSCN 18(2009) are met for management of clinical risk in relation to the deployment and use of health software. 33

34 10 Appendix A Core services Requirement Hardware Software Services Core practice administration Local administrative network file and print servers that enable remote desktop management, asset management, system upgrades with secure off site data replication on practice business traffic. Core office applications i.e. MS Office Software, encryption software, internet browser, . Back-up tape encryption software, back-up tape validations, internet browser, , clinical systems,. Ensuring software licensing legal compliance. Disaster Recovery and Business Continuity planning support. Desktop Support, including service desk, field support, remote desktop support and management including patch management, software upgrades etc, anti virus protection services etc. Nationally mandated systems Warranted secure hardware disposal service. Hardware configuration management, excluding third party hardware and software. Vendor management from procurement through to contract and supplier management. Scanning software. Vendor management from procurement through to contract and supplier management. Software to support National Systems eg) Identity Agent, CMS. Core administrative services (outside national services desks): Providing Local Officer Administrator support for all mandated services eg) access and support for NHS mail, including access to intranet/internet services, migration from local services to NHS Mail, file storage and backup services (on or off site), any relevant active directory services. Service Desk and Technical Support excluding Third Party hardware/software. Active Directory: creation, deletion of user and accounts. Planning and local implementation support for nationally mandated systems (eg GP2GP, SCR, C&B, Map of Medicine, N3, CQRS, EPS, Patient Access). This includes project management, training, data quality programmes, data migration, and some business change, 34

35 10 Appendix B Discretionary services The current list outlines the full range of discretionary systems and services to be transferred from PCTs. Requirement Hardware Software Services Accredited GP Clinical system enhancements Scanners for accredited GP Clinical System. Barcode Scanners. Patient arrival, appointments on-line, calling and kiosk systems. Additional Trays for printers. server, software, maintenance, and administration support. Emergency equipment in the event of network failure e.g. spare laptops and 3G mobile cards. Community modules for GP clinical systems. Dispensary Software. Document management software. Dictation software. Additional software and operating systems to support GP Clinical system enhancements. Primary Care Data Quality and PRIMIS support and enablement services, including ongoing data accreditation services, system optimisation, data management, information extraction/reporting services. Data Quality, paper light accreditation, chart training. Provision of legacy DVD with patient details post data migration. Out of hours technical support Extended hours technical support. Consultation services for new deployments and potential developments. Additional PCs, Printers, Servers and hardware to support GP Clinical system enhancements. User group facilitation to enable sharing of best practice, system optimisation and National System Programme Forums for Primary Care. 35

36 10 Appendix B Discretionary services Requirement Hardware Software Services Additional practice clinical systems & Diagnostic support Additional PCs, Printers, Servers and hardware to support additional practice clinical systems Blood pressure monitoring. Spirometry. 24 ECG. Anticoagulation Management Software. Additional software and operating systems to support Clinical communications and system interoperability. Project management of new IT systems. Clinical Safety and Assurance to comply with DSCN 14/ for clinical systems/software excluded from core and mandated services. Management of service support contracts / supplier liaison. Negotiation on Practices behalf with other commercial third parties. Clinical communications and system interoperability Additional PCs, Printers, Servers and hardware to support clinical communications and system interoperability. Order Communications systems for diagnostics and laboratory requesting and reporting. Discharge and referral messaging systems. Clinical Architecture Integration for Clinical Systems. integration engine to enable GP practice / acute staff to share patient information. Tele medicine hubs. Additional software and operating systems to support Clinical communications and system interoperability. 36