NHS WALES INFORMATICS SERVICE

Transcription

1 NHS WALES INFORMATICS SERVICE Delivering Information and Technology For Better Care Three Year Plan (January 2014)

2 CONTENTS 1. EXECUTIVE SUMMARY STRATEGIC CONTEXT LOCAL HEALTH NEEDS AND CHALLENGES CORPORATE VISION AND OBJECTIVES Vision Objectives Health Technology Assessment and Overview of Deliverables SERVICE CHANGE PLANS AND INITIATIVES Service Development and Programme Plans National Services (Applications) Infrastructure Services National Programmes and Projects Information Services Service Delivery Risks QUALITY IMPROVEMENT Our Planned Quality Commitments ORGANISATIONAL DEVELOPMENT Our Existing and Planned Workforce Profile Our Planned Organisational Development Commitments FINANCE National Context Organisational Context Revenue and Capital Funding Model Revenue Savings Plans Capital Financial Risk ESTATES AND CORPORATE SERVICES Estates Corporate Services STEWARDSHIP AND GOVERNANCE Our Board Arrangements NWIS 3 Year Plan , v26 Page 2 of 82

3 10.2 Working with our Stakeholders Internal Management and Governance Performance Management and Reporting Risk Management and Business Continuity APPENDICES Appendix 1 National Services (Applications) Appendix 2 Infrastructure Services Appendix 3 National Projects Appendix 4 Quality Improvement Appendix 5 Financial Controls, Reporting and Audit Arrangements NWIS 3 Year Plan , v26 Page 3 of 82

4 1. EXECUTIVE SUMMARY The NHS Wales Informatics Service (NWIS) delivers national information and IT services to support the provision of integrated care services for citizens across Wales. The organisation also sets the standard for health informatics professional leadership and development. Our strategy is based on the principle that effective and efficient information systems will give: Care providers the information they need to deliver better outcomes, more safely and more efficiently, and Welsh citizens access to information they need to support their own health and wellbeing. Health Boards, NHS Trusts and Local Authorities in Wales had previously planned and implemented discrete information services for their own local catchment populations. Now, the National Informatics Programme is coordinated and implemented by NWIS in partnership with the seven local Health Boards and the three Trusts. We are also, increasingly, working with Welsh Local Authorities on the CCIS project. The over-arching principles we use to plan the way forward are: Doing things Once for Wales Undertaking clinical and technical design together Focusing on information services not systems Making the best use of what we already have Doing things in common by design or agreement Ensuring safe migration to new services. NWIS 3 Year Plan , v26 Page 4 of 82

5 Our priorities are: The development of common infrastructure, including data centres, data networks (e.g. PSBA), mobile platform, data storage facilities including private cloud capabilities extending across the NHS in Wales Continue roll-out of systems to accurately identify patients and staff across Wales Further development of systems that share essential information and messages between services, such as the Individual Health Record (IHR) and Welsh Clinical Communications Gateway (WCCG) Progress adoption of systems that give better access to patient with systems such as My Health On-line (MHOL) Further implementation of the Welsh Clinical Portal s core clinical processes such as pathology and radiology requesting and reporting, medicines management and viewing of clinical information collected by other systems Further roll-out of common systems, such as new GP Clinical Systems, the new LIMS for Pathology and Blood Services, and RadIS2 and PACS for Radiology and imaging services Developing requirements and procuring a new system to improve document management and provision and sharing of the patient record, such as the Welsh Care Records Service Progress national adoption of a Community Clinical Information System (CCIS) that bridges the information gap between Health and Social Care for Health Boards and Local Authorities. We will continue to develop our three year business plan by working with Local Health Boards and Trusts to make sure that National and Local IT Plans are aligned. NWIS 3 Year Plan , v26 Page 5 of 82

6 2. STRATEGIC CONTEXT NWIS responds to a range of national strategies and plans for health and social care. The current principle drivers in this respect are: Together for Health (2011) 1 is the five year vision for the NHS, based around primary and community services, placing prevention, quality and transparency in healthcare. Digidol yn Gyntaf Delivering Welsh Public Services Online (2012) 2 is reviewing the Welsh public sector digital on-line services with the aim of increasing the range and quality and uptake by Welsh citizens. Framework for Delivering Integrated Health and Social Care (2013) 3. Welsh Government has recently ended a consultation on its proposals to develop closer relationships between health and social care providers to support a transformation in the quality and effectiveness of care for older people in Wales. The Commission on Public Service Governance and Delivery (2013) 4 has been formed by Welsh Government to review the way that public services are delivered and run. 1 See 2 See 3 See 4 See NWIS 3 Year Plan , v26 Page 6 of 82

7 3. LOCAL HEALTH NEEDS AND CHALLENGES Across Wales, Health Boards have been developing plans for the future safe delivery of services to patients. The following plans have been developed and are at various stages of engagement and consultation: South Wales Programme - Involves all Health Boards in South Wales (Abertawe Bro Morgannwg, Aneurin Bevan, Cardiff & Vale, Cwm Taf, Hywel Dda, Powys) but proposals only relate to main hospitals in the Cwm Taf, Cardiff & Vale, Aneurin Bevan and Abertawe Bro Morgannwg areas. Ideas have been proposed by clinicians about the future of a range of specialist hospital services: consultant-led inpatient paediatrics, neonatal care, obstetrics and A&E care. The ideas put forward include concentrating this expertise on fewer hospital sites - four or five - across South Wales. Healthcare in North Wales is changing - Betsi Cadwaladr Health Board. Proposals are based around the following principles: staying at home when it is safe and appropriate; more care closer to home Getting the best results from specialised services; better services on fewer sites; and improved acute hospital services Your Health: Your Future - Hywel Dda Health Board are running their own consultation exercise on proposals for change in the West Wales region. There are strong links between these plans and the South Wales Programme to make sure specialist services elsewhere in South Wales which are used by Hywel Dda residents continue to be available. We will continue to work with Welsh Government, NHS organisations and all other partners to ensure that their requirements, in the light of changing services, are met and aligned with national informatics policy. NWIS 3 Year Plan , v26 Page 7 of 82

8 In response to these needs and challenges, Informatics strategies have been developed by NWIS in support of delivering and improving technology services, in particular: National Infrastructure Strategy for NHS Wales (2009) National Security Strategy for NHS Wales (2009) National Application Strategy for Wales (2010) GP Clinical Systems Strategy Delivering next generation systems for General Practices within Wales (2010) The continued investment in the implementation of our Informatics strategies supports the delivery of these seven strategic benefits: Patient safety is increased Patient confidence Increased Legal/policy compliance increased Heath System efficiency increased Health system costs decreased Convenience of care increased Increased positive health outcomes NWIS 3 Year Plan , v26 Page 8 of 82

