INFORMATION STANDARDS GOVERNANCE PROCESS INFORMATION STANDARD DEVELOPMENT PROPOSAL FOR NEW OR CHANGED (INCLUDING RETIRED) INFORMATION STANDARD

Transcription

1 INFORMATION STANDARDS GOVERNANCE PROCESS INFORMATION STANDARD DEVELOPMENT PROPOSAL FOR NEW OR CHANGED (INCLUDING RETIRED) INFORMATION STANDARD ISRN 2011/004 National Complex Care Database December 2011

2 INFORMATION STANDARD DEVELOPMENT PROPOSAL FOR NEW OR CHANGED INFORMATION STANDARD This document should be completed using the GUIDANCE ON COMPLETING THE INFORMATION STANDARD DEVELOPMENTPROPOSAL NOTIFICATION SUBMISSIONTEMPLATE REVISION HISTORY Date of this revision: Version Revision Summary of Changes no. date 0.1 Initial Draft December 2011 Changes marked DISTRIBUTION This document has been distributed to Name Title Issue Date Version Gaynor Williams CHC National Programme Director 5 th December Jo Williams Project Manager, CHC National 5 th December Programme Claire Aston Senior Strategic Programme Manager 5 th December for Complex Care and Chair of National Complex Care Database Task & Finish Group Gillian Davison Community Applications Manager 5 th December Jon Walters Senior Software Developer 5 th December SUBMITTED BY: Document completed by: Anne Owen Role & organisation: Clinical Informaticist (Nursing) NWIS FEEDBACK TO BE PROVIDED TO: Feedback will be provided on the Proposal within 10 days of the WIGSB meeting. If the feedback is to be directed to another nominee please provide the name and contact details below. Page: 2 of 13

3 Name: Anne Owen SUBMISSION PURPOSE Proposal submitted for: Formal Approval If this Proposal submission is not for formal approval then please state the specific aspects on which you would like more detailed comments. Specific Areas for WIGSB to comment on when not submitting for formal approval at the Proposal stage Page: 3 of 13

4 SECTION 1: BACKGROUND 1. Information Standards Reference Number [From Information Services Division] ISRN 2011 / Name of Information Standard National Complex Care Database 3. Type of change a) Introduction of new standard 4. Type of standard [Select all that apply] Operational 5. Introduction Each Health Board in Wales currently operates a database that captures Continuing NHS Healthcare (CHC) related activity. The systems in place have developed over time to suit local circumstances, and have been inherited post 2009 NHS reorganisation from the previous Local Health Boards. Continuing NHS Healthcare is a term that describes a package of care fully funded by the NHS, where it has been determined by a process of assessment that the person has a Primary Health Need and is therefore eligible. In addition to Continuing NHS healthcare eligibility, Health Boards will fund care for their resident population through other processes those who are identified as having nursing needs as part of a residential care home placement would have the nursing element of the care package funded by the NHS. Joint packages of care with local authority partners are also in place across Wales, often for people who have specialist needs that can be either short term or long term in nature. The current databases in use across NHS Wales to capture CHC related activity vary in their purpose and functionality, with some set up to support robust financial monitoring, whilst others are broader in their scope and also capture clinical and process related information. Whilst these systems suit local purposes, they do not allow for comparisons across organisational boundaries or use consistent data definitions. In addition to this some Health Boards have received limited assurances from internal and external (Welsh Audit Office) audit scrutiny with pressure put upon them to improve the way they manage Continuing Healthcare Data. In May 2011, the Continuing Care Programme Board noted the opportunity to develop a single solution across Wales, adopting a once for Wales approach. Given the strong influence by the auditors, there is a sense of urgency to find a solution. A Task and Finish group has been undertaking work to deliver on the requirement to develop a single solution, taking into account the mandate of urgent action within an affordable cost envelope. The approach taken has been to utilise a database currently in use in Hywel Dda Page: 4 of 13

