Transformation Programme Health Board Chief Executives April 2018 - - PowerPoint PPT Presentation

CHI & Child Health Transformation Programme

Health Board Chief Executives

April 2018

B/18/53

Full Business Case

Issues with Legacy Systems

• Inflexibility: 30 – 35 year old legacy CHI and GPPRS and

Child Health systems are poor at supporting changing business priorities and at meeting new requirements. Cannot support Health and Social Care Integration.

• Poor Architecture: CHI processes are batch based and

compete for a very limited batch window. Both CHI and Child Health have poor data quality. Legacy Technology: hosted on the Fujitsu VME, old mainframe technology and expensive to maintain. Cannot support access control, audit, legitimate relationships.

• See Page 6 of FBC Executive Summary

• Digital Health and Social Care Strategy
• eHealth Strategy

– Declared legacy systems obsolete in 2014

• Children and Young People Strategies
• Vaccination Transformation Programme
• See Page 10 of FBC Executive Summary

Full Business Case

New Systems Support and Enable Strategies

Programme Progress

• Tranche 1: December 2014 – February 2017 Procurement

– CHI and GPPRS – Wipro – SCPHWS - Servelec

• Tranche 2: February 2017 – 28 March 2018 Due Diligence, Proof of

Concept and Full Business Case – Programme Board approved the FBC on 28 March (subject to funding). – FBC is now with SG for decision. – If approved the Programme Team will work with Health Board Lead Officers and suppliers to complete the implementation plan.

• Tranches 3 and 4: Implementation (Partially funded with additional

funding requested)

• Tranches 5: Transformation (No funding requested as yet)

Tranches 3, 4 and 5

• Many Benefits delivered within Tranches 3 & 4 whilst

Tranche 5 is transformational.

• Tranches 3 & 4 Benefits (Examples):

– Flexible modern solutions and increased automation – Single CHI record as source of the truth – Access control, legitimate relationships, improved security – One database across all Health Boards – Increased efficiency and fewer operators

• Tranche 5 Benefits (Examples):

– Real Time messaging instead of daily broadcasts – Introduction of the Record Locator Service (RLS) – Full audit capability on all transactions – Mobile working for Child Health – Integration with other national indices - English Patient Demographic Service (PDS), Welsh Demographic Service

Funding and Costs Position

Funding 10 Year Total (£) eHealth Leads Reinvestment Fund 15.060 eHealth Leads/ SG Requested for past funding (*assuming that it will be approved) 7.410 Additional Funding SG eHealth (total agreed to SG eHealth Leads Feb 2017 letter to NSS £12.206m) 12.206 Total 34.676 Funding Released after Switchover to New Systems Old CHI & Child Health System Savings 27.623 Total 62.30 Cost 10 Year Total Costs to Implement and operate new solutions 67.74

Funding shortfall over 10 years is £67.74 – 62.30 = 5.44 million (£3 million contingency is also being sought)

Legal Position Terminate after Tranche 2

• There is a specific right for NSS to terminate before issue
• f the Implementation Start Notice, subject to payment of

the PoC and DD charges.

• The contracts are in NSS’s favour proceeding to

Implementation - there was no guarantee that the project would proceed to full implementation and roll out.

• However, a case for compensation beyond the sums

agreed for the PoC and DD charges is open to question, there may be advantages in reaching some sort of accommodation with a contractor with regard to reputational damage, avoid a formal legal dispute.

Implementation Who Does What?

Programme Health Board Local Implementation Groups (LIGs)

Health Board Activities & Costs

• Health Board Local Implementation activities, including local testing or

activities needed to implement new working practices, are the responsibility of the respective NHS Health Boards.

• As with the procurement, the programme funding does not cover

payment to Health Boards to pay for Subject Matter Experts who support the Programme team – for example to support configuration decision making, or to carry out National User Acceptance Testing.

• GGC worked with the programme team to estimate some Health

Board Activities and costs which can be extrapolated for other Boards.

