GLA/NHS Information Revolution Project for London staffing support

Transcription

1 REQUEST FOR DIRECTOR DECISION DD520 Title: GLA/NHS Information Revolution Project for London staffing support Executive Summary: This project is creating a webpage and intranet page for London s GP practices (c1500). Londoners will access a landing page designed to be a living newspaper with health news, blogs, events and campaigns. Londoners can compare standards of GPs outcomes. Evidence shows that transparency drives up standards. There is a great deal of change within general practice with the move towards GP commissioning making this a challenging time to engage GPs. The service launches in November Therefore specialist support from practicing GPs is sought to enhance and increase stakeholder engagement. Further administrative support is sought to manage the project office. This paper seeks approval to commit up to 50,000 to: Secure temporary admin support immediately to run the office until August Recruit a fixed term administration officer to (September - March 2012) Award funding to NHS London as a contribution to its costs of paying clinical staff to support stakeholder engagement and GLA/NHS events to build stakeholder support for the project. Allocation of additional 50,000 to support the programme. Decision: 1. This paper seeks approval for expenditure of up to 50,000 on the NHS Information Revolution Project for London as follows: The award of funding of up to 20,000 to NHS London as a contribution to its costs of buying in a pool of specialist GP support to secure a time commitment 2 days per week from June to October 2010 to backfill frontline staff in order that they can maintain their service to patients. The recruitment of administrative support (estimated at 25,000) in the form of: an Agency Temporary staff member ( June August); and an Administrator (Grade 4), Fixed term contract from September 2011 to March 2012; and The commissioning of catering services for stakeholder events ( 5,000). 2. The allocation of additional GLA resources of up 50,000 to support the project during the year, expenditure of which will be subject to further approval. AUTHORISING DIRECTOR/HEAD OF UNIT I have reviewed the request and am satisfied it is correct and consistent with the Mayor s plans and priorities. It has my approval. Name Jeff Jacobs Position Executive Director, Communities and Intelligence Signature Date 1

2 PART I - NON-CONFIDENTIAL FACTS AND ADVICE Decision required supporting report 1. Introduction and background Background The coalition government and the NHS have identified information transparency as a key lever in the transformation of public services. In November, the NHS London working in partnership with the GLA will launch a flagship transparency service with the aim of transforming health care in London. Its aim is to redefine the relationship between patients, clinicians, the broader public and the NHS. Evidence shows that sharing information on health outcomes and provider performance is a powerful incentive for change. This project will put the GLA and NHS London at the forefront of the move towards transparency in the public sector. The NHS has made progress in recent years in introducing increased transparency in health care. However the NHS is lagging behind other health systems - health care consumers in London simply do not have access to new digital and information services. Business case for Funding There are compelling reasons to provide financial support to NHS London to enable it to launch this service as follows: The appetite and demand for information and online services shows no sign of diminishing. This project seeks to create a rich local source of online information and tools, and an information marketplace with relevant information for and about the local community. There is currently no credible information source for Londoners for Primary Care; no one place where people can go to understand and compare the relative merits of their GP service. No existing information service enables users to discriminate between local health care services based on quality or specialism. Improving the quality of maternity care is a priority in London. There is wide variation in maternity care across the city, and known issues with quality patient experience and productivity. There is a lack of good information about quality of care and outcomes at different maternity units. There is also demand from maternity service users for more convenient access to services and from clinicians for ways to reduce time-consuming form filling A significant and growing proportion of London s population has a Long term Condition (LTC) exerting pressure on services and making improving quality of care a concern for more patients and stakeholders. Patients with LTCs are estimated to account for over 80% of GP consultations and a substantial proportion of hospital admissions. Information transparency has the potential to improve case management and care for patients with LTCs improving quality of life for millions of patients and enabling substantial savings for the NHS and Local Authorities. This service aims to provide professionals and patients with the opportunity to engage with each other, compare services and carry out health care transactions. The GP is often the gateway into health care; the first and most frequent contact that people have with the NHS. It is therefore imperative that good locally sourced and locally based information is made easily available. General Practice is the logical starting point for this type of service, which promotes a bottom up, community-based approach to stimulating an information marketplace. 2