9 4. CORPORATE VISION AND OBJECTIVES 4.1 Vision We support the improvement of patient care through collaborative provision of high quality information, systems and technologies; Once for Wales. 4.2 Objectives Underpinning this vision, our seven objectives are: Maximise the value of Informatics investment for Welsh citizens and public sector health and social care providers Raise the quality and productivity of existing systems and services Promote the use of new technology as the enabler for innovation and the transformation of future services Incorporate quality and our values in everything we do Improve the enabling national infrastructure Be the Welsh informatics employer of choice Improve the NWIS corporate reputation by being effective and efficient. 4.3 Health Technology Assessment and Overview of Deliverables Global technology developments have revolutionised many aspects of our personal lives, including the way we want to communicate with health and social care services. The NWIS three year business plan recognises this and seeks to harness and embrace such requirements. Citizens will, therefore, increasingly be at the centre of our digital thinking and strategy. The NWIS strategy and programme implementation will be architected and planned for rapid change using open architectures with interoperability between systems and technical services a key deliverable. Our key principles will be: NWIS 3 Year Plan , v26 Page 9 of 82

10 Incremental by design Clinical and technical design must remain valid in the face of public service redesign in order to support Service change Enable interoperability using relevant standards Maintain world class clinical safety as the reliance of care processes on technology grows Whatever we do must be affordable and aligned to financial strategy and objectives. The above technological developments have cost implications for health organisations and are likely to increase in the future. The NWIS architecture is illustrated in the diagram below. Overview of Systems Architecture Individual Health Record Out of Hours Welsh Clinical Portal Clinician access where care is delivered GP systems (lifelong record) My Health Online Patient access over the internet e-referrals/ discharges Current hospital systems New hospital/ Community systems Radiology IS Laboratory IMS Prescribing Scheduling Ordering The diagram shows the continuous development of new systems which builds on the existing foundations in Health and transcends organisational boundaries. The NWIS approach will continue to support the use the service orientated architecture (SOA). This involves the consolidated use of SOA across Wales and the re-use of existing SOA components to support new requirements. NWIS 3 Year Plan , v26 Page 10 of 82

11 Our three year business plan will deliver: The completion of current implementations, to include: o National Master Patient Index (MPI) o Welsh Clinical Portal (WCP) o Individual Health Record (IHR in unscheduled care) o My Health On-Line (MHOL) o Welsh Clinical Communications Gateway (WCCG) o Cancer Network Information System (Canisc) o Laboratory Information Management System (LIMS) o Radiology Information System (RADIS2) o Picture Archiving and Communications (PACS) o Community Child Health System o Myrddin Patient Administration System o Hospital Pharmacy System o National Screening Services Systems o GP Systems Migration New schemes to include: o Welsh Care Records Service (WCRS) 5 to provide a national, patient centred registry and repository for documents and core patient information. o National Auditing Services (NIIAS) to strengthen our capabilities for monitoring and managing access to systems and services across the national platform o Emergency Department System, a framework contract that enables Health Boards to procure a system. o The development of a patient-centric national alerts and warnings service to improve patient safety (WCP development). o Increased scheduling, patient administrative and care planning capabilities (in the longer term to provide enterprise scheduling) 5 A national, patient centred registry and repository for documents and core patient information. NWIS 3 Year Plan , v26 Page 11 of 82

12 o Moving from procurement to implementation of the Community, Mental Health and Social Care solution (CCIS). o Develop the blueprint for implementing mobile technologies to support new apps, such as WCP on smartphones. o Additional investment in national infrastructure. NWIS 3 Year Plan , v26 Page 12 of 82

13 5. SERVICE CHANGE PLANS AND INITIATIVES 5.1 Service Development and Programme Plans Our priorities for the 3 Year Plan are to: Fulfil our mandated role and functions efficiently and effectively Maintain a high quality delivery of the portfolio of National services and change programmes Continued refinement of the arrangements with local organisations for the delivery of National information and infrastructure services Establish NWIS as a proactive and supportive co-producer within the NHS Wales Health and Social Care framework to deliver Informatics enabled improvements in services and outcomes that staff and Welsh citizens will recognise and value. We have analysed our internal strengths and weaknesses and external opportunities and threats and these are described in the table below. Internal Strengths Weaknesses High service quality and service satisfaction in delivery of 80 National Informatics Services Large scale, resilient and scalable systems and infrastructure Unique technical skills and expertise see below Large scale NHS holistic informatics knowledge and expertise contributing to transformation of delivery to foster the roles of citizens, carers and families in promoting well being. Only experienced provider of National Informatics Services in NHS Wales Pressure on operational support Moderate awareness and alignment of local service realities Perception of National orientation Demanding Modernisation Programmes Reliance on 3 rd party contractors for specialised skills NWIS 3 Year Plan , v26 Page 13 of 82

14 Internal Long term record of delivering National Informatics solutions across NHS Wales Only quality assured Informatics organisation in NHS Wales (ISO 9001) External Opportunities Threats Delivering Welsh Government Digital Strategy and intentions in NHS Wales Public sector austerity and NHS budget constraints Building on our international reputation and relations Changes in local organisation structures and Increasing focus on future Service Local Informatics developments not transformation e.g. care in the aligned with National strategy and plans community Maintaining quality services whilst Delivery of core clinical services through software development toolkit investing in Informatics innovation and transformational improvement Deliver new systems and service to transform NHS Wales To achieve our 3 Year Plan in the context of NHS strategies and our strengths, weaknesses, opportunities and threats we will undertake the following Service and Programme Plan developments. In 2014/15 we will continue to focus on consistently meeting our existing Service Delivery and Programme implementation plans in advance of the publication of the new Informatics Strategy for the NHS in Wales. The existing NWIS Services and associated change initiatives are broadly classified as: National Services (Applications) Infrastructure services Programmes and projects Information services NWIS 3 Year Plan , v26 Page 14 of 82

15 In addition, we expect our co-producers will need to access our expertise and support for not only delivering services and functionality they require, but also for assistance in scoping the requirements for information systems and drafting national business cases to ensure that they are able to maximise economies of scale regarding use of availability of information, use of infrastructure, matters related to information governance, security and technical standards. Our expertise includes: Leadership of Informatics, Information and Technical Strategy development Technical domain strategies, technical blueprint and roadmap development Technical architecture, clinical and technical design and application build Delivering National Application & Infrastructure Services Clinical and Technical assurance Statistical and analytical expertise Requirements and business analysis National Programme, project management and support National business case production and assurance Specialised Informatics procurement expertise Benefits management and measurement Information governance and development and use of information standards Service management and technical and user support. 5.2 National Services (Applications) NWIS National Services (Applications) objectives are underpinned by the aim to continually improve the current services through further review and development of the NWIS Service Catalogue to meet the needs of our users. National Services (Applications) are in various states of maturity: Mature: Operational systems that are fully transitioned to service. Continuous development is ongoing and enhancements to services undertaken managed through service boards working with partner organisations at a local level NWIS 3 Year Plan , v26 Page 15 of 82

