Detailed Business Case Single Computer Aided Dispatch Project

Transcription

1 Detailed Business Case Single Computer Aided Dispatch Project Author: Angela Ashton, Bluestar Project Manager Date: 16 October 2008 Doc Ref: BSS_4707_CAD Business Case v0.5 Version: Draft v0.5 Final Decision: Date By Decision {Date Made} Decision {Director Meeting, Trust Board} {Approve/Reject}

2 Table of Contents 1. STRATEGIC INFORMATION Background Assumptions and Constraints Benefits Risks SERVICE PERSPECTIVE Options Preferred option FINANCIAL IMPACT Capital & Revenue Cost OPTIONS ANALYSIS MANAGEMENT ARRANGEMENTS Project Plan and Overview Project Roles and Responsibilities Risk Management Procedures CONCLUSION DOCUMENT CONTROL Change Record Who Has Reviewed This Document Approvals CAD Business Case Page 2 of 12

3 1. Strategic Information 1.1 Background The creation of SECAmb resulted from merging the three existing ambulance trusts; the new combined entity is required to provide comprehensive, seamless Emergency Services across the whole of its geographical area. To this end, as part of operational and clinical governance requirements, the Trust has embarked upon a review of technologies at its disposal, and the roles they fulfil, in support of these responsibilities. This business case has been prepared as a result of the review, and proposes and supports a move to rationalise the number of technology solutions deployed across the Trust s Emergency Despatch centres (EDCs), from three to one single-supply implementation. The principal aim to result from such rationalisation is to overcome interoperability issues across the three locations. Presently there are three different CAD systems; Visicad at Lewes, MIS (Alert 2000) at Banstead and MIS (C3) at Coxheath. As these systems do not interconnect, the Trust is presently faced with difficulties in managing activities at the boundary areas of the former merged trusts, from a command and control point of view. This has an impact on overall Trust efficiency, and the delivery and quality of patient care. The business case also recognises the need to meet ongoing, increasingly stringent performance targets and expectations and projected increases in demand for the use of its Emergency Services. The Trust has a duty to, and must be able to, provide a seamless approach to resource scheduling, improve the efficiency of each of the EDCs, maximise the utilisation of its fleet and have consistent management information from which to do this; all in support of the delivery of and quality of patient services. To achieve its quantitative and qualitative goals, present and future, the Trust executive management, therefore, proposes to implement a single CAD solution across the whole of SECAmb. This is seen as an operational imperative and as such will be consistent with the Trust s strategic aims and operational plans as contained in its : Vision, to be a clinically focused, high performing, team-based organisation that matches and exceeds international best practice Five Year Strategic Objectives for 2008/09 Business Plan Assumptions and Constraints The following assumptions are fundamental to this case being approved and progressed: That the three current CAD systems need to be replaced That the Board accepts the legitimacy of the Procurement Process to date That the preferred supplier is acceptable to the Board That Capital & Revenue Funding is available to support the procurement, implementation and ongoing operation That the Implementation Plan is approved That the established Project Board and Project Team, who have demonstrated their commitment to the delivery of this project continue in place That other Trust personnel are made available as required to support the Project Management Team in the implementation CAD Business Case Page 3 of 12

4 The following constraints are acknowledged as having a potentially adverse effect on satisfactory further progress : That the Board delays the approval of the Business Case That the pressure of delivering performance targets, particularly Call Connect response times, may have an impact on the availability of time and resources that the Trust can commit, particularly as regards staff availability That implementation cannot be allowed to have any negative impact on achievement of performance targets That the predominance of the need to maintain current operational capability during any transition period can hinder implementation That the level of change required within the EDCs may exceed that envisaged with implications on staff training requirements and consistency in the initial operational periods 1.3 Benefits The Project Team identified benefits associated with this acquisition, as listed below. These have been used in the Procurement Evaluation process, in the determination of the Preferred Supplier. The benefits form part of the comparison and relative scoring of the tenders submitted by suppliers in response to the Invitation to Tender. Benefits assessed fell into three categories: Quality those benefits that cannot be quantified in financial terms and are scored accordingly Financial, but non-cash releasing benefits such as staff efficiency savings, improved training delivery etc but where the gains will not be realised as cash savings Financial Cash releasing savings made on existing support contracts Quality benefits A single CAD will facilitate the development of : Operational Staff Time Efficiencies Improving standard working practices, and help focus on high performance, allowing more effective and efficient deployment of staff with improvement of performance against response targets and better clinical outcomes EDC Effectiveness removal of the current localised cross border restrictions, improving service coverage at the boundaries of the former legacy Trusts EDC Efficiency improved standard working practices of the support staff across the three EDCs, enabling greater flexibility in the use of EDC resources Data Quality Data quality will be improved due to the consistent approach to recording of information Reporting from the improved consistency in data collection, consequently improved management information reporting, generated with greater ease and accuracy, assisting in better informed strategic and operational decision making IT Support with the elimination of multiple applications, and only one system on a single platform, there will be more flexibility of resource usage CAD Business Case Page 4 of 12

