1 A consistent approach to personalised care Designing for care Dr Paul Whatling Senior Clinical Consultant

2 A consistent approach to personalised care there were 325 million consultations with GPs or nurses in primary care In : 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 A consistent approach to personalised care Sept 1998 Jan 2001 June 2002

4 A consistent approach to personalised care Eastern Cluster Accenture North East Cluster Accenture Southern Cluster The Fujitsu Alliance North West & West Midlands Cluster The CSC Alliance London Cluster Capital Care Alliance, led by BT National Application Service Providers Infrastructure Service Provider Choose and Book Service Atos Origin (formerly Schlumberger Sema) NHS Care Records Service BT Local Service Providers N3, the National Network BT Service Providers

5 A consistent approach to personalised care  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 Three facts

6 A consistent approach to personalised care Implementation Schedule of delivery Challenge current practice Raise aspirations NPfIT Aims & Objectives Create Dissatisfaction User driven Commitment Generate Satisfaction Communication

7 A consistent approach to personalised care 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 A consistent approach to personalised care 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 A consistent approach to personalised care CRDB - Structural Overview Board Executive Team Stakeholder Network Cyril Chantler Jo Wiliams Board Member Talib Yaseen Harry Cayton 12 Board Members Director Executive Team Members Action Team Action Team Action Team Action Team Action Team John Bacon National Programme Board

10 A consistent approach to personalised care 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 A consistent approach to personalised care Design for care  “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

12 A consistent approach to personalised care Defining Action Teams CRDB Prioritisation Action Team Defined NPfIT deliverables New Requirements National Priorities

13 A consistent approach to personalised care Action Team Uses Network Action Team Suppliers Design Authority Information Standards NPSA NICE Healthcare Commission Front line staff Royal Colleges Patients Information Centre

14 A consistent approach to personalised care NPfIT Deliverables – Bundle 6 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

15 A consistent approach to personalised care NPfIT deliverables – the scale  3000 line items – LSP contracts  1600 Clinical input required!

16 A consistent approach to personalised care NPfIT deliverables  Symphysis-fundus height –

17 A consistent approach to personalised care

18 A consistent approach to personalised care Action Team Outputs Type 1 Type 2 Type 3 DH and other policy teams Technical design teams Service delivery and improvement Vision or policy document Common Specification Care pathway map

19 A consistent approach to personalised care

20 A consistent approach to personalised care Example of local process

21 A consistent approach to personalised care 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