1. Driving Value – the NIMM, the EA, the CUI, CASE & the TR
Dr Mark Ferrar, NHS Connecting for Health
26-FEB-2008

2. NHS Infrastructure Maturity Model (the NIMM)
And in the next 40 mins...
NHS Infrastructure Maturity Model (the NIMM)
Microsoft Enterprise Agreement (the EA)
Common User Interface Programme (the CUI)

3. The NHS Infrastructure Maturity Model
(the NIMM) 3

4. We Can Only Influence Change4

5. 1.34m 5th 850k 70% 1.54bn 6 10k NHS infrastructure numbers game
People working for the NHS in England
5th
5th Larger Employer in the World
850k
70%
% of IT Budgets Spent on Infrastructure & Operations
IT Users in the NHS
Annual NHS Spend on Infrastructure & Operations (Excluding NPfIT!)
1.54bn
Average Number of IT Identities a Typical Knowledge Worker has 6
10k
NHS People Working on Infrastructure & Operations 5

6. “Patchy” IT infrastructure maturity and performance
We need to raise the bar...
“Patchy” IT infrastructure maturity and performance
2005 “Infrastructure Themes” still valid today (in fact there’s evidence best/worst gap is widening)
NHS not getting to lowest (or even competitive) TCO
A consistent, well-managed desktop is key to supporting Local NPfIT programmes (NLOP)
Overall value eroded by premature use of high value technology

7. Infrastructure Challenges...
Expensive - according to analysts, 70% of typical IT spend goes on IT Infrastructure! (run the organisation) – (70% of £2.2bn = £1.54bn)
NHS IM&T Managers should not just rely on gut feel when setting investment priorities
Inconsistent terminology makes it difficult to benchmark (TCO)
Organisational changes in the NHS means that many IT infrastructures are in silos and not optimally managed
Some suppliers don’t create infrastructure solutions that NHS Trusts request, actually need or are ready for
Many NHS Trusts need help to build coordinated infrastructure improvement plans
Some key tasks often get overlooked because their impact on infrastructure is not obvious

8. Infrastructure Challenges
Expensive - according to analysts, 70% of typical IT spend goes on IT Infrastructure! (run the organisation)
NHS IM&T Managers should not just rely on gut feel when setting investment priorities
Inconsistent terminology makes it difficult to benchmark
Organisational changes in the NHS means that many IT infrastructures are in silos and badly managed
Some suppliers don’t create infrastructure solutions that NHS Trusts request, actually need or are ready for
Many NHS Trusts need help to build coordinated infrastructure improvement plans
Some key tasks often get overlooked because their impact on infrastructure is not obvious 8

9. The NIMM can help...
NHS Infrastructure Maturity Model provides guidance and helps trusts objectively benchmark for themselves their “as-is” infrastructure capabilities, then:
Use it to build a plan for coordinated capability improvement in a systematic way
Use it to set investment priorities and create a benefits plan to understand desired outcomes
Use it to collaborate with NHS suppliers so they create infrastructure solutions that NHS needs (and is ready for)

10. CASE CUI NIMM Common Themes – Integrated Projects Responsiveness
Re-use
Agility
Innovation
Manage Risk
Competency
ROI/Business Value
Efficiency
Consistency
Standards 10

11. Delivered online via PSPG (infrastructure best practice site)
Maturity Model Delivery Approach
Iterative & collaborative approach will regularly release new and updated features based upon feedback and requests from users
Develop the NIMM body of knowledge first then create tools to help users automate assessments and provide a management scorecard
Delivered online via PSPG (infrastructure best practice site)
Capability Maturity Documents developed for specific infrastructure capabilities
Virtual group of NIMM Champions from the NHS and key suppliers will feed into a feature wish list of maturity guidance that needs to be developed
ROI modeling tool being developed to help NHS Trusts create their own business case for improving maturity 11

12. We only have a limited number of Enterprise CAL Licenses (eCAL)
NIMM & Microsoft EA
We only have a limited number of Enterprise CAL Licenses (eCAL)
This will ramp up every year for the next 3 years
Enterprise Collaboration Technology needs eCAL
Not straightforward, check with you LAR
We want to get the most value from these licensees
We need to report our licensing position against eCAL
There are 2 capabilities that we want to use to gauge readiness
Software Asset Management
Collaboration Technology
We have developed Capability Maturity Documents for these that
Describe what we mean by these capabilities
Describe each Maturity Level including KPIs for each level
Recommend a level to aim for
Suggest resources to help achieve this 12

