Publications Gateway Ref No 01445 - NHS England · Publications Gateway Ref No 01445 GP IT Capital...

Publications Gateway Ref No 01445

GP IT Capital Approval Process Guidance Document April 2014 1

NHS England INFORMATION READER BOX

Directorate

Medical Operations Patients and Information

Nursing Policy Commissioning Development

Finance Human Resources

Publications Gateway Reference: 01445

Document Purpose

Document Name

Author

Publication Date

Target Audience

Additional Circulation

List

Description

Cross Reference

Action Required

Timing / Deadlines

(if applicable)

Guidance

LS1 7UE

[email protected]

Tracey Grainger

Programme Head of Primary Care IT

Quarry House

Leeds

This document notifies all interested parties of the arrangements for the new

GP IT Capital Approval Process for FY 2014/15 and beyond, as part of

Securing Excellence in GP IT Services: Operating Model 2014-16, 2nd

edition (the GP IT operating model).

31 March 2014 or publication of this document

NHS England

02 April 2014

CCG Clinical Leaders, CCG Chief Officers, NHS England Regional

Directors, NHS England Area Directors, Directors of Finance, GPs, Primary

Care IT support service providers

#VALUE!

Securing Excellence in GP IT Services: Operating Model 2014-16, 2nd

edition (the GP IT operating model)

None

NHS England and CCGs to operationalise this guidance

GP IT Capital Guidance

Superseded Docs

(if applicable)

Contact Details for

further information

Document Status

0

This is a controlled document. Whilst this document may be printed, the electronic version posted on the

intranet is the controlled copy. Any printed copies of this document are not controlled. As a controlled

document, this document should not be saved onto local or network drives but should always be accessed

from the intranet



GP IT Capital Approval Process Guidance – 2014/15 and beyond April 2014 1. Purpose

1.1 To notify all interested parties of the arrangements for the new GP IT Capital Approval Process for FY 2014/15 and beyond, as part of Securing Excellence in GP IT Services: Operating Model 2014-16, 2nd edition (the GP IT operating model).

2. Background

2.1 This guidance relates to the Strategic Systems and Technology (SS&T) central Patients and Information directorate (P&I) capital approvals process, and is to be applied when submitting bids against the national agreed GP IT capital budget.

2.2 NHS England has direct accountability for GP IT capital, which is managed by the P&I directorate. However bids will need to be submitted by CCGs or their delivery partners with support from their NHS England area team.

3. NHS England Capital Accounting Guidance

3.1 The NHS England Capital Accounting Guidance is outlined in the Gateway document referenced below, which explains the NHS capital rules in detail. Key points relating to GP IT capital are as follows:-

In accordance with NHS England accounting policies, property, plant & equipment is capitalised if:

it is held for use in delivering services or for administrative purposes;

it is probable that future economic benefits will flow to, or service potential will be supplied to, NHS England/CCGs;

it is expected to be used for more than one financial year;

individually have a cost equal to or greater than £5,000; or

collectively have a cost of at least £5,000 and an individual cost of more than £250, where the assets are functionally interdependent, they have broadly simultaneous purchase dates, are anticipated to have simultaneous disposal dates and are under single managerial control; or

form part of the initial setting-up cost of a new building, irrespective of their individual or collective cost. (Gateway reference 00984: Document available on request from [email protected])

mailto:[email protected]



National systems roll-out

For NHS England to capitalise expenditure in relation to national systems roll-out, a tangible or intangible asset would have to be bought or created and maintained on NHS England’s Fixed Asset Register. These assets would be accounted for in NHS England’s financial accounts. If the national system is owned by another organisation, e.g. HSCIC, and is not an asset of NHS England, then any costs incurred by NHS England in terms of initial set up, including roll-out of national systems, would be treated as revenue costs and expensed in year as they could not be allocated to assets maintained by NHS England.

4. Capital depreciation

4.1 Capital depreciation will be managed through NHS England financial processes and will not be funded from within the delegated revenue budget to CCGs for GP IT. This includes depreciation charges for legacy assets transferred from PCTs to NHS England on 1 April 2013.

