The Royal Wolverhampton NHS Trust Trust Board Report Meeting Date: 28 th September 2015 Title: ICT & Patient Access Cannock Position Report Executive Summary: Action Requested: The ICT & Patient Access Division was tasked to provide an IT and Health Records model capable of supporting the overall integration of Cannock Community Hospital (CCH) into The Royal Wolverhampton NHS Trust. The model / plan focused on delivering the changes both tactically and strategically to meet the continuing and evolving needs of the clinical services and our patients as part of the overall MSFT separation. For Information purposes only. Report of: ICT & Patient Access Progress and positioning for Cannock transition. Author: Contact Details: Links to Trust Strategic Objectives Resource Implications: Risks: BAF/ TRR (describe risk and current risk score) Public or Private: (with reasons if private) References: (eg from/to other committees) Appendices/ References/ Background Reading NHS Constitution: (How it impacts on any decision-making) Nick Bruce [Head of ICT & Patient Access Division] Tel 07970 107491 nick.bruce@nhs.net To build a reputation for excellence by achieving top 25% performance against key measures. To have an effective, well integrated organisation which operates efficiently. To maintain the financial health of the organisation and seek appropriate investment opportunities that enable further enhancement of patient services. Revenue: Capital: Workforce: Funding Source: N/A Public Overall RWT Transition plans. N/A In determining this matter, the Board should have regard to the Core principles contained in the Constitution of: Equality of treatment and access to services High standards of excellence and professionalism Service user preferences Cross community working Best Value Accountability through local influence and scrutiny
Background Details 1 The ICT & Patient Access Divisional Blueprint comprised of three main tranches of delivery: The current state of business operations (in terms of clinical systems and Patient Access services). Intermediate state to be delivered by the tranches of the programme, which enabled one or more intermediate benefits at Day 1, where the Patient Administration System (PAS) and Electronic Patient Record (EPR) in use at CCH would remain as is. This also applied to patient activity recording continuing on the former MSFT Medway PAS system and all clinical systems continuing as-is with the exception of Pathology and Pharmacy. Final state to be achieved by end of the last tranche (Full Integration and future expansion of RWT systems). At the heart of the Software Systems integration was the PAS (Patient Administration System) at RWT which is the lynch pin for all activity. This serves as the overall Master Patient Index providing patient information downstream to other key information systems such as the Trusts Clinical Web Portal (Electronic Patient Record). Effective Software Systems were completely dependent on provision of a robust, performant and solid infrastructure platform. Investment and delivery was critical across multiple tiers of infrastructure including, desktop equipment, Core / Edge network upgrades, server / storage provision and installation of high bandwidth multi-site connections. Providing safe and efficient back office functions as part of the Patient Access Services saw some complex analysis of all supporting processes to uphold patient care and clinical service requirements. The effective provision of patient records and overall strategic transformation of these back office services realised a successful transition of all patient appointments and continuation of electronic capture of paper records via additional scanning capability. Transition Position Day (1 November 2014) + 6 Months 2 Original Blue Print Scope Status Additional Comments Patient activity recorded in Medway PAS will cease for RWT Services and latest data will be recorded into the RWT Silverlink PAS. Referrals - All GP referrals will be handled by the RWT Appointments Centre including Choose and Book referrals. Outpatient appointments: All appointments will be booked onto the Silverlink PAS with the RWT appointment centre providing the central contact point for patients and healthcare professionals. All CCH clinic data will need to be collated and added to the Silverlink PAS. All RTT (referral to treatment) pathways will be transferred from the Medway PAS to the Silverlink PAS using the RTT Minimum Data Set protocol. Exception is Ophthalmology at Stafford. Page 2 of 7
TCIs (to come in) & Inpatient admissions all inpatients at CCH at the time of the PAS migration will need to be discharged and readmitted to the same ward in order to create a care spell on the RWT Silverlink PAS. Waiting Lists Waiting lists will be fully managed by RWT staff. E-discharges following the admission of patients onto the Silverlink PAS, the e- discharge record will be available for the clinicians at CCH to complete. All GPs from the surrounding area will need to have their addresses added to the RWT e- discharge system. Where addresses are not held in the system, staff are prompted to print and send the documents. Correspondence letters will be generated on the Silverlink PAS and these will replicate into Portal automatically. All Medway Patient Data will be provisioned into the Trusts Clinical Web Portal. All Scanned Patient Data will be provisioned into the Trusts Clinical Web Portal. All legacy MSFT system patient data will be provisioned into the Trusts Clinical Web Portal. Clinical Web Portal will be available to all CCH Site. Closedown of UHNM Medway System Access. Open Referrals Validation - 31,000 referrals required validation as these had not been closed on Medway for services that had transferred to RWT. In some cases, these dated back to 2009. Clinical Web Portal will be provisioned to all CCH GP Practices. Partially Exercise to add CCH GP Practices onto the e- Discharge system is ongoing due for completion November 2015. Approx. two thirds of the South Staffordshire GPs are in the system. Awaiting file extracts from UHNM supplier System C. Planned date for completion October 2015. RWT EPR System now completely independent of UHNM systems. Outstanding Awaiting UHNM to close down access to Medway system. All reliance on UHNM for this system has ceased, ICT SLA with UHNM terminated. This has no impact on RWT Services and does not present any risk. Approx. 1000 referrals remain open on Medway and need validation by service secretaries. (Total of 5000 referrals to be validated but over 4000 are closed on Medway and require RWT validation for completeness.) Data Sharing agreements signed. Demo of Portal system to GP Practice Managers complete. Awaiting final configuration of the remote access solution. Page 3 of 7