5 Supplier Management Greater influence on supplier product development, and a stronger supplier relationship will emanate from a single, larger, if somewhat more complex, implementation Non-cash releasing benefits Improved Quality of Healthcare Better utilisation of resources by facilitating despatch of most appropriate available local response in cross-border areas, where current deployment is masked at border areas, with potentially better outcomes for patients Improved Deployment of Operational Resource As well as improving the effectiveness of clinical coverage in border areas, any resultant reduced resource overlap and duplication will allow more effective use of staff, as well as minimising undue fleet use, reducing mileages, maintenance and fuel costs Improved EDC Operational Efficiency Consistent working practices across all EDCs, staff being able to work in any location and cover other dispatch areas without incurring travelling costs, also enabling better balancing of peak and other period workloads Improved Target Achievement : Call Connect With the allied development of a best practice approach to its EDC operation, the Trust s improvements in operational efficiency will support the better sustained delivery of its targets, and the delivery of a High Performance operating regime Improved EDC Staff Training This can be streamlined, covering one single best practice, with more flexibility in the use of training resources Improved Technology : EDC Remote Operations The proposed solution offered by the preferred supplier of a thin client approach, using a standard CITRIX application will allow remote operations from almost any site, including potential wireless remote access via 3G, even with limited connectivity. This will mean that control centres could be flexibly deployed to allow the monitoring and dispatch of vehicles from major incident sites, stations, fall back centres, training facilities and at one-off/regular events etc. Improved Technology : EDC Disaster Recovery & Business Continuity The proposed solution offers increased flexibility, and its speed of deployment using existing links, rather than the installation of current communications lines, would allow for quick equipping of alternative nearby locations at which to re-site a control room, as opposed to relocating to another EDC or training location. If a server goes down, client connections are automatically and seamlessly put on to another server, with no impact on the user Improved Technology : Application and User benefits The advantages of the proposed solution of thin client approach include : o o Flexibility on core application location will eliminate ultimate dependency on specific single computers All system administration and control over user, network, resource and application management can be done centrally, providing more control over the environment and access control and improving user experience o All data is stored on a central server allowing for easier data protection, and backup for quicker and easier recovery using a mirrored application elsewhere o o In the event of the failure of an individual user client machine, replacement is simpler and can be done with a lower spec machine than at present As software updates are applied to the application servers only, they will be quicker and more consistently applied CAD Business Case Page 5 of 12

6 Improved Management Reporting Single format, consistent data collection, providing for simpler generation of more accurate information and reports to support better management decision making Improved Efficiency in Administration Better, consistent and complete information will allow for more co-ordinated planning across all Operational matters Cash releasing benefits Current CAD Support Costs Supplier Support costs will be reduced from the combined current annual total of 192k to 155k per annum (Note: The Finance Table includes costs and savings on a gross basis - the 155k is included in Software Support costs) Out of Hours Calls The new contract includes 24 hour service cover, which current arrangements do not (Note: The current annual costs shown above include an estimated of the present average charge of 2k per annum for those costs) 1.4 Risks The Project Team identified the main risks being as follows : Implementation disruption having an adverse impact on the delivery of performance targets There needs to be adequate senior management input and other resourcing throughout the implementation and transition Inadequate Training A robust Training Plan, appropriately resourced, will be a necessity, as will management support in ensuring the availability, and compliance of staff in its achievement Unrealistic Timescales/Project overrun The timescales are very tight. Senior management support will be essential to drive these. Adequate contingency planning will be essential to ensure that control is maintained in the event of unforeseen events disrupting the implementation timetable Availability of Trust resources The Project Board and Project Team should remain committed to delivery with as little disruption as possible Power Supplies Adequacy This must be safe at all EDC locations, so their status will require to be continually monitored and managed 2. Service perspective 2.1 Options The Trust has the following options, and these were considered prior to the commencement of the formal Procurement Process : Option 1 - Do Nothing Retain the three current CAD systems. Life expectancy of existing system at Banstead would be limited as this is an old system which is no longer included on the development path of the supplier and could potentially be at risk of discontinued support in the future. This would not deliver consistency of business processes, management information etc by continuing to use three different systems. Option 2 - link the existing three CAD systems This was regarded as untenable, for exactly the same reasons as the Do Nothing option CAD Business Case Page 6 of 12