5. A new GP IT capital approval process

5.1 This new process has been designed to meet the following NHS England Central SS&T core principles and objectives:-

To implement an approach that establishes a fair and consistent approval process for GP IT capital investment across England for 2014/15 and beyond;

to set the framework for collaborative and effective capital planning going forward; and

to build upon the work done in 2013/14 and establish a collective and robust application process for GP IT capital approval, where NHS England SS&T, Finance, area teams and CCGs are clearly aligned.

5.2 It is based upon a universal approach for England which evaluates need and

the realisation of strategic objectives, and has been designed to provide more timely distribution of funds and greater assurance that programmes will meet delivery and financial milestones.

6. Capital approval timeline

6.1 A final approval target date of June 2014 has been set for the authorisation and distribution of all agreed 2014/15 capital monies:



Milestone Date 2014

Start design of new GP IT capital approvals process January

Circulate GP IT Capital Approval Process Guidance March

CCGs and area teams formulate and score Project Initiation Documents (PIDs) for submission to Regional Heads of Strategic Systems and Technology for assurance and inclusion in Regional Investment Panels

March & April

Regional Investment Panels held March & April

Central SS&T assurance group assure approved bids April & May

NHS England Finance Project Appraisal Unit (PAU) independently appraise and agree submitted bids. Approval then sought from the NHS England Chief Financial Officer

May

NHS England SS&T authorise commencement of agreed schemes and the distribution of all agreed 2014/15 capital bid monies to area teams

June

6.2 It is essential that all necessary steps are completed by key milestone dates

for the new process to be effectively delivered, however it is understood that this is a challenging timeline which could be prone to slippage. The key objective is to secure bids early on, and take decisions as soon as practically possible to enable this investment to be confirmed sooner rather than later in the year.

6.3 A detailed Project Delivery Plan has been circulated for the 2014/15 process, which assigns all necessary tasks to individuals and investment panels/groups. This was agreed at the SS&T design workshop and subsequent tele-conference in February 2014. A Task and Finish group has been created to facilitate and support timely and effective delivery.

6.4 The NHS England SS&T Primary Care Systems Commissioning Manager will monitor the progress of delivery during the plan cycle.

7. “Notional” regional GP registered population funding split

7.1 To assist with the overall planning process, the agreed £66m 2014/15 capital funding level has been notionally “split” across the four regions. These monies have been further aggregated into the main types of expected spend, based on current intelligence and the 2013/14 bidding round:



Notional GP capitation split (£m) 2014/15

Operational and Strategic Priority

Notional % of

expected spend

North Midlands &

East London South Total

Practice mergers/new practices resulting from commissioning decisions already made

10% 1.9 2.0 1.1 1.7 6.6

Systematic and planned technology refresh

45% 8.3 9.0 4.8 7.6 29.7

GP system replacement

30% 5.6 6.0 3.2 5.1 19.8

Service Improvement Programmes, including CCG schemes

10% 1.9 2.0 1.1 1.7 6.6

Other 5% 0.9 1.0 0.5 0.8 3.3

Total 100% 18.5 19.9 10.7 16.9 66.0

The splits above are purely indicative, and are shown as a guide to assist with planning during the bidding round. Ultimately all schemes will be judged on merit and “compelling need” for England against the overall total, and bid portfolios over and above the regional totals above may/could be prioritised for agreement during the central P&I directorate assurance process if they contain sufficient evidence to justify higher scores (see 8.4 below). However all assured bids must not exceed the total.

Worked example In its overall portfolio of bids, a region demonstrates “compelling need” across its estate, and earns maximum scores in the ‘practice mergers/new practices resulting from commissioning decisions already made’, and ‘systematic and planned technology refresh’ priorities. In this case the capital monies associated with these schemes pushes the overall amount approved above the “notional” regional amount by £3m. Therefore in order to balance spend against the £66m total, a reduction of £3m would have to made from the remaining three regions. This would be applied as part of the overall prioritisation basis.



8. Project Initiation Document (PID) and Scoring Matrix

8.1 A new GP IT PID has been created to ensure that all bids receive the required scrutiny and contain sufficient evidence that illustrates and justifies requests for capital expenditure. This is shown at the end of this document.

