GS1 and PEPPOL standards in Health Care - Demonstrator sites

Transcription

1 GS1 and PEPPOL standards in Health Care - Demonstrator sites Prepared by Commercial Directorate Department of Health June 2015

2 Introduction As part of the adoption of the global GS1 and PEPPOL standards across NHS the Department of Health (DH) has agreed to provide direct support up to six acute NHS trusts in England to act as demonstrator sites. The aim of these sites will be to demonstrate the true costs, challenges and resultant opportunities and benefits that arise from adopting the core enablers and primary use cases for GS1 and PEPPOL standards. This document outlines the process through which trusts will apply to be considered to become a demonstrator site and then how applications will then be considered and processed. It also then describes the approach being taken to the ongoing management and governance of the selected trusts. Background In 2007, the Department of Health published Coding for Success, which recommended the adoption of GS1 coding standards for patient identification and for manufactured products. The subsequent publication of the ISB1077 standard made the adoption of GS1 coding for patient identification a requirement for NHS Trusts. The benefits noted by Coding for Success from patient identification included: fewer medication errors; reduced risk of wrong-site surgery; and more accurate track and trace of surgical instruments, equipment and devices. Benefits from the coding of manufactured goods included improving efficiency and cost reductions. As well as patient safety benefits, the adoption of GS1, together with the PEPPOL messaging standard, brings significant benefits to procurement, across all parts of the trust, including pharmacy, estates and facilities, as well as ward stock management. The McKinsey report, Strength in Unity quantified recurring benefits of at least 3m per 682-bed trust, together with one-off costs of 2m offset by equivalent benefits. The NHS eprocurement Strategy was published DH in May 2014 and compliance with the strategy by NHS Trusts was mandated as a requirement of the 2014/15 NHS Standard Contract. Under this requirement, acute trusts are required to put in place a board-approved GS1 and PEPPOL adoption plan before the end of March 2015, now extended to the end of June DH has established a small, dedicated team and is working to establish an ongoing capability and to establish the critical national infrastructure required for utilisation by trusts. 2

3 Scope The GS1 coding and PEPPOL messaging standards support a number of use cases across both front line and back offices functions across NHS organisations. DH have structured the approach to these opportunities by identifying an initial set of three core enablers and three primary use cases. Acute NHS trusts should focus effort on adopting these across all (relevant), areas of their organisation. In parallel with this, work will continue through the DH team on further development of the secondary use cases and on validating costs and benefits. Core enabler 1 Location numbering GS1 provides the Global Location Number (GLN) standard for the identification of unique locations, such as a legal entity (eg a trust or a supplier); a functional entity (eg a cost centre or an accounting office); and a physical entity (eg a hospital or a warehouse). GLNs support each of use case by enabling an event to be matched to a location, whether this relates to a person; an asset; a product or a service. Core enabler 2 - Catalogue management Suppliers are required to place standardised master product data into a GS1 certified datapool. The GS1 Global Data Synchronisation Network links these datapools and an NHS Product Information Management system will be established to enable trusts to draw supplier master data from the datapools into their local catalogue solution. This process will ensure that accurate and consistent product information is used consistently across the NHS and its supporting supply chains. Core enabler 3 - Patient identification The ISB 1077 standard requires trusts to adopt GS1 barcoding standards for use on patient identity wristbands, enabling accurate identification of the patient, with barcode scanning facilitating the upload of clinical data into the electronic patient record. The GS1 standards enable electronic records to be created that capture details of the patient, caregiver, care location, and equipment and consumables utilised during an episode of care, facilitating clinical audit and product recall. Use case 1 - Inventory management Many products provided by suppliers to the NHS already carry GS1 barcodes and, over time, all products will be required to comply with this requirement. These barcodes can be used to manage inventory in all locations around a trust, from central stores to local stock rooms in wards and departments. Scanning the barcode enables key data to be captured electronically and exchanged without manual intervention into patient administration and purchase order processing systems. 3