3 Very little data on primary care services exists in the public domain. London has recently pioneered the development of a set 22 outcome standards for General Practice, which have been clinically endorsed by the GP Council and the Londonwide LMCs. These are the minimum standards that the public can expect of any GP service in London. Healthy London provides a natural vehicle through which to promote these standards to the public in an open and accessible way. Benefits The service will benefit patients, GPs and Londoners: Londoners Improve health outcomes and patient experience by making meaningful comparative data accessible to professionals and patients, driving peer review and development of local healthcare markets Improve patient experience through patient feedback Empower local health and social care organisations. Patients: Enable patients to make informed choices on Primary Care based on their own priorities Enable patients to feedback to their practice and receive responses Improve access and convenience for patients by bringing more practices online and increasing penetration of online transactions Empower patients to manage their own healthcare through access to medical records, repeat prescriptions, patient networks etc. GPs Enable meaningful comparisons with other practices and support sharing of good practice Increase flow of feedback from patients on their practice and on other providers they refer to Improve efficiency by providing easy access to transactional tools Prepare for future statutory requirements on quality and transparency. The Greater London Authority Act 1999 required the Mayor to lead preparation of a strategy which identifies health inequalities in Greater London, priorities for reducing them, and the roles to be played by key partners in implementing the strategy. The final Health Inequalities Strategy (HIS) and First Steps to Delivery Plan were published in April The Strategic Plan commits to finalising and publishing the HIS Delivery Plan, and coordinating delivery of early HIS priorities. The Strategic Plan delivery Form reference number that relates to this proposal is 89SP10/11 Will ensure our policy setting can better address health inequalities and their potential causes, one of which is unequal access to healthcare, as identified in the Fairer London priority section of the GLA s Strategic Plan. The project is linked to the GLS Strategic plan Section II listening to Londoners encouraging the fullest participation and engagement by all London s communities in developing the policies and strategies to improve London. The project will enable Londoners to access comparative information on general practitioners and allow them to comment on their treatment and service received and to engage in online forums with practice staff and other patients. The project also links to the Digital Engagement priority set out in the 2010 GLA Strategic Plan and the data displayed via this internet portal will be made available widely in its original form through the London Datastore. 3

4 Current Year Funding The project will be funded for 2011/12 as follows: NHS London 997k, from the Strategic Fund ( 830k) and the Medical Budget ( 167k) GLA will provide 50k contingency funding, and up to 45k staffing as outlined in this DD and 5k catering at stakeholder events. In addition, both NHS London and the GLA are providing resource and support in kind as set out in the business case appended as background. Project governance The Steering Committee is responsible for overall direction and decision-making, performance review and guidance to project leadership. The London Medical Committee, London-wide GP Council and NHS London are represented. The project is overseen by a steering committee chaired by Pam Chesters, Mayoral Adviser Health and Youth. Stakeholder Engagement Stakeholder engagement has identified enthusiasm among some GPs, although there has been some concern about the service generating extra workload (e.g., effort required to maintain up to date information about their practice on the portal). Small numbers of GPs, practice managers, Pathfinder leads and patients groups have been engaged and many are now involved in supporting the development of the project. Levels of GP engagement with the project can be increased through buying in dedicated time from practicing GPs to refine the marketing approach, using their existing contacts and networks and use peer to peer communications. Additional support required: A stakeholder engagement strategy has highlighted the importance of using clinicians to refine key messages, ensure that the product is developed with input from GPs, practice managers, demonstrate the value of the project and communicate the project vision to their professional colleagues. Additional support will allow quicker access to GP networks and contacts. The additional clinical resource will be used to establish and organising model. They will be required to set up local teams made up of GPs, practice managers, community groups and others, brief them and support them to engage GP practices across the boroughs. Leads will be generated from meetings between the project team, consortia leads and other primary care leaders as well as opportunities they generate themselves. It is standard practice to pay clinical staff in order that they can provide locum cover and maintain their expected level of service to Londoners. The decision to go ahead was taken by the project Steering Committee, chaired by Pamela Chesters, Mayoral Adviser Health and Youth Opportunities on 17 th May. Administrative support was required immediately therefore a temporary member of staff was sought from June to August via the Huntress agency with which the GLA has a regular contract. This was approved suing the Temporary Staff Approval form, which was signed by Jeff Jacobs, Executive Director, Health and Communities. This DD seeks approval to secure funding for a Grade 4 administrator full time on a fixed term contract from 1 September 2011 to 31 March Approval for the post via the STAF form will be completed concurrently with this DD. 4

5 2. Issues for consideration a) Links to strategies and Strategic Plan Section 309E of the Greater London Authority Act 1999 (the Act ) requires the Mayor to develop a strategy setting out proposals and policies for promoting the reduction of health inequalities between persons living in Greater London. The London Health Inequalities Strategy (HIS) was published by the Mayor in April The NHS Information Revolution project will increase access to NHS services and thereby support efforts to reduce health inequalities. Transparency and London Datastore all data generated through this project will be uploaded to the London Datastore and thereby be made directly available to the developer community to generate products of benefit to Londoners. The Strategic Plan Delivery Form reference number that relates to this proposal is: N/A b) Impact assessments and Consultation An Equalities Impact Assessment (EQIA) of the project will be undertaken to assess the potential impacts on particular equalities groups and to ensure that appropriate mitigation measures are undertaken. The EQIA will be led by NHS London. c) Risk There is a risk that GPs will not buy into the platform. The consequence is that GP take up will be low. This is being mitigated by stakeholder engagement with LMCs, Pathfinders, PCT cluster, patient groups and local authorities. This DD seeks approval for additional stakeholder engagement resources to further mitigate the risk. 3. Financial Comments Background 3.1 Approval is being sought for the GLA to commit expenditure of up to 100,000 on the NHS Information Revolution Project for London, which will include the following: The award of funding of up to 20,000 to NHS London as a contribution to its costs of buying in a pool of specialist GP support to secure a time commitment 2 days per week from June to October 2011 to backfill frontline staff in order that they can maintain their service to patients. Retrospective approval for agency temp for the period of June 2011 to Aug 2011 The recruitment of administrative support in the form of a grade 4 equivalent officer (in the form of agency temp and fixed term contract for the period from June 2011 to the end of March The commissioning of catering services for stakeholder events. The allocation of a GLA contingency budget of to 50,000 to assist the programme if required, for which further approval will be sought for any proposed expenditure. 5

