Title of Meeting: Primary Care Agenda Item: 8.1 ... · The GPIT Operating model specifies what the...

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Title of Meeting: Primary Care

Commissioning Committee Agenda Item: 8.1

Date of Meeting: 1 March 2018

Session (Tick) Public X Private Workshop

Paper Title: Data Quality Service

Responsible PCCC Member Lead Dr Rick Sweeney Governing Body Member

Report Author and Job Title Alec Cowell Head of Finance

Purpose (this paper if for)

Decision Discussion Assurance Information

X

Has the report (or variation of it) been presented to another Committee / Meeting? If yes, state the Committee / Meeting: Yes. A version of this paper has been to FPCC

Executive Summary Background The GPIT Operating model specifies what the GPIT funding, allocated to CCGs, should be spent on and specifies that core and mandated GP IT services must be the first call on this revenue funding. In the previous GPIT Operating model, data quality was not a core and mandated service and subsequently it was not procured by the CCG. The GPIT Operating model was updated for 2016-18i (implemented April 2017), which now states data quality is a core and mandated service, and therefore CCGs should procure it on behalf of their GP Practices. Data Quality Service The data quality service includes the following elements:

- Comprehensive data quality advice and guidance service available to all GPs, including training in data quality, clinical coding and information management skills.

- Development and delivery of a general practice data quality improvement plan, where necessary.

The service should include support for:

- National data audits/extracts/reporting eg National Diabetes Audit - General reporting - Template development/QA - Spreading best practice - Data migrations as part of system deployments - National system deployments for example. GP2GP, - SCR, CAB/e-RS, EPS - Clinical/medical terminology

Solution from eMBED eMBED have put together a service specification for a data quality service, based on the requirements of the 2016-18 GPIT Operating model. The offering is split into 5 different areas to include all aspects of data quality, including the following key areas;

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- Data quality support, including 2 visits per practice annually - Date quality training in all elements/areas - Development, creation, sharing and amending of templates - Writing and testing of clinical system reports - Providing a hazard review process for clinical templates

This additional service will cost £30k per annum based on the assumption that S&R CCG and VoY CCG also procure the service from eMBED. S&R CCG have already taken this investment through their relevant committees and approved was granted. VoY CCG are currently taking this investment through their relevant committees and at the time of writing this paper no decision had been made. 1 https://www.england.nhs.uk/digitaltechnology/wp-content/uploads/sites/31/2015/04/gp-it-operating-model-16-18.pdf Please see separate Appendix A for the full proposal from eMBED. Recommendations The Primary Care Commissioning Committee is asked to approve this investment in GPIT. Monitoring Monthly contract review meetings take place with eMBED. Monthly GPIT review meetings also take place with eMBED, which covers contracted services, IT projects and IT training CCGs Strategic Objectives supported by this paper

CCG Strategic Objective X

1 Quality, Safety and Continuous Improvement X 2 Better Value Healthcare 3 Well Governed and Adaptable Organisation 4 Health and Wellbeing 5 Active and Meaningful Engagement

CCG Values underpinned in this paper

CCG Values X

1 Respect and Dignity 2 Commitment to Quality of Care X 3 Compassion 4 Improving Lives 5 Working Together for Patients X 6 Everyone Counts

https://www.england.nhs.uk/digitaltechnology/wp-content/uploads/sites/31/2015/04/gp-it-operating-model-16-18.pdf

https://www.england.nhs.uk/digitaltechnology/wp-content/uploads/sites/31/2015/04/gp-it-operating-model-16-18.pdf

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Does this paper provide evidence of assurance against the Governing Body Assurance Framework? YES NO x

If yes, please indicate which principle risk and outline Principle Risk No Principle Risk Outline

Any statutory / regulatory / legal / NHS Constitution implications

This business case addresses the shortfall in mandated services for primary care.

Management of Conflicts of Interest

No conflicts of Interest have been identified prior to the meeting.

Communication / Public and Patient Engagement

Not applicable.

Financial / resource implications

£30,081 annually from 2018/19.

Outcome of Equality Impact Assessment

No applicable.