13. NIMM Example - SAM Maturity KPIs (Level 4)
KPI Description
Metric
Availability of electronic records on software purchased or no longer used
Asset Management system used
Records for >80% of software purchases
Policy for software purchase exists and enforceable
Policy exists and enforceable for >80% of purchases
Accountability for maintaining records
Formal central IT accountability exists, performance of this role measured every six months
On-going - Technology and process in place to track software installed
Coverage
Accuracy
Greater than 80% of PC estate
Greater than 80%
Ad-hoc - Technology and process to perform audit of software licensing position

14. Capability Description
NIMM Example - Gap Analysis for SAM
Capability Description
Target Maturity
Current Maturity
Needs Gap
Availability of electronic records on software purchased or no longer used
Records for >80% of software purchases
Records for approximately 50% of purchases exist. Absence of an asset management system makes it difficult to track this capability.
Need to deploy an asset management system.
Need to improve record keeping by 30%
Policy for software purchase exists and enforceable
Policy exists and enforceable for >80% of purchases
A policy exists but is not regularly communicated.
Need to create communications channels for IT policies.
Need to incorporate IT policies in HR, and training processes.
Accountability for maintaining records
Formal central IT accountability exists, performance of this role measured every six months
Accountability for this is informal and shared between purchasing and the service desk
Accountability is informal and responsibility is unclear.
Technology in place to track software installed
>80% Accuracy
Unknown Accuracy
Need technology with processes that can measure accuracy in tracking deployed licenses
>80% of PC estate covered
<50% of PC estate covered
Need to increase coverage by 30%
Technology to perform ad- hoc audit of software licensing position
Need technology with processes that can measure accuracy in auditing deployed licenses

15. Business of Delivering Infrastructure Services
Management “Scope” of the NIMM
Business of Delivering Infrastructure Services
Business Objective
Governance
Procurement
Value Management
Business Alignment
Business Alignment
People & Skills
Process & Automation

16. Network Devices & Services Infrastructure Hardware Platforms
Technology “Scope” of the NIMM
Patterns & Practices
Network Devices & Services
Infrastructure Hardware Platforms
Operating Systems
End User Devices
Common Applications & Services
IT Security & Information Governance

17. NIMM Summary Level 1 Basic Level 2 Controlled Level 3 Standardised
Disjointed, manual Infrastructure
Knowledge not shared
Reactive & ad-hoc
Unpredictable service performance
User driven “who shouts loudest”
Focus is to Avoid Downtime
Level 2 Controlled
Coordinated, manual Infrastructure.
Knowledge silos exist
Reactive with some planning in place
Services manageable & getting predictable
Problem driven
Focus is to Get Control
Level 3 Standardised
Standardized Infrastructure
Individual Level collaboration and knowledge sharing
Reactive & becoming proactive
Stable & architected IT Infrastructure
Request driven
Focus is to Adopt Standards & Best Practice
Level 4 Optimised
Consolidated and virtualized Infrastructure
Team level knowledge sharing & collaboration
Proactive & accountable
Continuous service improvement
Service driven
Focus is on Efficiency
Level 5 Innovative
IT & business stakeholders work in partnership
Enterprise level knowledge sharing & collaboration
Strategic asset
Drives service innovation
Value driven
Focus is to become a Catalyst for Innovation

