Decision Discussion Assurance Information X

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1 Title of Meeting: Primary Care Commissioning Committee Date of Meeting: 1 March 2018 Paper Title: Data Quality Service Responsible PCCC Member Lead Dr Rick Sweeney Governing Body Member Purpose (this paper if for) Session (Tick) Public X Private Workshop Report Author and Job Title Alec Cowell Head of Finance Agenda Item: 8.1 Decision Discussion Assurance Information X Has the report (or variation of it) been presented to another Committee / Meeting? If yes, state the Committee / Meeting: Yes. A version of this paper has been to FPCC Executive Summary Background The GPIT Operating model specifies what the GPIT funding, allocated to CCGs, should be spent on and specifies that core and mandated GP IT services must be the first call on this revenue funding. In the previous GPIT Operating model, data quality was not a core and mandated service and subsequently it was not procured by the CCG. The GPIT Operating model was updated for i (implemented April 2017), which now states data quality is a core and mandated service, and therefore CCGs should procure it on behalf of their GP Practices. Data Quality Service The data quality service includes the following elements: - Comprehensive data quality advice and guidance service available to all GPs, including training in data quality, clinical coding and information management skills. - Development and delivery of a general practice data quality improvement plan, where necessary. The service should include support for: - National data audits/extracts/reporting eg National Diabetes Audit - General reporting - Template development/qa - Spreading best practice - Data migrations as part of system deployments - National system deployments for example. GP2GP, - SCR, CAB/e-RS, EPS - Clinical/medical terminology Solution from embed embed have put together a service specification for a data quality service, based on the requirements of the GPIT Operating model. The offering is split into 5 different areas to include all aspects of data quality, including the following key areas; 1

2 - Data quality support, including 2 visits per practice annually - Date quality training in all elements/areas - Development, creation, sharing and amending of templates - Writing and testing of clinical system reports - Providing a hazard review process for clinical templates This additional service will cost 30k per annum based on the assumption that S&R CCG and VoY CCG also procure the service from embed. S&R CCG have already taken this investment through their relevant committees and approved was granted. VoY CCG are currently taking this investment through their relevant committees and at the time of writing this paper no decision had been made. 1 Please see separate Appendix A for the full proposal from embed. Recommendations The Primary Care Commissioning Committee is asked to approve this investment in GPIT. Monitoring Monthly contract review meetings take place with embed. Monthly GPIT review meetings also take place with embed, which covers contracted services, IT projects and IT training CCGs Strategic Objectives supported by this paper CCG Strategic Objective X 1 Quality, Safety and Continuous Improvement X 2 Better Value Healthcare 3 Well Governed and Adaptable Organisation 4 Health and Wellbeing 5 Active and Meaningful Engagement CCG Values underpinned in this paper CCG Values X 1 Respect and Dignity 2 Commitment to Quality of Care X 3 Compassion 4 Improving Lives 5 Working Together for Patients X 6 Everyone Counts 2

3 Does this paper provide evidence of assurance against the Governing Body Assurance Framework? YES NO x If yes, please indicate which principle risk and outline Principle Risk No Principle Risk Outline Any statutory / regulatory / legal / NHS Constitution implications Management of Conflicts of Interest Communication / Public and Patient Engagement This business case addresses the shortfall in mandated services for primary care. No conflicts of Interest have been identified prior to the meeting. Not applicable. Financial / resource implications 30,081 annually from 2018/19. Outcome of Equality Impact Assessment No applicable. Alec Cowell Head of Finance 3

4 Provision of GPIT core & mandated services for the development of a primary care data quality improvement plan, quality training and provision of data recording advice and support Services to be provided to: NHS Harrogate and Rural District CCG Prepared by: Jean Souter Solutions Manager embed Health Consortium Kier Business Services, Workplace Services Gateway 2, Holgate Park, York, YO26 4GB M: E: jean.souter@embedhealth.co.uk For: Alec Cowell Head of Finance NHS Harrogate and Rural District CCG T: E: aleccowell@nhs.net Template: KTG-PM-FR-008 Page 1 of 13

5 Contents Template Revision Control Document Version Control... 3 Glossary of Terms Executive Summary Project Background Project Objectives Scope Approach Overview of Services with 24 Month Deliverables Assumptions Constraints Service Charges (exclusive of VAT) Outline Project Plan Approval to Proceed Template: KTG-PM-FR-008 Page 2 of 13