6 Cost & Budget 3.2 The estimated cost of this proposal against expenditure type is summarised below: Expenditure type 000 Funding to NHS London 20 Agency Staff (June to Aug 2011) 5 Administrative Support (Grade 4 Equivalent) 20 Catering Services 5 GLA Contingency 50 Total The total estimated cost of this proposal to the GLA ( 100,000) will be funded by LHC partnership income carried forward from to be utilised on Health related projects. The income and associated expenditure will be accounted for within the Health Programme budget. 3.4 As detailed within the main body of this report, the total estimated project budget is 1,097,000, of which 997,000 will be funded directly by NHS London. The GLA will incur 50,000 expenditure on staffing resource, catering and an initial grant to NHS London. A further 50,000 has been allocated by the GLA for any additional resources required during the year. The expenditure of this additional 50,000 will be subject to further approval. 3.5 All appropriate budget adjustments will be made. Funding Agreement - Procurement Staffing issues 3.6 With regards to the proposed funding contribution to NHS London, this will be governed by a funding agreement. Consequently, officers are reminded to liaise with both the Legal & Finance Teams in the preparation of the associated funding agreement. In addition, the monitoring of the grant should be in line with the Authority s Funding Agreement Toolkit. 3.7 The creation and recruitment of administrative support equivalent to a grade 4 post on the GLA s pay and grading scheme will be subject to the Authority s HR policy and procedures (STAF process etc) and officers should liaise with HR in this regard. The recruitment of an agency staff for the period between June to August 2011 was subject to HR s recruitment procedure for agency workers. 3.8 All other procurement of goods and services relating to this proposal should comply with the Authority s Financial Regulations, and Contracts & Funding Code. 3.9 Any changes to this proposal, including budgetary implications will be subject to further approval via the Authority s decision-making process The Health Team within the Communities & Intelligence Directorate will be responsible for managing this project. 4. Legal Comments 4.1 The forgoing sections of this report indicate that: the decisions requested of the Director fall within the Authority s powers to do anything which is facilitative of or conducive or incidental to the promotion of social development in Greater London; and in formulating the proposals in respect of which a decision is sought officers have complied with the Authority s related statutory duties to: 6

7 (a) (b) (c) pay due regard to the principle that there should be equality of opportunity for all people; consider how the proposals will promote the improvement of health of persons, health inequalities betweens persons and to contribute towards the achievement of sustainable development in the United Kingdom; and consult with appropriate bodies. 4.2 Officers have indicated that the contribution of funding to the proposed recipients and projects will amount to the provision of funding and not a payment for services rendered. On the basis that this payment is to be funding, as opposed to the procurement of services, the Authority s Contracts and Funding Code ( Code ) requires the Authority to ensure that the funding is distributed fairly, transparently and in accordance with the Authority s equalities obligations. The Code also requires the Authority to demonstrate value for money in the allocation of this funding. Officers must also ensure that the funding is administered and managed in accordance with the Authority s Funding Agreements Toolkit. 4.3 Officers must ensure that funding documentation containing appropriate provisions to protect the Authority s interests are put in place and executed by Badminton England and the Authority before commitment is made to make any payments in respect of the proposed activities. 4.4 Officers must also ensure that any catering services commissioned for stakeholder events are procured in accordance with the Code and liaise with TfL Procurement in this regard. 4.5 Any recruitment to the posts being funded should take place in accordance with the Authority s Recruitment Policy and must be approved by the Head of Paid Service. In order to approve the post for and agency worker, a Temporary Staff Request Form will need to be signed. Agency workers should be used for as short a time as possible and in any event no more than 12 weeks. 4.6 In order to approve the fixed term post, a STAF Form should be completed and signed. Should the role be extended beyond a year in the future, the Head of Paid Service would need to approve the extension. In such circumstances a HOPS form should be completed. 5. Background/supporting papers Healthy London Business Case _

8 Public access to information Information in this form is subject to the Freedom of Information Act 2000 (FOI Act) and other legislation. Information on this decision will be included in the Mayor s report and decision list. The form will be available publically from then. Any facts and advice that should not be made automatically available on request should not be included in Part 1 but instead on the separate Part 2 form. Deferment is only applicable where release before that date would compromise the implementation of the decision being approved. Is the publication of this approval to be deferred? NO If yes, for what reason: Until what date: Is there a part 2 form NO ORIGINATING OFFICER DECLARATION: Legal Advice: The Commercial Law and Projects team have commented on this proposal. Financial Advice: The Communities and Intelligence finance team have commented on this proposal on behalf of the Assistant Director of GLA Finance. Tick to indicate approval Executive Director, Resources I have been consulted about the proposal and confirm that financial and legal advice have been taken into account in the preparation of this report. Signature Date 8