NHS Doncaster CCG IT Strategy 2015 - 2018

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IT Strategy

2015/16 – 2017/18

Draft Version 1.3

Last updated June 2015

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Contents

Page

1.

Introduction

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2.

Strategic Context 3

3.

IT Service Delivery for NHS Doncaster CCG and its Member Practices

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4.

Where are we now?

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5. “Personalised Health and Care 2020” - The new national information framework “

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6. NHS Doncaster CCG IT Strategy

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6.1 Doncaster Primary Care IT Strategy

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6.2

Doncaster Local Health and Care Community IT Strategy

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6.3

NHS Doncaster CCG Corporate IT Strategy

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7 Information and data security

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8. Implementing the strategy

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9. Review

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10. Glossary 18

Appendix 1: NHS Doncaster CCG IT Strategy 2015/2018 - Summary

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1. Introduction

This strategy has been developed to ensure that NHS Doncaster Clinical

Commissioning Group (CCG) has the IT capabilities to fully support the delivery of its

5 year Commissioning strategy and also reflects the goal of the new national

information framework to support the delivery of technology enabled, personalised

care services.

This strategy replaces the Doncaster Primary Care Trust IM&T Strategy (2007) and

the Doncaster Primary Care IT Strategy. These previous strategies were produced

in the context of the National Programme for IT. Since the end of that highly

prescriptive programme the approach to the development and delivery of IT strategy

in the NHS has become much more locally driven.

This strategy is written in the on-going context of the change in financial outlook for

the NHS and the need for enabling programmes, including information technology, to

drive the delivery of increased Quality, Innovation, Productivity and Prevention.

The strategic developments set out in this document have been identified and

developed through engagement with GPs and partners across the Doncaster Health

and Social Care community. Consequently this strategy impacts across primary,

secondary and community care as well as commissioners, and will require the

engagement and support of all partners to be fully realised.

The scope of this strategy is IT systems and services including websites. It does not

address information services or business intelligence. Telephony is also outside the

scope of this strategy.

2. Strategic Context

The aim of this document is to communicate the enabling IT strategy which will

support the delivery of NHS Doncaster CCG’s five year commissioning strategy

“Moving forward, getting better.” The IT strategy will also support delivery of the

National Information Board’s “Personalised Health and Care 2020” framework, which

is detailed in section 4.

The IT strategy has been developed following engagement with CCG Members and

Officers. We have developed our IT strategy with a focus on the implementation of

initiatives that will support delivery of the three strategic ambitions detailed in NHS

Doncaster CCG’s five year commissioning strategy and the six core priority domains

for delivery identified by the National Information Board in their policy paper

“Implementing ‘Personalised Health and Care 2020’”. These nine key strategic

priorities that the strategy has been produced to support are summarized below:

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NHS Doncaster CCG Strategic Ambitions:

• Care out of hospital - the provision of patient centred care outside of a hospital setting, either in the patients home or based around a primary care community team

• Care of the frail - the provision of high quality co-ordinated care that meets the needs of the patient based on integration, prevention, patient and carer involvement and access to responsive services

• Co-ordinated care - the provision of integrated care across a whole system that is responsive to patient needs, uses the latest technology to support service delivery and develops enhanced access to data and information across partner organisations

National Information Board Priority Domains:

• Enable me to make the right health and care choices: supporting digital services for patients and citizens

• Transforming general practice

• Out of hospital care and integration with social care

• Acute and hospital services

• Paper-free healthcare and system transactions

• Data for outcomes and research

A summary of the IT strategy showing how each of the proposed initiatives for primary care and the health and care community will support the priorities detailed above is shown in appendix 1.

The IT strategy has as its primary focus the integration of systems and information,

and the extension of IT services to make them highly available wherever access is

required. Achieving integrated information across services will be an essential part

in the delivery of the CCG’s strategic ambition of co-ordinated care across the

borough. Making IT systems and the vital patient data they contain more widely

available to clinicians, wherever they are working, will be a significant element in

meeting the CCG’s strategic ambition of care out of hospital.

The IT strategy also has a major focus on the delivery of continued improvements to

primary care IT systems and services. This will this provide significant support to

delivery of the Primary Care Strategic Framework of which the IT strategy will be an

enabling theme.