Alec Cowell Head of Finance

Commercial in Confidence Solution Proposal 21/12/2017

Template: KTG-PM-FR-008 Page 1 of 13

THIS IS AN UNCONTROLLED COPY WHEN PRINTED - THE ELECTRONIC COPY IS CONTROLLED

Provision of GPIT core & mandated services for the development of a primary care data quality

improvement plan, quality training and provision of data recording advice and support

Services to be provided to: NHS Harrogate and Rural District CCG Prepared by: Jean Souter – Solutions Manager eMBED Health Consortium Kier Business Services, Workplace Services Gateway 2, Holgate Park, York, YO26 4GB M : 07525 203094 E: [email protected] For: Alec Cowell Head of Finance NHS Harrogate and Rural District CCG T: 01423 799329 E: [email protected]




Contents

Template Revision Control Document Version Control...................................................................................................... 3 Glossary of Terms ................................................................................................................... 3

1. Executive Summary ......................................................................................................... 4 2. Project Background .......................................................................................................... 5 3. Project Objectives ............................................................................................................ 7 4. Scope ................................................................................................................................ 8

5. Approach........................................................................................................................... 8 6. Overview of Services with 24 Month Deliverables ......................................................... 9 7. Assumptions ................................................................................................................... 11 8. Constraints ...................................................................................................................... 11

9. Service Charges (exclusive of VAT) ............................................................................. 12 10. Outline Project Plan ....................................................................................................... 13 11. Approval to Proceed....................................................................................................... 13




Document Version Control Version Date Author Description 0.1 17/07/2017 Jean Souter First draft 0.2 17/07/2017 Paul Searle/Angela Wood Review of first draft 0.3 19/07/2017 Jean Souter Approved for release 0.4 21/12/2017 Jean Souter Service delivery from 29 to 24 months 0.5 0.6 0.7 1.0

Glossary of Terms Term Description CCG Clinical Commissioning Group GPIT General Practitioners Information Technology PCES Primary Care IT Enabling Services QOF Quality & Outcomes Framework (online database) CQRS Approvals, reporting and payments calculation system for quality outcome-related

achievement for GP practices SRO Senior Responsible Owner FTSE Financial Times Stock Exchange (companies index) ICT Information and Communication Technologies BAU Business as Usual SRO Senior Responsible Owner PID Project Initiation Documentation




1. Executive Summary eMBED Health Consortium would like to thank Harrogate and Rural District CCG for the opportunity to provide this proposal of services for the development of a primary care data quality improvement plan, quality training and provision of data recording advice and support. eMBED is a wholly owned subsidiary of the Kier Group, a FTSE 250 company with revenues in 2016 of £4.2b. Employing over 21,000 employees, Kier has delivered over £1bn of NHS healthcare development projects in the last decade and provides localised expertise from its network of offices across the UK, including locations in Leeds, Bradford, Sheffield , Hull and York. Currently eMBED is delivering services which include ICT, business intelligence, and a range of supporting back office corporate and business solutions to the 23 Yorkshire and Humber clinical commissioning groups under the NHS England Lead Provider Framework. Despite the size and complexity of this contract, eMBED successfully mobilised the contract very quickly by seamlessly transferring services and staff whilst continuing to provide the existing service with minimal disruption. Our approach to mobilisation was based on three core principles:

minimal change to the current service minimise disruption through stabilising the service key stakeholder and staff focused

This method of approach underpins the standard practices for delivery that we operate within and as such Harrogate and Rural District CCG can be assured that eMBED will mobilise and operate this new service requirement to the 19 GP Practices within the region, effectively whilst deploying industry leading methodology. In appointing eMBED as the service provider for data quality service, Harrogate and Rural CCG will benefit from our evolving transformational working practices which harness specialist hubs of industry experts, that will be deployed to provide you with an immensely wide breadth and depth of skills and expertise. Our scale means that we provide an agile, skilled workforce that can deliver business support services cost-effectively, these having been fine-tuned through our work experience with clients across our footprint. Our proposition is based on a 24 month contract of service with effect from 1st April 2018 (this aligns with the existing contractual term in place for support services). We trust that you will find this proposal meets with your requirements for data services and we welcome any questions that you may have arising from this document.




2. Project Background NHS England has released a new GPIT Operating Model 2016-18. This builds on the 2014-16 GPIT Operating model and details key changes namely, additional core services. The new operating model has four levels of service defined:

Core & Mandated GPIT - business as usual, getting the basics right - every member of general practice staff must have reliable, responsive and efficient IT systems, associated support services and equipment.

Enhanced Primary Care IT - focused on improving efficiency and effectiveness, innovative and effective approaches that will better support changes in the delivery of primary care services, including 7 day and extended hours working and ‘at scale’ models.

Transformational Primary Care IT - new or additional infrastructure that will enable integration of health and care and delivery of new and innovative healthcare models, where multiple organisations across care settings are working with general practice to share patient care.

General practice business support systems - these are the systems which are associated with the running of the Practice business and are not directly connected to patient care and should be funded by the Practice.

