NHS Informatics Professionals Conference 2006 Preparing the Future Today

NHS Informatics
Professionals Conference
2006
Preparing the Future Today
ASSIST in association with NHS Connecting for Health
Andrew Haw
Conference Chair and ASSIST
National Council Chair
NHS Informatics
Professionals Conference
2006
Preparing the Future Today
ASSIST in association with NHS Connecting for Health
Dr Philip Candy
Director of ETD
NHS Connecting for Health ETD
Programme
Preparing for the future today:
Strategising ETD for NHS CFH
Dr Philip C Candy
Director of Education, Training and
Development
NHS CFH
[email protected]
Overview of presentation
Some introductory comments about the future
The National Programme for IT in brief
• The processes
• The benefits
Strategising Education, Training and Development
Our organisation
Creating a distributed national team
Realising the benefits of this huge investment
The long term context: Creating a learning organisation
A place to start
thinking about
the future
Progress at the national level
The Government in 1997 identified the growth and application of
ICT and the development of electronic services and the skills to use
them as crucial to the UK economy. The UK was lagging behind
and the Government resolved to tackle these issues and move the
UK to the forefront of e-commerce and digital services.
Modernisation of the UK’s economy and public services through
new technology was placed centre stage in the 1998 Knowledge
Economy White Paper and the consequent decision to create the
Office of the e-Envoy and Minister for e-commerce.
In the last five years, we have made substantial progress towards
our vision of a ‘digitally rich’ UK. We have a world-leading position
in digital TV. We have one of the most advanced and most
competitive mobile phone markets in the world with 3G now starting
to make a real impact. We implemented the EU telecoms
framework in full with the advent of Ofcom and we remain the
leader in regulatory – and deregulatory - innovation.
Five propositions about the future
There is only one past, but there are multiple
futures
Technology will be more ubiquitous in the future,
but probably less visible
Managers need to be actively engaged in
creating – and advocating – the future
Knowledge is likely to be the key to individual and
organisational competitiveness and success in
the future
‘The future is already here; it’s just not evenly
distributed’ (William Gibson)
Introduction
Four ‘big shifts’ or ‘paradigm
changes’ that are affecting the world
of learning for the future
The Learning Society
Learning Communities
Learning
Organisations
Individual
Lifelong
Learner
Shift # II: From teaching to learning
The truth is that even those who enjoy to the greatest
extent the advantages of what is called a regular
education must be their own instructors as to the
greater portion of what they acquire, if they are ever to
advance beyond the elements of learning. What they
learn at schools and colleges is comparatively of
small value, unless their own after reading and study
improve those advantages.
Craik, G (1830). The Pursuit of Knowledge Under Difficulties.
London: Charles Knight and SDUK.
Shift # III: Recognition of the many
sources of learning
Families
Preschools and schools - primary and secondary
VET Providers (public and private)
Universities
The workplace: Business and Industry
The Media
Libraries and information specialists
Community groups (clubs/churches)
Government (Local/State-Provincial/National/Regional)
Shift # IV: The digital revolution
A glass web spans the globe which is transforming
commercial, social and cultural life in ways we do not
fully understand. The emergence of new digital
information spaces alongside the existing physical
places of public life is posing challenges for policy and
service developers. We are seeing the creation and
recreation of markets and economic activity; of political
and public discourse; of cultural research and learning
work.
Demspey, L (1999). Introduction. Information Landscapes for a
Learning Society. Bath: UK Office for Library and Information
Networking.
Towards a new approach to education
and training
New Lifelong
Learning Paradigm
Self-directed
Learning
Community
Partnerships for
Learning
Technologically
Assisted Learning
Major purposes of Connecting for Health
To connect delivery of the NHS Plan with the capabilities
of modern information technologies and, in particular,
to:
• Support the patient and the delivery of services
designed around the patient, quickly, conveniently
and seamlessly.
• Improve management and delivery of services by
providing good quality data to support National
Service Frameworks, clinical audit, governance and
management information.
• Support staff through effective electronic
communications, better learning and knowledge
management, cut time to find essential information
and make specialised expertise more accessible
(emphasis added).