The objectives of strategy for Doncaster CCG’s corporate IT are to provide a high

quality set of IT services that enable the CCG and its officers to:

• Have effective communications with the public, CCG Members and CCG Officers

• Drive internal efficiencies and reduce administrative time

• Work in a sustainable manner and support the corporate governance agenda

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3. IT Service Delivery for NHS Doncaster CCG and its Member Practices

The current responsibilities and configuration for the delivery of IT services to NHS

Doncaster CCG and Doncaster’s General Practices are as follows. NHS England is

responsible for primary care information services. It delegates the responsibility for

operational management of GP IT services to CCGs. In NHS Doncaster CCG Dr

Nick Tupper the GP IT Lead, supported by the Head of IT, is the responsible officer

for IT services provided to the CCG and its GPs.

In 2014 the CCG appointed a Head of IT, jointly with Rotherham CCG, to lead on the

development and delivery of local IT strategy and to manage the contract for delivery

of IT services to the CCG and the GPs. The Head of IT is supported in the

development and delivery of IT Services for Doncaster by the Support Manager -

Performance IT programme and project management, data quality and GP system

support services are procured from NHS Yorkshire and Humber Commissioning

Support (YHCU). IT services for the CCG and GPs are procured from Rotherham

Doncaster and South Humber NHS Foundation Trust (RDaSH).

In April 2014 the IT programme management and project management, data quality

and GP system support services currently provided by YHCU will be taken back in

house and provided by a joint team working directly for Doncaster and Rotherham

CCGs.

The IT services provided by RDaSH are supplied under an SLA that is renewed on

an annual basis. At present the negotiations for an SLA for the provision of IT

services during 2015/16 are on-going. During the course of the delivery of this

strategy it may be a necessary to seek supplementary or alternative IT service

provision to support its delivery or to meet the emerging requirements of the CCG

and General Practices.

4. Where are we now?

Doncaster Clinical Commissioning Group was established in April 2013 as a

statutory body under the Health and Social Care Act 2012. On establishment it

adopted the Information Management and Technology Strategy of the former

Doncaster Primary Care Trust. Working with its IT service providers, RDaSH and

YHCU, NHS Doncaster CCG has led a programme of work over the period 2013-

2015 that has focussed on:

• Implementation of systems and services procured under the National Programme

for IT

• Upgrade of GP IT systems and the refresh of GP PC workstations

• Modernisation of the CCG’s internal IT services

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Key deliverables from this programme of work that have been implemented or will be

achieved by March 2015 are:

• All practices have now uploaded Summary Care Records to the Emergency Care

Record

• 42% of practices will be enabled for Electronic Prescription Service (EPS)

Release 2

• All practices will have switched on GP2GP record transfer functionality

• All practices will offer online access to give patients the ability book

appointments, order repeat prescriptions and view their summary record

• Migration of all GP Practices to next generation clinical systems and

consolidation of the majority of practices onto the SystmOne and EMIS Web

hosted systems

• Upgrade of all GP PC workstations from the Windows XP operating system to

Windows 7

• Significant replacement of old PC workstations in General Practice

• Procurement of a remote working solution for use by all Doncaster GPs and

Registrars

• Procurement of an upgrade to the existing Doncaster Wide Area Network that will

extend it to all General Practices

• Establishment of Doncaster IT Forum, including representation from all Health

and Social Care partners, to promote working together and support the

development of interoperable IT systems and services

• Upgrade of all CCG officers PC workstations to laptops

• Implementation of Wi-Fi throughout the CCGs headquarters, providing secure

private and public network access

• Development of a vendor “agnostic” CCG network infrastructure that allows

equipment using various operating systems to connect and interoperate together

• Rollout of secure remote working functionality and remote access to email for

CCG staff

• Implementation of the BoardPad system to provide efficiencies in the distribution

and use of documents for key corporate meetings

This document details how NHS Doncaster CCG will take forward its IT strategy over

the next three years building on the work already done and taking into account the

requirements of the new framework for NHS IT that is described in the next section.

5. “Personalised Health and Care 2020” - The new national information

framework

The new NHS Information framework titled “Personalised Health and Care 2020:

Using data and Technology to transform Outcomes for Patients and Citizens” was

published on the 13th November 2014. The framework sets out a ten-year

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programme for transforming information for health and care so that services can

achieve higher quality care and improve outcomes for patients and service users. It

makes a commitment to delivering improved digital access for people to healthcare

services, their clinical records and other healthcare information and to improving the

sharing of information between health and care professionals.