16 Transitional: Newly developed applications in transition to service with local implementation continuing New: New services under development in the early stages of the project cycle and not yet implemented. A summary list of all our National Services (Applications) is detailed in Appendix Our Planned Mature Services Commitments Key objectives for operational systems/services relate to the provision of continued support managed under robust Service Management arrangements and the delivery of ongoing enhancements under service and quality improvement plans as required. This list is not exhaustive, but focuses on the main areas. NWIS has planned the following initiatives for its operational systems/services over the next three years: Existing Service Commitments Canisc Migrate CANISC infrastructure onto new hardware and disentangle from other 3rd party products Target Year(s) Dec 14 Resource/ budget Within Child Health Complete the development of the new Child Health system (CYPrIS) Produce a Mobile Device version of CYPrIS with limited appropriate functionality Implementation of CYPrIS across Wales Implementation of CYPrIS in other Home Countries Clinical Knowledge Services Sept 14 Jan 15 Jan 16 Mar 17 Within Resources HTTF Bid Within SLA income Evaluate and ensure the electronic content demonstrates Ongoing Within NWIS 3 Year Plan , v26 Page 16 of 82

17 Existing Service Commitments best value for money GP Systems Migration to New Hosted System(s) Implement GP to GP transfer Hospital Pharmacy Migration on to new hardware and improved resilience Integration Services Publication of software development toolkit Replace JCAPS and BizTalk Integration Engines with a newly procured Integration Engine. Master Patient Index Development of National Data Quality Service Continuous integration with systems as they develop Myrddin (PAS) Hardware refresh and consolidation for Powys and Cwm Taf General application improvements NRDS Enhance NRDS to hold appropriate information to support GP-to-GP transfer. Develop improved administration system for NRDS. RadIS2 Implement RADIS2 into Cardiff & Vale Implement RADIS2 into AMBU West Merging legacy RADIS2 instances into new Health Board Instances Enhance RADIS2 to implement Obstetrics functionality. Screening Services Rewrite Cervical Screening (subject to procurement tender) and ongoing support of new service Target Year(s) July 15 Mar 16 TBC Jun 14 Mar 16 Mar 17 Sept 14 Sept 14 Mar 15 May 15 May 15 Mar 15 Aug 14 Jun 17 Resource/ budget Within TBC New Business Case Within Within Within Within Business Case Web Services NWIS 3 Year Plan , v26 Page 17 of 82

18 Existing Service Commitments Migrate HOWIS onto new infrastructure Improve the Cascade content management system used to deliver a number of NHS Wales Websites. Enhance the new to support and implement the technology enhanced strategy (TEL) Welsh Demographic Service Migrate WDS onto new infrastructure in readiness to move to the new Data Centre. Enhance WDS functionality to support Welsh Birth Notification, GP patient trace. Target Year(s) Sept 14 Mar 15 TBC Jun 14 Sep 14 Resource/ budget Within TBC Within Our Planned Transitional & New Service Commitments We continue to develop and enhance the NWIS IT Services. The following initiatives for operational systems/services over the next three years include: Service Commitments LIMS Support the ongoing implementation & full operational service Target Year(s) Jul 15 Resource/ budget Within SLA & Resource Diabetes Readiness/ Operational support of live service Dec 15 Seek SLA Community, Mental Health and Social Care System Technical solution and service delivery, evaluation of options Design, implementation and on-going support arrangements PACS XDSI system Support installation of hardware within Datacentre(s) and implement registry service National Intelligent Integrated Audit Service: Design, implementation and on-going support arrangements Dec 14 March 15 Mar 15 Within Business Case & New SLA Within Resources New SLA NWIS 3 Year Plan , v26 Page 18 of 82

19 Service Commitments Welsh Care Records Service Technical solution and service delivery, evaluation of options Design, implementation and on-going support arrangements E-forms development Target Year(s) Jun 15 Apr 16 Jun 16 Resource/ budget Within Business Case & New SLA 5.3 Infrastructure Services NWIS provides and manages core Infrastructure on behalf of NHS Wales to improve the way information is delivered and stored. NWIS infrastructure broadly falls into two main categories: National infrastructure that NWIS provides and manages on behalf of NHS Wales. This includes: o Two national data centres and the server and storage equipment that run all of our national applications o Network links to the Internet and N3 (NHS England/Scotland) o Remote Access Services that allow NHS Wales employees to work remotely o services o Video and Audio Conferencing Services Local infrastructure for NWIS staff, including: o PCs, Laptops, Printers, File servers, etc o Wired and Wireless (WiFi) Local Area Networks (LANs) Additional information about the National Infrastructure can be found in Appendix 2. This infrastructure is mature and works well. However, investment is needed to achieve the following objectives: Maintaining operational services Increasing capacity and resilience Enabling new methods of working NWIS 3 Year Plan , v26 Page 19 of 82

20 5.3.1 Our Planned Infrastructure Services Commitments NWIS has planned the following initiatives for its infrastructure systems/services over the next three years: Infrastructure Services Commitments Maintaining operational services: Upgrade the National Active Directory to Windows Server 2012 Replacement of National Infrastructure (HMS) Replacement of the network infrastructure in the national data centres Replacement of hardware for Information Services servers Replacement of Domain Controllers across NHS Wales Target Year(s) Mar 15 Mar 17 Dec 15 Dec 16 Mar 17 Resource/ budget Within / Capital needed Within / Capital needed Within / Capital needed Within / Capital needed Within / Capital needed Replacing aging web monitoring/filtering system for NWIS users Deployment of new SAN for NWIS Client Services Replacing old NWIS PCs, Laptops, etc Replacing old NWIS offices LAN infrastructure General maintenance / upgrades of computer rooms General maintenance / upgrades of server and storage equipment Mar 15 Mar 17 Ongoing Ongoing Ongoing Ongoing Within / Capital needed Within / Capital needed Within / Capital needed Within / Capital needed Within / Capital needed Within / Capital needed Increasing capacity and resilience: Migration of infrastructure from existing BT Jul 14 Within Cardiff Data Centre to the BT Newport Data Centre. New SQL and VMware infrastructure (Provide Jun 16 Within / additional capacity and replace some aging Capital needed existing infrastructure) Upgrade of DMZ firewalls and DMZ networking Mar 15 Within / infrastructure (to provide faster access to Capital needed internet websites and to keep inline with the demand) Creation of a DMZ server farm at the Newport Mar 16 Within / Data Centre, to provide resilience for hosted Capital needed internet websites. Deploying WLAN Infrastructure for NWIS Within / NWIS 3 Year Plan , v26 Page 20 of 82

