UCC Dashboard BC 20110615 v1.0 QIPP UCC Dashboard Date: 15th June 2011
BUSINESS CASE
Name
/ QIPP Urgent Care Clinical (UCC) DashboardRelease
/ DraftDate: 15th June 2011
PRINCE2
Author: / Project Manager – QIPP Urgent Care Clinical DashboardOwner: / Operations Manager – Central London Healthcare Pathfinder GP Consortium
Client: / Central London Healthcare Pathfinder GP Consortium
Document Number: / UCC Dashboard BC 20110517 v0.1
Pathway for Business Case
Complete Y, N or N/A in Boxes / DateInitiation Stage
1) Statement of case discussed and endorsed by INWL Assistant Borough Director / Y / 18/03/2011
2) Executive Director Sponsorship Gained / Y / 18/03/2011
Delivery Stage
3) Business case and financial appendices completed?
a) Application made to INWL for funding / / /20
b) Project Commencement / 10/05/2011
c) Dashboard delivered / / /20
Review Stage
4) Endorsed by Operations Board / / /20
Closure
5) Project recommendations report received / / /20
6) Project closure approved
Document History
Document Location
/ This document is only valid on the day it was printed.The source of the document will be found in the File: \\wpct.local\Shared\Harewood Row\CLH\QIPP UCC Dashboard\Background documents\UCC Dashboard BC 20110517 v0.1.doc.
Revision History
/ Date of next revision:Following UCC Dashboard Project team meeting on .
Revision date / Previous revision date / Summary of Changes / Changes marked
15 June 2011 / 19 May 2011 / Finalisation of costs for application to NHS INWL / Using ‘track changes’
Approvals
/ This document requires the following approvals.Signed approval forms are filed in the UCC Dashboard files at Central London Healthcare Pathfinder GP Consortium
Name / Signature / Title / Date of Issue / Version
Rosalyn King / ProjectSponsor
Chair – NHS INWL Board
UCC Dashboard Project team
Name / RoleRosalyn King / ProjectSponsor
Ian Allsup / Project Manager
Neville Purssell / Clinical lead
Ed Cox / Informatics lead
Sheron Madhushanka / GP training lead
Chris Carter / IT lead
Adam Duncan / LCW lead
Ayo Kaseem / Information Governance lead
Marina Tempia / CLCH lead
Iain Taylor / ICHT lead
Chris Pfeiffer / ICHT technical lead
Distribution
/ This document has been distributed to:Name / Reason / Date of Issue / Version
UCC Dashboard Project team / To agree and initiate the business case and project plan
NHS INWL Board / To approve business case and authorise costs
Simon Hope / Assistant Borough Director
Background
The ‘Pioneer Stage’ of the National UCC Dashboard commenced in January 2011. Central London Healthcare Pathfinder GP Consortium was confirmed as a ‘Pioneer site’ following a successful expression of interest to the Department of Health in January 2011. The aim is to develop and deploy an UCC Dashboard solution to GP practices by the end of July 2011.
The UCC Dashboard forms part of the National agenda for Quality, Innovation, Productivity and Prevention (QIPP) and aims to deliver a live view for practitioners to be aware in real time when patients have accessed urgent care services.
Purpose
The purpose of this business case is to:
· initiate and embed the QIPP UCC Dashboard to GP practices with data feeds from:
o Imperial College Hospitals NHS Trust, Accident and Emergency
o London Central and West Unscheduled Care Collaborative,
o NHS Inner West London – sub cluster of PCTs
o Central London Community Healthcare, Rapid Response Nurses
o Central London Healthcare Pathfinder GP Consortia
· sufficiently demonstrate active embedding of knowledge within each organisation
Contents
This business case contains the following topics:
Topic / See PageReasons / 3
Options / 4
Benefits expected / 5
Risks / 5
Cost / 6
Timescales / 6
Investment appraisal / 6
Appendix one – Data fields / 7
Appendix two – QOF indicators / 8
Reasons
The primary reason for the end product from this project is to enable GP practices within the consortia to more adequately meet the requirements of the National agenda for QIPP, specifically enabling better delivery against the non-elective element of the QIPP programme.
The UCC dashboard provides data in easy to analyse form, detailing where and when patients have attended urgent care facilities.
Scope
Data flow matrix;
Service / System / Current Flow / Future FlowA&E / Symphony / SUS / Data feed to iCAPS
Urgent Care Centre / Adastra / SUS and Spreadsheet feed / Data feed to iCAPS
Rapid Response Nurses / RiO / SUS from NHS Westminster / Data feed to iCAPS
Data fields for extraction from these systems for upload to the UCC Dashboard are noted in appendix one.
Using the Interoperability work has enabled the definition of the work required to enable the current user defined access controlled data warehouse (iCAPS at NHS Westminster) accessed by commissioners, finance staff, PbC clusters, Practice Managers and GPs (currently 150 users) via a secure N3 connection to be updated to carry the required ‘live’ (updated daily) feed for the UCC Dashboard, together with the reports already available.
Resolution of coded data field conflicts to standardise data interpretation for the UCC Dashboard will be untaken prior to roll out of the UCC Dashboard.
Access controls in place for current users will be reviewed to ensure appropriate authorised access is maintained, to meet data protection requirements for confidentiality and information security.
This project will enable the UCC Dashboard to further enrich information in iCAPS, as data detailing the usage of services ‘out of hours’ via London Central and West Unscheduled Care Collaborative will now be included.