The framework proposes a locally driven approach to decisions on systems,

programmes, interfaces and applications, which will be supported by a set of

nationally defined standards and definitions and clear expectations regarding

interoperability. It identifies that generally the IT systems currently used in health

and care lack the capacity to share information and that this lack of interoperability is

a major and fundamental problem that has not been addressed successfully by

previous national strategies. The framework’s key commitments, relevant to this

strategy, are:

• Citizens will be able to view GP records by 2015

• The SNOMED CT clinical coding system is to be adopted by all primary Care

systems by December 2016

• Citizens will be able to access and write into all their health and care records by

2018

• By 2018 clinicians in primary, urgent and emergency care will be operating

without paper records

• All patient care records will be digital, interoperable and accessible in real time by

2020

• Citizens will be offered a single point of access, through NHS Choices, to

common digital transactions like booking appointments

• Patients will increasingly be offered mobile care records that they control the

access to. A proof of concept focusing on End of Life Care and Maternity records

will be carried out to test this

Further guidance on implementation of the framework will be published in June

2015. Following this NHS England will work with national and local commissioners to

develop roadmaps for the introduction of interoperable digital care records and

services by providers, which will be published in April 2016.

This strategy sets out how locally in Doncaster we will take forward the aims of the

new framework. As the additional guidance, standards and definitions are

introduced we will need to review how they impact upon our plan and take action to

amend them as necessary.

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6. NHS Doncaster CCG IT Strategy

This strategy is aligned to the 5 year Commissioning Strategy and sets the strategic

direction for IT developments over the next three years. The strategy is divided into

the three sections that follow, which look at how IT will be used to support:

• The delivery of primary care services in Doncaster

• The integration and sharing of information across the Doncaster health and care

community

• The commissioning function of NHS Doncaster CCG

NHS Doncaster CCG will ensure that when delivering this strategy that information

and new technology is equally accessible across vulnerable groups. At the point of

implementation of each project a full Equality Impact Assessment will be carried out

and this will be subject to regular monitoring. NHS Doncaster CCG’s partners will

also be required to share evidence that they have carried out Equality Impact

Assessments on their developments.

6.1 Doncaster Primary Care IT Strategy

The objective of our Primary Care IT Strategy is to provide optimised clinical systems

in all Doncaster Practices, which support the appropriate sharing of information

across care pathways and allow patients to be a partner in their own care. The

infrastructure for these systems will ensure that high quality information will be easily

available to clinicians in all care settings.

This section is divided into the two sections below looking at our proposals for

primary care IT systems and primary care IT infrastructure:

6.1.1 Primary Care IT Systems

The GP IT systems in Doncaster are provided under the national GP Systems of

Choice (GPSoC) and the Local Service Provider (LSP) contracts. GPSoC has

currently been extended until the end of 2016, however the LSP contract will expire

in July 2016. At this time the contracts for all General Practices in Doncaster who

use SystmOne will be novated to the GPSoC contract, providing for continued use of

the system without interruption. In addition to GP clinical systems the GPSoC

contract has been widened to include a range of subsidiary systems and services

that include document management, data extraction and system interoperability. We

will review these subsidiary services to ensure that NHS Doncaster CCG makes best

use of the framework contract.

As detailed in section 3 a significant amount of work has been done over the last 2

years to standardise the clinical IT systems used in General Practices in Doncaster

and to introduce the additional functionality of national systems and services such as

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GP2GP record transfers and Electronic Prescribing. This work has been successful

and the standard of GP IT systems in Doncaster now is good. With the introduction

of a common set of systems there comes the opportunity to review ways of working

across practices to ensure that maximum benefit is being achieved from the systems

and that best practice is being shared and followed. There is also a requirement to

review training needs in practices and ensure that appropriate training has been

given to support optimal use of the systems.

There has been less focus in Doncaster on the integration and sharing of data

between systems at a local level, particularly between primary and secondary care.

For example the introduction of the electronic transfer of clinical letters has been in

the implementation phase for several years but has never been fully deployed to all

practices and the deployment of discharge notifications has not started. Similarly the

introduction of Order Communications using the ICE (Integrated Clinical

Environment) system has been implemented in a few practices in Doncaster but the

majority of practices do not currently have their implementation scheduled. The

ability of the ICE system to allow lookup of historic pathology and radiology test

results is of benefit to patient care and can generate significant efficiency savings by

avoiding unnecessary repeat testing. Through this strategy we will work with our

providers to ensure that local messaging systems are fully implemented in a timely

and robust way.

