1. Directory of Services Data Collection Workshop R1 and R2 Presented by Sue Wales / Claire Dalton April 2005

2.  Overview of Choose and Book  New functionality provided in Release 2  DoS – what it is – what to collect  Break  DoS – Gaining agreement Agenda

3.  This workshop describes DoS data collection in the order in which it appears on the R2 DOS template – this is not necessarily the order in which you may complete the activities  This workshop does not cover Service Selection Booking Guidance  Everything we discuss today is documented in the ‘Describing Services Available in Choose and Book (v2)’ document, found at: http://nww.chooseandbook.nhs.uk/implementation/directory.asp Please note …..

4. Key Policies Patient Choice:  Choice of where – by Dec 2005, patients should be offered a choice of 4-5 providers when referred for elective care  Choice of when  Choice of who Booking:  Opportunity to have booking made within 24 hours of decision to refer

5. Overview (1)  Target for end June 2005 relates to first consultant outpatient booking from referrer to provider  Release 2 functionality supports:  All referrer to provider bookings  Named clinician referrals and bookings  Clinician-specific views  Indirectly bookable services (IBS)  Clinical Assessment Services (CAS)

6. CaB is a booking tool, not a clinical tool Choose and Book PASGP System Overview (2)

7. The Directory of Services (DoS)

8. DoS: What is it?  The DoS holds information describing the services / clinics that organisations provide, to enable referrers to refer and book their patients  Well defined services allow referrers to be confident that they are referring or booking into the right service  Well defined services allow hospital clinicians to be confident that they will receive appropriate referrals

9. Three key elements to the DoS  Service Defining: where you describe services / clinics – includes Service Specific Booking Guidance (SSBG)  Service Selection Booking Guidance: question and answer style decision trees which direct referrers from a specialty to clinic type and priority  Commissioning Rules: information about the contract between PCT and provider

10. Service Definitions  Are loaded by a provider DoSser – referred to as a ‘Service Definer’  They describe a service in a way that helps a referrer to decide whether it is appropriate for their patient

11. Clinic Type:

13. Service Selection Booking Guidance  Loaded by a PCT DoSser  Helps the referrer to identify the most appropriate clinic type and priority, once they have selected the specialty  Not required to meet the deadline in June 2005 - there will be national guidance produced in July 2005

15. Commissioning Rules  Loaded by a PCT DoSser  For each service their PCT wishes to commission  Referrers can only refer into services that have been commissioned by their PCT – they can however browse the DoS to see all services should they wish

16. Commissioned service can be viewed by referrers within the PCT when searching for available services

17. Defining services

18.  Collect data about each service using the R2 DoS template (or one of your own)  Obtain ‘sign-off’ to each template from provider and commissioning leads  Enter data from each template into Choose and Book DOS, keeping paper or electronic copies with version numbers as a record  Publish the service in the DoS, and once that service is then commissioned by a PCT, it is then available to all referrers within that PCT The overall process…..

19. Recording data for each service Directory of Services Data Collection Template v2 24/03/2005 Can be downloaded from: http://nww.chooseandbook.nhs.uk/implementation/directory.asp

20. Sections in DOS Template  Service details  Clinic types  Contact information  Service personnel  Service specific booking guidance  Instructions  Slot management  Referral letter details  Service definition sign off  Permitted values

21. Service Details (1)  Service ID: automatically populated by the system Needs to be put against clinic in PAS  Service name: Each service name has to be unique across the country! The national naming convention is: Service name-Department name-Organisation name-NACS code e.g. Leg Ulcer-Vascular Dept-Mayday NHS Trust-RJ6  The field can hold 100 characters but a maximum of 70 is advised (to prevent it from scrolling off the screen at referral)  No need to indicate service location or whether it is directly bookable or IBS, as this is indicated elsewhere on bookings screens  Ref: Service Naming Convention for the CaB Directory of Services 11/03/05 on the Choose and Book website

22. Organisation and location codes  Every health organisation, including the independent sector, should have NACS codes set up, e.g. Royal Free Hospital = RAL, Barnet PCT = 5A9  Locations (i.e. site codes) associated with Trusts have 5 digits e.g. RAL22  Finchley Memorial Hospital is a location for two acute Trusts (codes are not visible on CAB)  For services provided by Barnet & Chase Farm Hospital, Finchley is RVL02 in the NACS  For services provided by Royal Free Hospital, Finchley is RAL22 in the NACS  NACS codes can be found at: http://nww.nhsia.nhs.uk/nacs/pages/access_database.asp  Your NACS lead is listed in this spreadsheet – they can request additions / amendments: http://nww.nhsia.nhs.uk/nacs/pages/downloads/OC1.xls