4 Use case 2 - Purchase-to-pay processing The use of PEPPOL messaging standards supports the electronic transfer of information between trust and supplier, without manual intervention. Together with the GS1 coded product information this enables automated matching of order, invoice and delivery notification speeding up subsequent payment. The accuracy and automation of barcodes reduces costs in requisitioning, ordering and payment. Use case 3 - Product safety recall Forthcoming European legislation will require hospitals to be able to electronically track and trace medical devices to individual patients. Scanning barcodes on the patient wristband and on the device, into the patient record enables product safety recalls to be managed, facilitating prompt recall of affected patients upon receipt of a product recall notice, together with identification and isolation of faulty products. Demonstrator site trusts will be expected to adopt the three core enablers and the three primary use cases across all relevant areas of their organisation. Demonstrator site selection process The approach to selection of demonstrator site trusts is a staged process. Application Those trusts wishing to apply to become a demonstrator site should submit a strategic outline adoption plan for the core enablers and primary use cases in line with guidance already provided. In addition to the strategic outline plan the trust should also complete and submit a cover sheet, illustrated in appendix A This table aims to capture a range of definition factors, described in more detail in the next section. The purpose of these factors is to enable selection of a range of NHS acute trusts as being representative of the majority of NHS acute trusts across England. The application should also confirm the name of the trust s nominated executive sponsor illustrating that the application has the support of the trust s board. Applications should be ed to owen.inglis-humphrey@dh.gsi.gov.uk no later than 30 th June Short listing DH are establishing a review panel, to be chaired by Pat Mills (Commercial Director, Department of Health), which will consider the submitted applications. The intention is to short list no more than twelve of the applications, based on factors including such things as; The quality of the submitted strategic outline plan; Proposed levels of investment required and benefits projected; 4

5 Proposed timeline for adoption activities; and, The definition factors provided as per the chart in appendix A. Detailed planning For the twelve short-listed trusts support will be provided, in the form of a DH funded professional services organisation engagement. This engagement will be aimed at supporting the trust to develop, over a period of three months, a more detailed and fully costed Strategic Outline Business Case in line with the HMT 5 case model. The professional services organisations will be appointed by DH and will be provided with detailed guidance and direction in respect to what will be looked for by the review panel following submission of plans. Adoption activities will need to align with a proposed set of phased gateways, illustrated in appendix B The purpose of these phases is to ensure that planned adoption of the three core enablers and three primary use cases progress in parallel, and will be used for the successful demonstrator sites for the release of staged funding. The detailed strategic outline business case should then be presented to the trust s board to receive their support and endorsement. This is to recognise that, whilst funding will be provided by DH effort will still be needed from the trust to effect the adoption as well as to produce resulting case studies. Trust board approved strategic outline business cases should then be submitted to DH ( address as before) no later than 13 th November Demonstrator site selection The established review panel will consider the submitted strategic outline business cases looking in particular at such things as: The detail and credibility of the plan covering all relevant areas and aspects of the trust; The support and engagement of an executive level sponsor; Identification within the plans of a dedicated, full time programme manager; Establishment of base line metrics for each of the major elements; A commitment by the trust to produce case studies; and A commitment from the trust to host site visits and peer reviews following adoption. The chosen demonstrator site trusts will then be informed of their selection and the trust s nominated sponsor will be invited to join the steering group for adoption of the standards alongside representatives from organisations including DH, NHS England and MHRA. Upon being selected as a demonstrator, trusts should identify their programme manager, establish their governance arrangements and start advancing the 5

6 approved plan. The programme manager will then be invited to join a monthly delivery group, alongside programme managers from the other demonstrator sites and the DH work stream leads. This group will be tasked with ensuring that there is shared learning and consistency of approach across the demonstrator sites, sharing of knowledge and experiences as well as working through identified challenges in a collegiate manner. DH will also appoint a dedicated and experienced accountant to work across the demonstrator sites, supporting benefits realisation and monitoring effective use of funds provided. Feedback and support For those applications received at either stage and not selected to progress, as well as for those trusts publishing adoption plans but not applying to be a demonstrator, the DH will provide review, feedback and guidance. The overall aim is for all acute NHS trusts in England to work towards adoption of the three core enablers and three primary use cases. Guidance and support will continue to be produced and shared in order to assist all NHS acute trusts to, as a minimum, adopt the core enablers at this stage. Contact Should there be any questions or queries arising from this document then, in the first instance please contact Owen Inglis Humphrey GS1 and PEPPOL Adoption Commercial Directorate Department of Health Skipton House, 80 London Road, London SE1 6LH owen.inglis-humphrey@dh.gsi.gov.uk Tel:

7 Appendix A Definition Factors Factor Scale Teaching Hospital Yes Linkage to institute No Governance Foundation Non-FT Financial performance >10% Deficit <10% Deficit Break Even Positive (surplus) Case Mix General acute Some specialisms Specialist centre Main Locale City Centre Urban Rural Size (based on bed numbers) <450 beds >900 beds Number of sites Process maturity Red Amber Green CQC assessment Outstanding Good NHS litigation authority assessment Requires improvement (Turnover / Contribution) Inadequate 7