Our proposals for primary care IT systems i. We will continue to work with General Practices and the Medicines

Management team to implement release 2 of the Electronic Prescription Service (EPS). EPS brings many benefits to GP practices, pharmacies and patients. It allows prescriptions to be cancelled at any time until they have been dispensed and replacements can be sent electronically giving greater control of what is being dispensed to the patient. Electronic prescriptions cannot be lost, reducing the risk of duplicate prescriptions being generated. The process for dealing with repeat prescriptions is more efficient as there is no need to issue, sort and file paper prescriptions or prepare for the prescriptions to be collected, instead the electronic prescription can be signed electronically and sent to the dispenser of the patient’s choice. EPS will be implemented in 60% of practices by March 2016 in line with national targets, with the remainder of practices to be implemented over the life of this strategy.

ii. The national Patient Online programme is expected to be enhanced in 2015/16 to give patients full access to their GP record. We will work with practices to implement this additional functionality to the mandated targets,

iii. Starting with the electronic transfer of clinical letters we will run a programme of work in partnership with Doncaster and Bassetlaw Hospital (DBH) to implement electronic messaging to all practices. This will be followed by the implementation of electronic discharge messages. The timeframe for this deployment will be dependent on DBH systems and processes but is expected to commence in 2015/16. We will seek to clarify timescale and process as soon

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as possible and develop a schedule for full implementation.

iv. During 2015/16 we will run a programme of work in partnership with Doncaster and Bassetlaw Hospital (DBH) to complete the implementation of ICE for Order Communications and results requesting in all practices.

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We will work with RDaSH to identify how information held in Community records can be shared with GPs across Doncaster regardless of the clinical systems they use. We will also seek to implement messaging and tasking between primary and community clinicians across clinical system platforms.

vi. All General Practices in Doncaster achieved Paperlight Approval status by 2011. Since then the data accreditation work ceased and the practice Paperlight approval status has lapsed. We will implement a new data accreditation process for all practices along with training and support to improve data standards where required.

vii. Clinical data entry templates have become an essential part of recording information in General Practice, but the quality of the templates in use across Doncaster is unknown. A well designed template enables the accurate recording of detailed information at the point of care and can speed data entry and ensure consistent structure and coding. In 2015/16 we will work with practices to review the current templates in use and produce a set of standardised templates.

viii. A Training Needs Analysis (TNA) for General Practice clinical systems will be developed in partnership with GP colleagues. We will then commission an agency to carry out the TNA with all practices and prepare and deliver a training programme to meet the identified training needs.

ix. Starting with a review of the Docman system in February 2015 we will explore the additional systems and services that are available under the GPSoC framework and work with GP Members to identify those which should be adopted for use across the CCG.

x. Starting in 2015 the PBCI (Practice Based Commissioning Information) portal will be migrated into a new CCG GP Members Portal that will accessible to all GPs securely over the N3 network. The portal will provide access to all information that the GP Members need in one place including Target information, waiting list information, a Directory of Local services, practice analytic data and commonly used forms. The portal will be developed overtime to meet the needs identified by the GP Membership.

xi. In 2015 we will work with colleagues from General Practice to review the market for risk stratification systems and our existing risk stratification tool to determine if it meets the needs of the GP Membership. Dependent on the findings a new risk stratification system may be procured and implemented. Whichever system is used in the future the risk stratification tool will be loaded with both primary and secondary care activity data.

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6.1.2 Primary Care IT Infrastructure

The focus of our work on primary care IT infrastructure during the period of this

strategy will be to modernise the IT systems and services provided to Doncaster’s

GP practices while ensuring that we keep existing equipment up to date and fit for

purpose. We will ensure that GPs have access to modern, high performing

equipment and that they are able to work remotely.

The IT equipment, systems and services funded by the CCG for General Practices

will be in line with the guidance document “Securing Excellence In GP IT Services:

Operating Model 2nd edition 2014-16.” This guidance identifies three categories of

service:

• Core IT Services (available to all general practices)

• Add-on GP IT Services (discretionary, to align with CCG strategies)

• Out of scope services

All Add-on GP IT services supported by the CCG will be subject to agreement by the

CCG Members.