23. Service Details (2)  Service comments: a free text description of the service you are defining. NB: this is a note for the service definer only, and will not be displayed to the referrers. Can be used to record names of those who contributed to the content/clinic Ids from PAS  Service Location: name of the location/site where the service is taking place (from a picklist)

24. Service Details (3)  Specialty: pick list of specialties that has been set nationally  Appointment type: pick list of types of appointments  Service Provider Organisation Type: pick list of types of organisation (e.g. acute trust) N.B. Pick lists are shown in the set of permitted values (at back of template)

25. Service Details (4)  Professional Type: pick list of what type of care professionals are in or leading the clinic (e.g. consultant, allied health professional, etc…)  Advice Request Processing Available: is the service willing to accept and respond to requests for advice and guidance from referrers? Yes / No Potential business consequences of saying Yes or No: Yes: How much work will it create? Who is paying for the time? But may divert potential inappropriate referrals? No: Will this reduce the number of referrals?

26. Directly or Indirectly Bookable? Directly Bookable? Yes / No Directly Bookable Service  A service in an organisation that has a CaB compliant PAS  A service that the referrer can directly book the patient in to Indirectly Bookable Service (IBS)  A service in an organisation that does not have a CaB compliant PAS  A service for which the referrer can do the referral or appointment request but cannot do the booking using CaB. The booking has to be made later, through a Booking Management Service

27. Referrer PASChoose & Book ReferrerPAS Booking Manager Directly Bookable Indirectly Bookable CaB and PAS links

28. Indirectly Bookable Services (IBS) IBS is used by organisations that do NOT have a CAB compliant PAS Steps when patient chooses service that is IBS: 1. Appointment request is made and printout provided with telephone number for patient to call to complete booking 2. Patient calls the number to complete a booking 3. A Booking Manager books appointment on the local PAS 4. A Booking Manager records appointment details in CaB

29. What the referrer sees …. (1)

30. What the referrer sees …. (2)

31. Service Details (6)  Service effective date range start: From which date is the service operational? If it is already running, put in today's date. The service will not be available for booking in to until after the date you enter. For directly bookable services, the first slot harvest will only occur after this start date  Service effective date range end: Is there an end date for this service? CaB will no longer harvest slots from your PAS if it is directly bookable or display it to the referrer. If this field is left blank, CaB will assume this service is ongoing.

32. Publish  The Publish box comes next in the DOS loading screens  You should only click in Publish when the service definitions have been agreed and ‘signed off’ and you are ready for referrers to see it N.B. If you are not yet ready to publish the service, then you can save the information entered in the DoS, and then publish it later.

33. Clinic Types  Clinic types are set nationally  Particular clinic types have been mapped to each specialty  You may select many clinic types per service  This affects a referrer’s search for a service  The current National Clinic Type List for Choose and Book is version 5 [16/03/05].  Version 6 will be available Mid-May 2005 (The list will then be ‘frozen’ until end Oct) http://nww.chooseandbook.nhs.uk/implementation/directory.asp

34. Contact Information  Service contact name: the name of the key contact person for this service. Referrers may use this to contact your service. NB: Suggest that a role and/or department is entered rather than a specific name of a person  Contact address: automatically populated from the organisation code  Booking telephone number: mandatory for IBS. Is printed out on the patients referral summary for the patient to call to complete their booking for an IBS  Hours of operation: mandatory for IBS. What hours can the patient call the number to make a booking?  Contact telephone number: a contact telephone number for the service in general for the referrer to contact  Fax number: fax number of the service department  E-mail address: of the department  Text telephone: of the department

35. What the referrer sees….

36. Service Personnel  Staff Mix: pick list for male, female, mixed; of the staff in the service  Named for Referrals / Named Clinicians: This means are they a ‘named clinician’ for the referrer to use to search for services so a referrer may search for services provided by a named clinician. You may have none or several named clinicians per service. Slots will need to be allocated within PAS. NB: Named clinicians need to be in a workgroup, so need to be registered  Allocated Clinicians: names of all clinicians who provide service - may have none or many allocated clinicians. Being allocated, allows the clinician to view his own worklists NB: Allocated clinicians need to be in a workgroup, so need to be registered