21 Infrastructure Services Commitments Offices at Swansea, Mamhilad and Mold. Establishing a Major Incident Response Centre at NWIS Brunel Offices Target Year(s) Mar 15 Dec 14 Resource/ budget Capital needed Within / Capital needed Enabling new methods of working: Deployment of infrastructure for NHS Wales to run Microsoft Lync Deployment of a Mobile Device Management solution for allowing NWIS to access corporate services from NWIS staff Tablets/SmartPhones (including BYOD) Investigate use of Microsoft Direct Access Deployment of Virtual Desktop Infrastructure for NWIS clients Oct 14 Oct 14 Jun 15 Oct 15 Subject to Health Technology Fund Within / Capital needed Within / capital needed Within / Capital needed 5.4 National Programmes and Projects Our Planned National Programmes and Projects Commitment(s) We have planned the following enhancements to National Programme and Project activities over the next three years. We will align our ongoing and new Programme and Project activities with NHS Wales Local Health Board plans, under the direction of the National Implementation Management Board. It should be noted that we will use this Three Year Business Planning process to reaffirm our Programme and Project commitments, revenue and capital funding for 2014/15 and beyond. Assuming that national and local funding is confirmed to cover the National Programme and Project requirements, we expect our more significant and material activities to include: Programme & Project Commitment(s) Community, Mental Health and Social Care solution: National procurement complete (Master Service Agreement - (Health Boards to include local funding in their 3 year plans National Roll Out Target Year(s) Dec 14 Mar 17 Resource/ budget Resources Required (Capital and Revenue) NWIS 3 Year Plan , v26 Page 21 of 82

22 Programme & Project Commitment(s) Target Year(s) Resource/ budget Community Pharmacy: Electronic Transmission of Prescription Claims: Business Case to be produced Product available - Early Adopter Product available - National Common Ailments Service: Roll out to remainder sites Discharge Medicines Review Service (DMR): Hospital to Pharmacy (Option Appraisal and way forward to be agreed) Solution to be procured/developed (subject to Business Case) Implementation Mar 14 Feb 15 Jun TBC (by WG) Mar 15 Mar 16 Mar 17 Funding stream to be identified Revenue required for national support and local implementation Resources required subject to Business Case CANISC: WCP to Canisc Integration and implementation in Velindre Cancer Centre Scoping and agreeing integration of Canisc to WCCG Cancer Documents available across NHS Wales via Document Repository Multi-disciplinary team module available Diabetes: Product Available Early Adopter National Rollout GP Links: Implement national Message Integration between secondary and GP Practises throughout Wales Hospital e-referrals (HERS 1): Completion Implementation of Phase 1 (Electronic interface for Medical Records Departments) Individual Health Record (IHR): User Interface Improvement Scoping of IHR/WCP reconciliation Improved functionality to be determined and delivered (e.g. Advanced Care Plans and consent model Laboratory Information Management System (LIMS) : Mar 15 Mar 15 Mar 16 Mar 16 Dec /17 Oct 14 Sept 14 Dec 14 Mar 15 Apr 17 Business Case: approved Resources subject to Business Case Within Resources Within Resources Resources subject to Business Case NWIS 3 Year Plan , v26 Page 22 of 82

23 Programme & Project Commitment(s) LIMS HB Implementation(s) o Core Disciplines o Genetics Module* o Blood Tracking o Blood Transfusion o WTAIL (WBS) o HB Legacy Data Repository (Blaenavon) Migration complete Wales Pathology Handbook (WPH): Phase 2 Clinical Front End (CFE) Scoping Phase 2 CFE Development Phase 2 (CFE) release to Service Phase 3 WPH Revision Scoping Phase 3 WPH Development Product Available - national Point of Care Testing Business Case Procurement completion Implementation Master Patient Index (empi): Completion of implementation to support Community and Social care Medicines Management Scoping and Options for Hospital Pharmacy and eprescribing Procurement / Build National availability Target Year(s) Oct 14 Dec 14 Dec 14 Mar 15 Mar 15 Jul 14 Jul 15 Jul 14 Feb 15 Mar 15 Sept 14 Aug 15 Oct 15 Mar 14 Oct 14 Apr Mar 17 Sept 14 Dependent upon scope agreed Resource/ budget Within Resources and Capital approved (*Genetics Business Case in progress) Resources subject to Business Case Resources subject to Business Case Capital required for Infrastructure (2016) Resources subject to Business Case My Health Online (MHOL): Phase 1 functionality, e.g. Alerts, Mobile App, messaging and online registration Product Available - national Phase 2 functionality e.g. diary, medical record, carer access Scope confirmation Apr 15 Apr 16 Funding to be confirmed as part of GP contract, subject to scope National Intelligent Integrated Audit Service (NIIAS): Interim Audit Service for WCP access to IHR National Solution Available for LHB Call off Completion of Early Adopter & Full June 14 Mar 15 Mar 17 Within Resources subject to Business Case NWIS 3 Year Plan , v26 Page 23 of 82

24 Programme & Project Commitment(s) Implementation Patient Administration System (Myrddin): Published Annual Operational Work Plan 2014/15 (Business Cases will be produced where new modules are developed requiring capital investment) Picture Archiving and Communications System (PACS): Completion of National Rollout across NHS Wales PACs integration: o Assessment of network capacity and infrastructure o Product available (Fuji sites) national o Product available (other sites) Readiness: Provision of project management support to NHS organisations Target Year(s) Apr 14 Mar 17 Mar 15 Jun 14 Sept 14 Mar 15 Ongoing Resource/ budget Resources subject to business case Within Capital may be required Within Within Radiology Management System (RADIS2): Decommission of RADIS1 completed across NHS Wales Deployment of RADIS2 ABMU (subject to LHB decision) Development Completed: RADIS2 (Requesting) available for deployment Systems Integration Tools Replacement Publication of software development toolkit Procurement complete Implementation for national messaging Welsh Care Record Service (WCRS): Establish and make available a National framework Contract for EDRMS (Electronic Document Repository Management System) to Local health Boards Implement a Central Document repository Create E-Forms for Clinical Data entry Welsh Clinical Communications Gateway (WCCG): WCCG Phase 2 o Clinic Letters o Discharges o Supplementary messages o Advice requests o Reporting o Cross border o Canisc Sept 14 Dec 15 Mar 16 Apr 14 Apr 14 Apr 16 Jun 15 Apr 16 Jun 16 Within Resources Capital requirement Subject to Full Business Case re Capital Funding Resources to be confirmed NWIS 3 Year Plan , v26 Page 24 of 82