Funding for new GP IT equipment is provided on an annual basis through application

for capital monies from NHS England. In addition to this national funding NHS

Doncaster CCG will invest its own funds to support the significant developments that

are outlined in the following proposals.

Our proposals for primary care IT Infrastructure i. Plans have been agreed to implement a scheme that will provide IT remote

working equipment for all GPs and Registrars. Through this scheme we will roll out 314 laptops with 3G/4G capabilities that will provide all GPs and Registrars in Doncaster with remote access to their clinical systems, email and other networked services. The outcome of this project will be to improve the remote working capabilities of GPs in Doncaster. The scheme has been funded for two years covering all equipment, licensing, data, installation, and support charges. Implementation will commence in early 2015/16 and, through the use of third party support, will be deployed quickly to all users. As part of this scheme we will also pilot the use of Apple laptops in all localities to asses how well they interoperate and the benefits they offer over Windows based laptops.

ii. Plans have been agreed to implement a full fixed private network that will connect the CCG and Doncaster General Practice sites. This network will allow DCCG to provide improved resilience, central file storage, Wi-Fi and improved remote working capabilities to all practices and will lay the foundations for continual improvement of technology services for General Practices. The new network will replace the old “West network” that currently connects some Doncaster practices allowing centralised services to be extended to all practices. The network is being procured under the Public Sector Network

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framework contract and will allow us to develop secure connections to other public bodies including DBH, RDaSH and DMBC when this is required. The network links, storage architecture and Wi-Fi solution are all currently in procurement. Implementation of the new services will commence in April 2015 and are expected to run over a 24 month period.

iii. As detailed in point ii. above the development of the centralised network will provide a platform that enables the rollout of Wi-Fi networks to all General Practices. These Wi-Fi networks, for the use of practice staff, will allow the laptops deployed through the remote working scheme described in point i. to connect to the clinical system and local network resources (printers, scanners, etc) in the practice. We will arrange for the Wi-Fi supplier to offer practices the opportunity to implement public access Wi-Fi, at their own cost, as part of the installation service. Implementation of the Wi-Fi solution will follow on from installation of the central network connection and run over the period April 2015 – March 2017.

iv. During 2015/16 we will run a pilot with several practices to enable them to provide remote consultations for their patients. CCG member practices have advised that the delivery of this type of service is important to support them in modernisation of the delivery of primary care services. This pilot will be evaluated and the findings will be used to inform how these services are rolled out to further practices. Pilot practices will be agreed by the CCG Members. The pilot will run for the first half of 2015/16 and be evaluated during the second half of the year.

v. Throughout the time period of this strategy we will continue to monitor the condition of the equipment (PC, printers, scanners and networking equipment) used in General Practices across Doncaster and make annual bids to NHS England for capital funds to provide appropriate replacements. This process is intended to continually improve the technology available in General Practice by replacing devices which are end of life and will reduce the risk to business by ensuring all devices have the appropriate support and warranties. For 2015/16 bids have already been submitted to cover the replacement of some network servers, PCs, printers and scanners. The approval of these bids is being awaited.

vi. To support the use of GP clinical systems in the practice setting we will rollout PC monitor upgrades. This scheme will replace all the existing PC monitors in practices with a high definition 23" wide screen monitor or dual monitors. Many of the monitors currently used in general practice are significantly out of date. The new monitors can help to improve productivity by increasing the screen size to accommodate the current version of GP clinical systems. The new screens will be implemented during 2015.

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6.2 Doncaster Local Health and Care Community IT Strategy

The objective of our IT strategy for the health and care community of Doncaster is to

join up information across care pathways and settings so that health and care

practitioners have easy access to all the information they need to provide high

quality, safe and effective services. IT services will be interoperable to allow

practitioners access to information in all care settings.

NHS Doncaster CCG have identified the delivery of co-ordinated care as one their

three strategic ambitions. The goal set out in the five year commissioning strategy

states:

“We will use technology to drive forward improved communication between patients, carers and partner organisations. Our aim is to use patient information to improve commissioning decisions and use technology to improve integrated, personalised, co-ordinated care across partner organisations.” In addition to this local goal the new NHS information framework discussed in

section 4 also sets CCGs and their health and care partners a series of objectives for

the integration of patient information over the next five years.