7 Option 3 - Implement a single, Trust wide, CAD This would require a formal procurement and implementation, but provide foreseeable continuity and additional operational benefits. 2.2 Preferred option Option 3 was the preferred Option, supporting the Trust s vision, strategic and operational objectives, as stated above. A Formal procurement process has been undertaken. This assessed supplier organisational and technical and capabilities, and those deemed fit were invited to submit appropriate tenders. These were formally evaluated by the Project Team, including User Evaluations (5th 7th March 2008 and 28th April 2008), Site Visits, Technical Evaluation and Compliance with Terms & Conditions and a preferred supplier selected, this choice being ratified by the Project Board. The supplier whose product both meets the needs of the Trust and which has the technical ability to deliver the required solution is adjudged to be AssetCo, using its VisiCad solution. 3. Financial Impact 3.1 Capital & Revenue Cost For the sake of simplicity the financial projections are based as if the capital spend for 2008/09 and 2009/2010 is incurred under UKGAAP. From 2009/10 onwards, under IFRS, capital spend incurred on software intangibles may be treated as revenue spend. The amounts involved are not material ( 30k). It is anticipated that the implications of any IFRS changes that may be required, eg the writing out of the balance sheet of software intangible, when reporting standards change, will take place during the initial transition stage between 2008/09 and 2009/10, and impact on the balance sheet at that date, rather than as items affecting the bottom line in 2009/10. Timing would appear to be of essence. Any delay in the project timetable that defers any major parts of the proposed 2008/09 capital spend into 2009/10 may result in that spend instead becoming a direct charge to the Trust s revenue costs in that year and hence impact directly on the 2009/10 bottom line. This may make the project financing untenable. Otherwise the amounts shown cover the marginal costs associated with the CAD implementation. (The current costs identified specifically to the existing CAD are the 311K maintenance, that will not be payable in future. Additionally there is only one member of IT staff works on maintaining the CAD who will continue, but the amount is of zero impact and immaterial in this context). Cost Base All are shown at current pay and prices levels Capital The Initial Cost will be 1053k, 266k for hardware, 586k for software and 211k for implementation costs. There will be a further capital requirement of 262k every third year for a technology hardware refresh. These Capital Costs include irrecoverable VAT. Revenue The Estimated additional revenue cost in 2008/2009, including the initial implementation stage, is 316K. Of that, 312k relates to non recurrent charges. Of those, approximately 82K covers costs of implementation; 56K by the supplier, with 26K being incurred by the Trust directly, with the remainder being the anticipated Impairment Charge of 230k, relating to the write down of the existing CAD s NBV at 31 March CAD Business Case Page 7 of 12

8 Thereafter, the level of the estimated net increase in Revenue Costs, after offsetting current maintenance costs with a full year value of 311k that will no longer be incurred. This will be 342k in 2009/2010 and fluctuating from around 150k to revenue saving of 6k from 2010/2011 to 2015/16. The main recurring components of these costs are charges for Supplier support of software and hardware and costs incurred directly by the Trust in respect of depreciation and costs of capital. If the transition to IFRS occurs as anticipated, with the software asset being written down to a Nil value, the depreciation charge from 2009/10 will decrease by approximately 130k, up to and including 2014/15, with the bottom line adjusted accordingly. A summary of the Capital and Revenue costs is contained in Appendix A. 4. Options Analysis The evaluation process required formal analysis of the benefits that would be derived from the varying supplier proposals submitted. A number of suppliers were eliminated by formal decision making at different stages of the evaluation process. A summary of the Project Team s scoring of the main factors, for the two suppliers finally considered, is as follows : Supplier OBS Responses Supplier Total Score Weighted Score Ranking Weighting % Score AssetCo MIS User Evaluations 5 th 7 th March 2008 Supplier Total Score Weighted Score Ranking Weighting % Score AssetCo MIS User Evaluations 28 th April 2008 Supplier Score Ranking Weighting % Score AssetCo MIS Terms & Conditions Compliance Supplier Ranking Weighting % Score AssetCo MIS Site Visits Supplier Score Ranking Weighting % Score AssetCo MIS Overall Supplier Score Ranking Score AssetCo 1 95 MIS CAD Business Case Page 8 of 12