Training of central systems e.g. PAS, e- discharge, e-referrals will be undertaken by RWT staff. System support will no longer pass through the shared service and will go directly to the RWT Service desk and be supported by the teams at New Cross. Library services provided by RWT, where some joint UHNM/RWT records will need to be scanned into an electronic record where relevant. All Scanning capability moved to RWT Scanning bureau, including 1x scanner from MSFT. All user email accounts migrated to NHS Mail accounts. All PCs at CCH site moved onto the RWH network, PC replacements deployed with migration to Windows7, Printer and other desktop equipment deployed. High speed connectivity links (Primary and secondary) installed between the RWT site and the CCH site. User accounts, shared drives and file & print services migrated to RWT Network & Servers. Telephony Core at RWT to be replaced with new BT Core Switch in preparation for Switchboard transition. Telephony Switchboard services to migrate to RWT Switchboard The Bleep service to be migrated to RWT systems Estates to install repeater to enable the bleep service to reach all parts of the CCH estate. Significant replacements to be made to the Cannock Network Edge Switches. New Network Core Switch installed at CCH Site. Installation of 500k Storage Area Network Solution for all Electronic Storage across the Trust. RWT Pharmacy system to be deployed to replace MSFT pharmacy system. Data Sharing Agreement and provision of Pathology results access to Staffordshire and Stoke on Trent Partnership Trust services in the Cannock region Although current notice period is still being served with SSHIS Service Level Agreement until December 15. Agreed under ongoing Health Records SLA with UHNM until March 16. Scanning SLA with UHNM now terminated. Existing links remain in place between CCH & County site for continued access if required. Volumes of calls are greater than anticipated, additional resource is being recruited to ensure sufficient switchboard operators on the boards during peak periods. Page 4 of 7
Provision of access to MSFT Pathology and Radiology systems from New Cross Hospital for historical reports RWT Theatres system to be deployed to replace MSFT theatre system. RWT Radiology System to be deployed to replace MSFT system Expansion and improvements of Wi-Fi capability at CCH Site. Provisioning of IT within new Endoscopy Suite at CCH Winscribe digital dictation will be completely rolled out to consulting rooms and other clinical areas SafeHands solution will be rolled out across CCH Site. Vital PAC will be rolled out across CCH Site. Pathology e-requesting solution deployed to CCH Site. Pathology e-requesting pilot GP Sites deployed. Network CAB Refresh, to replace old CAB technology and cabling for network rooms in CCH Site. Remodelling of CCH telephony and implementation of Further Security firewalls for the CCH Network. ICT Deployment of A&E system at CCH Minor Injuries Unit. ICT Support for new Rheumatology Unit Service currently reviewing potential improvements for system to improve RWT configuration. Initial Wi-Fi implementation successfully completed, but further expansion of this capability is under review. Additional business case was agreed and this is now complete. Pending Cost negotiation ongoing with supplier around recurring annual charges. Dependant on new Vital PAC Upgrade due 30 th September 15. 160 new ipod devices ready for deployment. Pending Business case approved at September CRG, orders being progressed. Business case targeted for October CRG. 3 The following is a list of Services with corresponding dates which have successfully transitioned to the Royal Wolverhampton NHS Trust PAS system with supporting Patient Access Services. Page 5 of 7
Specialty Clinic's Successfully Transitioned to RWT Silverlink PAS held at Cannock and Stafford Dermatology 12 January 2015 Neurology 09 February 2015 Gastroenterology 09 February 2015 Gynaecology 09 February 2015 General Surgery 09 February 2015 Obstetrics 10 February 2015 Rheumatology 23 February 2015 Therapies 16 March 2015 Orthopaedics 16 March 2015 Cardiology 30 March 2015 Ophthalmology 01 April 2015 Endoscopy 09 April 2015 Radiology 22 April 2015 Orthoptics 27 April 2015 Paediatrics 18 May 2015 Neuro rehab 29 June 2015 Continence Service 11 August 2015 Respiratory 01 September 2015 Epilepsy service 01 October 2015 ENT TBC November 15 Other Cannock Related ICT Improvements: Intranet & Internet both in support of the Trust as a whole and to account for activities and services at Cannock, the Intranet and Internet are being revamped which has seen substantial investment in infrastructure by IT including new web servers, new Content Management Systems and increased capacity on externally hosted domains. Page 6 of 7
This will be accompanied by new designs, reviewed and renewed content, functionality and a centralisation of specialist sites into a corporate presence. CWP (common web platform) Capacity CWP has been further enhanced with new physical capacity and a refresh of key areas of the hardware architecture. The software has also received both a database and application refresh (on-going) which will also help support Cannock activities specific to the way patient records are displayed and accessed, along with performance enhancements. CWP Carousel the deployment of the Carousel for documentation from Cannock is partly implemented / imminent. This will greatly enhance the way in which clinicians use their documentation and streamline the patient record into a single journey, especially for information migrated from former MSFT systems. BT Commissioned Wi-Fi Survey planned across New Cross, West Park and Cannock site. This will highlight Wi-Fi poor signal areas to be addressed for greater ways of mobile working plus enable planned deployment of Public / Patient Guest Wi-Fi which will form part of the ICT bids / plans for early next FY. ICT Technical Services are working in partnership with Cannock GP Practices to review further opportunities for expansion of the RWT Telephony Solution, this is a network based digital telephony solution that will allow GP practices to monitor and manage their reception services. Page 7 of 7