(Department of Health (June 2002) Delivering 21st century IT, Support for the NHS)
The vision for the National Programme
Why the National Programme is Vital
The application of what we know
already will have a bigger impact on
health and disease than any drug or
technology likely to be introduced in the
next decade: Knowledge is the Enemy of
Disease
Dr Sir Muir Gray
(Director of Knowledge Process and Safety)
Education Training and Development:
Current situation
In support of the National Programme, there is already a
diverse mix of education and training activities
Local, Regional (Cluster) and National levels
Both taught and self-directed
Limited take-up of elearning solutions
Driven by the rollout of the National Programme
Applications
Each National Application has its own Education Training
and Development strategy
However actual implementation is a shared responsibility
with Local Service Providers
So…
How have we tackled the challenge?
Core purpose of CfH Education Training
and Development
To encourage and accelerate the uptake,
spread and creative use of information and
communication technologies in support of
high-quality patient-centred healthcare.
National ETD
Primary objectives:
• To support, enable and harmonise National and local provision
of education and training programmes, interventions and
approaches, to maximise impact and minimise confusion and
duplication at the frontline
• To strengthen the capacity for learning and enhance the
readiness for implementation by all staff at the frontline
• To provide high quality, evidence-based advice and
information about educational interventions across the service,
and collaborate with those engaged in similar research
activities
• To support the development and networking of informatics
specialists, education and training practitioners, clinicians and
leaders seeking to implement IT solutions
• To manage the workstream efficiently and coordinate all
aspects of the workstream, ensure its alignment with major
strategic goals and priorities, and facilitate the mainstreaming
of its work over time.
How are we organising ourselves
to deliver these five main goals?
Sic evenit ratio ut componitur: The
small Book about Large System Change
Sir John Oldham
Three essential elements of large system
change:
The systematic transfer of knowledge
The creation of an environment that facilitates
the uptake of ideas
A unified policy framework and infrastructure for
spread
National ETD programme areas
Principal Programmes and Platforms (PPP)
• [The systematic transfer of knowledge]
Frontline Readiness for Implementation (FRI)
• [The creation of an environment that
facilitates the uptake of ideas]
Evaluation Research and Dissemination (ERD)
• [A unified policy framework and
infrastructure for spread]
Professional Development and Support (PDaS)
Work-stream Leadership
and
Coordination
Administrative and
Project Management
Support
Principal Programmes
and Platforms
Frontline Readiness
for Implementation
Evaluation Research
and Dissemination
Professional
Development
and Support
But these aren’t our only objectives
There are other vital aspects to support our work
Work-stream Leadership
and
Coordination
Administrative and
Project Management
Support
Principal Programmes
and Platforms
Frontline Readiness
for Implementation
Evaluation Research
and Dissemination
Professional
Development
and Support
Strategy and Standards, Relationships Management, Knowledge Management,
Communications and Engagement, Professional and Staff Development within ETD
National ETD in the context of regional
differences
“Regions are becoming focal points for
knowledge creation and learning in the
new age of global, knowledge-intensive
capitalism, as they in effect become
learning regions. The learning regions
function as collectors and repositories
of knowledge and ideas, and provide
the underlying environment or
infrastructure which facilitates the flow
of knowledge, ideas and learning”
Richard Florida
(1995) Toward
the Learning
Region,
Futures, 27(5),
pp. 527-536
The need to form a distributed national team with
local variations
Building a distributed national
team
One way of increasing our ‘reach,’ enhancing
our acceptance, and also broadening our skill
set has been to include colleagues already
working in the field…
An integrated ETD Team
Nationally
based
3
2
Locally
(cluster)
based
1
4
Locally focussed
Nationally focussed
So much for the organisation charts…
What are we actually trying to deliver?
The Benefits of the National Programme
Realising the Benefits of the National
Programme: An Overview
Improved patient experience and outcomes
Enhanced clinical
Encounters
Superior organisational
performance
Safe transition to new ways of working
Planned development
in specific skills
Communication, and
support to make the changes
A culture of learning and
continuous improvement
What interventions are available to realise these benefits?