37. Workgroups (1)  A Workgroup is a group of staff who need access to information in this service (e.g. admin staff and the clinical staff for that service)  Workgroups determine which groups of patients the staff can see  The staff role in CaB and Smartcard registration determines how much information an individual can access for that group of patients (e.g. clinical info or just admin info)  Required to be set up in all provider organisations be they primary or secondary care (directly and indirectly bookable services) Ref: Choose and Book P1R1 Workgroup Implementation Guidance v1.1 27/07/04 http://nww.chooseandbook.nhs.uk/implementation/directory.asp

38. Workgroups (2)  When you populate the DoS you need to identify the names of those members of staff who need to have access to CaB  But you do NOT have to enter individuals in the DoS, instead you select one or more workgroups against each service  Therefore you need to set up workgroups first  All staff in a workgroup must be Smartcard registered NB: Workgroups will eventually be supported by SDS, but not until P1R2 or later – the process described on the next few slides should be used until June 2005

39. Building workgroups (1) 1.For each service, list by name all members of staff who need access to CaB and identify them as clinical, support, etc… 2.Make sure all identified members are registered with Smartcards 3.Record the User ID (UID) numbers from each Smartcard – you will need these when you set up each workgroup 4.When all staff are identified, split them into groups which can be used to set up workgroups for one or several services E.g. ‘Outpatient admin’ could be set up as one large workgroup to be allocated against every outpatient service. For clinical staff, ‘General Surgery clinicians’ may be a natural grouping - their workgroup can be selected for general surgery services only 5.You should now have several groupings of staff with names and UID numbers N.B. Any staff member may be in one or many different workgroups

40. Building workgroups (2) 6.Name each workgroup – this must be unique with a maximum of 40 characters. Recommended convention to ensure uniqueness is: organisation code–clinic type/specialty/department/location–types of staff E.g. RKE-Whittington Vascular-Clinical / RKE-Whittington Outpatients-Admin 7.Record your workgroup on the Choose and Book Workgroup Request Form and get this approved 8.Call the NPfIT Service Helpdesk and ask them to set up a new workgroup for you on 08453 665665 9.The helpdesk then passes the request on to Atos to load as a workgroup: this has a 3-day turnaround

41. Building workgroups (3)  Staff need to be authorised to set up and manage workgroups  Authorisation for this role needs to be provided by the relevant contact  North East – susan.hughes@npfit.nhs.uk  North West and West Midlands – rob.scott@npfit.nhs.uk  Southern – peter.cambouropoulos@npfit.nhs.uk  Eastern – david.adams@npfit.nhs.uk  London – luke.davie@npfit.nhs.uk

42. Service Specific Booking Guidance SSBG helps referrers to select the right service from choices returned by CAB  Conditions treated  Procedures performed  Exclusions  Required Investigations  Administrative Requirements  Service notes  Alternative services  Booking details

43. Clinic Type:

44. Conditions Treated  What conditions does your service see or treat?  It may also help to identify exclusions (clearly marked) in this box just in case referrers do not open the exclusions box  Describe in free text form with a maximum of 2000 characters (including spaces)  Can insert web link (website addresses) to take the referrer or patient to a useful website for more information

45. Procedures Performed  What procedures does your service carry out at this first appointment? In the clinic? Or in that service from that clinic? E.g. ‘At the clinic appointment we perform urinalysis and blood glucose tests. Depending upon the outcome of the initial appointment, the service then performs TURP and TURBT procedures’  Describe in free text form up to a maximum of 2000 characters (including spaces)  It is possible to insert a web link to take the referrer or patient to more information E.g. Trust website, condition specific websites e.g. Diabetes UK

46. Keywords  Keywords can be are for conditions treated and procedures performed  20 boxes with a maximum of 255 characters in each – it is easier to manage if similar conditions/symptoms are grouped within a single box  Separate each keyword with a comma  These will be used by a referrer to find appropriate services, so think about what a referrer might use to search for your type of service  Do not record negatives (e.g. not hypertension) as the service will be listed if the referrer types in hypertension  Include both versions of frequently misspelled words E.g. haematology, hematology

47. Exclusions  What conditions does your service NOT see or treat in this service?  Describe in free text form with a maximum of 2000 characters  Can insert weblink (website addresses) to take the referrer or patient to a useful website for more information

48. Required Investigations  What investigations does your service want the referrer to initiate prior to the appointment ? (e.g. certain blood tests or x-rays)  NB: there is no guarantee that the referrer will comply, but you have the opportunity to ask for it  Describe in free text form with a maximum of 2000 characters

