Emed3 Fit Notes - Project Initiation Document

eMED3 Fit Notes - Project Initiation Document

eMED3 Fit Notes (P0017/002)

Project Initiation Document

Amendment History:

Version / Date / Amendment History
0.1- 0.5 / 18-Aug-2011 / First drafts for internal review and comment
1.0 / 1-Sep-2011 / Issued for formal review
1.1 / 25-Sep-2014 / Reissue due to change in scope
1.2 / 30-Jan-2015 / Updated to account for change in scope

Reviewers:

This document must be reviewed by the following:

Name / Signature / Title / Responsibility / Date / Version
Rebecca Jarratt / Senior Project Manager
Richard McEwan / HSCIC Architect / IG
Mike Curtis / HSCIC Lead GPSoC Architect
Amit Chawla / Solutions Assurance
Gemma Lofthouse / Service Management
Graeme McGowan / GPSoC Commercial Team
Simon Richards / DTS Assurance Lead
Dave Pool / Non Functional Solution assurance
Ann Newman / DWP
Melissa Ruscoe / GPSoC programme Manager
Toto Gronlund / eMED3 business owner

Approvals:

This document must be approved by the following:

Name / Signature / Title / Responsibility / Date / Version
Nick McGruer / DWP Director
Kemi Adenubi / Programme Director of GP IT
Peter Short / National GP Lead

The controlled copy of this document is held by the work area it covers. Any copies of this document held outside of that area, in whatever format (e.g. paper, email attachment), are considered to have passed out of control and should be checked for currency and validity.

Contents

eMED3 Fit Notes (P0017/002)

Project Initiation Document

1Background

1.1Introduction

1.2Overview

1.2.1Project History

1.2.2Approvals

1.2.3Project Requirements

1.2.4Project Benefits

1.2.5Business Case

1.2.6Exclusions from Scope

2Project Definition

2.1Project Approach and Deliverables

2.2Assumptions

2.3Procurement Strategy

3Project Organisation

3.1Project Structure

3.2Key Stakeholder Groups

3.3Project Resources and Responsibilities

3.3.1Project Authority

3.3.2Project Board

3.3.3Project Management

3.3.4Delivery Team

4Project Management

4.1Project Controls

4.2Project Tolerances / Exception Reporting

4.3Risks and Issues Management

4.4Risks and Issues

5Project Plan

5.1HSCIC Resource Management

5.1.1HSCIC Resources

5.1.2Requesting Resources and Time Recording

6Quality Plan

7Communications Plan

8Project Costs

8.1Cost Breakdown

Created Using Template v5.0

eMED3 Fit Notes - Project Initiation Document

1 Background

1.1 Introduction

This project is being requested and funded by the Health, Disability and Employment (HDE) of the Department for Work and Pensions (DWP). The project was initiated by the DWP to convert the current paper MED 3 certificate (fit notes) into an electronic form and made available in all GP Systems of Choice (GPSoC) systems. This element of the project (Phase 1) is now complete.

The original scope of Phase 2 of the project included the delivery of a data extraction service that intended to flow data from Suppliers, through the Data Transfer Service (DTS) and pulled out into a DWP data warehouse for processing. Following successful assurance of the data extract functionality, the weekly scheduled extract from three of the four principal system suppliers into DTS commenced in late 2012. Due to a number of internal issues to DWP, they were unable to pull data from DTS to store and transform within their internal system, therefore requested for the DTS “send” functionality to be switched off and instructed GPSoC to postpone the data extraction phase of the project until further notice. The DWP approached GPSoC in early 2014 and requested for HSCIC to deliver a mechanism that lands, stores, transforms and publishes fit note data on behalf of DWP.

The HSCIC are providing a fully chargeable service to the DWP for the delivery and assurance of the eMED3 form (electronic fit notes) and for the maintenance, support and service management of the eMED3 data set.