8 Factor Teaching Hospital Governance Financial performance Case Mix Main Locale Size (based on bed numbers) Number of sites Process maturity CQC assessment NHS litigation authority assessment Description Is the trust a recognised teaching hospital or linked with an institute? Has the trusts been formally recognised as achieving Foundation Trust status? During the previous financial year ending (March 2015) did the trust project a surplus or deficit position? As an approximate indication how does the trust view itself in terms of the mix of clinical cases it handles and services it delivers? What is the primary geographic locale of the trust in terms of the community it serves? What is the total, aggregate number of beds within the facilities operated by the trust? How many discrete sites does the trust manage clinical activity at? Based on the current state assessment matrix completed as part of the strategic outline plan, what is the current state of adoption of GS1 and PEPPOL standards across the trust? During the most recent CQC assessment what rating did the trust receive? Expressed as a percentage, what is the trust s current annual turnover divided by the trust s NHS Litigation Authority contribution level? 8

9 Appendix B phased delivery Programme Phase Use case GLN prefix in place. Trusts GLN registry in place. Trust GLN registry populated. 100% of trust Trust GLN registry populated. 100% of relevant trust locations have GLN s. Trust GLN data is populated into GS1 UK GLN registry. 50% of trust locations have GLN. 100% of trust locations have barcoded place to administrate GLN s. Location locations allocated a 50% of trust labels. Final case study including costs and management GLN locations have All in trust systems using GLN as location barcoded labels. identifier. Interim case study including costs and Catalogue Management Patient ID Catalogue management system in place. Detailed gap analysis 50% patients have GS1 wristbands given on admission. Point of care scanner solution provider agreed. Where appropriate source data from provisional central PIM. Trusts systems have been modified to utilise GTIN s, GLN s and associated attributes 100% of patients have GS1 wristbands given on admission. Detailed processes and training plans in place to roll out point of care scanning. Where appropriate source data from provisional central PIM. Integration with PIM to relevant in trust systems is in place. Catalogue. IM Interim case study including costs and Relevant in trust system are capable of storing, receiving and transmitting relevant information to point of care scanners. PAS etc. Point of care scanning for patient identification in place in 50% of the trust. Interim case study including costs and All trust master data is taken from the PIM. place to administrate trust master data. Final case study including costs and All in patients have wrist bands given on admission. Wristbands are scanned to positively identify the patient. Appropriate goods are associated to the patient by scanning. Scanned information is stored in relevant systems. PAS etc. Final case study including costs and place to administrate trust systems and processes. 9

10 Inventory Management P2P Product Recall Detailed plan for every part in place. Single in trust logistics structure agreed by the board. Inventory management (Including consigned stock) solution vendor agreed. Access point provider selected and live. Updated product recall process in place Implementation of IM systems and processed underway. 25% of relevant products can be tracked by batch and serial number to the patient. 50% reduction in Web requisitions. Interim case study including costs and benefits produced 30% of trusts purchase orders and invoices are machine to machine (AP). Interim case study including costs and 25% of product recall are being done using the new processes. 50% of relevant products can be tracked by batch and serial number to the patient. 75% reduction in web requisitions. Interim case study including costs and Inventory storage locations to be based on GLN coding structure with AIDC (automatic information and data capture) in place to automatically capture product and location information. 60% of trusts purchase orders and invoices are machine to machine (AP). Interim case study including costs and Where available, both purchase order and invoice are based on GTIN coding for products as well as GLN coding for both supplier reference and delivery location. 50% of product recall are being done using the new processes. Interim case study including costs and Single in trust logistics organisation in place. Less than 0.5% of orders are generated by Web requisition. 100% of relevant products can be tracked by batch and serial number to the patient. Final case study including costs and place to administrate trust Inventory management processes. Except where specifically justified (through commercial, emergency or operation requirement) and agreed, there should an average 2-3 weeks supply of stocked product held across the trust. 100% of trusts purchase orders and invoices are machine to machine (AP). Final case study including costs and place to administrate trust P2P process. 50% of product recall are being done using the new processes. Final case study including costs and place to administrate trust product recall processes. 10

11 Appendix C selection process timeline Design selection approach Launch Trusts develop outline plans Deadline for submission Review & Shortlist Shortlisted trusts to develop detailed plans Deadline for submission Review & Select Announce Commence adoption DH activity Trust activity 11