6 Document Version Control Version Date Author Description /07/2017 Jean Souter First draft /07/2017 Paul Searle/Angela Wood Review of first draft /07/2017 Jean Souter Approved for release /12/2017 Jean Souter Service delivery from 29 to 24 months Glossary of Terms Term CCG GPIT PCES QOF CQRS SRO FTSE ICT BAU SRO PID Description Clinical Commissioning Group General Practitioners Information Technology Primary Care IT Enabling Services Quality & Outcomes Framework (online database) Approvals, reporting and payments calculation system for quality outcome-related achievement for GP practices Senior Responsible Owner Financial Times Stock Exchange (companies index) Information and Communication Technologies Business as Usual Senior Responsible Owner Project Initiation Documentation Template: KTG-PM-FR-008 Page 3 of 13

7 1. Executive Summary embed Health Consortium would like to thank Harrogate and Rural District CCG for the opportunity to provide this proposal of services for the development of a primary care data quality improvement plan, quality training and provision of data recording advice and support. embed is a wholly owned subsidiary of the Kier Group, a FTSE 250 company with revenues in 2016 of 4.2b. Employing over 21,000 employees, Kier has delivered over 1bn of NHS healthcare development projects in the last decade and provides localised expertise from its network of offices across the UK, including locations in Leeds, Bradford, Sheffield, Hull and York. Currently embed is delivering services which include ICT, business intelligence, and a range of supporting back office corporate and business solutions to the 23 Yorkshire and Humber clinical commissioning groups under the NHS England Lead Provider Framework. Despite the size and complexity of this contract, embed successfully mobilised the contract very quickly by seamlessly transferring services and staff whilst continuing to provide the existing service with minimal disruption. Our approach to mobilisation was based on three core principles: minimal change to the current service minimise disruption through stabilising the service key stakeholder and staff focused This method of approach underpins the standard practices for delivery that we operate within and as such Harrogate and Rural District CCG can be assured that embed will mobilise and operate this new service requirement to the 19 GP Practices within the region, effectively whilst deploying industry leading methodology. In appointing embed as the service provider for data quality service, Harrogate and Rural CCG will benefit from our evolving transformational working practices which harness specialist hubs of industry experts, that will be deployed to provide you with an immensely wide breadth and depth of skills and expertise. Our scale means that we provide an agile, skilled workforce that can deliver business support services cost-effectively, these having been fine-tuned through our work experience with clients across our footprint. Our proposition is based on a 24 month contract of service with effect from 1 st April 2018 (this aligns with the existing contractual term in place for support services). We trust that you will find this proposal meets with your requirements for data services and we welcome any questions that you may have arising from this document. Template: KTG-PM-FR-008 Page 4 of 13

8 2. Project Background NHS England has released a new GPIT Operating Model This builds on the GPIT Operating model and details key changes namely, additional core services. The new operating model has four levels of service defined: Core & Mandated GPIT - business as usual, getting the basics right - every member of general practice staff must have reliable, responsive and efficient IT systems, associated support services and equipment. Enhanced Primary Care IT - focused on improving efficiency and effectiveness, innovative and effective approaches that will better support changes in the delivery of primary care services, including 7 day and extended hours working and at scale models. Transformational Primary Care IT - new or additional infrastructure that will enable integration of health and care and delivery of new and innovative healthcare models, where multiple organisations across care settings are working with general practice to share patient care. General practice business support systems - these are the systems which are associated with the running of the Practice business and are not directly connected to patient care and should be funded by the Practice. The embed Service Delivery Management team attended a meeting with the CCGs the objectives being to: Understand what has changed in Core & Mandated GPIT service provision (assuming CCGs wish to commission new services from April 1st 2017) Understand the funding model as defined by NHSE Outline implications to IT service and CCG in delivering the new model The GPIT Operating Model NHS England holds accountability and provides funding CCGs commission GPIT service and drive integrated care Commissioned by CCG provided by service delivery organisations Template: KTG-PM-FR-008 Page 5 of 13