49. Administrative requirements  What particular administrative tasks does your service want the referrer to do prior to sending the patient? (e.g. ensure the referral letter includes a copy of the past month’s diabetes blood glucose monitoring for the patient)  NB: there is no guarantee that the referrer will do it, but you have the opportunity to ask for it  Describe in free text form with a maximum of 2000 characters

50. Service notes  The ‘any other business’ section of the DoS, where you can enter any other messages or items of information of use to the referrer about your service  Web links can be used here  Describe in free text form with a maximum of 2000 characters

51. Alternative services  Are there any alternative services that you would like a referrer to consider before referring/booking the patient to your service? (e.g. to get the patient reviewed by a physiotherapist prior to referring them to an orthopaedic clinic)  Describe in free text form with a maximum of 2000 characters

52. Booking details  This field is only for Indirectly Bookable Services (IBS)  Will only be available to the DoS loader if you have selected ‘No’ to Directly Bookable in previous section  Free text field where you can describe more detailed information about how the patient should make their booking  This will be printed on the patient’s appointment request summary that is printed off by the referrer (for patients who have been referred to an IBS)

53. Instructions These are instructions to the patient that will be printed on the Appointment Booking Summary that is printed off for the patient by the referrer (for patients where the booking is made) E. g. for an ophthalmology clinic you could instruct the patient to make sure they do not drive, as the eye test that will take place in the clinic will affect their eyes so they cannot drive for 2 hours.

54. Slot Management (1) Only applicable to those services which are Directly Bookable  Choose and Book ‘harvests’ slots nightly  Booked appointments confirmed with PAS in real-time  Cancellation on PAS confirmed or notified to Choose and Book in real-time  Cancellation on Choose and Book notified to PAS in real-time  One patient, one slot - no overbooking  Re-books must be performed on CaB, not PAS

55. Slot Management (2)  Polling range from current date: how many days ahead can CAB harvest slots from your PAS at the midnight harvest?  Polling Frequency: recommend daily  Provider System Organisation: the organisation where the PAS belongs  Provider System: the address of the PAS, taken from a pick list from the spine  The PAS must be end-point registered on the spine to appear on the pick list (there are different arrangements where the PAS is managed by another Trust)  See ‘End point Registration Requirements for Loading Services into the Choose and Book DOS’ at http://nww.chooseandbook.nhs.uk/implementation/directory.asp

56. Referral Letter Details (1)  Referral Required: Does your service require a referral letter, yes or no? (If you enter ‘No’, there will be no opportunity to reject the booking)  Lead time: For Directly Bookable: is the number of days ahead of the appointment that the Service being referred to requires the Referral Letter to be sent by the referrer. If a referring clinician has not submitted a Referral Letter by this time, they will be flagged in CAB in the practice as being overdue with the letter For IBS: this is preset at 7 days from the referral day  Freeze time (not applicable for IBS): is the amount of time ahead of the Appointment after which no further changes to the referral letter will be permitted. Think about how many days your clinics/services need to process referrals and print letters off when preparing a clinic

57. Referral Letter Details (2)  Exclude Saturday or Sunday: Yes / No, for whether you want to count Saturdays and Sundays in the days for lead and freeze times  Utilise Referrals for Assessment Worklist: Yes / No, this is applicable to CAS / GPSI services and enables users to determine whether or not they see the Referrals for Assessment worklist?

58. Gaining agreement Content of Service Definitions will require agreement from both the Provider Organisation and commissioning PCT(s)

59. Steps to gaining agreement For each service to be put into the DoS…. 1.Provider organisation sets out their Service Definition using the template 2.Gain agreement of the way it is described by the provider clinical team lead for that service 3.Take that to each of your purchasing PCTs (commissioners) for them to agree NB: use the template 4.Make any changes until you get both sides to agree with the Service Definition content 5.Ask designated leads from commissioners and providers to sign the DOS template 6.Save the DOS template and keep version numbers

60. Any questions

61.  Describing Services Available in CaB v2.0 [24/03/05]  DOS Data Collection Template v2 [24/03/05]  National Clinic type List for Choose and Book v5.0 [16/03/05]  CaB P1R1 Workgroup Implementation Guidance v 1.1 [27/07/04]  End Point Registration Requirements for Loading Services into DoS  Service Naming Convention for the Choose and Book DOS v 0.6 [11/03/05]  DOS demo CD available to order from the CaB website [25/04/05] References on nww.chooseandbook.nhs.uk

62. For a response to specific questions about the Directory of Services, please e-mail Claire Dalton: Claire.Dalton@npfit.nhs.uk