The four interventions in summary
Create a culture of learning and continuous
improvement
Communicate relentlessly, and provide support
to make the changes
Provide planned development in specific skills
Support a managed transition to new ways of
working
4. Safe transition to new ways of working
Implementation Guidance and Support
Planning for benefits;
Project management;
Risk management;
Change management;
The human dimensions of change;
Measurement and benefits realisation;
Use the Roadmap for Transformational Change
(RTC)
Roadmap for Transformational Change
Lastly, putting the immediate
priorities…
… in the longer term context
IT isn’t just for the specific purpose
2. Technical
proficiency with
specific applications
3. Ability to use
technologies for learning
4. Ability to use technologies for
other knowledge applications
Elearning: The
Next Big Thing in
Preparing for the
Future Today
The challenges for National ETD in a
nutshell
To broaden the conception of ETD away from a simple
‘roll-out’ philosophy
To have ETD all the same size letters in people’s minds
(not eTd)
To build ETD in at the beginning rather than bolting it on
later
To simplify, harmonise and synchronise the existing offers
To recognise and celebrate excellent practice where it
already exists
To emphasise that learning is a lifelong process
Not this approach to lifelong learning…
But this one…
NHS Connecting for Health
Education Training and Development
(ETD) Workstream
Dr Philip C Candy
Director – ETD
[email protected]
NHS Informatics
Professionals Conference
2006
Preparing the Future Today
ASSIST in association with NHS Connecting for Health
Katie Davis
Director of Government IT Profession
E-Government Unit
Cabinet Office
Government IT Profession
Government IT Profession
Katie Davis
Director of Government IT Profession
e-Government Unit, Cabinet Office
16 May 2006
Transformational Government
“The future of public services has to
use technology to give citizens
choice”
“We are stronger and more effective
when we work together than apart”
“We have to have the right people…
to plan, deliver and manage
technology-based change”
Our aim…
Recognise a government-wide IT
Profession up to and including board
level and provide IT Professionals with
the opportunity to reach the highest
levels of the Public Service
Framework for sharing
CIO –
Head of
Profession
Practitioner
Procurement and
Management Support
Service Delivery
Delivery
Management
Solutions Delivery
and
Implementation
Senior
Practitioner
Business
Change
Management
Lead
Practitioner
Enterprise Strategy
and Architecture
Architecture, Information
and Innovation
Competency
Lead /Senior
Manager
CIO (Board level)
National IT Academy
IT-enabled Policy Delivery Workshop
Saïd Business School, University of Oxford
30 Jan – 02 Feb 2006
Register your interest
www.cio.gov.uk/itprofession
The future…
Ian Dodge
Policy and Strategy Directorate
Department of Health
Health Reform
ASSIST Conference
Ian Dodge, Strategy & Policy
Directorate
May 2006
3 Strategic Challenges
1.Reform policy
- Enabling clarity & coherence
2.Implementation of reform
- Focus capability & understanding
3.Communication
Health reform in England
This document describes a framework for
reform of the NHS in England and
> explains how the reforms are intended
to be mutually reinforcing;
> re-states the rationale for reform;
> summarises the initiatives already
announced;
> lays out a programme of further policy
development for 2006.