Delivery of these goals and objectives will require close engagement and co-

operation between the CCG and its partners to implement a set of integrated and

interoperable systems and ensure that the necessary information governance is in

place. Since the end of the NHS National Programme for IT and the ceasing of the

local IT programme board in Doncaster, the co-ordinated delivery of IT systems and

services has largely gone into abeyance. NHS Doncaster CCG recognises the need

for a joined up approach to IT in order to deliver integrated and co-ordinated care

services and the following proposals detail the approaches that will be taken towards

achieving this.

Our proposals for Doncaster Local Health and Care Community IT Strategy i. We will work with our health and care partners to establish a local IT

Programme Board that will agree and oversee the delivery of a co-ordinated IT strategy for Doncaster. Work has already commenced on this agenda with DMBC proposing a group that would report into the Health and Social Care Theme Co-ordinators group, which is part of the Health and Wellbeing Board structure. GP Members will be consulted on the proposals for the Board and the requirements for clinical representation on it.

ii. We will work with our health and care partners to implement a local clinical portal that will enable the sharing of health and care information between agencies across the health community. The clinical portal will support the safe, secure and timely sharing of information about our patients and service users to support the integrated delivery of health and care services. It is expected that the delivery of a clinical portal will support the Doncaster health community in

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reducing unnecessary hospital admissions, improve clinical safety and support better care co-ordination. Some initial work, which was instigated by the End of Life Care Programme, to look at possible solutions has commenced. Following on from this DBH have agreed to lead a piece of work to develop a clinically focussed user requirements specification that includes requirements across the health and care community. In parallel with the development of this user specification we will develop a business case for funding of the system which will be sent to the CCG’s Governing Body for their consideration. It is expected that procurement of a clinical portal will take place during 2015/16 and that implementation and development of the portal will take place over the remainder time of this strategy. One of the first priorities for use of the portal will be to support the development of an integrated End of Life Care record and register of Doncaster patients.

iii. The Medical Interoperability Gateway (MIG) is a solution developed by Healthcare Gateway that enables simple and secure access to patient information held in GP records in other care settings. While the plans for a local clinical portal are under development we will review the functionality of the MIG against local requirements to determine if it could be used either to support long-term development of the clinical portal or as an interim solution to improve information sharing in Doncaster in the shorter-term. Potential uses of the MIG will be discussed with GP Members during 2015/16.

iv. As detailed in section 4 all commissioners will be required to develop a roadmap for the introduction of interoperable digital care records and services by providers, which will be published in April 2016. Using the output from our work to develop a local clinical portal we will develop and agree a roadmap for interoperable systems with all our partners and agree it through the proposed IT Programme Board described in section i. It is expected that this roadmap will form a key part of a future joined-up Doncaster Health and Care IT strategy.

v. NHS Doncaster CCG is currently carrying a procurement exercise for the provision of unplanned care services. We will work with the chosen providers to ensure that they implement comprehensive information sharing with other providers across the health community, including links to both primary and community care systems to facilitate sign-posting and onward delivery of care in the community.

vi. As an enabler to integrated working we will look to provide joined-up Wi-Fi networks across Doncaster Health and Care sites that will enable staff to work across sites with full access to their own systems and services. The first phase of this project will expand the "DCCG-Wi-Fi" network to incorporate the current DMBC building. By providing a secure connection to the DMBC building NHS Doncaster can improve the collaborative working between the two organisations by removing unnecessary technical barriers.

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6.3 NHS Doncaster CCG Corporate IT Strategy

The objective of our IT strategy for the corporate function of the CCG is to ensure

that we maximise on the potential of IT systems to communicate with the public,

service users, our partners, the CCG Membership and ourselves. CGG members

and staff will be supported in their work by high performing, robust and resilient IT

services that are flexible, scalable and support the delivery of innovation and new

ways of working.

NHS Doncaster CCG already has a well-developed and robust IT infrastructure that

will be developed and maintained over the course of this strategy. The key

objectives of the forward IT strategy are centred on the development of services that

will improve communications with service users, GP members and CCG staff.

These developments are outlined in the following proposals.

