Digital Primary Care (DPC): Strategy & Overview & GPIT, Digital Maturity and Assurance Programme Update Sue Cooke, Senior Programme Manager for GPIT Programme Digital Primary Care, NHS England

To share progress to date for the Digital Primary Care (DPC) strategy and associated programmes (e.g. Digital Maturity, GPIT and GPSoC)

Primary Care is changing radically (“Out of Hospital” Care Models) Current GP IT enablers (GPSOC & GP IT Op Model) may not be fit for future purpose Interoperability is a key enabler and is not being delivered The digitally enabled patient (e.g. Patient Online & PHR) will have significant impact on GP IT

A 12 month programme to ensure that NHS England has a clear vision and strategy for digital primary care which supports: Contemporary national & local strategic drivers Service driven organisational changes The digital consumerisation trend in healthcare Fulfilled by: Fit for purpose, effective, high value enablers (e.g. GPSOC, GPIT, Op, transformation incentives) A vibrant supplier marketplace supporting innovation, choice and agile service models An assurance and digital maturity framework

RefDeliverable D1GPSOC business case & strategic fit review D2Publish GP IT operating model strategic fit review D3Interim/bridging interoperability model D4Market development strategy D55-10 year vision for Digital Primary Care D65 year strategy for Digital Primary Care D73 year integrated roadmap for Digital Primary Care and linked programmes

GPSoC Business Case & Strategic Review Interoperability Solution GP IT Operating Model Strategic Fit Review Marketplace Development Drivers: NIB Framework Deliverables: D1 Work Packages: WP1.1, WP3 Resources: NHSE, HSCIC Commissions: N/A Drivers: NIB Framework Deliverables: D3 Work Packages: WP5.1, WP5.2 Resources: NHSE, HSCIC, Endeavour Commissions: HSCIC Led Drivers: NIB Framework Deliverables: D2 Work Packages: WP1.1, WP4 Resources: NHSE Commissions: N/A Drivers: NIB Framework Deliverables: D4 Work Packages: WP2.1 Resources: NHSE Commissions: Yes (TBC) Enablers Visioning Primary Care Landscaping Digitally Enabled Patient Impact Drivers: NHS 5yr Forward View Deliverables: D5 Work Packages: WP6.1, WP6.2, WP7.1 Resources: NHSE, Stakeholders, External Commissions: Health Foundation (TBC) Drivers: NIB Framework Deliverables: D5 Work Packages: WP6.3, WP7.1 Resources: External Commissions: Yes (TBC) Strategy & Roadmap Digital Primary Care Drivers: NIB Framework Deliverables: D6, D7 Work Packages: WP1.2, WP7.2, WP7.3 Resources: NHSE + New Commission Commissions: Health Foundation (TBC)

Digital Primary Care Transitional ProgrammesSMS Sue Cooke Microsoft Licensing Jo Gander Informatics capability developmentSue Cooke, GPIT Programme Lead Levers & Incentives LeadJo Gander, Senior Systems Commissioning Manager, DPC Assurance ModelDoug Scott, DPC Strategy Lead Finance Sue Cooke, GPIT Programme Lead Stakeholder Engagement GPIT Programme Work Streams Digital Primary care (DPC) Cross Programme Stakeholder Group GPSoC – GPIT – PMCF – Digital Maturity – Primary Care Commissioning GPIT Steering Group Chair, Jo Gander Primary Care Delivery Oversight GroupDigital Technology SMT Digital Primary Care (DPC) Strategy Board Formal Process Informal Process Work Stream Governance GPIT Governance