Health Reform
Money following the
patients, rewarding the
best and most efficient
providers, giving others
the incentive to improve
(transactional reforms)
More choice and a much
stronger voice for patients
(demand-side reforms)
Better care
Better patient
experience
Better value for
money
A framework of system
management, regulation
and decision making which
guarantees safety and
quality, fairness, equity and
value for money
(system management
reforms)
More diverse providers,
with more freedom to
innovate and improve
services
(supply-side reforms)
Key Issues
• Transition from hierarchical telling to embedded
incentives
• Achieving a strategic shift to prevention and wellbeing
• Clinical engagement: reform mechanisms intended to
drive quality
• Articulating the overall blend of delivery mechanisms:
choice PbR & PBC; PCT “managed commissioning”;
independent regulation; SHA system management
• One size doesn’t fit all: segmenting the blend by
sector
• Within each, extent of competition & choice of
provider; and where monopolies, contestability for
supply
Key Issues (cont)
• Demand side capability: managing volume; strategic
commissioning
• Supply side flexibility particularly acute service
reconfiguration
• Ensuring workforce supply supports service need
• Supply chain integration – cooperating & competing
at the same time
• Transparent & robust financial management &
banking systems
• Commissioner and provider failure regimes; &
maintaining service continuity
• Availability & utilisation of high quality timely
information
Health Reform in England
“Annexe C” Forthcoming Guidance Timetable
2005 2006
Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
Health Reform in England: update and next steps
Rules for 2006/07
White Paper on primary and community health and care
Dec 2005
Jan 2006
Early 2006
Dec 2006
Updated framework and rules for 2007/08
Framework for commissioning, PBC and national contract
template for 2007/08
Summer 2006
Framework for next steps on patient choice: implementation
(to 2008) and options on future policy
Autumn 2006
Framework for future of provider reform
Summer 2006
Framework for future workforce development
Summer 2006
PbR 2006/07 - tariff and scope
Review of information requirements
Jan 2006
Spring 2006
Framework for future of PbR 2007/08 and beyond
Wider review of regulation
Framework for management and regulation of the healthcare system
Ensuring quality and safety of clinical care in the reformed
healthcare system
Autumn 2006
Spring 2006
Summer 2006
Autumn 2006
2006/07 NHS challenges: Operating
Framework
• Financial balance
• Service targets
• Reform implementation
Implications for information?
Critical importance of CfH programme - particularly care
records in a more plural environment. Some specific
challenges for DH:
• Information & systems to support commissioning esp
PBC and demand management
• Information & systems to support 18 week maximum
wait pathways – timing challenge
NHS Informatics
Professionals Conference
2006
Preparing the Future Today
ASSIST in association with NHS Connecting for Health
Professor Denise Lievesley
Chief Executive
NHS Information Centre
The Information Centre for health and social
care
Information at the heart of decision making
16 May 2006
The new centre: history &
background
A Special Health Authority since 1st
April 2005
That has taken on
• information-management
functions from former
NHS Information Authority
• statistical functions from
DH, including social care
Independent Board
Approx 350 posts
Leeds based
Data are the most important and under-used
assets in the health and social care system
The transformation of data into information that
is valued and used is fundamental to
delivering better health and better services
Information Centre Strategy
Our vision:
Information at the heart of decision making
throughout Health and Social Care
based on
• authoritative comparative data
• an independent perspective
Our five strategic imperatives :
Deliver
information of
integrity
Provide effective
access to
information
Promote an
information
culture
Support policy
development and
research
Be a dynamic,
customer-focussed
organisation
Pro-active information broker
• Understanding and anticipating the nature of decisions
across all levels of the health and social care system
• Translating these into comparative information needs
• Mapping current availability and quality of information
• Working in partnership with others to reduce duplication and
fill the gaps
• Ensuring that data are properly managed, supported, shared
and made more accessible in a timely way
• Setting and promoting standards in data collection and use
• Strengthening capacity for informed decision making
especially through the use of comparative information
associated products
and
The key principles of good information
Valued –accepted as having authority and value. People
understand it and are prepared to exchange it to achieve
mutual benefits
Straightforward to collect –a natural and expected by-product
of providing and using health and social care
Meaningful –always have relevance to its users, such that it
improves and adapts to the way it is used to fulfil different
purposes at different times
Easy to access –be available to people who need it when they
need it, within clear and simple rules of access
Used –acquires value when it is used in the process of making
decisions and achieving positive results
Collectively, we need to
transform the flows of information,
transform attitudes towards information
and the ways people use it
To improve quality, fairness and efficiency in
health and social care
Who is the information
for?
Patients and
service users
Commissioners
Providers
The public
Policy
makers
Managers and
regulators
“The way forward is to develop a shared
picture of the diverse information needs
across the system, and to create a strong
platform that allows an information market
to develop to meet those demands.”