Our proposals for NHS Doncaster CCG corporate IT systems i. Starting with a review of the Microsoft Lync platform we will determine if the use

of a Unified Communications system could be adopted by NHS Doncaster CCG to support efficient and effective communication between CCG officers and the GP Members. In June 2015 we will trial the Lync system offered by YHCU and evaluate how it could be used to improve CCG wide communications and what benefits the system can offer. If it is agreed that a Unified Communications system will be of benefit to the CCG the chosen platform will be implemented during 2015/16.

ii. We will explore the use of collaboration tools, such as the private social network system Yammer, to support full engagement with the GP membership. These tools help people to collaborate on work across departments and locations. In 2015 a piece of consultancy will be commissioned to review the current market for collaboration tools, compare these against NHS Doncaster CCG’s requirements and advise on which would be the best solution to adopt. The chosen platform will be implemented in 2015/16.

iii. In response to the national re-procurement of the NHSmail system and the need to adapt the current local email system to new security standards we will work with our IT service provider to identify if NHS Doncaster CCG should remain on a locally provided email system or migrate to the new NHSmail service. The choice of system will also impact on GP practices and they will be engaged in the system selection exercise, which will be carried out during 2015/16. If we remain on a local email service improvements will be made to allow web access to the system and increase the size of mail boxes.

iv. A new public website for NHS Doncaster CCG that promotes improved engagement with our community is in development and will be released in August 2015.

v. Following the release of the new public website we will work on the development of a new corporate website for use by CCG Officers and

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Members. This site will support easy access to all common corporate systems, information and documents that CCG officers require. The site will be developed incrementally starting in 2015.

vi. NHS Doncaster CCG is keen to promote the development and use of apps to support access to services and the delivery of care, and has already developed an app that provides a guide to the use of local health services. Over the course of this strategy we will engage with staff and GP Members to identify further opportunities for developing apps that improve the delivery of care. We will participate in the Code 4 Health initiative when it is implemented by NHS England in 2015 and support our staff in learning how to develop apps and other digital services.

vii. We will continue to develop and upgrade the hardware used by our staff, ensuring that they have high performing equipment that is fit for purpose. During 2015 all our laptops will be converted to solid state drives to enhance their performance and additional software will be installed to improve system capabilities.

viii. During 2015 we will pilot the use of Apple workstations on the CCG network to test how well they perform and inter-operate with the existing Windows environment. This pilot will help us to determine what benefits Apple workstations can offer and if they are a viable alternative to the existing Windows based PCs and laptops for use in the commissioning function.

7. Information and data security

The delivery of this strategy will require the application of robust information

governance and data security. Over the course of this strategy we will develop

appropriate approaches to information sharing and data security that are

implemented across the health community and ensure that service users and the

public are well informed about the uses of their sensitive personal data.

Our proposals for information and data security i. We will continue to use the Information Governance Toolkit to drive forward our

Information Governance capabilities. The toolkit will be relaunched by October 2015 to reflect enhanced information governance and data security requirements.

ii. We will further strengthen the role, responsibilities and functions of our senior information risk owner and information asset owners in-line with national proposals.

iii. We will work with our providers to ensure they implement the enhanced data security standards and requirements that will be published by the HSCIC in 2015.

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iv. We will implement the national roadmap for a whole-system, consent-based approach to information sharing when this is published by the National Information Board in 2016.

8. Implementing the strategy

The vision described in this strategy will form the basis of annual operational delivery plans

that will be delivered by the IT services staff and IT service provider (RDaSH) detailed in

section 2. Delivery of these plans will be overseen by the GP IT Lead. In support of the

delivery of this strategy the following principles will apply:

IT Strategy: principles of development i. We will engage with the GP Members on an annual basis to identify and agree

their priorities for IT developments. These priorities will form the basis of the annual delivery plans for each of the three years of this strategy.

ii. We will deliver our services in an agile way, and design services that are capable of frequent, iterative improvement.

iii. We will ensure that we have appropriately trained staff to deliver this strategy and that we have access to specialist skills as required.

iv. We will ensure that the CCG has appropriate digital capability in-house, including specialist skills.

v. We will use simple, flexible procurement routes, such as G-Cloud and the Digital Services Framework.

vi. We will make use of cloud technology where appropriate.

vii. We will ensure a level playing-field for open-source software and demonstrate an active and fair consideration of using open-source software.

9. Review

This strategy will be reviewed as a minimum every 3 years.