18. 1 2 3 4 5 Gartner Model Mapping to NIMM Policy/Value-Based
Basic
Rationalized
Virtualized
Service-Based
Standardized
Infrastructure resources pooled
Services managed holistically
Uncoordinated infrastructure
Standard resources, configurations
Consolidate to fewer
Policy/Value-Based
Dynamic optimization to meet SLAs
Objective
Ability to Change
Pricing Scheme
Business Interface
Resource Utilization
Organization
IT Management Processes
Reduce complexity
Economies of scale
Flexibility, reduce costs
Service-level delivery
React
Weeks
Weeks to days
Weeks to minutes
Minutes
Months to weeks
Fixed costs
Reduced, fixed costs
Fixed shared costs
Variable usage costs
None, ad hoc
Business agility
Minutes to seconds
Variable business costs
Class-of-service SLAs
Flexible SLAs
End-to-end SLAs
No SLAs
Known
Shared pools
Service-based pools
Unknown
Central control
Consolidated
Pooled ownership
Service-oriented
None
Business SLAs
Policy-based sharing
Business-oriented
Reactive -Proactive
Life cycle management
Proactive
Mature problem mgmt
Prediction, dynamic capacity
Service
End-to-end service management
Chaotic – Reactive
Ad hoc
Value
Policy management
Desktop, Device and Server Management
Business Benefits
Mobile workers stay current with direct connectivity between corporate networks and devices
Using a system management tool will reduce per-PC management costs
IT Benefits
Monitoring services help simplify identification issues, quickly determine the cause of the problem, and efficiently restore services to prevent potential IT problems
PCs that are faster and less expensive to deploy
Reduced help desk and operations costs
Administrators can ensure data protection and compliance with corporate security policies, including ability to set password policies and remotely remove data from devices
Security and Networking
Established policy standards provide a more consistent computing environment
Improved desktop security by rapidly and reliably delivering patches to targeted vulnerabilities
Centrally managed patches provide a more stable and secure infrastructure
Efficient and reliable TCP/IP network configuration helps prevent IP address conflicts and conserves the use of IP addresses through centralized management of address allocation
Controlled, robust environment that can withstand attacks through security ”layers” at the perimeter, server, desktop, and application levels
Reduced complexity of hardware and software operations lead to smoother change management processes
Identity and Access Management
Increased user productivity through simplified logon process
Lower administration costs due to management of fewer identity stores
Progressing toward implementing compliance with regulations
Reduced cost of managing user accounts
Reduced helpdesk volume
Fewer digital identities
Identities are centrally managed
Data Protection and Recovery
Effective data management strategy drives stability in the organization and improves productivity
Standards for data management enable policy enforcement and define SLAs, improving the business relationship to IT
Strategic approach to data management enables better data recovery procedures, supporting the business with a robust platform
Organization is closer to implementing regulatory compliance
Mission-critical application data are kept in a safe place outside of the IT location
Basic policies have been established to guarantee access to physical media (tapes, optical devices) when necessary

19. IT and Security Process
Microsoft IO Model Mapping to NIMM 1 2 3 4 5
Dynamic
Standardized
Rationalized
Basic
Desktop, Server, and Device Management
Software distribution, Patch management, Mobility, Imaging, Virtualization
Data Protection and Recovery
Backup, Restore, Storage management
Security and Networking
Policy, Anti-malware, Firewall, Access control, Network protection, Quarantine
IT and Security Process
Best practice guidance on cost-effective solution design, development, operation, and support
Identity & Access Management
Directory services, User provisioning, Directory-based authentication
Desktop, Device and Server Management
Business Benefits
Mobile workers stay current with direct connectivity between corporate networks and devices
Using a system management tool will reduce per-PC management costs
IT Benefits
Monitoring services help simplify identification issues, quickly determine the cause of the problem, and efficiently restore services to prevent potential IT problems
PCs that are faster and less expensive to deploy
Reduced help desk and operations costs
Administrators can ensure data protection and compliance with corporate security policies, including ability to set password policies and remotely remove data from devices
Security and Networking
Established policy standards provide a more consistent computing environment
Improved desktop security by rapidly and reliably delivering patches to targeted vulnerabilities
Centrally managed patches provide a more stable and secure infrastructure
Efficient and reliable TCP/IP network configuration helps prevent IP address conflicts and conserves the use of IP addresses through centralized management of address allocation
Controlled, robust environment that can withstand attacks through security ”layers” at the perimeter, server, desktop, and application levels
Reduced complexity of hardware and software operations lead to smoother change management processes
Identity and Access Management
Increased user productivity through simplified logon process
Lower administration costs due to management of fewer identity stores
Progressing toward implementing compliance with regulations
Reduced cost of managing user accounts
Reduced helpdesk volume
Fewer digital identities
Identities are centrally managed
Data Protection and Recovery
Effective data management strategy drives stability in the organization and improves productivity
Standards for data management enable policy enforcement and define SLAs, improving the business relationship to IT
Strategic approach to data management enables better data recovery procedures, supporting the business with a robust platform
Organization is closer to implementing regulatory compliance
Mission-critical application data are kept in a safe place outside of the IT location
Basic policies have been established to guarantee access to physical media (tapes, optical devices) when necessary

20. Perform a self assessment using the NIMM
How should you use the NIMM?
Perform a self assessment using the NIMM
Prioritise and invest to improve lowest scoring areas
Aim for a balanced score, rather than excellence in isolation
Higher value MS EA technologies only available to those with CAPABILITY to exploit them
Leverage capabilities of Core EA products that are licensed for all and don’t default to Enterprise products that aren’t – especially if your organisation isn’t ready to exploit them

21. The Microsoft NHS Enterprise Agreement
(the EA) 21

22. EA Framework
Remaining 6 years of the 9 year EA
Orders placed for years 4, 5 & 6
Software Assurance on all products
Deploy up to 800,000 seats over 6 years (850K inc. “flex”)
Core CAL & Enterprise CAL Suites
Growth in “Knowledge Worker” tools
340,000 SQL Client Access Licences

