[Information Management and Technology] Service Operating Plan FY2017 (Version 0.1)

Transcription

1 Service Operating Plan FY2017 (Version 0.1) [Information Management and Technology] Author / Owner Name Position Signature Date Paul Dubery Deputy Director of I M & T Clinical Sponsor Directorate Approval Working Beyond Boundaries to deliver Quality care for everyone, every time

2 Table of Contents Introduction Service Profile: National Context Local Context... 6 Looking back... 7Error! Bookmark not defined. 4. Key Achievements and Successes Key Issues and Challenges Lessons Learnt Risk Benchmarking Finance... Error! Bookmark not defined. 10. Workforce Looking Forward Key Assumptions Summary Analysis Service Objectives and Cost Improvement Plans APPENDIX 1 Trust Vision, Values and Goals

3 Introduction 1. Service Profile: Key service responsibilities IT Servicedesk Single Point of Contact (SPoC) for all incidents and service requests. End User Device Support Services Support and maintenance of PCs, Laptops, Tablets, network printers, mobile/smart phones and other IT assets / services to customers. IT Procurement - Procure IT equipment on behalf of customer organisations including mobile/smart phones Remote Access Solutions Isle of Wight NHS Trust IT Dept will provide those members of staff who require access from home and / or multiple locations, with secure access to their work systems from corporate laptops, PCs or Smart Phones etc. Asset & Lifecycle Management Manage capital assets throughout their lifecycle including purchase, tracking, maintenance, licencing and secure disposal in line with current environmental legislation standards. Network and Infrastructure Services Provide a secure infrastructure to allow staff to access local and remotely hosted applications and to communicate effectively using voice or data. Telephony Services Manage & Support VoIP and analogue telephony infrastructure and associated devices. Systems Management Services Enterprise administration of distributed applications. Storage and Data Management Services To provide hosting for applications and data administered by customers or third party companies Disaster Recovery Supports the execution of disaster recovery plans in case of a major incident or loss of service. Including the provision of technical recovery of IT systems within the context of overall customer disaster recovery plans. Information Security Ensuring compliance with relevant legal, statutory, regulatory, contractual standards and obligations. Maintenance of the Isle of Wight NHS Trust IM&T Security Policy. To manage key Information Management system applications for clinical and administrative services specifically, CSC PAS, EMIS Symphony, ISIS and Civica Paris. Operational Systems Support Desk To provide technical support to all Systems Users to include PAS/Patient Centre, Symphony, ISIS and Paris. Systems Training delivery To provide a training service both workplace support and more formal classroom training sessions utilising various methodologies System Management and development Ensuring that Systems are fit for purpose and meet National Reporting Standards. This includes strict access control that meets IG Standards, configuration of functionality, master file maintenance, data collection mechanisms and template production relating to above systems. Interface Monitoring Managing flows through integration engines (Rhapsody and Viaduct ) Data Quality Validation across Systems Providing technical expertise on data flows and data collection in line with the NHS s Data Dictionary and reporting requirements Support Line - Provide first line support Line to Admitted patient s friends and relatives Project Management Subject matter expertise - Support in the implementation of IT projects / solutions Solution scoping Analysis based on identified requirements Project delivery Project management and planning, risks and issues management, lessons learned, budget management, project closure. Supplier liaison delivery negotiations, contract and price management, 3

4 Key service deliverables IT Information Management I M & T Projects Service desk provision IT asset register Financial management Annual routine system maintenance upgrades to various applications Ensure data is collected accurately and reported via CDS (in accordance with the Data Dictionary) Implement a robust method for capturing and reporting RTT waits Ensuring that all ISN s are implemented as dictated by HSCIC Provide both a training and support service to all system users ensuring that local SLA s are met Audit system usage and escalate as appropriate if breaches are made - in accordance with the Care Record Guarantee Supporting service initiatives EMH Contract Milestone delivery of all I M & T Projects covered within the business plan. Key service relationships (internal and external) HSCIC External Trusts Local Authority MLAFL Council ICT service users PIDS CSU/CCG Portsmouth Hospital Trust Contracting Information Governance Suppliers Dependencies on Good staff attendance Appropriate capacity(staffing) Fully developed procedures Staff training (internal and external) Adequate departmentally housed Application Managers for departmental systems Advanced knowledge of Trust priorities and any requirement for IT involvement Adequate funding for infrastructure or assured rolling replacement resources (Capital and revenue funding) Staff morale Storage to cover reactive purchasing 4