25 Programme & Project Commitment(s) Target Year(s) Product available - national Sept 14 Mar 17 Welsh Clinical Portal (WCP): National product of IHR View in WCP available National product - clinical prioritisation of ereferrals available Implementation of WCP with LIMS integration in all LHBs MTED nationally available (current scope) MTED extended scope nationally available ADT functionality Mobile device platform Community Care Information System integration National WCP/TRRR pilot one organisation Nationally available WCP/TRRR Patient handover functionality, nationally available Welsh Demographic Service (WDS): Welsh Birth Notification service Implementation to mirror changes to Adoption Legislation Advanced Trace GP Registration Sep 14 May 15 Mar 15 Apr 14 Mar 15 Mar 15 Mar Mar 15 Mar 16 Mar 16 Jun 14 Dec 14 Dec 15 Mar 16 Resource/ budget Resources subject to business case Within Resources Subject to business case A description of each Project is detailed in Appendix Information Services Information Services have a pivotal role to play in delivering trusted information critical to decision making and public accountability as well as standardised measures and national comparisons which are key to improvement. This is at a time of austerity and there is an expectation of achieving savings through the rationalisation of information services. Information Services key objectives are: NWIS 3 Year Plan , v26 Page 25 of 82

26 1. Improving information quality and data standards Ensuring the right quality information is provided, using clear governance and standards in data and data collections 2. Improving access to and interpretation of data through better presentation and reporting Ensuring fair and equal access to information 3. Providing relevant information services Delivering the information that frontline services need to meet their priorities and acting as the core source for official statistics published by WG and other bodies for the purposes of national accountability Our Planned Information Services Commitments The key priority for Information Services is to ensure the right information is produced to the right quality at the right time alongside enabling business continuity. Over the next three years, the demand for, and components of this service, will remain: Responding to ad-hoc requests for information Undertaking specialised statistical analysis The provision of value-added data extracts to other agencies The production of agreed performance, health outcome and other measures Health services research support The provision of health intelligence. In addition, standard operating procedures to ensure an agreed understanding of the requirement, timely turnaround of requests, intelligent presentation of data and effective quality assurance of outputs are essential and will be further developed. Whilst embracing the relevant components of Service Management, Information Services will continue to adopt more agile business processes with an emphasis on closer collaboration with clients and more devolved ways of working across the organisation. NWIS 3 Year Plan , v26 Page 26 of 82

27 We have planned the following information activities over the next three years. Information Services Commitment(s) Raising the profile of information: To align endeavours around the forthcoming National Information Strategy Target Year(s) Mar 15 Resource/ budget Within Modernise Information systems, with investment in products and skills more suited to the delivery of visualised business intelligence. This to be achieved by the adoption of the Microsoft SP2014 and associated BI toolset. Mar 16 Subject to Business Case Work across NHS Wales to develop a Enterprise Corporate Data Warehouse Strategy. This to include both corporate secondary use data sources and those currently untapped information sources contained with key operational systems (Canisc, Myrddin, LIMS, WCCG etc) Dec 2014 Within Implementation of Corporate Data Warehouse Sep 2017 Subject to Business case To support, develop and facilitate benchmarking solutions building on the economies of scale achieved by the rationalisation of the NHSW CHKS contract Mar 16 Within Development and expansion of the NWIS Information Standards (reference data, clinical coding, data quality, datasets and MDSs) Mar 15 Within Support and promote Wales Informatics Assurance processes (WISB, Analysis and methodologies Group) Ongoing Within Use of formal business analysis process to identify, specify and help address key gaps in the availability of data and information priorities current include: Ongoing Within o o o o The development of a community services dataset Mental Health information requirements Specialised and tertiary services information requirements Outcome, quality and system bases measure and metrics NWIS 3 Year Plan , v26 Page 27 of 82

28 Information Services Commitment(s) Primary, Community, Social Care & Mental Health information o Establishing a primary, community, social care and mental health informatics service o Putting this service on a secure footing o Addressing immediate priorities (QOF 2014 and beyond) o Developing a primary, community, social care and mental health Data Warehouse o Practice profiles and other envisaged products Target Year(s) Mar 16 Resource/ budget Within 5.6 Service Delivery Risks The key strategic and operational risks are outlined below. NWIS has monitored these and other emerging risks under regular review and, based on understanding the consequences, has developed mitigating actions where possible. Key Risk(s) National Services (Applications) Resources will not be sufficiently available to complete the development of Continual Service Improvement Plans (CSIPs) for all required services resulting in no clear pathway for service development There could be lack of Health Board/Trust resource to take forward ITIL alignment Lack of technical resource resilience within the Operational Services Team could mean that targets are not met if key are not available Systems classed as Medical Devices are subject to inspection by MHRA (Medicines and Healthcare Regulatory Authority) to Mitigation(s) Service Management Boards Change Advisory Boards Engagement with Health Boards/Trusts to identify, commit resource and agree timescales Vacancy Control discussions at monthly Executive Board meetings (following submission of business cases) Achievement and maintenance of ISO certification against standards. Development of SOPs to address requirements of NWIS 3 Year Plan , v26 Page 28 of 82

29 Key Risk(s) ensure compliance with the Medical Devices Directive. If not compliant, the MHRA can act to stop use of systems meaning NWIS systems/services would be unavailable to NHS Wales Infrastructure Services Failure to invest continuously in network capacity to keep pace with network traffic. National Programmes and Projects Lack of Health Board/Trust resource to effect timely implementation of new products/developments Information Services Risk of loss of services due to a reliance upon a series of disparate, and retrospective and untimely minimum datasets and aggregate returns and legacy products mean that increased and changing demand cannot be met Mitigation(s) standards and directives to ensure compliance with Design resilience into the infrastructure and ensure that applications leverage this capability Regular testing of failover/disaster-recovery processes. Consider network capacity investment in all plans and developments. Engagement with Health Boards/Trusts to identify resource and agree timescales Work with Stakeholders to establish and implement up to date information requirements NWIS 3 Year Plan , v26 Page 29 of 82

30 6. QUALITY IMPROVEMENT NWIS continuously strives to be acknowledged by its customers, partner organisations and stakeholders as a centre of expertise and innovation in the provision of specialist IT and Information Services. A description of the quality initiatives is given in Appendix Our Planned Quality Commitments In order to demonstrate and excel in the service we deliver, NWIS is committed to comply with all statutory and regulatory requirements and the requirements of the International Standards, ISO 9001:2008, ISO 14001:2004, ISO 27001:2005, ISO :2011 and Business Continuity ISO 22301:2012 and to continually improve its effectiveness by the use of performance indicators and review. NWIS products (systems and services) will also be subject to MHRA (Medicines and Healthcare products Regulatory Agency) inspection. Quality Commitment(s) Establish and maintain a fully functional Integrated Management System (IMS) reporting on quality performance To maintain certification against the following standards for the entire range of NWIS services - ISO 9001:2008 (Quality Management) - ISO 27001:2005 (Security Management) this will involve the transition from the 2005 standard to the new revised ISO 27001:2013 Standard To achieve certification for the whole organisation: - ISO 14001: 2004 (Environmental Management) - ISO :2011.(Service Management) To engage with the Medicines and Healthcare products Regulatory Agency with regard to system compliance with Target Year(s) Sept 2014 Dec 2014 Sept 2014 Sept 2014 Resource/ budget Within Within Budget (additional resource reqd) Within NWIS 3 Year Plan , v26 Page 30 of 82