1.1.1 Introduction update

Due to the change in scope, as detailed above, and as the original requirements were developed and agreed in 2012 the project consulted with the HSCIC’s Information Governance team in October 2014 and it was agreed that a Privacy Impact Assessment (PIA) was required and therefore conducted in a short timeframe. This raised a number of risks due to IG advice that the dataset in its current form is potentially identifiable. Mitigating actions were defined for each risk and were the basis for the plan to comply with legal and ethical obligations. A key output of the PIA included the requirement for Suppliers to uplift the eMED3 schema to ensure the data to be extracted is de-identified to an acceptable level and therefore reducing the risk on the HSCIC.

A key output of the PIA was the requirement for a Legal Direction. The project team and DWP liaised with the DH sponsorship team (Victoria Cave/Jennifer Byrom) in November 2014 to initiate work on the Direction and DWP agreed responsibility for overseeing the development. Approval of the Direction was planned for the March 2015 HSCIC Board however ministers decided to postpone approval until the conclusion of purdah.

In March 2015, DWP and DH ministers met and decided that the eMED3 requirement must respect patient objection codes due to a change in DH’s patient objection policy. A CCN was communicated to Suppliers on 19th May to request Suppliers to implement the changes required to respect patient objections. The CCN also included the removal of specific free text field items to reduce the risk of patient identification and therefore the HSCIC will be landing a low/very low risk data set.

1.2 Overview

1.2.1 Project History

Dame Carol Black reviewed the relationship between citizens’ sickness and worklessness and the impact of each on the other in Great Britain. Her report in May 2008, ‘Working for a Healthier Tomorrow’, offered the fundamental conclusion that a healthy workforce is a happier, more productive workforce.

In response to these recommendations, in November 2008, the Department for Work and Pensions (DWP) and the Department of Health (DH) jointly published a strategy: ‘Improving health and work: changing lives’ proposing the following key initiatives:

Healthcare professionals: Provide the tools to better address health and work issues, including roll-out of the revised medical certificate (the new ‘fit note’).

Provide Employers with tools to help them better manage absenteeism in the workplace by using the recommendations in the new electronic ‘fit note’ to help someone return to work from a period of sickness absence.

Individuals: Test a range of early intervention services to give them the direct support they need to return to work, including improving advice from GPs about fitness for work, including the new ‘fit note’.

In 2008/9 DWP commissioned an eMED3 Proof of Concept (PoC) project with a GPSoC supplier in South Wales to prove technical concepts and evaluate stakeholder reactions to electronically enabled medical certification. Based on the success of this pilot and as a matter of high priority to meet the objectives stated in ‘Improving health and work: changing lives’, the DWP and DH re-engaged with HSCIC to progress national rollout across all UK GP Practices the electronic issuance of the fit notes (eMED3).

1.2.2 Approvals

Phase 1

DWP and HSCIC SMT approval was received to spend £26,584 (chargeable to the DWP) in completing the HSCIC Delivery Framework Feasibility Stage. HSCIC accrued £27,434 (excl. VAT) at the end of this stage (c. end August 2011). At the time of updating, the following has been achieved:

DWP finalised and approved the ‘eMED3 requirements’ specification
Contract Change Notification (CCNs) were issued to the 6 GPSoC Suppliers requesting costs and schedules to deliver the eMED3 requirements
GPSoC supplier responses have been progressed to a point where DWP can progress with funding approvals to complete the whole project - £1.3M.
DWP have achieved internal (PAB) approval to spend £1.3M. This covers the GPSoC supplier contracts to a value of £1M and the HSCIC total costs of £236K (inclusive of the accrued £26,459 + VAT).
DWP received approval from the Minister of State for Employment to spend £1M (required for the GPSoC supplier contracts).
An MOU was developed in liaison with the DWP and was signed by both parties

Phase 1 of the project is now complete (as of October 2014) and the following approvals were in place prior to completion:

MOU signed between HSCIC and DWP
DWP funding approval from the Minister of State and Employment
CCNAB approvals (signed CCN’s)

Phase 2

The project is now in Phase 2 and prior to this commencing formally, the following approvals will be in place:

Updated and signed MOU between HSCIC and DWP
Following review of the proposal produced by HSCIC IT Development, DWP received approval to spend £300,000, which includes coverage of the new scope of the project; HSCIC to collect, store, transform and publish the fit note data on behalf of DWP.
DWP have between £3m-£5m to fund a number of proposals including the eMED3 project and have confirmed if costs rise, within reason, they are able to cover these due to the high profile nature of the project.
Following uplift of the requirements and schema to account for the new changes DWP approved the documents.
CCN (GPSoC-CCNa-021) was approved and issued to the 4 Principal GPSoC Suppliers requesting costs and delivery timescales.
Add CCN Response details here[MH1]

