Derbyshire Local Digital Roadmap Derbyshire Local Digital Roadmap Paper-free at the Point of Care 2020 Version: 3.0 Date: January 2017 Status: Publication Version Authors: Nikki Hinchley, Paul Greenhead, Claire Hilton & Paul Hetherington Page 1 of 82 Derbyshire Local Digital Roadmap Document Control Issue No. Issue Date Summary of Issue Version 1 29/06/16 Final Draft 2.0 Revised draft following feedback from NHS England 2 06/10/16 2.0 Review 3 13/01/17 Publication Version 3.0 Approvals Name Organisation Date of Version Approval STP Chief Group Derbyshire Sustainability and 2.0 Transformation Rakesh Marwaha Derbyshire Informatics Delivery Board 2.0 Ian Hazel Chesterfield Royal Hospital NHS Foundation 2.0 Trust (Acute) Mark Norwood Derby Teaching Hospitals NHS Foundation Trust 2.0 (Acute) Alvaro Pancisi Derbyshire Community Health Services NHS 2.0 Foundation Trust Steve Bowyer East Midlands Ambulance Service NHS Trus 2.0 Peter Sanderson Derbyshire Healthcare NHS Foundation Trust 2.0 (Mental Health) Nat Pearson Derbyshire Health United/ OOH Provider (Nat) 2.0 David Gurney Derbyshire County Council 2.0 Colyn Kemp Derby City Council 2.0 Distribution Name Title Date of Issue Version STP Chief Group Derbyshire Sustainability and 2.0 Transformation Nikki Hinchley Derbyshire CCGs IM&T Commissioning & 2.0 Programme Manager Claire Hilton IM&T Enablement Benefits Manager 2.0 Rakesh Marwaha Derbyshire Informatics Delivery Board 2.0 Ian Hazel Chesterfield Royal Hospital NHS Foundation 2.0 Trust (Acute) Mark Norwood Derby Teaching Hospitals NHS Foundation Trust 2.0 (Acute) Peter Sanderson Derbyshire Community Health Services NHS 2.0 Foundation Trust Alvaro Pancisi Derbyshire Healthcare NHS Foundation Trust 2.0 (Mental Health) Page 2 of 82 Derbyshire Local Digital Roadmap Name Title Date of Issue Version Steve Bowyer East Midlands Ambulance Service NHS Trust 2.0 Nat Pearson Derbyshire Health United/ OOH Provider (Nat) 2.0 David Gurney Derbyshire County Council 2.0 Colyn Kemp Derby City Council 2.0 Paul Hetherington Derbyshire STP LDR Lead 2.0 Page 3 of 82 Derbyshire Local Digital Roadmap Table of Contents 1 Executive Summary ......................................................................................................................... 7 2 Introduction .................................................................................................................................. 11 2.1 Contributing Organisations ................................................................................................... 12 2.2 Development of the Derbyshire LDR .................................................................................... 12 2.3 Engagement with the Sustainability Transformation Plan ................................................... 13 2.4 The wider context of Public Services change ........................................................................ 14 3 Derbyshire Digital Vision ............................................................................................................... 15 3.1 Derbyshire Digital Strategic Principles .................................................................................. 15 3.2 Derbyshire Digital Priorities .................................................................................................. 16 3.3 The Derbyshire Digital Ambition ........................................................................................... 17 4 Strategic Value of the Local Digital Roadmap ............................................................................... 21 4.1 Citizen Impact ....................................................................................................................... 21 4.2 Health and Care Professionals Impact .................................................................................. 21 4.3 LDR Benefits .......................................................................................................................... 24 5 Alignment to STP ........................................................................................................................... 28 5.1 Place Based Care ................................................................................................................... 30 5.2 Urgent Care ........................................................................................................................... 31 5.3 Prevention and Self-Management ........................................................................................ 32 5.4 System Efficiency .................................................................................................................. 34 5.5 System Management ............................................................................................................ 35 5.6 Supporting STP New models of care ..................................................................................... 36 5.7 Future change impacts on local IM&T .................................................................................. 37 6 LDR Baseline Position .................................................................................................................... 38 6.1 Derbyshire Digital Maturity................................................................................................... 38 6.1.1 Derbyshire Organisations Digital Maturity Readiness & Capability Assessment .......... 40 6.1.2 Primary Care Digital Maturity ....................................................................................... 41 6.1.3 Social Care Digital Maturity ........................................................................................... 41 6.2 Summary of Key Achievements and Current Initiatives ....................................................... 42 6.2.1 DIDB Work Streams ....................................................................................................... 43 6.2.2 Progress against LDR Capabilities and DIDB Work Streams.......................................... 