Matthew Swindells, Policy Adviser to the
Secretary of State
Issues
• overlapping data collections are
constructed to fulfil different purposes
• data collected to fulfil one purpose fails
to meet another purpose
• data are not standardised or collated at
national level to enable comparisons to
be made
• data are not organised for ease of use
• people find it hard to access data and
information
• fear of how data will be used stops it
being shared or even collected
• ‘perfect’ data fails to provide useful
information
“The pursuit of excellence can sometimes get in
the way of the ‘good enough’. If the
information isn’t there, the decisions still get
made anyway…”
Professor Bernard Crump, Chief Executive,
NHS Institute for Innovation and Improvement
National Programme for IT
CfH playing a leading role in addressing many of these
issues
• Data collected once will be used many times
• Information will be shared
• Quality should be improved
The Information Centre is
• the users’ interface to SUS
• responsible for the data which will not be collected
through NPfIT
• tasked with developing value-added data
services, and products
Our ten pledges
•
•
•
•
•
•
•
•
•
•
Streamline data collections
Improve the quality and usability of comparative
data
Improve access to national comparative data
Negotiate access to reference datasets beyond
health and social care
Stimulate the market in disseminating and
promoting the use of national comparative
information
Promote the value of good information
Improve information on social care
Improve information to support meaningful
choice and decisions
Support successful commissioning
Develop a guide to primary care for consumers
Principles underpinning our work
• collect data once only, use them many times
• be temperate in data requests – no data collection
for the sake of it
• share data across agencies (concordat)
• identify key data needs and reduce response burden
• promote access to data
• develop data policies
• permit deliberate replication, avoid ignorant
duplication
• ensure that the value of the data is commensurate
with the resources used to collect it
• deliver the data back to the providers
Recent developments
Working with signatories to Healthcare Commissionled Concordat to:
• maximise streamlining and sharing of
information and data collections
• assure data collections are necessary and add
value
• eliminate collections where there is duplication
or burden outweighs value.
Developing authoritative assurance and approval
process
Tension between local and national
needs
Ideal situation: the same information of
value in serving both national and local
needs, to reduce burden of data collection
Worse situation: national needs distort local
priorities and demands are made for
associated data collection without
consideration of local resource implications
Role of IC: to act as honest broker between
competing demands
Recent developments
Information Catalogue
Searchable list of central information collections
relating to Health and Social Care.
Work to improve usability and increase the number
of, accuracy and amount of data given for each
collection.
Further major enhancements planned
Foundation to co-ordinate and reduce
collections.
Available to all at
http://www.ic.nhs.uk/infocat
Recent developments
Dr Foster Intelligence
Announced on 17 January.
Triple advantage of better information, better
tools and better care by:
• Effective delivery of information to front
line management
• Showing how information can be used to
make better decisions
• Helping users to value information and
see how it supports their activities.
Making a step change
Current activities of the IC
Developing Healthcare Resource Groups and other casemix tools
for:
• Reimbursement under Payment By Results
• Costing
• Benchmarking analysis
Collecting and analysing the data for
• Quality and Outcomes Framework
• the GP and dental contracts
• pay negotiations
• prescribing costs
• NHS workforce
• NHS estates
Supporting users of these data
Updating national data standards, and ensuring compliance with
international standards
Planned enhancements
• Align financial data standards with other standards such
as commissioning datasets, performance data and
workforce data.
• Analyse workforce data to enable workforce planning in
relation to skill mix; staffing levels; pay levels.
• Improve the quality and utilisation of cost data
• Meet the immediate challenge of improving information
to support tariff-setting, with a particular focus on linking
cost and activity
• Enable effective procurement through improved use of
prescribing cost data
• Link available data on quality, costs and outcomes
Conclusions – new era in
information?
The Information Centre’s role and priorities
A flavour of our current work
Partnership – working with suppliers and users of
information to consult and collaborate on what is
collected, how it is used, how it is presented ….
You can’t manage what you do not measure
NHS Informatics
Professionals Conference
2006
Preparing the Future Today
ASSIST in association with NHS Connecting for Health