5 Dependency to Corporate and clinical service areas, I W Council, EMH, CCG, 2. National Context The I M & T Department have many National drivers and standards to adhere to. Information Technology Health and Social Care Code of Connectivity Freedom of Information Act Data Protection Act I G Toolkit ITIL Best Practice Standards National IT procurement framework H M Government cloud first Policy NHS secure E mail standards Paper-free at the Point of Care Information Systems RTT Monitoring and Reporting - ober_2015.pdf Paper-free at the Point of Care CDS Reporting to include CYPHS, MHMDS, MCDS National Dataset changes. (ISNs) National Programme - Bowel Screening / Scoping Data Capture EMH Reporting Requirements OAKKS CQUIN Targets 5

6 3. Local Context The following items were identified in conjunction with operational business planning leads and each item will be a draw on the capacity within the I M & T department which will need to be factored into our resource plans. The I M & T Department are currently resourced to deliver business as usual activity which includes support, maintenance and infrastructure upgrades and additional resources will be required to cover new projects. One model would be to ensure that as funding is applied for to Capital Investment Group, by operational departments, adequate cover for I M & T should be factored in. However, it is not usually possible for us to employ additional team members for short term projects who will have the necessary skills and experience to support these projects, However, a more pragmatic forward planning approach would be to take on apprentices within both I M & T departments with a view to training them to cover less complex jobs there by freeing up more experienced staff which will give existing staff opportunities to develop further and contribute towards succession planning. This will also ensure that there are adequate resources to cover additional project work within the department without day to day business falling behind. 6

7 Looking back Key Achievements and Successes IT department successes in 2015 IT networks Telephony upgrade The whole phone system was upgraded which in turn updates all 1100 phones. Important to stress that during this process nothing went down and no calls were lost. This was all the servers that provides the resilient phone system, voice mail, auto attendants, soft phones etc. We estimate about another are still on the old system. Shackleton First off site fully integrated voice and data resilient system which is not dependent on hospital site with free calls between. MAAU wireless upgrade Endoscopy wireless and telephony IT Servicedesk Calls logged in 2014 = and a forecast for 2015 shows (7% increase) Currently supporting 1931 desktop pcs, 782 laptops, and 235 servers Currently have 3331 active network users and 5721 mailboxes to support The department has saved the organisation over 81k with careful equipment procurement (needs validating with Mark) Servers Paris upgrade (from an IT perspective) very successful Ambulance system (Valentia) upgraded GU server replaced Theatreman upgraded Various infrastructure servers upgraded. Information systems successes in = calls logged and e mails responded to forecast with e mails. Increase of 7.4% calls and 4% e mails. The number of ISIS users has risen from 2181 in 2014 to 3198 in 2015 increase of 46%. The department has continued to work in supporting clinical areas to go paperless in their clinics and from April 2015 to date the following additional areas have now fully engaged. Patient Lists: Inpatient notes: Clinical Noting: Outpatient: Clinical Noting: Scanning: Multi-Disciplinary Teams (Cancer) Pain Nurse Diabetes Infection Control Tissue Viability Respiratory General Surgery Gynaecology 7

8 TCIs: Assessments: Respiratory Cancer Nurse Specialists Paediatrics Gastroenterology MFU Administrative - Secretaries MFU Gynaecology Chest Investigation Pilot AKI Discharge Summary Assessment MH Discharge Summary Assessment 5. Key Issues and Challenges Information Technology Keeping an aging network running Lack of departmental system management has led to our department having to pick up the pieces Unpredicted service requests and demands Lack of involvement at the early stages of projects (SME input) Insufficient resources to support rolling replacement Departmental capacity Clear 5 year organisation strategy Inadequate revenue funding Information Systems New resource into the team training & support implication on existing staff MedeTrax Connectivity on the wards for mobile devices RTT Pathway data capture, monitoring and reporting PARIS Business as Usual Limited resource Numerous System Upgrades managed under Business as Usual umbrella I M & T Projects Lack of engagement to change existing culture Capacity to continue rolling out ISIS Pressures on wards and services delaying roll outs Adequate resource funding for Capital Projects 6. Lessons Learnt Information Technology We need to break down silo working in the department to enable a complete vision. There is a need to ensure that all Projects that have an IT workstream are fully defined at outset to avoid wasting the time of the department. IT need to be more involved in the early stages of a contract Information Systems Engage earlier with the system users on the ground floor Ask for assistance from Clinicians who will be the main system user 8