31 Quality Commitment(s) Medical Devices Directive To prepare for assessment against the following standard: - ISO 22301: 2012 (Business Continuity) Target Resource/ Year(s) budget 2015 Within NWIS 3 Year Plan , v26 Page 31 of 82

32 7. ORGANISATIONAL DEVELOPMENT Our workforce is and will be imperative in ensuring that NWIS discharges its ongoing commitments and works in a co production and collaborative manner with our partners and Welsh Government. Because of the specialist nature and complexity of Informatics service innovation, improvement and deliver, it is critical that an effective workforce plan is implemented that: Underpins the Three Year Business Plan and embodies our approach to leadership, our workforce strategy and learning and development strategy that has been developed in consultation with a wide range of stakeholders Delivers the sustained productivity, improved quality and cost efficiency savings to all directorates Is adaptable and flexible enough to accommodate unforeseen new service and project demands Acknowledges that given the nature of NWIS activities, a certain level of temporary expertise and resource is required that will enable us to manage capacity peaks and troughs and avoid recruitment on a permanent basis Developing the workforce to support Welsh Government Digital Wales initiatives 7.1 Our Existing and Planned Workforce Profile The current NWIS establishment directly employed workforce numbers are shown below. Planned WTE resource required to underpin service growth is also detailed prior to any subsequently imposed cost improvement/savings plan. Directorate/Team Executive Management Operational Services, Commercial Services and Information Services Total current WTE Establishment % WTE 2014/15 Planned 2015/16 Planned 2016/17 Planned 8 1.6% % NWIS 3 Year Plan , v26 Page 32 of 82

33 Directorate/Team Total current WTE Establishment % WTE 2014/15 Planned 2015/16 Planned 2016/17 Planned Programmes & Projects % Finance, Business Assurance & Corporate Services % NHS Engagement, Workforce & OD Team % Clinical Informatics % Nursing & Social Care Information % Total % Our Planned Organisational Development Commitments In a period of acknowledged austerity, NWIS aims: To continue striving to develop structures that are fit for purpose with roles, skills, flexibilities and competencies of all staff aligned to corporate objectives Develop desired capacity and capability to fulfil National Service & Project obligations Improve the quality and time devoted to Service & Quality Improvements Develop robust and equitable workforce planning across the directorates and reduce sickness absence To be an Employer of Choice Organisational Development Commitment(s) Workforce Development: Develop new and extended roles to support new ways of working Work with Health Boards and Trusts to identify areas where resource can be Target Year(s) Mar 2015 Sep 2014 Mar 2015 Resource/ budget Within Within NWIS 3 Year Plan , v26 Page 33 of 82

34 Organisational Development Commitment(s) Target Resource/ Year(s) budget shared Within Continue to improve workforce data and analysis, including further embedding of ESR (Electronic Staff Record) across the organisation Learning & development: Continue the informatics development 2014 to 2017 Within programme, including apprenticeships, graduate interns and management trainees Establish a programme of Knowledge Sharing Events across Wales 2014 to 2017 Within Develop the capacity and capability of line managers to deliver excellent human resource management in their day to day management of their staff Mar 2015 Within Support the wider NHS Informatics Within Service in providing tools in terms of workforce surveys, national identity and common structures/job descriptions/titles to ensure a consistent approach Continue to work with Education Business Within Partnerships and schools and career services to promote informatics as profession and provide opportunities for young people Co-Production and Engagement: Strengthening processes for partnership Sep 2014 Within working and staff engagement and support, improving decision-making and supporting staff well-being Recruitment: Integrated service, workforce and financial Within NWIS 3 Year Plan , v26 Page 34 of 82

35 Organisational Development Commitment(s) plans will be developed for all services which outline the future changes to the shape and size of the workforce. This will enable effective and responsive recruitment, re-deployment and re-training processes to be put in place. Workforce Health / Equality & Diversity: Develop a culture of workplace health that focuses on supporting and improving employee well-being Further development of the Health & Wellbeing Action Plan Achieve Investors in People (IIP) accreditation Continue programme of Equality Impact Assessments. The Trust s Single Equality Scheme and Action Plan, establishes and promotes the strategic commitment to equality and diversity through recruitment, employment, retention, training and development practices Productivity: Review Workforce & OD management processes and practices within NWIS to improve the quality of staff and support managerial empowerment and accountability Target Year(s) March 2015 March 2015 March Sep 2015 Resource/ budget Within Within Within Within Within NWIS 3 Year Plan , v26 Page 35 of 82

36 8. FINANCE 8.1 National Context The scale of the real terms total reduction in Welsh Government central funding for to has required tough decisions to be taken about expenditure across government and careful consideration of pressures and priorities in all portfolios. Notwithstanding the (real terms) decrease in funding, issues such as the implementation and roll out of new national services and unfunded service growth means that NWIS will face considerable budgetary pressures. These pressures mean that we will need to deliver maximum value from investment through a focus on improving the quality of service by prioritising changes which also deliver greater efficiencies. 8.2 Organisational Context NWIS will continue to adopt a dynamic approach to financial leadership this will involve the Director of NWIS and Director of Finance ensuring that scarce are efficiently and economically utilised. The objective will be to ensure that the business plan is financially grounded and sustainable and is balanced (with due regard to flexibly manage and expenditure limits over a rolling 3 year period if required). Consequently, the plan is supported by an achievable (although challenging) savings target. In order to continue to have a balanced financial plan in each financial year there is a savings requirement of 5.4% in 2014/2015, 4.3% in 2015/2016 and a further 5.1% in 2016/2017. Key Financial Objectives for the Organisation include: Revenue Breakeven within 3 year flexibility (subject to approved robust savings plans) Remain within Capital Resource Limit Meet Public Sector Payment Target NWIS 3 Year Plan , v26 Page 36 of 82

37 8.3 Revenue and Capital Funding Model NWIS receives the majority of its funding from the Welsh Government to cover the day-to-day running costs of IT services and projects during each Financial Year. This takes the form of both revenue and capital allocations for operational and strategic developments. Financial forecasts are summarised below: Forecast Revenue Position 2014/ / /17 M M M Forecast Income Forecast Expenditure Savings Plan/Target Net End of Year Forecast In order to achieve breakeven significant savings will need to be obtained (see Section 8.5). Forecast Capital Investment 2014/ / /17 M M M Total Funding Total Schemes Spend Surplus/(Deficit) Planned capital schemes exceed available funding, NWIS will look to Welsh Government and further reduction of costs in order to allow all to be completed. NWIS 3 Year Plan , v26 Page 37 of 82

