NHS GRAMPIAN
Analysis of Strategic Risk – New Patient Management System
Aim
As part of the ongoing improvement of the risk management processes, it was agreed that a strategic risk would feature at each Board meeting.The risk to be discussed in December 2010 is Risk ID 749 - New PAS system and ways of working are not successfully implemented. An extract from the Datix System is provided as Appendix 1.
Strategic Context
The Strategic context is the Strategic Risk Register.
Discussion
The consortium of Boards (Grampian, Lanarkshire, Glasgow, Borders and Ayrshire & Arran), concluded the Patient Management System (PMS) procurement process on behalf of the Scottish Government Health Directorate and signed a contract for the supply and implementation with TRAKcare in March 2008. NHS Grampian (NHSG) has subsequently signed an individual Call Off contract.
Contracts
Management of the exit from existing contracts is in place with regular communications with iSoft, the supplier of our current Patient Administration System, Mental Health System (PiMS) and Protos System. The current contract for our current Mental Health System (PiMS) has been extended to March 2012. We are currently negotiating with ISoft to allow “view access only” to both PAS and PiMS for one year after switch off.
Implementation
The build of Scottish Foundation System (SFS) has been completed and is now being configured to meet local operational requirements. PMS Implementation will be in a number of stages as follows:
- Maternity and Neonatal (Protos replacement) - November 2010
- Core PMS -February 2011
- Order Communications- September 2011
- Mental Health- November 2011
The TrackCare product is rich with functionality and provides NHSG with a tool to support new, holistic ways of working. The scale of going live with all elements simultaneously was considered too high risk for NHSG. As a result the staging of functionality go lives has been phased in such a way that the business can sustain the change.
Key risks
The main programme risks and current positions are as follows:
Current Key Risks / Current PositioniSoft support for PAS and PiMS runs out April 2011. / PAS contract cannot be extended.
PiMS contract has been extended to March 2012.
A further mitigation to the risk of not being able to access “old” data is being dealt with through negotiating with ISoft to allow “view access only” to both PAS and PiMS for one year after switch off.
Intersystem capacity to deliver the programme across five Boards / Intersystems team is on site and working well with NHSG PMS team. Work is ongoing to ensure appropriate skill mix available at the appropriate time and meet key programme milestones.
There is a potential emerging risk around Intersystems technical capacity that may require to be escalated depending upon resources deployed to NHSG.
Managing expectations and ensuring core system and modules are implemented prior to the development of an EPR (Electronic Patient Record) / PMS Sponsoring Group has agreed an approach to each “go live”.-
The introduction of PMS is the first stage of a long development process to:
- Redesign business processes to fully exploit PMS functionality
- Replace a paper based records system with an electronic one
- Review “legacy” information systems and replace their functionality with PMS
- Exploit IT technology advances e.g. wireless network and mobile devices
Capacity of Sectors to release staff for training to use new PMS system / SBAR produced and recommendations accepted i.e.
A Training Plan has been produced and an e-Learning package developed. Work is ongoing to identify staff for training and establish individual training needs. Sector General Managers are in process of providing plans on how they will support the release of all staff that require training in advance of the Core go live date, including risks and their mitigating actions to ensure that all staff are competent in the use of the new system and that NHSG can continue to meet its national reporting requirements. (Please note that this will include 18RTT processes).
Data Quality issues may impact on our ability to migrate data and report. / SBAR produced and recommendations accepted i.e.:
Sector General Managers need to give assurance on the process in place to ensure data quality and that identified errors are timeously rectified and steps take to prevent recurrence.
In the interim the PMS Programme team will investigate funding further additional staff to correct errors / clean data in preparation for data migration to PMS
In addition data quality standards and PMS user operation standards should be built into staff performance monitoring and management
Need to agree reporting prioritisation between ISD and national reporting (e.g. RTT) and the need to continue to provide operational management reports to support the delivery of patient care. / SBAR being prepared to agree reporting prioritisation between operational reports, ISD and national reporting.
ISD have agreed to NHSG deferring further submission of our returns until the end of February 2011. We will complete the submission of existing SMR’s from PAS, but new episodes of care will be transferred as part of the data migration and submitted from PMS. This avoids the risk of trying to match part completed data from one system to another.
Conclusion
The Director of Special Projects as Accountable Officer for Risk ID 749 has provided assurance to both the Strategic Management Team and the Performance Governance Committee about the adequacy and effectiveness of the system for managing the risks. This paper provides Board members with information about the current key risks and how they are being managed. Board members will be given the opportunity to explore these with the Accountable Officer.
Recommendation
The Board is asked to seek assurance on the management of Risk ID 749.
Ewan Robertson
Director of Special Projects
November 2010
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Appendix 1
Risk ID and Title: ID 749 New PAS system and ways of working are not successfully implemented
ID / Initial Assess / Strategic Objective at risk / Description / Context and/or Impact / Category / Risk level / Controls / Gaps in controls / Action / Latest Assess / Notepad749 / 24-Aug-2009 / Exploit opportunities arising from single system working / The current PAS system is to be replaced by March 2011 by a new PMS. There is a comprehensive project management approach in place to support this implementation. / Significant disruption to services; Delays/ lost data; Existing system unable to continue as back up; Performance negatively impacted; Reputation damaged / Information / HIGH / a) Local Project Governance arrangements in place
b) National Controls through the PMS Consortium Planning Group
c) Monitoring by Board PMS Sponsoring Group
d) Board Committee briefings - PGC and eHealth Committee
e) Signed call off contract with Intersystems
f) PMS risk register
g) Joint Project Initiation Document (PID) in place with Intersystems with agreed milestones & outcomes / 1) ISOFT support for current PAS runs out in April 2011 (including PIMS)
2) Current PAS system does not meet the 18 week Referral To Treatment (RTT)
3) Service staff capacity to be released for training and system configuration (clinic templates)
4) Data quality issues may impact on our ability to migrate data and report
5) Reporting prioritisation for local and national requirements during transition to new PMS / 1) ISOFT extension for PIMS Mental Health being negotiated beyond March 2011
2) RTT contingency plans in place until PMS go live
3) Sector GM's to provide plans on how they will support staff for release on training
4) Sector GM's to give assurance on the process in place to ensure data quality and errors rectified to prevent recurrence, in liaison with BCWD team.
5) SBAR being prepared to agree reporting prioritisation between operational reports, ISD and national reporting / 10-Nov-2010 / 22/09/2010 reviewed by SMT. ? For further discussion re risk level. PMS project has own risk register.
21.12.09 Moved to Strategic CRCP as per November 2009 workshop.
Data extracted from Datix 10th November 2010
Situation
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