9 Key Funding Principles NHSE will continue to provide national funding as part of CCG baseline allocations Investment of enhanced and transformational services must be CCG led From 2016/17, GPIT revenue monies will be distributed directly to CCGs to manage locally, through CCG baseline allocations The first call on GPIT revenue funding locally is the provision of core and mandated GPIT services In order to ensure that NHS England and CCGs comply with accounting policy, revenue allocations are being considered instead of capital for GPIT infrastructure requirements. In recognition of the cost pressures in commissioning Primary Care IT Enabling Services (PCES) an additional in year allocation of 1.4m was made in 2029/16, specifically targeted at enhancing IG support arrangements. Funding provision for 2016/17, allocated to Regional Teams for the direct commissioning of these services, has been uplifted to 11m (full year effect). embed is pleased to confirm its ability to deliver to Harrogate and Rural District CCG data quality services which are fully compliant and to specification. Our highly experienced senior leadership team will oversee the delivery of our services; and a team of experienced data quality product specialists will deliver them. With our excellent track record of working alongside the 23 Yorkshire & Humber CCGs and our significant and scaled experience in data quality services, Harrogate and Rural District CCG can be confident of our capability to quickly mobilise our service provision and detailed further within this document is our approach, deliverables and timescales. Template: KTG-PM-FR-008 Page 6 of 13

10 3. Project Objectives The project objective is for the CCG to commission primary care data quality services to support primary care GP practices and services by: Making best use of their clinical systems Providing support to primary care users to ensure that the recording and use of clinical data is in line with the NHS Information Standard Expert resourcing for core primary and integrated care clinical systems Provision of Clinical tools, templates, data sets and reporting support for clinical and commissioning planning, review and decision making Supporting the delivery of consistent, comparable and secure clinical, professional and organisational data in relation to primary care and provided services Providing information for CCG Clinical Governance and performance monitoring Providing Clinical Commissioning and professional data sets, templates, data extraction and query sets, assurance and compliance Within the Harrogate and Rural CCG region there are 17 GP Practices. embed is able to propose a schedule of service planning over a period of 13 weeks. During this time we will manage the recruitment process to appoint additional new talent to our existing team of data quality specialists. If the CCG is in a position to sign off this proposal with agreement to proceed by 31 st December 2017 then embed will mobilise service provision with effect from 1 st April 2018 approval to proceed sign off at any date following this will move the go live date respectively. We are committed to supporting you to deliver efficiencies and improvements in data quality services. embed has the ability to add value which could not be delivered by an in-house service. We are a successful and experienced commissioning support organisation, already in partnership with the Yorkshire & Humber CCGs and as such this scale of service delivery enables us to provide you with access to a range of specialist expertise as well as real insights and learnings. embed is proposing the supply of data quality services from 1 st April 2018 for a period of 24 months until March 2020 this aligns with the existing contractual term in place for support services. Template: KTG-PM-FR-008 Page 7 of 13

11 4. Scope Our approach to the scoping phase of the requirements will be to verify and detail every aspect of the services that will be delivered to ensure that the mobilisation plan is robust and to ensure that no services are omitted, duplicated or adversely impacted. This phase of due diligence is designed to fully determine the size, scale and scope of the mobilisation required, identifying all risks and issues with the services, whether perceived or real; so that they can be effectively managed and mitigated. Should these reviews highlight any additional remediation work to be undertaken to facilitate mobilisation this will be captured and discussed in detail with the appropriate party. 5. Approach The project will be started, planned, delivered and closed in accordance with PRINCE2 based methodology. The Project Manager will be responsible for developing and delivering against a project plan, risk/issues register, communication/engagement plan and benefits plan. These project documents will be regularly reviewed by the Project Manager and any slippage, requests for change and/or corrective measures required will be reported to the Senior Responsible Owner (SRO)/Sponsor and, if required, escalated to the Project Board for approval. The Project Manager will provide a regular progress report to the Project Board and other governance bodies at regular intervals to be agreed; arranging meetings, as required, to support planning and engagement activities. The SRO will be responsible for monitoring progress on the project and (with the Sponsor) for approving changes outside the agreed project plan, scope, quality and/or tolerance. embed recommends the implementation of our three stage model: Stage 1 Discovery Establish Project Governance and agree PID. Stage 2 Specification Planning Define and Plan Stakeholder engagement, key communications and mobilisation activities. Stage 3 Solution Implementation Commence service mobilisation which will include dependencies, critical path and interfaces with all stakeholders and all activities necessary to satisfy service readiness. A Project Management Office will oversee all activities during the Mobilisation period providing robust and well tested processes and providing the necessary assurances allowing the CCG to deliver its statutory responsibilities. Template: KTG-PM-FR-008 Page 8 of 13