The eMBED Service Delivery Management team attended a meeting with the CCGs the objectives being to:

Understand what has changed in Core & Mandated GPIT service provision (assuming CCGs wish to commission new services from April 1st 2017)

Understand the funding model as defined by NHSE Outline implications to IT service and CCG in delivering the new model

The GPIT Operating Model

NHS England holds accountability and provides funding CCGs commission GPIT service and drive integrated care Commissioned by CCG provided by service delivery organisations




Key Funding Principles

NHSE will continue to provide national funding as part of CCG baseline allocations

Investment of enhanced and transformational services must be CCG led

From 2016/17, GPIT revenue monies will be distributed directly to CCGs to manage locally, through CCG baseline allocations

The first call on GPIT revenue funding locally is the provision of ‘core and mandated’ GPIT services

In order to ensure that NHS England and CCGs comply with accounting policy, revenue allocations are being considered instead of capital for GPIT infrastructure requirements.

In recognition of the cost pressures in commissioning Primary Care IT Enabling Services (PCES) an additional in year allocation of £1.4m was made in 2029/16, specifically targeted at enhancing IG support arrangements. Funding provision for 2016/17, allocated to Regional Teams for the direct commissioning of these services, has been uplifted to £11m (full year effect).

eMBED is pleased to confirm its ability to deliver to Harrogate and Rural District CCG data quality services which are fully compliant and to specification. Our highly experienced senior leadership team will oversee the delivery of our services; and a team of experienced data quality product specialists will deliver them. With our excellent track record of working alongside the 23 Yorkshire & Humber CCGs and our significant and scaled experience in data quality services, Harrogate and Rural District CCG can be confident of our capability to quickly mobilise our service provision and detailed further within this document is our approach, deliverables and timescales.




3. Project Objectives The project objective is for the CCG to commission primary care data quality services to support primary care GP practices and services by:

Making best use of their clinical systems

Providing support to primary care users to ensure that the recording and use of clinical data is in line with the NHS Information Standard

Expert resourcing for core primary and integrated care clinical systems

Provision of Clinical tools, templates, data sets and reporting support for clinical and

commissioning planning, review and decision making

Supporting the delivery of consistent, comparable and secure clinical, professional and organisational data in relation to primary care and provided services

Providing information for CCG Clinical Governance and performance monitoring

Providing Clinical Commissioning and professional data sets, templates, data extraction

and query sets, assurance and compliance Within the Harrogate and Rural CCG region there are 17 GP Practices. eMBED is able to propose a schedule of service planning over a period of 13 weeks. During this time we will manage the recruitment process to appoint additional new talent to our existing team of data quality specialists. If the CCG is in a position to sign off this proposal with agreement to proceed by 31st December 2017 then eMBED will mobilise service provision with effect from 1st April 2018 – approval to proceed sign off at any date following this will move the go live date respectively. We are committed to supporting you to deliver efficiencies and improvements in data quality services. eMBED has the ability to add value which could not be delivered by an in-house service. We are a successful and experienced commissioning support organisation, already in partnership with the Yorkshire & Humber CCGs and as such this scale of service delivery enables us to provide you with access to a range of specialist expertise as well as real insights and learnings. eMBED is proposing the supply of data quality services from 1st April 2018 for a period of 24 months until March 2020 – this aligns with the existing contractual term in place for support services.




4. Scope Our approach to the scoping phase of the requirements will be to verify and detail every aspect of the services that will be delivered to ensure that the mobilisation plan is robust and to ensure that no services are omitted, duplicated or adversely impacted. This phase of due diligence is designed to fully determine the size, scale and scope of the mobilisation required, identifying all risks and issues with the services, whether perceived or real; so that they can be effectively managed and mitigated. Should these reviews highlight any additional remediation work to be undertaken to facilitate mobilisation this will be captured and discussed in detail with the appropriate party.

5. Approach The project will be started, planned, delivered and closed in accordance with PRINCE2 based methodology. The Project Manager will be responsible for developing and delivering against a project plan, risk/issues register, communication/engagement plan and benefits plan. These project documents will be regularly reviewed by the Project Manager and any slippage, requests for change and/or corrective measures required will be reported to the Senior Responsible Owner (SRO)/Sponsor and, if required, escalated to the Project Board for approval. The Project Manager will provide a regular progress report to the Project Board and other governance bodies at regular intervals to be agreed; arranging meetings, as required, to support planning and engagement activities. The SRO will be responsible for monitoring progress on the project and (with the Sponsor) for approving changes outside the agreed project plan, scope, quality and/or tolerance. eMBED recommends the implementation of our three stage model: Stage 1 – Discovery Establish Project Governance and agree PID. Stage 2 – Specification Planning Define and Plan Stakeholder engagement, key communications and mobilisation activities. Stage 3 – Solution Implementation Commence service mobilisation which will include dependencies, critical path and interfaces with all stakeholders and all activities necessary to satisfy service readiness. A Project Management Office will oversee all activities during the Mobilisation period providing robust and well tested processes and providing the necessary assurances allowing the CCG to deliver its statutory responsibilities.