8.2 The GP IT PID must be submitted by the CCG, working with its GP IT delivery partner (e.g. CSU) and NHS England area team. It must be completed and submitted to the Regional Head of Strategic Systems and Technology for assurance and inclusion in the GP IT Capital Approval Investment Panel with an indicative scheme score (see 8.4 below).

8.3 Several pieces of evidence are requested within the PID, which has been designed to ensure that all key elements have been captured to enable investment panels to appraise and approve final bids. Business justification for bids should be evidenced at an appropriate level of detail (dependent upon the scope and scale of individual bids) to confirm the strategic need and relative priority of the proposed investment.

8.4 A GP IT Scoring Matrix has also been included, which provides an assessment mechanism for each bid to evaluate essential need, return on investment (invest to save) at three levels, and qualitative and indirect benefits that support strategic direction. The Scoring Matrix assesses bids against the following criteria:

1. The main Operational and strategic priorities of anticipated spend and their essential or non-essential contribution to main operational functionality:

Operational and Strategic Priority Priority

ranking


5

Systematic and planned technology refresh 5

GP system replacement 3

Service Improvement Programmes, including CCG schemes 3

Other 2

The first two priorities are recognised as essential for the operation of GP practices, and therefore attract the highest score;

the third, although important, is not recognised as essential, and therefore attracts a lower score;

the fourth is based upon quality and innovation, and has again been scored lower due to the non-essential nature of the category; and

the fifth priority, “other” is not fully defined, and therefore attracts the lowest score.



And

2. The main reasons determining investment priorities:

Investment priority

Essential for operation of service

Investment to save revenue of above 20% annually over five years of the level of investment

Investment to save revenue of above 10% annually over five years of the level of investment

Investment to save revenue between 0% and 10% annually over five years of the level of investment

Investment to provide qualitative or indirect benefits and support strategic direction

Priority ranking

5 4 3 2 4

The first priority is for services which are essential for the operation of GP practices, and therefore attract the highest priority score;

the second recognises the value of the highest level of potential revenue saving over five years (>20%), and therefore attracts the joint second highest score;

the third and fourth reflect the potential of lower levels of revenue saving over five years (saving of >0% and <=10% plus saving of >10% and <=20%), and therefore have lower scores, and

the fifth priority recognises the value of quality, innovation and delivery of objectives that support strategic direction, which, if fully evidenced, will attract a higher score.

Overall scores are derived by multiplying the Operational and Strategic Priority score by the Investment Priority score. They must then be prioritised into a “hierarchy of potential acceptance” against the “notional” allocation splits shown in 7.1 above. If a bid portfolio exceeds its regional notional split, it will be considered on merit and “compelling need” by the Central SST P&I Assurance Group against all other bid portfolios received across England (see 7.1 above).

NOTE – schemes over £100k should contain a greater level of detail, notably a clear illustration of potential “invest to save” revenue savings over five years, and qualitative or indirect benefits that support strategic direction. Scoring matrix worked examples (see boxes above)

a. A new GP practice has recently been commissioned and needs to be populated with GP IT equipment. It cannot operate effectively without this. Although the building itself has been funded from a separate premises budget, the funding for the equipment must come from the GP IT capital investment budget.

Therefore it is a leading operational priority attracting a score of 5 in the “Operational and Strategic Priority” section. As noted, it is essential for the



operation of service, and therefore also attracts a score of 5 in the “Investment Priority” section.

In this example a score of 25 is derived by multiplying the two scores.

b. A potential new GP replacement system has been appraised. Although this replacement is not essential for the operation of service, there is sufficient evidence to demonstrate a 22% revenue saving annually over five years of the level of investment. Therefore it is a lower Operational and Strategic Priority, attracting a score of 3, but attracts a higher “Investment Priority” score of 4 due to the “invest to save” potential.

In this example a score of 12 is derived by multiplying the two scores. 9. GP IT capital approval investment panels

9.1 Four regional investment panels have been created to appraise and approve all bids before they are submitted to the SS&T Primary Care IT inbox ([email protected]).

