1. GP Information Hub in Trafford Briefing for GPs January 2009

2. Introduction/Summary A small GP-led group has been working on the theme of creating an information infrastructure for Trafford as part of the wider work on developing an integrated care organisation. This set of slides summarises where thinking has got to – the decisions we need to consult upon and proposed next steps This pack is being sent around a focus group which was involved as this work began for their comments before the proposal is put to a wider group representing all practices in Trafford

3. Elements We have been working on a number of elements and produced a number of drafts for consultation – An Information Sharing Agreement – The Terms of Reference for the Governance body – A list of high level requirements for the “Hub” – A list of options for achieving those requirements

4. An Information Sharing Agreement A draft based on other (local) agreements already in place Focus on the agreement between practices and the governing body/organisation Other information flows (in and out) would be subject to further agreement Need to agree the consent model

5. Terms of Reference and What the Hub will Do

6. High Level Requirements Allows data from different systems to be accessible through one log in screen Has RBAC (Role based access control) with control held by a system administrator at the PCT Makes data accessible to view for different healthcare professionals in different care settings Allows for expansion of the system to accommodate different information streams in future (eg Social Care, A&E etc) Generates standard management reports and allows ad hoc queries to be designed, run and saved. Can import and export data in defined present formats Is web based and preferably is managed and administered locally Allows functionality to be added in as necessary to help address the priorities in the PCT’s Commissioning strategic plan (CSP) such as CVD and Cancer. The ability to query the data and systematise the results of the queries for disease registers will be required. Is completely secure, not simply because of RBAC but because the storage of the data meets very high standards of data security and is compliant with the Data Protection Act and endorsed by our Caldicott Guardians. Needs to deal with patient consent to access and the ability to seal elements of the record and identify Can be owned by the Organisation. As a corollary to the local hosting as described above, the access to and use of data held in the system will be controlled by the local organisation Provide a mechanism(s) by which information can be absorbed back into primary care systems Providing a means of communication between clinicians /users of the system e.g. through an in box Abilty to store and retrieve images Ability to flexibly set data quality (completeness and consistency) thresholds for accepting records and reporting back to the source Provide a means of transferring records between practices Provide a flexible means by which practices can opt out of (or into) extracts of views of data for specific purposes Provide data which is identifiable (in which case encryption should be used), anonymised or pseudonomised depending on circumstances

7. Options for next 2-3 years Whilst no particular option has been selected we believe there are a number of options that might be workable – A – Do nothing (does not achieve the objectives but a comparison) – B – Lorenzo B1 – Current plan in OIP B2 – Integrated plan in ICO context – C – Use existing systems C1 – Graphnet C2 – EMIS Web C3 – In Practice Systems – D – Procure new systems – Eventual plan likely to be a combination

8. Example Plan in Outline Dec 08Jan 09Feb 09Mar 09Apr 09 Stage 1 Statement of Requirements TOR/ Governance Model Options Definition GP Consultation/ Meeting Decision to Proceed (1) Stage 2 Review Options Select Option Negotiate Decision to Proceed (2) Implement Stage 3 Information Sharing Agreement

9. Longer Term Plan in Outline 08/0909/1010/1111/1212/13 Agree Options /Create Plan First phase – Practice Extracts Second Phase Introduce Integrated Info Flows (Within Trafford) Lorenzo Deployment Care management (plus) Lorenzo Deployment Clinicals part 1 Lorenzo Deployment Clinicals part 2 Third Phase Introduce Integrated Info Flows (with other organisations) Lorenzo Deployments Across GM E..g Mental health and Christies