9 The preferred supplier selected in accordance with this process was therefore AssetCo. 5. Management Arrangements 5.1 Project Plan and Overview A High Level Project Plan has been prepared and this has been approved by the Project Board. The key milestones are set out below. A detailed Implementation Project Plan will be developed in conjunction with the supplier during finalisation of the contract. Below is an outline implementation plan for guidance purposes only and will be subject to change once implementation planning has commenced with supplier. Milestone Dates Preferred Supplier Identified August 2008 Full Business Case Development August / September 2008 Business Case Approval - FASC October 2008 Business Case Approval - Trust Board January 2009 Contract Negotiations September / January 2009 Site Role Out ~1 March 2009 Training April/ May 2009 Go Live May 2009 Post Implementation Support May 2009 / June 2009 Site Role Out ~2 June 2009 Training July / August 2009 Go Live September 2009 Post Implementation Support September / October 2009 Site Role Out ~3 October 2009 Training October / November 2009 Go Live November 2009 Post Implementation Support November / December 2009 Post Implementation Review December 2009 / January 2010 Project Sign Off January Project Roles and Responsibilities Project Management Structure and Methodology The project will be implemented in accordance with the standard NHS methodology, ie Projects in a Controlled Environment (PRINCE2) Project Governance Overall responsibility will rest with the IM&T Working Group CAD Business Case Page 9 of 12

10 The CAD Project Board will report directly to the IM&T Working Group. Its role will be to oversee all project delivery activities, including those related to the specification, business case, procurement and implementation. It will approve all major plans and authorises any major deviation from the agreed Stage Plan. It is responsible for signing off stage completion, authorising commencement of subsequent stages, ensuring that the required resources are being committed, arbitrating on any conflicts and negotiating solutions, either internally within the Trust or with external bodies. It approves the appointment and responsibilities of the Project Manager and any delegation of its Project Assurance responsibilities. A CAD Project Team has the role of supporting the procurement and implementation on a day to day basis. It reports periodically to the CAD Project Board. The project manager will provide a monthly highlight report to the Project Board. All formal project documentation will be prepared using PRINCE2 templates (adapted for NHS use). Documentation will be subject to at least one round of formal review. Lists of reviewers and approvers will be agreed with the Project Manager. Product Descriptions will accompany documents issued for review. Project Evaluation The project will be subject to a post project review, at an agreed time after go live, (this is normally 12 months) to address what lessons might be learned with regard to the delivery of project objectives against deliverables and problems encountered, to set out enhancements which may be made to best practice, and transfer of risk, to make recommendations for future developments, and to arrange for Project handover, including any still outstanding issues, and final sign off 5.3 Risk Management Procedures A risk management procedure has been developed to identify any potential risk to the project. A risk and issues register will be maintained for the duration of the project. All issues or risks identified will be logged, assigned an owner, given a risk and impact rating and any actions that will be taken to mitigate the issue/risk recorded. Once/if an issue or risk is resolved the actions will be documented and the risk or issue marked as closed. All risks shall be managed effectively; with all severe risks/issues being escalated to the project board via highlight reports. In the event that any risk is deemed so severe that it cannot wait for a routine Project Board meeting, an exception report will be immediately be prepared for, and a decision sought from, the Project Board. 6. Conclusion The reasons and evidence for moving to a single CAD are strong and the Board is recommended to give this appropriate approval CAD Business Case Page 10 of 12

11 6. Document Control 6.1 Change Record Date Author Version Reason for Change 16 Oct 08 Angela Ashton Draft V Oct 08 Angela Ashton Draft V0.2 Review by Alan Smith 27 Oct 08 Angela Ashton Draft V0.3 Minor Modifications 10 Nov 08 Angela Ashton Draft V0.4 Changes Incorporated with comments from NEDs 9 Jan 09 Angela Ashton Draft V0.5 Amendments as a result of November Trust Board 6.2 Who Has Reviewed This Document Name Position Date Ian Arbuthnot Steve Moss Alan Smith Greg Timmins Matt Gibbons Senior Responsible Owner Finance Finance Finance Finance Any other Department affected by Project 6.3 Approvals Functional Director {Signature & Date} Director Meeting Trust Board CAD Business Case Page 11 of 12

12 SOUTH EAST COAST AMBULANCE NHS TRUST COMPUTER AIDED DESPATCH PROGRAMME BUSINESS CASE SUMMARISED FINANCIAL INFORMATION APPENDIX A Yr 0 Yr 1 Yr 2 Yr 3 Yr 4 Yr 5 Yr 6 Yr 7 Yr 8 Yr /9 2009/ / / / / / / / /18 Total K K K K K K K K K K K Capital Expenditure Hardware ,042 Software Licences Implementation Costs Total Capital Expenditure REVENUE EXPENDITURE Additional Revenue Costs Recurrent Revenue Costs Software Support ,764 Hardware Support Depreciation ,606 Cost of 3.5% Total Recurrent Revenue Costs ,737 Add: Non Recurrent Revenue Costs Implementation Costs Impairment Charge - Writedown of former CADs Total Additional Revenue Costs ,437 Less: Reduction in current CAD costs ,716 Net Additional Revenue Costs ,721 BALANCE SHEET NBVs Balance brought forward 0 1, Additions 1, ,869 Depreciation ,606 Balance carried forward 1, CAD Business Case Page 12 of 12