Membership All panels will have, as a minimum, the following representation: i) Senior representative with clinical knowledge of GP IT ii) Regional Primary Care Commissioning Director or delegated

representative iii) Regional Director of Finance or delegated representative iv) Regional Head of Strategic Systems and Technology Along with any other nominal support required by the group (e.g. any additional technical, financial, primary care commissioning etc. experts).

Purpose and duty The purpose and duty of the panel is as follows:

i) To appraise and agree or reject the proposed PIDs submitted to it. Panels must be satisfied that there is sufficient evidence and description to justify the priority scores ascribed to bids, and must reject any scheme which does not demonstrate compliance with the PID criteria;

ii) to ensure that all financial capital rules have been followed and adhered to, along with any local governance arrangements; and

iii) to prepare a portfolio of all agreed and rejected bids to be submitted to the SS&T Primary Care IT inbox ([email protected]) for assurance.





Terms of Reference Membership

Representative Role Panel involvement Name

Senior representative with clinical knowledge of GP IT

Chair To chair and steer meeting, ensuring overall clinical oversight and involvement

Regional Primary Care Commissioning Director or representative

Panel member

To ensure that bids fit with primary care commissioning priorities

Regional Finance Director or representative

Panel member

To ensure that bids are compliant with NHS England capital rules and any other financial considerations

Regional Head of Strategic Systems and Technology

Panel member

To lead the development of CCG bids with area teams

Administrator Panel support

To assist with meeting preparation and take minutes

It is expected that all members attend the Regional Investment Panel meeting. Where this is not possible through annual leave, sickness or other circumstances an appropriate representative must attend. Quorum For decision making the Chair and at least three other panel members must be in attendance. Reporting arrangements

Minutes and actions of meetings will be distributed in a timely fashion to panel members and all other interested parties and stakeholders. Purpose The Regional GP IT Capital Approval Investment Meeting has the responsibility to agree and approve or reject proposed bids submitted to it. It will provide resource and specific commitment to support the appraisal process and verify the evidence provided to justify the overall case for funding and validate the priority score ascribed to bids.



Roles and objectives: To undertake this responsibility effectively the GP IT Capital Approval Investment Panel will:

Sign off and agree or reject the PID.

Formally ensure and document that all NHS England Capital Finance rules and any local governance arrangements have been adhered to.

Review all risks, issues and exceptions relating to the above and determine appropriate courses of remedial action.

Report any proposed courses of action to the SS&T Primary Care IT inbox ([email protected]) for resolution.

Frequency of meetings A maximum of three meetings to be held between March and May 2014, as scheduled within the Project Delivery Plan. Extra/additional meetings may also be required as determined by the operation of the process.

10. Central SS&T assurance

10.1 All bids (agreed or rejected) by investment panels must be submitted to the SS&T Central P&I directorate for final assurance. This is to ensure that the Director of Strategic Systems and Technology, as budget holder for GP IT capital, has final oversight of all completed bids and can be assured that all proposed GP IT capital investment is aligned with operational and strategic objectives, capital rules, and any constraints itemised within the GP IT operating model.

10.2 This assurance step in the process also ensures that all bids have received a full and transparent appraisal within the P&I directorate, and also provides the opportunity to address and resolve any emerging operational issues or financial constraints which may impact at national level.

10.3 Central SS&T P&I assurance will also arbitrate, resolve and administer any funding contention if necessary, in collaboration with Regional Heads of Strategic Systems and Technology, e.g. if one region proposes a portfolio of bids which robustly evidences overall “compelling need” exceeding the notional pot limits etc.




Central SS&T P&I assurance group Terms of Reference Membership

Representative Role Assurance involvement Name

GP Chair To ensure overall clinical oversight and involvement

Central SS&T Head of Business Systems

Assurance group member

To work with the group to ensure that all bids contain sufficient evidence that illustrates and justifies requests for capital expenditure, and that all capital rules have been adhered to.

Richard Jefferson

Central SS&T Primary Care Programme Head


To work with the group to ensure that all bids contain sufficient evidence that illustrates and justifies requests for capital expenditure, and that all capital rules have been adhered to.