5 Health Board. This system has been developed by NWIS, working in partnership with Hywel Dda Health Board and meets a number of requirements, including financial, quality, placement and clinical data. Following a workshop in August 2011, a requirements catalogue was created, scored and mapped to the current functionality of the Hywel Dda Database. The majority of the functionality of the Hywel Dda Database fitted with the requirements identified by the workshop attendees with only a few some additional essential features being needed. It was agreed by the CHC National Programme that the best option was to use the Hywel Dda Database with the additional features as identified at the August 2011 Workshop. The product has been given the name the National Complex Care Database. 6. Sponsor CHC Programme Board, jointly chaired by Jan Williams and Rob Pickford 7. Developer NHS Wales Informatics Service Jon Walters 8. Implementation Date 31 st March 2012 Page: 5 of 13

6 SECTION 2: BUSINESS JUSTIFICATION 9. Purpose The purpose of the National Complex Care Database is to provide a single database solution across NHS Wales for the capture of information in relation to those people requiring longer term care, including, but not limited to, Continuing Healthcare. Other categories of care package that will be captured include jointly funded arrangements with local authority partners, and the nursing care element of a residential care placement The database will contain a record for each patient, into which details of financial invoices will be entered together with some administrative data regarding the patient. The development of a single solution would ensure: A consistent process and definitions in place across Wales removing the current variation that prevents like for like comparisons; The ability to compare trend information across organisational boundaries; The ability to transfer records to other Health Boards to follow the person if they move to another area; Increased resilience and sustainability into the future. Compliance with the Wales national architecture approach and audit requirements. 10. Scope The National Complex Care Database will be accessed and used across NHS Wales by NHS Wales clinical staff who deliver continuing care to patients, NHS Wales finance staff and NHS Wales administration staff for data input The National Complex Care Database allows the end user to Enter Patient Demographic Information. Lookup Welsh Demographic Information (WDS) not yet available. Enter Finance Identifiers (Oracle). Enter Care Co-ordinator Information. Enter Social Care Information. Enter Correspondence Information. Enter Lasting Power of Attorney Information. Enter Next of Kin Information. Enter Continuing Health Care (CHC) / Funding Nursing Care (FNC) Applications. Enter Retrospective Reviews (Ombudsman Cases). Enter Finance Invoices as per Ledger. Upload files to the patient record. Enter Comments or record communication of client/patient information. Run reports 11. Funding Page: 6 of 13

7 Existing resources within NHS Wales Informatics Service have been deployed to develop the National Complex Care Database and to take it through the Governance Process. Access to the database will be via existing desktop computers containing a web browser using the NHS Network. 12. Support Support for the development of the National Complex Care Database has come from: National Continuing Healthcare Programme Board End Users a Workshop was held in August 2011 to establish a set of requirements for the National Complex Care Database (see Appendix??) Task & Finish Group established following the Workshop in August. Members represent clinical, finance and administration. Meets monthly to quality assure progress NHS Wales Informatics Service has developed the National Complex Care Database, is taking the National Complex Care Database through the Governance process and will assist in the roll out and service management of the National Complex Care Database. Page: 7 of 13

8 SECTION 3: HEALTH INFORMATION STRATEGIC AND OPERATIONAL FIT 13. Strategic Fit The National Complex Care Database is in the process of being scrutinised by NWIS Design Assurance Group (DAG) and the National Architecture & Design Board (NADB). 14. Operational Fit The database is currently successfully being used in Hywel Dda. 15. Known standards in use nationally and internationally Page: 8 of 13

9 SECTION 4: THE PROPOSAL 16. Proposed Solution Attached is the User Guide which will provide further information on how the National Complex Care Database will be used. The National Complex Care User Guide v4.docx One of the aims of the National Complex Care Database is to be able to produce comparable data across the Health Boards. We are arranging to meet with Data Standards colleagues to work through the drop down lists contained within the National Complex Care Database to ensure that where possible national standards are used. CHC Database Field List.docx Work is also underway by the CHC community to standardise and refine some of the more specialised fields for example Care Categories. This is not yet complete. 17. Fitness for Purpose End User Perspective The CHC community has been closely involved with the setting of the requirements for the National Complex Care Database, assisting in the design and the quality assurance of the product. CHC Requirements Log v08.xlsx Notes from Meeting docx Final COMPLEX Final Notes of final draft notes of CARE DATABASE -... meeting jlw.docx meeting jlw.docx Governance The National Complex Care Database has been scrutinised at a Patient Safety Workshop on 23 rd November No patient safety risks were identified. Clinical Risk Register is attached Clinical Risk Register xlsx The National Complex Care Database has been presented to the NWIS Design Assurance Group (DAG) on 29 th November 2011 and to National Architecture & Design Board (NADB) on 14 th December It is to be noted that the Wales Audit Office has been kept involved with the development of the National Complex Care Database and a representative of the WAO attended a session on 23 rd November to review the product. Page: 9 of 13