12 6. Overview of Services with 24 Month Deliverables Deliverable Provision of a service which provides customers with data quality products, advice and guidance: Primary Care Data Quality Training Description Development of an annual primary care data quality improvement plan Clinical systems typically include SystmOne and EMIS WEB Provision of 2nd Line function through the Clinical Application, Data Quality Support and Training team to resolve data quality incidents and service requests for support. The definition of data quality service provision includes: advice and guidance will cover, READ coding structure within clinical systems (SystmOne and EMIS WEB), data entry of information onto clinical records, data extraction through clinical searches and reports, protocols and concepts. Will also provide guidance on understanding CQRS and open Exeter. The data quality improvement plan will include access to a suite of data quality reports designed for practices to interrogate their own clinical system patient data. Practices will create a schedule of data quality improvements, as agreed with the CCG. The Data Quality team will work closely with GP Practices; providing dedicated resource, to ensure that support, advice and guidance can be delivered and shared to help maintain business processes and requirements. Facilitate with CCG the content of a data quality improvement plan that will be available to all GP practices Provide a summary annually to CCG for GP practice achievement against the data quality improvement plan and Quarterly update on practice uptake of the data quality improvement plan Training for primary care users in Data Quality and Information Management Primary care users are defined as: GP Practice employed staff Training will be delivered through the following methods: Template: KTG-PM-FR-008 Page 9 of 13

13 Deliverable Description classroom workshops, e-learning, remote access Training modules to include: READ Code training (Version 2, CTV3 & SNOMED CT ) Summarising of electronic patient record, to also include use of GP2GP Register Validation Methodology Medical Terminology Provision of data recording advice and support Provision of customised Primary Care data reporting Additional, bespoke training courses can be made available to CCG staff (the content and charges of which can be agreed as required). Provision and assurance of a range of mechanisms including recommended coding and data entry templates in line with national or local requirements. The service will be provided to GP practices and will provide them with guidance where patient information is shared with other service providers. Provide a service to support the use, maintenance and development of templates and reporting for national and locally commissioned services, where clinical system providers have not provided the resources. Develop a structure for the hosting of templates and reports on the clinical systems platform Manage and maintain the templates repository We will provide a service for integration of referral forms with clinical systems. We will require confirmation from the provider that the form is current and the most up to date, prior to the form being integrated into the clinical system. Referral forms will be managed as category 5 service requests. Will provide a service to review existing (embed Created) centrally held clinical system data entry templates & protocols up to an annual basis as requested, agreed and planned with the CCG. Will provide a service to review existing (embed Created) centrally held clinical system data entry templates in line with QOF business rule updates. Data extraction, analysis and detailed reporting on data recorded in primary care customised to the needs of the requestor Will provide a service to write (and test) clinical system Template: KTG-PM-FR-008 Page 10 of 13

14 Deliverable Description reports (using system clinical reporting tools) where the CCG has requested and a designated lead is identified. This will include advice and guidance in understanding the reporting requirements, writing the clinical system reports and fully testing, before distributing to practices. This does not include running the clinical system reports. Hazard Review Process Advice and guidance to GP practices in running bespoke tools to analyse extracted data where that tool is written and published by the DQ Service, e.g. Health Check monitoring Review of individually created data entry templates, coding lists, formularies at GP practice level We will provide a template assurance process with input from designated clinical lead General practice support providing advice on concepts and processes via practice engagement, bulletins and remote support. In line with established CCG hazard review process, ensure that data entry templates, protocols and referral forms meet their designated standards. 7. Assumptions The following assumptions exist: Stakeholders and stakeholder organisations will co-operate in this project Stakeholders and stakeholder organisations will be released to participate in this project Current ICT architecture is understood and documented There is a legal basis for the required information sharing 8. Constraints The following constraints exist: Stakeholder availability to support the project Template: KTG-PM-FR-008 Page 11 of 13

15 9. Service Charges (exclusive of VAT) Service No. of GP Practices CCG Cost Data quality services as detailed within Table 1 (above) 17 Harrogate and Rural District 30, Month s Charges 30, These annual charges will be invoiced on a monthly basis These charges have been calculated based on providing the service to 3 x CCGs (Scarborough and Ryedale, Vale of York and Harrogate and Rural District) and therefore would need to be reviewed if for any reason a CCG decided not to commission the service. Template: KTG-PM-FR-008 Page 12 of 13

16 10. Outline Project Plan Activity Planning/ Delivery/ Closure Timescale Establish project governance and agree PID Planning Week 1-2 Stakeholder engagement and analysis, including key Planning Week 3-13 communications and mobilisation activities to provide more information on the service offer, existing provision and agree key customer contacts. Start recruitment Planning/Delivery Week 1-13 Service Mobilisation Delivery Week Approval to Proceed I have reviewed this Solution Proposal document and the proposals are acceptable to me. I authorise embed to initiate this project. Name Signature Date Template: KTG-PM-FR-008 Page 13 of 13