38 8.3.1 Revenue Funding The majority of NWIS revenue income is sourced from Welsh Government (86%) including an allocation for capital charges (depreciation). All other anticipated income (14%) relates to the payment of services provided by NWIS. There are also a range of services provided to NHS Wales, England, Northern Ireland and the private sector for which users provide funding directly. Typically these income streams have more of a trading relationship and consequently can be more volatile in nature due to changes in service levels/terminations. Source of Funds 2014/ / / /17 % M M M Welsh Government 86% Welsh Health Boards 8% Welsh Trusts 5% NHS England 1% Private/Other 1% Grand Total NWIS 3 Year Plan , v26 Page 38 of 82

39 8.3.2 Capital Funding Capital funds are received exclusively from Welsh Government and are grouped by: Discretionary Capital Funding: Internally prioritised schemes Strategic Capital Funding: Accessed by way of business case (subject to ministerial approval) and are, in general, larger schemes. Source of Capital 2014/ / /17 M M M Discretionary Strategic Total There are also subsequent revenue implications as a result of capital spend, these can encompass: Future Support Maintenance Training Capital Charges (Depreciation) For the planning purposes it is assumed that Welsh Government will fund capital charge costs. 8.4 Revenue Income and Cost Assumptions The following assumptions have been made within the plan: Welsh Government Income Funding will be Flat Cash over the next three years There is to be no inflationary uplift for NHS Wales agreements. A zero increase in NHS Tariffs. General contractual risk managed from the risk contingency reserve. NWIS 3 Year Plan , v26 Page 39 of 82

40 Savings initiatives can be met, subject to risk and sensitivity analysis and continuous budgetary control throughout the medium term financial forecasted plan In estimating the annual cost increases a number of items were identified for inclusion. These are summarised below: Pay A zero base approach has been adopted for all pay costs with each directorate identifying the resource required to provide services adequately. Public sector pay increases will be limited to 1% per year Staff entitlement to incremental progression Uplift of Superannuation liability from 2015/16 Removal of National insurance rebates in 2016/17 Non pay A combination of zero base approach has been used in order to eradicate any spare financial capacity at an early stage and also to identify additional resource consequences of new projects/implementations allied with general non staff inflationary uplifts. Local pressures Unfunded Service Growth such support of the new applications and systems post implementation Application of Revenue Funds NWIS income is allocated across the four investment categories and additionally to fund Strategy/Support Directorates and Overheads. Over 38% of NWIS income is used to fund Infrastructure Services which includes provision of the National Datacentre. Application of Funds (by Service Group) 2014/ / / /17 % M M M National Services (Applications) 15% NWIS 3 Year Plan , v26 Page 40 of 82

41 Application of Funds (by Service Group) 2014/ / / /17 % M M M Infrastructure Services 38% National Programmes & projects 12% Information Services 4% Strategy, Support & Overheads 30% Grand Total Application of Funds (By Spend Group) 2014/ / / /17 % M M M Staff 37% Non Staff & Estates 45% Depreciation 13% SLAs & Disbursements 5% Grand Total 100% Figures are gross and are subject to savings plans Statement of Comprehensive Net Income Forecast income and expenditure for the next three years is outlined below. Income & Expenditure Summary 2013/ / / /17 M M M M Welsh Government Welsh Health Boards Welsh Trusts NHS England Private/Other Income Total Income Staff Non Staff NWIS 3 Year Plan , v26 Page 41 of 82

42 Income & Expenditure Summary 2013/ / / /17 M M M M Agency/External Consultancy Depreciation Disbursements Estate SLAs Total Expenditure Surplus/(Deficit) Just over 39% of costs forecast for 2014/15 is derived from staff with the remainder being a combination of non staff elements and depreciation. This may appear be a slightly lower ratio than in other NHS organisations as NWIS incurs significant non staff expenditure by way of all Wales contracts and agreements Cash Flow NWIS treasury management services are provided by Velindre NHS Trust. Management of cash balances is dependent upon Trust strategy. 8.5 Savings Plans The initial forecast position presented varying deficits across the financial years (as detailed in the table below). The deficit has been addressed by assigning agreed organisation wide savings plans. The savings initiatives are very challenging and managing the balance between impact on stated objectives and financial breakeven will be a key activity. Details of savings plans to support the balanced financial plan are as follows: Savings Plans 2014/ / /17 Staff Vacancy/Turnover Management NWIS 3 Year Plan , v26 Page 42 of 82

43 Staff Resource Requirement Review Non Staff CIP Target (non recurring) Estate Savings Target Total Required Total ( M) Significant resource is required in order to support upcoming projects. This is targeted for review with the intention of releasing funds by reorganising existing capacity or revising delivery dates. 8.6 Capital The NWIS Capital Plan is consistent with strategic goals and corporate objectives. The source of capital funding reflects the funding provisionally allocated to NWIS in the Welsh Government All Wales Capital Programme over the next three years Capital Assumptions Any planned deficits will be managed by NWIS and the Welsh Government through the regular Capital Review meetings Depending on the type and value of investment, capital spend will be subject to agreed business case protocols and approved by the appropriate authority Capital Spending Plans Planned capital investments are reported below. Planned Capital Investment 2014/ / /17 M M M Business Intelligence Systems Modernisation Canisc Community, Mental Health and Social Care Solution NWIS 3 Year Plan , v26 Page 43 of 82

44 Planned Capital Investment 2014/ / /17 M M M Common Ailments Service Corporate Data Warehouse Development of Primary Information Service Diabetes Discretionary Capital GPSS/ Software etc Electronic Transmission of Prescription Claims GP Links Individual Health Record (IHR) Information Standards Infrastructure Replacement Plan National Intelligent Integrated Audit Solution Laboratory Information Management System (LIMS) Patient Administration System (Myrddin) Radiology Management System (Radis 2) Systems Integration Tools Replacement Welsh Clinical Portal (WCP) Welsh Clinical communications Gateway (WCCG) Welsh Care Records Service (WCRS) Total Surplus/(Deficit) Assets Current Condition and Performance NWIS invests in IT assets, both tangible and intangible, on behalf of NHS Wales. NWIS does not have any land or property assets. The current condition and performance of assets are continually reviewed and assessed and future investment decisions are made upon the basis of assets required to support information technology developments in NHS Wales. NWIS 3 Year Plan , v26 Page 44 of 82