10 18. Testing / Pilot The National Complex Care Database has been successfully used in Hywel Dda Health Board since March 2011 with close liaison between the developer and the end user to fix any bugs in the system and to make minor changes to improve the usability of the system. NWIS is in the process of identifying a testing resource to undertake the technical testing required to ensure the product can be safely scaled up to a national level. This will be completed before the national Go Live from 31 st March The CHC community has been asked to nominate end users to undertake User Acceptance Testing in order that the National Complex Care Database can be signed of ready for Go Live prior to 31 st March Information Governance An initial assessment was undertaken on 31 st October. A full Information Governance Assurance Process (IGAP) is in the process of being completed Complex Care Database IG Repor Commercial Considerations There are no commercial issues to note. Page: 10 of 13

11 SECTION 5: IMPACT ASSESSMENT 21. Impact Assessment The National Complex Care Database has been successfully used in Hywel Dda Health Board. Feedback from potential end users across Wales, who have seen the National Complex Care Database demonstrated and have accessed the Training version report that it is user friendly and straight forward to use and navigate around. The main impact of using the database will be in 2 main areas Migration of data from existing CHC databases to the National Complex Care Database Potential change in ways of working/recording information Data Migration The migration of existing data to the National Complex Care Database is seen as a significant piece of work both on a technical side (in the development of scripts to import the data as no two databases are the same therefore each script has to be tailored to suit individual need) and also on the CHC community who will be required to validate the data. NWIS is working with the local IM&T Departments to provide the necessary templates and guidance to assist with this task. Change Management The National Complex Care Database Task & Finish Group is facilitating a dialogue between end users of the database across Wales to help them share ways of working and good practice. This will need to continue as the National Complex Care Database is rolled out and beds down and plans are being made to establish service management arrangements for the finished product. Page: 11 of 13

12 SECTION 6: DEVELOPMENT PLAN 22. Development plan National Complex Care Database Action Plan ACTION Initial Data Quality Internal work within each Health Board to Quality Assure data held Requirements Gather Requirements Development Development of National Complex Care Database Governance Patient safety workshop identify attendees Invite attendees Patient Safety workshop held Presentation to NWIS Design Assurance Group National Architecture Design Board Welsh Information Standards Board Initial Overview of National Complex Care Database Identify attendees HB Leads HB Leads Jon Walters LEAD HB Leads Gaynor Williams/Jo Williams Peggy Edwards Jon Walters, Rob Jones Anne Owen, Jon Walters/Gill Davison & identified lead (Anwen Pearce to confirm) Anne Owen & Gaynor Williams HB Leads TIMESCALES

13 Invite attendees GW/JW Production of User Guide GW/JWalters/ JWilliams/AP Overview held Identified attendees Training Identify National Trainer Sue Thomas Create training documentation Training Lead Establish training plan Training Lead Content of National Complex Care Database GW/CA/JW Discussion and agreement on care package categories need for consistent HB Leads via Development Group categories across all LHBs Confirmation of access levels and permissions HB Leads Sign off of National Complex Care Database Task & Finish Group Local Health Board Engagement Establish CHC contact and Health Board IM&T contact NWIS/Task & Finish Group Local familiarisation of CHC and National Complex Care Database LHB IM&T Leads Data Migration Local HB Lead/Gill Davison Data migration plan established Gill Davison Hosting Lead to establish an approach Mike Jones Service Management Lead to establish an approach John Richmiller Page: 13 of 13