1.2.3 Project Requirements

The high level requirements are:

Phase 1: To convert the current paper MED 3 certificate (fit notes) hand-written by GPs into an electronic form available in all HSCIC GPSoC systems including:

Standardised electronic capture by the GP systems of all relevant MED3 data against the patient’s record;
Secure printed MED3 certificates (Unique IDs and 2D Bar Coding);
Electronic printing of the statement by the GP system for signing and delivery to the patient;
Capabilities to enquire on the history of issued eMED3 certificates (including GP2GP certificate transfer) and secure re-printing of duplicates (for employers, insurance, etc.);

Phase 2: Secure frequent extract (e.g. weekly) of ‘anonymous patient’ data about absence from work from the GP practices, store and process that data and provide an output in the form of a publication to DWP.

1.2.4 Project Benefits

Benefits to the DWP include:

Wider deployment to Scotland and Wales using the same HSCIC GPSoC supplier systems. See Assumptions (section 2.3).

Administrative cost savings through electronic issuance of the eMED3 form using GP systems. Medical Statements (also known as form Med 3 or ‘fit notes’) provide evidence of incapacity for benefit and sick pay purposes. They are exclusively paper based. DWP prints and distributes up to 20 million forms annually. As forms need to be stored and distributed securely this comes at significant administrative cost (both direct and indirect).

Advanced Analysis. A lack of data on forms issued and the advice they contain means that Government cannot analyse trends and patterns within sickness absence. This is a significant strategic weakness when formulating policies to reduce and prevent inactivity.

Fraud Reduction. The electronic medical statement will also introduce new measures to reduce fraud which will further prevent abuse of the system such as the current sale of fake forms over the internet.

Benefits to patients and the NHS include:

Integration to the patient’s electronic record (EPR). Significant improvement in record quality through standardised edit and capture of the eMED3 data.
Improve Patient Safety. Hand-written forms increase the possibility of misinterpretation of advice (by patients and their employees) which can place a patient at increased risk.
Time saving completion of e-med3 forms compared to paper
Improved continuity of certification (record & legibility)
GP2GP transfer of certification record
Ability to produce duplicates
Improved completion of e-med3 information/form through application of logical system rules
Potential for internal audit

1.2.5 Business Case

The DWP own the eMED3 project business case and are responsible for any benefits realisation planning, tracking and reporting.

1.2.6 Exclusions from Scope

The following products and activities will be deemed out of scope for this project:

Transfer of ‘patient identifiable’ data (such as NHS number, full postcode). For this project the transfer of data to an internal data warehouse will be constrained to ‘patient anonymous’ data. A separate project will be initiated to transfer ‘patient identifiable’ data once DWP have refined the requirements and any associated IG and ‘consent models’.

Delivery to GP practices who use the HealthySoft (CrossCare product) – this has been agreed as not providing VFM based on the GP market share (c. 11 practices across England).

Transfer of data by way of a secure hard drive. Due to HSCIC policy, data transfer mechanisms are risk assessed and following the risk assessment of this proposal, it was deemed inappropriate.

The scope of this project does not include collections from Scotland and Wales. Data will be collected from practices within England only.

2 Project Definition

2.1 Project Approach and Deliverables

Phase 1

For Phase 1 the approach and specialist deliverables for the remainder of eMED3 project will be as defined, agreed and approved within the tailored CAP Approach (inserted below).

Management products and HSCIC SMT gated approvals followed the HSCIC Delivery Framework.

Phase 2

For phase 2 the approach and deliverables for the remainder of the eMED3 project will be delivered as defined and agreed within the IT Development Framework (inserted below). The IT Development choice of method is Agile.