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10. Glossary

Code4Health The NHS Code4Health programme was launched by NHS

England in March 2015. The programme provides doctors,

nurses and care staff with specialist training and support to

create and deliver their own IT programmes and products to

increase their involvement in the development of online tools that

will directly lead to improved care. ICE ICE (Integrated Clinical Environment) is a portfolio of software

products developed by Sunquest that are widely used in Acute

NHS Trusts and Primary Care to support the safe, efficient and

easy to use requesting of laboratory tests, radiology exams,

therapies or any other service. Lync The Lync system is a unified communications system developed

by Microsoft. The cloud based implementation of Lync offered

by the YHCU allows integration between email, instant

messaging, presence information and video conferencing PBCI Portal The PBCi portal is a bespoke solution provided by Doncaster

Clinical Commissioning Group (DCCG) to increase the

understanding of key information to clinicians and practice

staff. It has been designed to be completely managed by the

DCCG and requires no external consultancy support. As this

resource is developed in house, it offers unlimited possibilities in

regards to the distribution of information to Doncaster GP

Practice. The system provides intelligence on unplanned and

planned care activity, a document library providing general

guidance and information on clinical commissioning, as well as a

function to submit evidence of enhanced service claims. The

system also enables GP Practice staff to submit requests for

information which go directly to the Performance and Intelligence

team at NHS Doncaster CCG. Solid State Drive A solid state drive is a replacement for traditional hard disk drive

which has no moving parts or disk and instead stores data on

data chips similar to portable memory sticks. Solid state drives

are much quicker than traditional disk drives and allow

computers to boot up and operate quicker. SNOWMED SNOMED CT (Systematized Nomenclature of Medicine --

Clinical Terms) is a standardized, multilingual vocabulary of

clinical terminology that is used by physicians and other health

care providers for the electronic exchange of clinical health

information.

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Unified Communications

Unified communications is a phrase used to describe any

communications system, usually a business system, that

encompasses a broad range of technologies and applications

that have been designed, sold and supported as a single

communications platform or as one entity. Unified

communications system generally enable companies to use

integrated data, video, and voice in one supported product.

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Appendix 1: NHS Doncaster CCG IT Strategy 2015/2018 - Summary

Priority Area National Programme Local Strategy Outcome

Doncaster CCG Strategic Ambitions

Care out of hospital NA

• GP remote working programme

• remote consultations pilot

• development of a local clinical portal

• development of a local interoperability roadmap

• Doncaster wide health and care Wi-Fi network

• improved patient experience

• improved efficiency

Care of the frail NA

• implementation of electronic clinical letters

• risk stratification system review




• implement the Medical Interoperability Gateway (MIG)


• urgent care service information sharing


• improved access to information for clinicians and patients/careers

• interoperable systems

Co-ordinated care NA


• implementation of electronic order communications (ICE)

• record sharing between Community and Primary Care

• establish a local Health and Care IT programme board









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National Information Board Priority Domains

Enable me to make the right health and care choices: supporting digital services for patients and citizens

• nhs.uk, including access to personal health records

• digital primary care services

• digital 111

• digital applications library

• support for self-care

• support for digital inclusion

• implementation of the Patient Online programme



• improved access to digital services and transactions

• improved efficiency and productivity

Transforming general practice

• General Practice Systems of Choice (GPSoC)

• GP IT

• GP2GP

• Prime Minister’s Challenge Fund (PMCF)

• General Practice paper-light accreditation

• GP systems template review

• GP systems training programme

• GPSoC review

• GP Members web portal

• risk stratification system review


• General Practice private data network

• General Practice Wi-Fi networks


• General Practice IT equipment refresh

• General Practice monitor upgrades



• improved access to information

• improved efficiency

• support for new ways of working

• high quality data

Out of hospital care and integration with social care

• ePrescribing

• ePharmacy

• urgent and emergency care

• integration with social care online

• care accounts

• local Authorities

• implementation of the Electronic Prescribing Service







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Acute and hospital services

• elective/non elective care

• eHospitals

• summary Care Record

• electronic Health Record

• barcodes

• supplier side efficiencies





• improved access to information for clinicians

Paper-free healthcare and system transactions

• interoperability

• automation of system transactions

• electronic Health Record

• Summary Care Record

• electronic medicines supply chain

• digital diagnostics

• back office transactions, e.g. BSA, pensions

• wider system access – dentistry, defence etc


• implementation of electronic order communications (ICE)

• record sharing between Community and Primary Care




• General Practice IT equipment refresh

• General Practice monitor upgrades









• improved efficiency and productivity


Data for outcomes and research

• data platform/strategy

• system-wide consistency of data capture at point of care

• transparency

• genomics




NHS Doncaster CCG IT Strategy 2015 - 2018

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