The National Programme for IT in the NHS

The National Programme for IT in the NHS in England (NPf. IT) Richard Granger Director General September 2004

Context The NHS serves 52 m people in England. In 2002 -2003 it dealt with: – 325 m consultations in primary care (each person visits their GP an average of 6 times a year) – 13 m outpatient consultations – Almost 5. 6 m people admitted to hospital for planned treatment – Nearly 13 m people attended A&E – 4 m emergency admissions – 617 m prescription items issued

Digital Information leads to Health In the NHS in England: • 10. 8% of patients on medical wards experience an adverse event, 46% of which were judged to be preventable • One third led to greater morbidity or death, this means almost 1, 300 hospital deaths each year could be prevented • An average of 8. 5 additional days unnecessarily spent in hospital • If the data from a sample of trusts are extrapolated across the NHS, this costs almost £ 2 billion each year • 12% of adverse events were related to medicines use

Our aim • To deliver a 21 st Century health service that is better for patients, citizens, clinicians and people working in the NHS through the efficient use of Information and Communication Technology • To improve the convenience, quality and safety of patient-centred care by ensuring that those who give and receive care have the right information, at the right time

The IT ‘No Needless …. ’ List • No needless harm • No needless inaccuracy • No needless clinical tests • No needless approximation • No needless inefficiency • No needless bureaucracy

SMain: National Programme for IT A ten year £ 6. 2 bn programme to deliver four key elements: – NHS Care Records Service • National Patient Record Spine • Local Service Providers – Electronic appointment booking – Electronic Transmission of Prescriptions – Underpinning IT Infrastructure and network

Shopping. . . • rapidity • creation of a multi-supplier contestable post award framework • appropriate risk transfer • completion/service risk remains with the contractor • additional capacity • clear understanding of what we want to buy • ensure applications and systems perform before we buy them • buy things that work together • cope effectively with change • equitable approach to intellectual property rights www. dh. gov. uk/Policy. And. Guidance/ Information. Technology/National. ITProgramme/fs/en

Suppliers National Application Service Providers National Infrastructure Service Provider Local Service Providers North West & West Midland cluster The CSC Alliance Southern cluster The Fujitsu Alliance North East cluster Accenture Eastern cluster Accenture London cluster Capital Care Alliance, led by BT

What the NHS will see July 2004 Jan 2005 Jan 2006 Jan 2007 Choose and Book (2004 on) NHS Care records Service (Security, messages, personal demographics) GP IT (QMAS) PACs (phase 1) (phase 2) (phase 3) LSP bundles (NE and E) Electronic Transfer of Prescriptions GP to GP transfer LSP bundles (North West/West Mids) LSP bundles (London and Southern) NHS Care Records Service - clinical records start NCRS - future releases Jan 2008

LSP bundles - examples IT package solutions to support: • Maternity bundle • Theatre management bundle • Patient Administration System bundle: - Master Patient index - Clinical data repository - A & E tracking - Registration, admissions, discharges & transfers - Bed management etc • Clinical support bundle - Results reporting - Order communications - Clinical noting and correspondence - Discharge summary

Value This will be achieved by: • • Avoiding multiple procurements Significant reduction in time taken on procurement and acquisition costs Reduced unit costs for applications and systems e. g. PACS Ensuring that multiple national suppliers maintain on-going post award competitive pressures at the time of any change, extension or renewal

Value, an example : PACS Technology to capture, store, display and distribute medical images • far less waiting for X-rays and scans to be processed and checked • reduced costs as there will be no films and less storage space and resource • taken over 5 years to get PACS in 25 trusts. Roll out to 142 trusts by March 2006 and all 178 by March 2007 • average price of total PACS system reduced by 50% with 71% pricing reduction on disc storage and 82% on PACS servers

Nationwide Security Authentication

What are we building? Electronic Booking www. chooseandbook. nhs. uk Create referral request Book appointment EBS Create referral letter View booking status Request advice & guidance EBS Referrer or Booker (via Primary Care System) Booker (via New NHS Network: N 3) BMS Book appointment View booking details Internet Patient via Internet & Unique Booking Ref No Create referral letter BMS Book appointment Change appointment Create referral request BMS Book appointment Change appointment

Electronic Booking What may come next? • • • Patients booking via the internet into primary care Services delivered via Digital TV Linked appointments Transport requirements Primary-to-primary booking Tertiary booking and referral Follow-up appointments Clinical assessment services Onward referrals

What are we building? NHS Care Records Service • A single electronic health care record for every individual in England: – a comprehensive life-long history of patients’ health and care information, regardless of where and when any by whom they were treated – providing healthcare professionals with immediate access to summary of care encounters and clinical events held on a national data repository. 52 m patient records – supporting the NHS to collect and analyse information, monitor health trends and to make the best use of clinical and other resources – essential information held at local level where most care is delivered.

What are we building? New National Network (N 3) • A combination of Broadband connections and network services to link all NHS organisations in England with specialist applications and wider Internet applications • Orders already placed for the first 3, 300 Broadband connections for the NHS • NHS will represent 10% of all Broadband usage in Britain • In longer term data circuits will provide voice services to make phone lines redundant and increase savings • Over the next 7 years new contract will save an estimated £ 900 m compared to existing NHSnet contract n 3@nhsia. nhs. uk

Today’s Challenge Front line systems E-Booking NCRS and national applications Testing NPf. IT Testbeds LSP 1 GP system 2 PAS 1 Standards - Compliance - Performance - Connectivity Sandpit 1 Sandpit 2 Sandpit 3

Planning Summary of Planning information 16, 000 Primary and Secondary Sites 12, 000 dentistry sites Approximately 38, 000 sites not including Pharmacy sites There are 10 significant milestones per site, which represents in excess of 380, 000 milestone. Each site will have in excess of 100 implementation activities which will generate 380 million activities. Approximately 112, 000 milestones and activities for National System Programmes Choose & Book Spine N 3 ETP CONTACT PACS

Our vision A digital health service that is fit for the future