Tracey Grainger

Central SS&T Primary Care Systems Commissioning Manager


To work with the group to ensure that all bids contain sufficient evidence that illustrates and justifies requests for capital expenditure and that all capital rules have been adhered to.

John Sadler

Central SS&T Business Systems Commissioning Manager



Peter Sherratt

Central SS&T Business Systems Project Manager



Sian Greenley

It is expected that all members participate in the Central SS&T P&I assurance process.



Where this is not possible through annual leave, sickness or other circumstances an appropriate representative must be nominated to participate. The group will also work with the relevant Regional Head of Strategic Systems and Technology as appropriate during this stage. Quorum For decision making the Chair and at least three other assurance group members must authorise assurance for all bids.

Purpose The Central SS&T P&I assurance group has the responsibility to ensure that all proposed GP IT investment has been robustly appraised within the NHS England P&I directorate and is aligned with operational and strategic directives, capital rules, and any constraints itemised within the GP IT operating model. Roles and Objectives: To undertake this responsibility effectively the Central SS&T P&I assurance group will:

complete an assurance audit which ensures that all finalised and approved or rejected bids received during the process contain sufficient evidence to justify their priority scores

complete an assurance audit which ensures that all NHS England Capital Finance rules have been adhered to and applied

resolve any proposed course of action lodged by investment panels to the Central SST P&I inbox

arbitrate, resolve and administer any funding contention noted in section 7.1 above, and inform all parties as appropriate with reasons for decisions made and agreed outcomes.

Timeframe for completion of assurance The timeframe for assuring all bids will be from March to May 2014. At the end of this period the Central SS&T P&I Primary Care Systems Commissioning Manager will then submit all finally assured bids to Regional NHS England Finance Project Appraisal Unit (PAU) leads. 11. NHS England Finance PAU assurance

11.1 Upon receipt of all assured SST P&I finally assured bids, currently planned for 5 May 2014, the NHS England Finance Regional PAU leads will commence their independent assurance process. The aim is that this will be completed by Friday 16 May 2014. Upon completion, all bids will then be submitted to the NHS England Chief Financial Officer for consideration of approval.



12. NHS England Chief Financial Officer agreement

12.1 Upon receipt of all assured SST P&I PAU assured bids on 19 May 2014, the NHS England Chief Financial Officer will appraise all finally submitted bids for capital approval. Friday 30 May 2014 has been set by the PAU planning process for receipt of all agreed bids.

13. Notification of all finally approved bids and delegated capital budgets

13.1 Upon receipt of all finally agreed bids and capital expenditure, regional NHS England Finance PAU leads must send all PID detail to the Central SS&T Primary Care IT inbox ([email protected]) and Heads of Regional Strategic Systems and Technology. The planned date is Monday 2 June 2014. Upon receipt of the information the SS&T P&I Primary Care Systems Commissioning Manager will notify all finally approved bids and delegated budgets to area teams.

14. Invoicing arrangements for capital expenditure

14.1 Area finance teams will administer all invoicing arrangements with CCGs and/or their GP IT delivery partners (e.g. CSUs). All invoices will go through the normal financial authorisation process escalating through Regional Directors of Finance as necessary.

14.2 All GP IT acquisitions are NHS England assets which are funded through the NHS England GP IT capital budget. Therefore where a CSU is the delivery partner arrangements should be made to allow the CSU to raise Purchase Orders (POs) directly on the NHS England ledger having fist confirmed that the requisite business case approval has been secured. Confirmation that the relevant investment has secured the required formal business case approval and subsequent approval of resulting POs will remain the responsibility of NHS England at area team (at Director of Finance) level. For other delivery partners and non CSU supported CCGs alternative arrangements resulting in a recharge to NHS England should be made.

15. GP IT capital expenditure monitoring

15.1 The central SS&T team is currently formulating a national reporting process for GP IT capital investment. This is expected to be on a monthly basis, and full detail will be issued in April 2014 to area and regional teams.