9 Discuss new functionality with both Doctors and Nurses to obtain a balanced view The need to have sight of all business cases and understand the implications I M & T Projects Initial engagement from for all I M & T projects with IT department Definitely not move forward unless project fully driven by champion Ensure adequate resource funding for capital projects 7. Risk Threats: IT Security Management which is a post required in order to comply with the IG toolkit; this post coordinates and executes security policies and controls as well as assessing the vulnerabilities within the Trust. There is currently nobody in the I M & T Department picking up this responsibility following the disappearance of the IT and IM Heads. Directorates devolving responsibilities onto Corporate services without required resources following. Reactive Organisation in challenging times affecting current plans IT enablement work as part of MLAFL does not appear to be fully funded which could be a risk to satisfactory delivery Lack of Technical strategy Capacity to fully update network security procedures Staff retention as demand on department increases Opportunities: External access to funding for Paperless by 2020 Vanguard links Explore knowledge and ideas sharing 8. Benchmarking The following were supported with the same IT staffing levels for both years /15 80 servers, 1800 devices, no wi-fi, no IP phones, PAS patient admin 450 servers, 2800 devices, campus wide wi-fi, IP phone system, 10 clinical systems We have invested just 1.9% of our total capital and revenue budgets on IT. The Wanless Report 2004 recommended a minimum of 4%. Total IM& 9

10 T revenue budget 9. Finance 5 year draft capital plan Current revenue budget 10

11 Proposed CIPS 11

12 10 Workforce Current structure Exec Director of T&I ICT Structure & Resource Deputy Dir of ICT Applications Manager ICT PM (.8 wte) ICT PM Desktop Systems/server Network Project & Admin Support Pat Hobbs (.66 wte) Analyst Specialist x2 Analyst Specialist Analyst Specialist x2 Team Supervisor Team Supervisor Team Supervisor ICT Procurement Officer ICT Analyst ICT Analyst ICT Analyst ICT Analyst ICT Analyst Application Support x2 Application Support x3 Application Support x2 Application Support x1 Information Technician Information Technician Applications/software Customer Service Infrastructure/hardware Proposed new structure Exec Director of T&I ICT Structure & Resource Deputy Dir of ICT IT Security Manager Applications Manager ICT PM (.8 wte) ICT PM Desktop Systems/server Network Project & Admin Support Pat Hobbs (.66 wte) Analyst Specialist x2 Analyst Specialist Analyst Specialist x2 Team Supervisor Team Supervisor Team Supervisor ICT Procurement Officer ICT Analyst ICT Analyst ICT Analyst ICT Analyst ICT Analyst Application Support x2 Application Support x3 Application Support x2 Application Support x1 Apprentice Apprentice Information Technician Information Technician Apprentice Applications/software Customer Service Infrastructure/hardware 12

13 Looking Forward Key Assumptions Ref. Assumption Rationale / evidence base Impact and consequence if proved false 1 Sufficient Capital funding General vulnerability of Trust infrastructure 2 Sufficient Revenue funding As above 3 Adequate support from Occupational Health Summary Analysis Strengths Information systems have a spread of expertise which means we do not rely on one specialist. Huge amount of expertise around IT solutions wide skill set. Broad knowledge of data standards and strong IG links. A lot of experience of juggling priorities and delivering technical solutions to a reactive organisation. Wide experience in IT procurement Staff have a strong sense of ownership of the infrastructure and its availability Staff work ethics Infrastructure choice of best of breed technologies over the years has provided resilience. High level of local expertise and knowledge Ability to understand and solve complex problems whilst maintaining an infrastructure that supports the highest percentile of healthcare solutions. Threats There is currently nobody in the I M & T Department picking up the responsibility for IT Security following the disappearance of the head of IT. Directorates devolving responsibilities onto Corporate services without required resources following. Reactive Organisation in challenging times affecting current plans IT enablement work as part of MLAFL does not appear to be fully funded which could be a risk to satisfactory delivery Lack of Technical strategy Capacity to fully update network security procedures Staff retention as demand on department increases Weaknesses Keeping an aging network running Lack of departmental system management has led to our department having to pick up the pieces Unpredicted service requests and demands Lack of involvement at the early stages of projects (SME input) Insufficient resources to support rolling replacement Departmental capacity Lack of clear 5 year organisation strategy Inadequate revenue funding Lack of engagement to change existing culture Funding to continue rolling out ISIS Pressures on wards and services delaying roll outs Adequate resource funding for Capital Projects Lack of staff training in basic IT skills Pace of organisational change Unrealistic expectations Opportunities Possible external access to funding for Paperless by 2020 Vanguard links Knowledge and ideas sharing 13