Improved patient pathway planning is a key deliverable (both in terms of patient care and economically), such that ‘live’ notification of attendance any of the centres noted in the project purpose will enable more immediate follow up, including information to, where appropriate, redirect patients to their GP or for their GP to redirect the patient to an appropriate alternative service.
This project will not within the initial rollout deliver access to the UCC Dashboard to any users who do not currently access the iCAPS data warehouse. Future access will be defined by the purpose and justification for the access, this will not enable external commissioned services to access the UCC dashboard, due to the potential to present unfair advantages to those providers in future negotiations for service delivery. The recommendation for external services providers is to create a local dashboard, based on the data feed being sent to the iCAPS data warehouse for the UCC Dashboard, to enable local benefits from a ‘live’ view of usage of their services.
Options
Option 1 – Do Nothing
Option 2 – Agree to fund the required costs to enable the changes to current software in use to provide the data as required to implement the Urgent Care Clinical Dashboard, as noted in the costs section below.
Benefits expected
These are listed in the Memorandum of Understanding for QIPP Urgent Care Clinical Dashboard Pioneer sites (available on request) and listed again here for ease of reference:
· Improvement in decision making to manage clinical care
· Facilitates immediate targeted decisions to improve patient care and avoids delays of data cleansing processes
· Improved quality of care as peers compare performance
· Reduced time and effort to capture and report information
· Increased staff satisfaction (and hence performance) as teams feel ownership of local level of quality care delivered
· Improved data quality as a result of information being displayed locally and feeding back into more accurate original capture – reinforcing 'capture once, use many times' behaviour.
· Provide real-time practice level unscheduled care activity to inform decision making around access in primary care, which will also enable practices to demonstrate compliance with the Quality and Outcomes Framework (QOF) indicators: QP9, QP10 and QP11 (appendix two).
Supported by
· Protecting patient data versus operating NHS business effectively
· Improved engagement with independent NHS business partners
· Policies & procedures for identifiable data
· Flows of identifiable data & repositories
· Organisational awareness & training of usage & IG
· Clear targeted consistent expert advice on information governance issues
· Monitoring and audit to validate information management
· Inventory, authorisation & registration of identifiable data users
Risks
The key risks to the success of the implementation the QIPP UCC Dashboard are listed in the Memorandum of Understanding for QIPP Urgent Care Clinical Dashboard Pioneer sites (available on request) and listed again here for ease of reference:
· Insufficient resource capacity to implement dashboard
· Conflicting priorities across clinical, IM&T, and IT teams hinder successful implementation
· Extracting the necessary data from source systems may prove complex and time consuming
Other more general risks are:
· Inability to meet the NHS Act 2006 Section 251 legal framework for use of patient data.
All of these risks are linked to National guidance for risk management based on:
· Mitigating risks through the use of NHS Act 2006 Section 251/regulations
· Caldicott Principles & existing IG regimes
· Good practice on security, de-identification, etc
· Managing identifiable data within ‘NHS family’ and Data Processors
§ Commissioners
§ NHS commissioned care providers
§ Data processors
· Secure environment requirements
§ Adhere to Caldicott Principles
§ New Safe Havens & access controls operational
§ Adhere to NHS Good Practice
Costs
Option 2:
All costs are currently set according to the view of the business partner responsible for the system concerned – subject to final confirmation, following consultation with the system providers on data set extraction changes and annual maintenance fee updates. The expectation is that the actual costs will be less than shown, with excess funds returned (subject to agreement).
Summary revenue impactDirect costs: Contractor Pay
Financial year 2011/12 / Initial 12 week contract / Additional 6 week contract (contingency) / Total costs for 2011/12 financial year
£000 / £000 / £000
Project Manager
Summary revenue impact
Financial year 2011/12
Exclusive of VAT / Data extract change requirements (non-recurring) / Annual additional maintenance (recurring) / Total costs for 2011/12 financial year
£000 / £000 / £000
Smartcard access (costs met outside project scope by NHS INWL)
iCAPS (costs met outside project scope by NHS INWL)
Symphony
Adastra (INWL)
Adastra (LCW)
RiO
Total
Overall total / £
Timescales
The expected discussion and approval of this business case is intended to enable a project implementation completion date of 29th July 2011. Any slippage to this date should not incur further costs, excepting project management (annotated separately in this business case), as the costs are for data extract updates and annual maintenance of information systems to support the Dashboard do not require contingency funding.
Investment appraisal
Acceptance of the recommended option will deliver the benefits and enable mitigations against the risks noted in this business case.
Review of the benefits and reassessment of the risks at regular intervals (recommended to be at 6 month intervals) following the project close and transfer to routine working practice, is expected to identify further benefits and enabling the risks to have sufficient actions/mitigations to reduce them to low from being moderate.
Appendix one
Data fields for inclusion in the Urgent Care Clinical Dashboard
Data field / Description of fieldNHS Number / NHS number of the patient
Name / Patient’s name
Postcode / Patient’s postcode
Date of Birth / Patient’s date of birth
Date of contact / Date the patient accessed the service
Location / Where the patient has presented (e.g. A&E, UCC, rapid response nurses, etc)
Admission type / Source of referral:
E.g.
00 GENERAL MEDICAL PRACTITIONER
01 Self referral
02 Local authority social services
04 Work
Diagnosis and Outcome read code / Patient diagnosis by Health Professional
Prescribed items / Drugs and treatments administered whilst accessing the service, inc drugs and treatments prescribed for the patient’s discharge
Date of discharge / Date patient is no longer the responsibility of the service
Discharge code / Describes how the attendance concluded
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UCC Dashboard BC 20110615 v1.0 QIPP UCC Dashboard Date: 15th June 2011
Appendix two
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