16. Queries and further help

16.1 Please forward any queries or requests for further guidance to: [email protected]





NHS England GP IT Project Initiation Document – 2014/15

Note: A separate MS Word version of this form is available at the same web location as this document

TITLE OF SCHEME

NAME OF THE CCG MAKING THE APPLICATION

Sponsor:

CONTACT DETAILS

Please provide details of lead sponsor officer for the scheme (name/title/office & mobile phone number/email address).

GP IT DELIVERY PARTNER CONTACT DETAILS

Please provide details of the lead GP IT delivery partner contact. (name, title, office, mobile phone number, email address)

BRIEF GP IT SCHEME DESCRIPTION

Please include description of:

(a) location (b) scope (c) objectives and benefits – these may be financial and/or non-

financial (d) wider stakeholders and their interest e.g. potential occupants

STRATEGIC NEED

Please provide justification for the scheme.

CONSISTENCY WITH COMMISSIONING AND PREMISES DEVELOPMENT (if applicable)

Please provide a brief description of new premises commissioned and old premises de-commissioned, and service improvement schemes submitted through the general Capital process. Please also provide timescales.

CAPITAL COST ESTIMATES (including VAT)

14/15 15/16 16/17 17/18 18/19 Total Total Capital Cost: £xk £xk £xk £xk £xk £xk


REVENUE SAVING

Net revenue impact (by financial year) 14/15 15/16 16/17 17/18 18/19 Total Net Revenue Impact £xk £xk £xk £xk £xk £xk Please provide details of the revenue/quality benefit in sufficient detail to support the derived score from the Capital Approval Matrix below.

PRIORITY SCORE

Please provide the score that you have derived from the GP IT Capital

Approval Scoring Matrix below

PROPOSED PROCUREMENT STRATEGY

Where available please attach a key milestones plan e.g.: Date of procurement Planned start of works Estimated completion date Also demonstrate: Compliance with procurement rules and Standing Financial Instructions Value for money in the procurement process

KEY RISKS

e.g. Ability to be completed within FY Other

ENDORSED BY (if required)

CCG DIRECTOR OF FINANCE

Organisation

Name

Date

AREA TEAM HEAD OF FINANCE

Organisation

Name

Date

NHS ENGLAND P&I INVESTMENT PANEL

Organisation

Name

Date

Name


INVESTMENT PANEL DECISION (For NHS England SS&T P&I Regional Investment Panel use)

Please document the decision made and provide supporting reasons for approving or rejecting the scheme. Please demonstrate where appropriate that acceptance of the scheme is a fair investment to support equitable and consistent progress towards standards and strategic system deployment within the region. Please document that all capital rules and any associated local governance arrangements have been adhered to.

FINAL CENTRAL SS&T P&I DIRECTORATE ASSURANCE (For NHS England Central SS&T P&I Assurance Group use)

Please document that the NHS England Central SST P&I Assurance Group is assured that the scheme is aligned with operational and strategic objectives, capital rules, and any constraints itemised within the GP IT operating model.

Provide supporting main reasons for approving or rejecting the scheme.

NHS ENGLAND CHIEF FINANCIAL OFFICER APPROVAL (For NHS England Finance PAU team use)

Please document whether approval given by Chief Financial Officer.


GP IT Capital Scoring Matrix

Financial and Qualitative Priority

Essential for operation of

service

Investment to save revenue of above 20%

annually of the level of investment

Investment to save revenue of above 10% annually of the

level of investment

Investment to save revenue between 0%

and 10% annually of the level of investment

Investment to provide

qualitative or indirect

benefits and support strategic direction

Operational and Strategic Priority

Score 5 4 3 2 4


5 25 - - - -

Systematic and planned technology refresh 5 25 - - - -

GP system replacement 3 - 12 9 6 12

Service Improvement Programmes, including CCG schemes

3 - 12 9 6 12

Other 2 - 8 6 4 8

Publications Gateway Ref No 01445 - NHS England · Publications Gateway Ref No 01445 GP IT Capital...

Documents

Transcript of Publications Gateway Ref No 01445 - NHS England · Publications Gateway Ref No 01445 GP IT Capital...