23. EA offers... Windows Vista Business Edition
Upgraded to Windows Vista Enterprise Edition
Four Virtual Operating Systems
Windows Bit Locker Drive Encryption
Multi Lingual User Interface
Desktop Optimisation Pack
Softgrid
Core CAL
Windows Server CAL
Office Exchange Server Standard CAL
Office SharePoint Server Standard CAL
Systems Management Server CAL
Enterprise CAL also includes
Office Communications Server Standard CAL
Office Communications Server Enterprise CAL
Windows Rights Management CAL
Office SharePoint Enterprise CAL
Office Exchange Enterprise CAL
Operations Manager Client OML
Forefront Security Suite (Anti Virus)
Office 2007 Professional Plus Edition
Access
PowerPoint
Word
Excel
Outlook
Publisher
Communicator
Integrated Enterprise Content Management
Integrated Electronic Forms
Information Rights & Policy
Enterprise Edition also includes
OneNote
Groove
SQL CAL

24. And also... Windows Update Services Server(s) within N3
Access to Digital Learning Academies & Digital Literacy Programme
Home User Programme and EPP
Training Vouchers & E-Learning Tools
Desktop Deployment Planning Services

25. New Stuff... SharePoint CAL for all desktops
Groove growth at 50,000 per year
Anti-Virus (Forefront)
223,000 in Year 4 allowing existing AV deals to “unwind”
Vista Enterprise
Only pay for Vista Business
SoftGrid
Application virtualisation fixes “Java Hell”

26. New LAR deal
Enrolment Areas
LAR
Number of Desktops
Allocation
NWWM
Bytes
160,900
25%
South
138,350
21%
London
111,200
17%
NE & DH
Trustmarque
116,150
18%
EM & ALBs
Computacenter
123,400
19%
TOTAL
650,000
100%

27. Most Favoured Customer. Lower cost per desktop than initial 3 years
Value
Most Favoured Customer.
Lower cost per desktop than initial 3 years
Improved collaboration and security.
50% increase in CUI funding
Contributes to OGC discounting

28. The Common User Interface Programme
(the CUI) 28

29. CUI Phase 2
3rd October Development Agreement signed for 4 Projects delivery in Phase 2:
(“Classic”)
Clinical Applications and Patient Safety (CAPS)
Information Management and Technology (IM&T) Tools
Knowledge Worker Tools (KWT)
(“New”)
NHSmail Technology Refresh (TR) 29

30. CUI Phase 2 - Management
3 discrete governance controls across the Classic and New projects.
Phase 2 of CUI “Classic” Projects governance changes:
Prof Michael Thick (CFH CCO) joining the programme at Steering Board level
Formal cross Projects Board, including:
National Clinical Leads
SHA CIOs
ISB
Service Implementation 30

31. CUI Phase 2 - Controls
Distribution of the Products brought in-house to NHS CFH (via existing cui.nhs.uk and PSPG)
Development of CUI integrated communications plan across the Tech Office
Utility of new and emerging engagement channels
Tie in with CFH initiatives
NIMM framework and taxonomy
Collaboration Architecture & Solution Enablers (CASE)
Smarter internal use of EA technologies (e.g. SharePoint) to manage stakeholders 31

32. CAPS - Delivery
Design guidance has begun to influence NHS systems development
Extensive guidance published to the Clinical and Supplier community
12 Requirement DSCNs approved and issued by the ISB
CUI documents undergoing incorporation into the NHS CFH Technical Baseline where possible
6 UK suppliers actively adopting CUI guidance
UK and Worldwide interest in using CUI guidance in requirements and contracts 32

33. KWT - Delivery Guidance, research and products covering:
Enablers to support NHS Entities migration through fundamentals of attaining NIMM levels 1-3
Abbreviation Manager
NHS Office Client Installer
User Task Analysis
Office Version Migration Guides
Document Collaboration and Compliance
Medical Research Services 33

34. IM&T Tools - Delivery
Documents, tools and templates have been created and made easily accessible to NHS Trusts via the interactive Planning and Deployment Guide (see slide 21)
36 NHS Entities using guidance as Early Adopters
72 people from 51 NHS Trusts attending 14 dedicated Special Interest Group meetings shaped the guidance
19,080 NHS PCs are already live and benefiting from NHS CUI D&I guidance and when remaining pilots Live, at least 75,000 PCs benefiting from the NHS CUI D&I guidance
9 of the 10 Infrastructure Optimisation assessed trusts moved from Basic to Standardised maturity level following Systems Management Server pilots 34