Digital Maturity: Programme Update

Design AssessValidate Report Display

Capabilities for Joined Up Care Giving Health & Care Professionals the Capability… Illustrative Examples Outcomes/ Benefits 1. Care Records & Plans To capture information for subsequent use by others, and to use information captured by others, supporting better clinical decisions at the point-of-care Accessing details of diagnoses Accessing demographics/contact details Developing a single multi-agency care plan Accessing detailed patient history Patient safety Quality of care Continuity of care Care co-ordination 2. Decision Support To react more appropriately and promptly to events happening across the system through automated rules-based analysis, prompts and alerts Being alerted to: Deteriorating patients An end-of-life plan Hospital admissions A discharge-ready patient 3. Care Transfers, Orders & Communications To assess, make referrals, process transfers, record discharges, summarise care episodes and place orders to/with other professionals Making a referral to another service Ordering radiology services Discharging a patient from a service Summarising an A&E episode 4. Remote CareTo monitor, diagnose, counsel or advise patients remotely and access expert advice at the point of care Tele-monitoring Tele-consultation Tele-coaching

GP IT: Programme Update

To set the direction of travel for the future of ‘Securing Excellence in GP IT services’ To reflect the ambitions of the NIB, 5 Year Forward View and NHS Business Plan To update to reflect recent organisational changes To provide a framework to embed best practice To update accountability and commissioning responsibilities To define expected minimum and additional service standards and assurance processes moving forward for GP IT To develop an Assurance progress for delivery of GP IT Operating model while providing the necessary guidance and intelligence to facilitate implementation

Add-on Service Provision GP IT provision at CCG discretion to support local strategic initiatives and commissioning strategies to improve service delivery Core Service Provision GP IT standard support services as set out in Securing Excellence in GP IT Services operating model General Practice Business Support Systems Funded by the general practice to support corporate business delivery functions

GP IT Enhanced Service (Effectiveness) GP IT Core (Efficiency) Integrated Services (Transformational) GP Business Systems (Licence to Operate) GP IT Core Service & Funding Meet minimum technical specification defined in the GP IT Operating model Meet GP IT core Digital Maturitys description Are not funded from elsewhere already GP IT Enhanced Service & Funding Meet enhanced technical specification defined in the GP IT Operating model Meet GP IT enhanced Digital Maturity description Demonstrate improvements for Patient facing services and/or business efficiency outcomes Can provide assurance to demonstrate agreed improvements in outcomes Integrated Service Model Exceeds Core and enhanced technical specifications defined within the GP IT Operating model and is integrated and wider than primary care Qualify to apply for Transformation funding The submission for funding meets the agreed criteria to demonstrate improved patient experience and digital maturity Not funded from elsewhere already

Key Activities: 1.4 Core Focus Groups established April ‘15 with small group of SMEs identified by Regional Heads to support early discussions around approach looking at; a.Finance b.Digital Maturity c.Technical Service Specification 2.GP IT Delivery Team linked in with GPSoC, Digital Maturity, Primary Care and NIB teams to further inform early development 3.GP IT high level plan developed and specific work streams defined as well as deliverables 4.Small stakeholder events to be held in each region (agreed locally) for initial feedback early June to further inform work to date 5.Larger stakeholder events to be held in each region (agreed locally) end of June/early July to further inform work to date and next stage of development 6.Draft GP IT Operating model document available late July/early August for review (Plan to publish Sept ‘15) 7.Work streams to support next stage of delivery initiated July ‘15 around Service Specification, Assurance model and KPI development 8.Work stream deliverables complete Nov ‘15 and draft documents available for review and approval process to begin 9.GP IT Service specification, Assurance model and KPIs ready to go live April ‘16

As we develop and refine the Digital Primary Care strategy we will further enhance the primary care digital maturity trajectory (both extending it and enriching it) EfficiencyEffectivenessTransformation Core GP ITEnhanced GP ITIntegrated GP ITPatient Activation Care records & plans Patient administration Appointment management reporting Morbidity registers Decision support Care transfers Order comms Results reporting e-Referrals e-Discharge Summaries Integrated working with other care settings and multidisciplinary teams General practice(s) at scale Supporting 7 day week & extended hours working Enhanced access models Primary care services supported at any point (location) of care delivery Patient direct access to electronic records and health services Patient contribution to their record, care planning electronically Maturity

Assurance Business as UsualTransformational Poor VFMHigh Risk EfficiencyEffectivenessTransformation Core GP ITEnhanced GP ITIntegrated GP ITPatient Activation Maturity

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