14 Conclusions: IT INFRASTRUCTURE Our IT infrastructure continues to age and fall behind the rolling replacement schedule. It is important to bring this infrastructure up to date to enable services to develop using technology and to maintain the services that are already part of our business as usual. There is currently a risk of network and server instability due to the age of equipment and delays in a rolling replacement programme due to funding challenges. Failure to address these vital upgrades leaves the Trust vulnerable to system failure and business and patient safety risks. ELECTRONIC PATIENT RECORDS We need to maintain the momentum and work to the Paperless at the Point of Care agenda to ensure delivery by 2020 whilst at the same time, working with the MLAFL Agenda in enabling integrated services. There is great concern that we have begun on the Paperless journey and have introduced a mixed economy of electronic and paper records which brings with it the risk of confusion and capacity issues amongst clinical staff. This has had the effect of disengagement and backwards moves by some clinicians. CAPACITY We need to re-introduce the vital post of I T Security Manager to be responsible for the leadership and effective management of the Information Security Agenda, ensuring the protection of all data held within the organisation and related third parties. We need to strengthen our current support teams and enable succession planning by bringing trainee staff into the teams and plugging gaps in current service provision. This will help us to deliver our large agenda and support the sometimes unplanned needs of the organisation We also need to reduce the vulnerability of the department where very specific specialist skills are relied upon from a small number of staff with the further development of standard operating procedures notes and increased training. We need to improve our staff attendance/sickness ratios to avoid reduced capacity. 14

15 11. Service Objectives and Cost Improvement Plans Objective Planned Benefits Resources Required Associated CIP ( ) Risk and Link to Trust Goals (see dependencies appendix 1) Start Date Due Date KPIs / Success Measures Monitor IT service provision via Service Level Agreement Improve Staff attendance to 97% Fully developed procedures and identify group of capable executors. To ensure that all Capital equipment is deployed within plan. To recruit apprentices To do an options appraisal around the need for an I T Security Manager. Define requirements (Job description) Update IT Strategy to include Technical Strategy Provides baseline for the service and KPIs but also helps to manage service users expectations Improved capacity Greater flexibility and reduction of vulnerability Free up storage issues, ensure users get full benefit of upgrade as soon as possible. Avoid extended warranty costs. To widen the capacity of the IT department To agree a way forward to cover this gap in service provision Clear understanding of which devices we will Currently scoping external supplier maintenance requirements/gaps. Health and Wellbeing initiatives and support from Occupational Health Will try to achieve within budget 3 wte apprentices x * An option is employment of 1 wte N/A Inadequate revenue Budgetary constraints. This piece of work will encroach on adhoc service delivery time Inadequate staffing capacity In sufficient departmental resources to deliver plan IG tool kit compliance Devices needed to All Cost Effective and sustainable services. Skilled and capable staff. Cost effective and sustainable services. Working with others to keep improving our services. Wokring with others to keep improving our services. Immediately March 2017 Immediately Immediately March 2017 Immediately All May 2016 June 2016 Working with others to keep improving our services. Skilled and capable staff. April 2016 July 2017 Measured against SLA March 2017 Sickness statistics Completed and verified procedures March 2017 Project handover Staff in post, projects on target I G tool kit compliance All February 2016 April 2016 Strategy update

16 Objective Planned Benefits Resources Required Associated CIP ( ) Risk and Link to Trust Goals (see dependencies appendix 1) Start Date Due Date KPIs / Success Measures Staff training (internal and external) ISDX decommissiong Phase II Wireless infrastructure upgrade Phase III Clinical support on the journey to Paperless Improve skills of the department This will continue with the upgrading of the ISDX system and will ensure that the benefits of digital telephony are fully delivered to the Trust. xx to come This allows for wider and more robust coverage for devices requiring the use of our wireless network as 230,000 specified in various departmental plans. 172,500 enable efficiency within work flows or benefits of digital working will not ensue. Inadequate access to funding Current remaining analogue telephony will be unsupported in 2017 Public wi-fi access, patient wi-fi access, extended use of mobile devices for paper free clinical areas. Skilled and capable staff. A positive experience for patients, service users and staff. 31/07/ /03/2017 Course completion All June 2016 March 2017 A positive experience for patients, service users and staff June 2016 March % transition to digital telephony Deployment of upgrade to planned Clinical areas 11 Switches and Network Cabinet upgrades 12 Firewall replacement This ensures the continued stability of the Trust s network and associated infrastructure This ensures the continued security of 322, ,000 Failure to upgrade would put the Trust at All June 2016 March 2017 Deployment risk of network instability. Failure to upgrade would All June 2016 March 2017 Deployment 16