Activity Cost (£) Child Health Testing 17,000 Child Health Migration 46,000 New CHI Testing(pre go live) 18,000 CHI Migration 11,000 Total 92,000

Commission

• Scottish Government (as primary funders of this Programme) will

commission a Board / multiple Boards / a consortia to lead on the implementation phase…

• Key content of commissions

– Introduction / Background – driven by FBC – Commissioned Organisation or Consortia – decision required… – Scope / Objectives / Deliverables – driven by FBC – Governance Arrangements – decision required… – Conditions, Constraints and Limits – decision required…

• Response from Commissioned organisation

– Recommendations / Risks / Assumptions – decision required… – Projected Costs – See FBC – Programme Plan / Timeline – See FBC – Confirmation of Acceptance through own Governance – when ready

Implementation Risk Factors

• Large Scale
• Multiple sub-projects
• New technologies (systems and platforms / infrastructure)
• Scope certainty / knowledge of existing systems
• Mission critical systems / high cost of failure
• Multi-supplier / overall design risk sits with client
• High levels of dependency – supplier and client side
• Dual running of environments / high cutover costs
• High level of local collaboration / activity required

Mitigating the Risks - 1

• OWNERSHIP – Commissioned organisation

– Joint ownership (NSS + territorial Board) ? – Board Chief Executive involvement / engagement / SRO ? – Scottish Government directorate involvement

• MULTIPLE SUPPLIERS – How to best manage

– Retain strong procurement / commercial / legal help – Ensure implementation phase CCNs are watertight – Create supplier sub-group within Programme Governance – Integrated plan with formal acceptance of all parties

• COLLABORATION WITHIN NHSS – How to assure

– Formal commitments through each Board Chief Executive – High visibility through Health Board governance structures – Board Lead Officers represented on governance groups

Mitigating the Risks - 2

• COST CONTROL – Risk mitigation

– Clear delineation of programme costs ownership – Strong programme level financial tracking regime – Contingency arrangements/limits – Strong supplier contract management/billing oversight – Risk sharing across NHSS ?

• QUALITY ASSURANCE – Oversight / Control

– Continued high level of project/programme board scrutiny – External QA/Board assurance on regular basis – Adherence to MSP/PRINCE 2 methodology – Resilience/sustainability of team addressed/assured

• OTHER KEY ISSUES FROM CHIEF EXECUTIVES?

Major Decisions Required - 1

• SG Oversight / Commissioning Directorate

– SG eHealth department lead / GG ?

• Joint Ownership Model

– NSS (holds contracts) + AN Other ?

• Governance Structure

– As per current structure + linkage with CE Group ? – New SG Digital governance link tbd

• Chief Executives involvement / engagement

– Programme Board membership / leadership ? – Regular Review / Major Decision consultation ?

Major Decisions Required - 2

• Supplier Management Group

– NSS, Servelec, Wipro, Atos, Health Board linkage ?

• Resource Commitment / Risk Sharing

– Chief Exec letter / MOU / written commitment ? – SG role / underwriting of risk ?

• External Assurance

– Programme Delivery - Ongoing / Gateway / Internal Audit ? – Clinical Assurance arrangements tbd ?

• Conditions, Constraints & Limits

– Tolerances and Contingencies / Escalation routes ? – External dependencies ?

Approval / Timeline

• FBC / Commission Consultation / Approval / Governance

– CHI / CHS Programme Board (FBC approval complete) – SG Funding & Sponsoring Directorates / DoF – eHealth Leads Group – SG Digital Assurance Board / Delivery Board – Chief Executives Group – Commissioned Health Boards Governance Groups – Local Health Boards Governance Groups

• Timeline for Commission

– Discussion with Programme Board: December 15 – Review with SG eHealth: January 12 – Discussion with Chief Executives: January 16 – Draft in correspondence for Programme Board: January 26 – FBC: February 23rd – Back to Chief Executives Now