Designing for care

1. Designing for care Dr Paul Whatling Senior Clinical Consultant

2. In 2003-2004: there were 325 million consultations with GPs or nurses in primary care 13.3 million people attended a first outpatient appointment with a consultant nearly 13.9 million people attended A&E and there were 4.2 million emergency admissions over 5.4 million people were admitted to hospital for planned treatment over 649 million prescription items were dispensed in the community 6.4 million calls were made to NHS Direct 6.5 million hits to NHS Direct Online over 1.5 million patients visited walk-in centres Source: Chief Executive’s Report to the NHS, May 2004

3. Sept 1998 Jan 2001 June 2002

4. Service Providers National Application Service Providers Infrastructure Service Provider Choose and Book ServiceAtos Origin (formerly Schlumberger Sema) N3, the National NetworkBT NHS Care Records ServiceBT Local Service Providers North East Cluster Accenture North West & West Midlands Cluster The CSC Alliance Eastern Cluster Accenture Southern Cluster The Fujitsu Alliance London Cluster Capital Care Alliance, led by BT

5. Three facts • We have 6 years to deliver healthcare IT solutions • Those solutions must meet the needs of the service • We must ensure effective engagement of service users and providers

6. Scheduleof delivery Implementation NPfIT Aims &Objectives Communication Challengecurrent practice Commitment GenerateSatisfaction CreateDissatisfaction Raise aspirations User driven

7. User driven • Focus at the local level • National dissemination of local work • Enabling national strategy locally “Making the local national and the national local”

8. The work • Design of systems and processes • Ethical principles • Safety • Best practice • Standards • Support implementation • Change in ways of working • Inform education and training agenda

9. National Programme Board John Bacon Harry Cayton Board Talib Yaseen Cyril Chantler Jo Wiliams Board Member 12 Board Members Executive Team Director Executive Team Members Stakeholder Network Action Team Action Team Action Team Action Team Action Team CRDB - Structural Overview

10. CRDB - assurance process • Identify the values, principles and processes of care and ensure that these are taken into account in the implementation of systems for NHS and social care • Ensure that ethical issues are adequately addressed and that agreed ethical principles are consistently applied

11. “Action Teams” Nationally led core team Local groups’ work Clear objectives Short time-frame Stakeholder network Links existing networks Resource for expertise Communications Peer support Open to all Design for care

12. Defining Action Teams NPfITdeliverables CRDBPrioritisation NationalPriorities Action Team Defined NewRequirements

13. Action Team Uses Network NPSA HealthcareCommission Suppliers DesignAuthority NICE Action Team InformationCentre Front linestaff InformationStandards RoyalColleges Patients

14. View, construct and modify care plans and pathways within care settings Integration of care plans and pathways within the common patient record across all care settings. Integrated care pathways including advanced decision support across all care settings, process monitoring alerts and branching. Phase1 Phase 2 Phase 3 NPfIT Deliverables – Bundle 6

15. NPfIT deliverables – the scale • 3000line items – LSP contracts • 1600Clinical input required!

16. NPfIT deliverables • Symphysis-fundus height – 118.2.5

18. Action Team Outputs Type 1 Visionor policydocument DH and otherpolicy teams CommonSpecification Type 2 Technicaldesign teams Type 3 Carepathway map Service deliveryand improvement

20. Example of local process

21. Our goals • To develop a system for moving and sharing health information that is: • Patient focused • Improves patient outcomes • Improves choice and control for patients • Helps clinicians to make better decisions • Reduces errors • Is practicable/usable/effective