17 Objective Planned Benefits Resources Required Associated CIP ( ) Risk and Link to Trust Goals (see dependencies appendix 1) Start Date Due Date KPIs / Success Measures 13 Server refreshes Desktops, laptops, carts, toughbooks, battery replacements and mobile devices. Upgrades to Windows 7 environment. ISIS upgrade including Docman renewal. ISIS upgrade and other IT enablement work (working with MLAFL - Vanguard) traffic to and from the Trust s network This ensures continued up to date environment and appropriate support for maturing servers This ensures the use of up to date equipment. Moving on to supported software. This ensures that the Trust are continuing to work towards the 2020 target of Paperless at the Point of Care and this helps to avoid clinical staff working in a mixed economy of paper and electronic records for too long. This ensures that the Trust are continuing to work towards the 2020 target of 200, , ,500 Capital Revenue costs 5250 support and maintenance c/f from 2015/16 project. Initial costs to be funded by vanguard but there will be recurring put the Trust at risk of instability and continuity. Failure to refresh could lead to server instability and possible restricted access to current held data Capital funding Delay in moving to windows 7 across the Trust Capital funding Storage capacity for a large number of IT devices. Capital funding Milestone delivery for 2015 may be delayed due to All June 2016 March 2017 All 31/07/ Replacement of servers maturing during 2016/17 Rolling replacement plan All 31/07/ Renewal receipt All 31/07/ Project Delivery 17

18 Objective Planned Benefits Resources Required Associated CIP ( ) Risk and Link to Trust Goals (see dependencies appendix 1) Start Date Due Date KPIs / Success Measures To fully assess the Network Cabinets in the Trust to identify any areas where additions/improvements are required Support business unit with I M & T resources for their Business Plans To devolve IT system budgets to departments Explore income generation opportunities and improve our ability to take on additional business Paperless at the Point of Care and this helps to avoid clinical staff working in a mixed economy of paper and electronic records for too long. Prevent any potential network failure See Business plans of Business units 121, Should be move out to the departments who are responsible for and who rely on, these systems. costs around additional staff to support mobile devices and recurring support costs. If resources are required this will be established during this scoping exercise and schedule for 2017/18 See 5 above This will reduce the amount of CIP I M & T need to find Unknown current delay in access to Vanguard finance. This could affect further access to milestone funding. If this feasibility study is not carried out during 2016/17 any required improvements All 31/07/2016 1/12/2016 Report will not be identified and included in the list of Capital requirements. The handover following reorganisation. All 01/04/ /03/2017 Project delivery Funding. known This will not be possible without the additional capacity Cost effective and sustainable services Cost effective and sustainable services 01/04/ /03/2017 CIP improvement 01/04/ /03/2017 CIP improvement 18

19 Objective Planned Benefits Resources Required Associated CIP ( ) Risk and Link to Trust Goals (see dependencies appendix 1) Start Date Due Date KPIs / Success Measures requested Fully update network security management procedures. Review all IT Policies to ensure fit for purpose Introduce a number of schemes to boost staff morale Carry out an impact assessment for all contractual items Improve security processes To tighten up and strengthen departmental procedures To ensure that staff are happy in their work and therefore Capacity Possible CIPs Unknown Capacity to carry out this piece of work. Cost effective and sustainable services. A positive experience for staff Workloads may make it A positive experience for difficult to patients, service users and offer team staff events. There may be no scope here at all Cost effective and sustainable services 01/04/ /03/2017 Updated procedures 01/04/ /03/2017 Policies reviewed 01/04/ /03/2017 Feedback at appraisal 01/04/ /03/2017 Report 19

20 (Identify the cost improvement schemes that you plan to deliver over the next 2 financial years. The Trust has a baseline target for all services to achieve recurrent savings targets of 5% against allocated budgets. Budget holders should identify 8% savings to mitigate against scheme under delivery) [This table has been designed to capture information in a uniform way across the Trust. Please do not add/delete columns or merge cells] Cost improvement scheme title Planned savings - pay ( 000 s) Planned savings - non pay ( 000 s) Workforce implications Risk and dependencies Start date 1 What is going to be done to reduce cost Identify planned pay related savings 2 Kelway Back up solution Datix PACS Contract Reduction VS Proactive Websense 8692 BMS Remote Access (need 7 to do capital bid instead) 6170 Identify planned non pay related savings Identify related changes to the workforce What will stop or enhance the chances of achieving this scheme? When will budgets be adjusted to realise the savings? 8 BT Circuits (Upgrading to newer technology) 9 Chubb Security (IT Dept doors go onto Trust system) Mercarto ( look at getting a contract reduction at renewal )

21 Cost improvement scheme title Planned savings - pay ( 000 s) Planned savings - non pay ( 000 s) Workforce implications Risk and dependencies Start date 11 ISIS savings. Turning off paper and printing. 12 Sunrise ( contract over 3 years, therefore maybe negotiate 10% reduction)

22 APPENDIX 1 Trust Vision, Values and Goals 22