44 6.2.3 Progress against Universal Capabilities......................................................................... 46 Page 4 of 82 Derbyshire Local Digital Roadmap 6.2.4 Mapping Capabilities and Universal capabilities with current Derbyshire Initiatives .. 50 7 Derbyshire Digital Delivery Plan .................................................................................................... 52 7.1 Digital Capability Deployment Plan....................................................................................... 53 7.2 Capability Deployment Schedule .......................................................................................... 58 7.3 Capability Deployment Trajectory ........................................................................................ 58 7.4 Universal Capabilities Delivery Plan ...................................................................................... 59 8 Infrastructure - System Wide ........................................................................................................ 63 8.1 Access to Systems ................................................................................................................. 63 8.2 Community of Interest Networks (COIN) .............................................................................. 63 8.3 Wireless access ..................................................................................................................... 63 8.4 Mobile working ..................................................................................................................... 64 8.5 Data Centres.......................................................................................................................... 65 8.6 Virtual Desktop ..................................................................................................................... 65 8.7 Communication ..................................................................................................................... 65 8.7.1 NHS mail 2 ..................................................................................................................... 65 8.7.2 Unified Communication ................................................................................................ 65 8.8 Cyber Security ....................................................................................................................... 66 9 Readiness ...................................................................................................................................... 67 9.1 Leadership and Governance ................................................................................................. 67 9.2 Clinical Engagement .............................................................................................................. 68 9.2.1 Chief Clinical Information Officer .................................................................................. 68 9.3 Patient Engagement .............................................................................................................. 68 9.4 Investment Sources – National and Local ............................................................................. 68 9.5 Resource Utilisation Plan ...................................................................................................... 69 9.6 Change Management Approach ........................................................................................... 70 9.7 Benefits Management Approach .......................................................................................... 71 9.8 Integration across footprint areas ........................................................................................ 72 10 Information Sharing .................................................................................................................. 73 10.1 Local Authority Citizen Survey Responses to Information Sharing Questions: - .................. 75 10.2 Adoption of NHS Number ..................................................................................................... 77 10.3 Adoption of SNOMED CT ...................................................................................................... 78 10.4 GS1 Adoption ........................................................................................................................ 80 11 Risk Management ..................................................................................................................... 81 11.1 Risks and Rate Limiting Factors ............................................................................................. 81 Page 5 of 82 Derbyshire Local Digital Roadmap 11.2 Minimising Risks arising from Technology ............................................................................ 82 Page 6 of 82 Derbyshire Local Digital Roadmap 1 Executive Summary The Derbyshire Local Digital Roadmap sets out an ambitious vision for how the local health and care system intend to exploit digital technology to deliver the Sustainability and Transformation Plan and Paper-free at the Point of Care by 2020. Derbyshire has a strong track record of informatics partnership and collaboration, fostered and coordinated by the Derbyshire Informatics Delivery Board (DIDB). The strength of these existing relationships between health and care providers, commissioners and the public has been the key to articulating the ambition of this roadmap. It has provided a solid background of local cooperation and shared strategy upon which this roadmap has been built and a strong foundation upon which this ambitious vision can be achieved. The development of the LDR has been undertaken in conjunction with the creation of the Derbyshire Sustainability and Transformation Plan to ensure that the ‘golden thread’ of digital enablement runs through Derbyshire’s ambitions and plans for sustainable transformation. It has been shaped to meet the dual requirements of the STP and NHS Digital, but importantly its primary focus is to use information and technology innovatively to deliver better quality outcomes to