45 Intangible software developments are continually enhanced to satisfy the requirements of the NHS. These developments need to be supported by hardware and infrastructure that is fit for purpose and that is adequately supported and maintained. The NWIS capital programme makes provision for a refresh and renewal programme of assets based upon their condition and suitability of purpose. For Audit purposes, a validation exercise is performed on an annual basis and part of this exercise is to review the condition of assets and their estimated useful lives to the organisation. This informs the future investment programme and helps to identify asset disposal. 8.7 Financial Risk NWIS will closely monitor the risk associated with its financial plans to ensure activity is delivered within financial to achieve a break-even position. Financial risk is managed as an integral part of the NWIS overall Risk Management Strategy referred in Section Key Risk(s) Revenue Cost Improvement - NWIS is required to find significant annual savings/cost reductions to service unfunded cost pressures and growth. The achievement of this, in an environment where the generation of additional income is likely to be more difficult, represents a major challenge both for 2014/15 and beyond. Contractual Risk Negotiations with suppliers and NHS Wales organisations typically surrounding payment and system implementation timetables are likely to impact the NWIS financial plan going forward. Mitigation(s) Strict saving plan management, with Executive Board monthly performance reporting Generation of a contingency reserve. NWIS 3 Year Plan , v26 Page 45 of 82

46 Key Risk(s) Possible shrinkage in the English customer base English users of the Child Health System are currently re-evaluating their overall strategy which may impact their requirement and NWIS revenue streams. Central budget reductions Reductions in funding from Welsh Government would severely impact the organisations ability to deliver stated objectives and financial breakeven. Mitigation(s) With the redevelopment of the new system English users will be targeted, allied to a revised pricing mechanism. Continue ongoing dialogue with Welsh Government identifying possible impact and where there is inflexibility within the plan. LIMS Implementation Slippage the slippage of any dates will impact on revenues receivable and possibly future years liabilities should implementation not be fully rolled out during the financial year 2014/15. The anticipated increased demand on services which may affect resource requirements include further transition from project to operational services. Possible increased resource need for 24/7 cover for critical services. Capital Insufficient capital funding would impede the ability of NWIS to meet its stated objectives. Monitor current implementation plan to ensure timely notification of financial impact of any slippage and target/identify further saving requirement. Funding of parallel running costs may need to be time limited. Look at skill mix, with a view to increasing capacity by multi-skilling. Review and maximise support provision and on-call availability. Continue meeting with Welsh Government in order to secure Capital Funding (see 8.6.1). NWIS 3 Year Plan , v26 Page 46 of 82

47 9. ESTATES AND CORPORATE SERVICES 9.1 Estates Due to its All Wales remit, NWIS has a presence across the country. Currently, staff are based within offices in a number of locations as highlighted in Figure 3. NWIS is keen to optimise usage of the Estate and will take into account the opportunity to implement flexible working practices and travel substitution by the utilisation of hot desking and video and audio conferencing where possible. The organisation manages a number of Data Centres which, by their nature, need to be in secure locations, services are currently migrating to centres at Blaenavon and Newport. Additional national data centre capacity has recently been sourced to facilitate this. Within the existing estate, NWIS has a number of different arrangements for servers (local and regional) and a review is currently focused on rationalisation. Within the next two years, leases on two of the larger properties, Brunel House (Cardiff) and Bocam Park (near Bridgend), are due to expire. NWIS has already NWIS 3 Year Plan , v26 Page 47 of 82

48 engaged with the NHS Wales Shared Services Partnership Facilities Services (NWSSP-FS) to access expert advice with regard to the optimum location of offices. Planned Estate Commitment(s) Development of a Business Case recommending the way forward for the Brunel and Bocam Park properties Development of an Estates Strategy (based on the outcome of the Business Case) Review local data centre arrangements with a view to rationalisation Estate Rationalisation (based on outcome of Business Case) Target Year(s) Apr 14 Apr 14 Sep 14 Sep 14 to Dec 15 Resource/ budget Within Within Within Within (or capital spend to save?) 9.2 Corporate Services Key objectives for Corporate Services relate to the provision of continued support managed under firm operational, quality and business assured processes. The table below focuses on the main planned initiatives over the next three years. Corporate Services Commitment Target Year(s) Resource/ Budget Continue to develop the NWIS Risk Management Within resource Structure to reflect current/future need Review and update the NWIS Business Continuity Plan Apr 2014 Within resource Test Business Continuity Plan as per test programme Within resource Ensure appropriate arrangements are in place for access to Trust corporate services Within resource Continue to develop organisational performance Within resource reporting mechanisms NWIS 3 Year Plan , v26 Page 48 of 82

49 10. STEWARDSHIP AND GOVERNANCE 10.1 Our Board Arrangements The NHS Wales Informatics Services (NWIS) is a non-statutory organisation hosted by Velindre NHS Trust. There is an NHS Wales Informatics Management Board (NIMB) which is accountable for all informatics activity undertaken by the NHS in Wales. All Health Boards, NHS Trusts and Welsh Government are represented on the Board. A hosting agreement for NWIS activities is in place with Velindre NHS Trust, together with a service level agreement for a number of corporate services. NWIS reports to several Velindre Trust Board Committees, including the Audit Committee, Quality & Safety Committee and Information Governance and IM&T Committee. In addition, attendance is made to a number of other sub-committees and Trust Groups. Regular reports are tabled at these Committees and Groups providing the Trust with assurance that there is compliance with policy and procedures Working with our Stakeholders NWIS has robust governance structures in place to ensure performance is managed, targets are met and that there is a culture of continuous improvement. There are structures in place for Operational (Mature) Services and for Programmes, which includes new product developments and procurements. Operational Services are overseen by Service Management. The National Service Management Board (NSMB) has embarked on a programme of work that includes the NHS Wales adoption of ITL best practice for service management and the establishment of a National Service Desk structure addressing both national and local requirements. Each Operational Service has a governance structure overseen by their own Service Management Board (SMB). NWIS 3 Year Plan , v26 Page 49 of 82

50 There is an NWIS Assurance Process for Programme Governance which is overseen by the National Architecture Design Board (NADB) and the Patient Safety Approval Board (PSAB) to ensure any new product/service is clinically safe (see Clinical Risk Management Process diagram below). This consists of three stages: Strategic Fit (NADB) and Service Specification (NADB) Initial Implementation in a Live Environment and agreement of Service Management Arrangements (PSAB) Authority to Implement (NADB) Clinical Risk Management Process: Step 1 Clinical Risk & Safety Assessment Plan Presented to PSAB Step 2 Clinical Risk Assessment (Details of clinical risk workshops and risk register) Step 3 Clinical Risk Assessment Report Presented to PSAB Step 4 Clinical Safety Case Report Step 5 Post Pilot Review Report Step 6 Pre Release Stage Report (Clinical Authority to Release) Presented to PSAB NADB approval Stage 1 Design Brief Strategic Fit NADB approval stage 2 Service Specification NADB approval Stage 3 Product Release / Authority to Implement Following implementation, new products/systems will transfer to Operational Services Governance arrangements. Finally, in the broader sense of Stakeholder Engagement, the NWIS Engagement Directorate supports all NWIS business activities by ensuring that NWIS has an effective and productive relationship with NHS Wales, its constituent organisations and the wider public sector. NWIS 3 Year Plan , v26 Page 50 of 82