The approach and deliverables for the new requirement changes (GPSoC-CCNa-021) will be defined and, agreed and approved within the tailored CAP Approach (inserted below)

2.2 Assumptions

The following assumptions have been made with regards to eMED3 as a whole:

The HSCIC IT Development team will use DTS as the transport channel for receipt of the eMED3 data extracts from the GP practices
Any eMED3 requirements specific only to Scotland and Wales (including live Deployment) is outside of the HSCIC GPSoC contract and will therefore be managed by the DWP.
DWP make resource available to cover full assurance of the first eMED3 system. This is to ensure that the DWP and HSCIC Solutions Assurance are aligned in regards to the eMED3 functionality.

2.3 Procurement Strategy

The existing HSCIC GPSoC Framework is being used to leverage the contracts between the Authority and GP Systems Suppliers to deliver the eMED3 form to GP practices.

There are no other HSCIC procurement considerations for this project.

3 Project Organisation

3.1 Project Structure

This section of the document outlines the overall project organisation necessary to implement the eMED3 project.

Figure 4.1: Overall Project Structure

3.2 Key Stakeholder Groups

Key stakeholders include

Health Disability and Employment Directorate - Department for Work & Pensions
Health Improvement & Protection Directorate - Department of Health
HSCIC IT Development team
BMA
JGPIT – the eMED3 objectives have been presented and feedback given (includes the Devolved Administrations).
GPC – Continued engagement will be required to satisfy the GP community on the appropriateness of the output. DWP will lead on this with support from Peter Short.

3.3 Project Resources and Responsibilities

3.3.1 Project Authority

This project is being requested by Peter Wright (Principal Scientific Adviser and Deputy Director) and sponsored by the Health Disability and Employment Directorate (HDE) of the Department for Work and Pensions (DWP).

Nick McGruer (Deputy Director for Health Disability and Employment Directorate at the Department for Work and Pensions) has overall responsibility.

Within HSCIC this project is stand-alone and will be managed under the remit of GPSoC on the HSCIC Programme Delivery olio. James Hawkins will represent eMED3 through the gated approvals at HSCIC SMT.

3.3.2 Project Board

Project board members directing the project include:

Melissa Ruscoe (HSCIC GPSoC Programme Manager) – Chair
Peter Short – GP National Clinical lead (deputy)
David Bryant – Head of IT Development – Senior Supplier
Nick McGruer – DWP HDE Directorate Deputy Director
Toto Gronlund – Business Owner

The following stakeholders are also invited to the Project Board updates:

HSCIC and DWP Project Managers
HSCIC IT Development management

3.3.3 Project Management

The HSCIC Project Manager (PM) is Mike Howley

The DWP Project Management activities are managed by Ann Newman

Each GPSoC supplier will provide a named Project Lead.

HSCIC Supplier Release Managers will be engaged by the HSCIC Project Manager for their respective suppliers.

3.3.4 Delivery Team

GPSoC suppliers:

EMIS
INPS
TPP
Microtest

DWP team and the HSCIC team (also see Section 7 – HSCIC Resource Management):

David Bryant (IT Development Head)
James Scanlan (IT Development Manager)
Amerjit Singh (IT Developer)
Kevin Deadman (IT Tester)
Jill Darlington (Delivery Manager)

4 Project Management

4.1 Project Controls

Project Managers will continue to update the eMED3 Project Board at specific key points in the project. Minutes and update packs are drafted by the HSCIC Project Manager (reviewed by DWP Project Managers) and then submitted to the Project Board attendees by the HSCIC PM.

The HSCIC PM will engage DWP with the GPSoC suppliers as required. HSCIC resource utilisation against plan will be reported monthly.

GPSoC Suppliers will provide detailed project plans / checkpoint reports to the HSCIC PM / Supplier Release Mangers. Regular update (conference calls) will also be set up between HSCIC and the GPSoC suppliers to go through progress, plans and reports. DWP PM’s will attend these conference calls as required.

4.2 Project Tolerances / Exception Reporting

No project tolerances have been set for this project.

Phase 1

HSCIC costs were recorded on a T&M basis and were capped at £236K. This made provision for the delivery and assurance of 4 suppliers (and 9 GPSoC systems).

GPSoC Supplier costs were agreed and approved via the Contract Change Notifications (CCN). The values agreed in the CCN were effectively a fixed price model.