the people of Derbyshire. And in this context, digitally enabling health and care is just part of a greater journey; ALL public services, whether local or national, are on their own digital journeys, that collectively empower and benefit the citizen in all their interactions with public services. These already include Police and Fire, Local Government and many of the central Departments of State that deal directly with the citizen, e.g. DWP. It is necessary to design and deploy these programmes of complex change separately but not in ignorance of each other; the whole must be greater than the sum of the parts, or we will all have missed an important opportunity offered by the digital age, in terms of exploiting:  Shared digital assets, solutions, knowledge and services  Commoditisation/ rationalisation of processes and solutions  Interoperability of solutions and data  The power of the internet The ability of the citizen to be a co-creator of their public service experiences, not just a consumer of them. In developing the LDR, the Derbyshire health and care system have extended and shared their understanding of individual partners’ digital maturity and identified and addressed the collective implications in planning for the footprint. This willingness to share learning and insight and plan collectively has enabled the creation of an ambitious roadmap that provides a clear and achievable plan to support the STP to meet the challenges of closing; the health and wellbeing gap, the care and quality gap and the finance and efficiency gaps by 2020. Page 7 of 82 Derbyshire Local Digital Roadmap Derbyshire Digital Vision Right information, right people, right time “ We will use information and technology to facilitate system change, across the whole health and social care economy. To ensure appropriate and accurate information is available and accessible to our patients and their clinicians, supporting the provision of high quality ” outcomes, in the delivery joined up care Figure 1: Derbyshire Local Digital Roadmap Vision In order to deliver this vision, a number of Digital Roadmap Priorities and high level delivery plan have been devised. Derbyshire Digital Roadmap Priorities 1. Exploit the Derbyshire Summary Care Record expanding viewing access and increasing information available to patients and health and care professionals 2. Develop the Digital Care Record creating an editable, patient owned DCR containing all relevant records and information accessible by patients, carers and health and care professional 3. Deliver Interoperability providing real-time information for DCR with bi-directional updates between DCR and source systems accessible by patients, carers and health and care professionals 4. Expand E-Prescribing ensuring all prescribing is electronic across all settings 5. Make medication records and information available to all patients, carers and health and care professionals 6. Introduce joined up asset tracking and management use GS1 for optimal visibility and common tracking of high value assets across Derbyshire 7. Give professionals technology and tools to support them to fulfil their roles effectively 8. Promote assistive technology to support self and remote monitoring by users and health and care professionals 9. Increase remote communications and consultations to enable citizens and health and care professional to communicate more efficiently and conveniently 10. Improve online information, advice, guidance and assessment giving citizens the information they need to self-assess and triage and route to the appropriate service based on their need 11. Increase electronic transfers and integrate with online services including all referrals, transfers (any to any), discharge and correspondence with history and records included in DCR Page 8 of 82 Derbyshire Local Digital Roadmap 12. Increase electronic orders and results requests in real time, published online through the DCR, with alerts to citizens and health and care professionals and integrated into clinical systems 13. Increase access to information tools and alerts to support decision making 14. Enable mobile health and care professionals to work anywhere connecting at partner and citizen settings with offline working where internet access is unavailable 15. Increase sharing of common technology infrastructure making it easier to collaborate, reducing cost and taking advantage of local economies of scales 16. Explore sharing of common ICT and Business Services to reduce cost 17. Develop a Derbyshire wide Business Intelligence capability, pulling data from all available systems and providing tools for analysis and insight Derbyshire Digital Roadmap Delivery Plan The plan sets out a high level sequence of projects identified to deliver the LDR, building on the existing work of the Connected Derbyshire Programme and DIDB work streams and taking into account current and planned initiatives. Figure 2: Derbyshire LDR Programme Plan Overview Page 9 of 82 Derbyshire Local Digital Roadmap The potential benefits to the health and care system are significant but must be understood in relation to the wider initiatives outlined in the STP. The technologies, initiatives and digital innovation identified in this roadmap will not deliver the benefits required in isolation. As the LDR makes clear, the success of this delivery plan is contingent on the much broader system and cultural changes set out in the STP. Leadership and Governance The governance model for the LDR builds on the architecture of the Derbyshire Informatics Delivery Board. The connection with the STP governance model is maintained through the role of the Chairman and LDR sponsor, Rakesh Marwaha, who is a member of the STP Chiefs group. The importance of clinical leadership is fully recognised and its importance reinforced by the role of the Chief Clinical Information Officer. The LDR has been endorsed by Senior STP Executives, Health & Wellbeing Boards and members of the Derbyshire Informatics Delivery Board, which includes both Derbyshire County and Derby City Council. Page 10 of 82