6. Overview of Services with 24 Month Deliverables Deliverable Description Provision of a service which provides customers with data quality products, advice and guidance:

Development of an annual primary care data quality improvement plan

Clinical systems typically include SystmOne and EMIS WEB

Provision of 2nd Line function through the Clinical Application, Data Quality Support and Training team to resolve data quality incidents and service requests for support.

The definition of data quality service provision includes: advice and guidance will cover, READ coding structure within clinical systems (SystmOne and EMIS WEB), data entry of information onto clinical records, data extraction through clinical searches and reports, protocols and concepts. Will also provide guidance on understanding CQRS and open Exeter.

The data quality improvement plan will include access to a suite of data quality reports designed for practices to interrogate their own clinical system patient data. Practices will create a schedule of data quality improvements, as agreed with the CCG.

The Data Quality team will work closely with GP Practices; providing dedicated resource, to ensure that support, advice and guidance can be delivered and shared to help maintain business processes and requirements.

Facilitate with CCG the content of a data quality improvement plan that will be available to all GP practices

Provide a summary annually to CCG for GP practice achievement against the data quality improvement plan and Quarterly update on practice uptake of the data quality improvement plan

Primary Care Data Quality Training

Training for primary care users in Data Quality and Information Management

Primary care users are defined as: GP Practice employed staff

Training will be delivered through the following methods:




Deliverable Description classroom workshops, e-learning, remote access

Training modules to include:

READ Code training (Version 2, CTV3 & SNOMED CT )

Summarising of electronic patient record, to also include use of GP2GP

Register Validation Methodology Medical Terminology

Additional, bespoke training courses can be made available to CCG staff (the content and charges of which can be agreed as required).

Provision of data recording advice and support

Provision and assurance of a range of mechanisms including recommended coding and data entry templates in line with national or local requirements.

The service will be provided to GP practices and will provide them with guidance where patient information is shared with other service providers.

Provide a service to support the use, maintenance and development of templates and reporting for national and locally commissioned services, where clinical system providers have not provided the resources.

Develop a structure for the hosting of templates and reports on the clinical systems platform

Manage and maintain the templates repository

We will provide a service for integration of referral forms with clinical systems. We will require confirmation from the provider that the form is current and the most up to date, prior to the form being integrated into the clinical system. Referral forms will be managed as category 5 service requests.

Will provide a service to review existing (eMBED Created) centrally held clinical system data entry templates & protocols up to an annual basis as requested, agreed and planned with the CCG.

Will provide a service to review existing (eMBED Created) centrally held clinical system data entry templates in line with QOF business rule updates.

Provision of customised Primary Care data reporting

Data extraction, analysis and detailed reporting on data recorded in primary care customised to the needs of the requestor

Will provide a service to write (and test) clinical system




Deliverable Description reports (using system clinical reporting tools) where the CCG has requested and a designated lead is identified. This will include advice and guidance in understanding the reporting requirements, writing the clinical system reports and fully testing, before distributing to practices. This does not include running the clinical system reports.

Advice and guidance to GP practices in running bespoke tools to analyse extracted data where that tool is written and published by the DQ Service, e.g. Health Check monitoring

Hazard Review Process Review of individually created data entry templates, coding lists, formularies at GP practice level

We will provide a template assurance process with input from designated clinical lead

General practice support providing advice on concepts and processes via practice engagement, bulletins and remote support.

In line with established CCG hazard review process, ensure that data entry templates, protocols and referral forms meet their designated standards.

7. Assumptions The following assumptions exist:

Stakeholders and stakeholder organisations will co-operate in this project Stakeholders and stakeholder organisations will be released to participate in this project Current ICT architecture is understood and documented There is a legal basis for the required information sharing

8. Constraints The following constraints exist:

Stakeholder availability to support the project




9. Service Charges (exclusive of VAT)

Service

No. of GP

Practices

CCG Cost

Data quality services as detailed within Table 1 (above)

17

Harrogate and Rural District

£30,081.22

12 Month’s Charges £30,081.22 These annual charges will be invoiced on a monthly basis These charges have been calculated based on providing the service to 3 x CCGs (Scarborough and Ryedale, Vale of York and Harrogate and Rural District) and therefore would need to be reviewed if for any reason a CCG decided not to commission the service.




10. Outline Project Plan

Activity Planning/ Delivery/ Closure

Timescale

Establish project governance and agree PID

Planning Week 1-2

Stakeholder engagement and analysis, including key communications and mobilisation activities to provide more information on the service offer, existing provision and agree key customer contacts.

Planning Week 3-13

Start recruitment Planning/Delivery Week 1-13 Service Mobilisation Delivery Week 14

11. Approval to Proceed

I have reviewed this Solution Proposal document and the proposals are acceptable to me.

I authorise eMBED to initiate this project.

Name Signature Date

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