1. N3 / Help the Hospices - Connecting Hospices Workshop John Hemsley Business Leader N3 Self Funding Customers

2. Domestics

3. Objectives of the day The objectives of today are to: Provide a description and background to N3 Benefits to a Hospice of being connected to N3 Present the options available to a Hospice Overview and detailed Provide an opportunity for questions and answers Outline the next steps for up you to gain access to N3

4. Agenda TimeSpeaker 10:30Welcome and objectives of the dayJohn Hemsley, N3SP 10:35Hospice Connect and the current state of playDr Steve Plenderleith, Help the Hospices 11:55Hospice Connect/ICT Hub Survey 2008Jacquie Wakeford, Miriona 11.35Coffee break 11:55N3 Service and options for hospicesJohn Hemsley, N3SP 12:15Set-up & configuration of N3 connectionKaushik Roy, N3SP 12:45Lunch & networking on 34 th floor 13.45CFH Information Governance – Statement of Compliance David Stone, CFH & Dr Kevin King, CFH 14.45A hospice experienceDr David Butler, Consultant in Palliative Medicine Countess Mountbatten House, Southampton 15.15Next stepsJohn Ellis, N3SP 15.35Q & A 16.05Finish

6. Gossip, Rumour and Salacious Tittle Tattle Dr Steve Plenderleith March 2008 Possibly !!

7. THEN

8. “The Magnificent 7 10 and me” Northern Cluster Meeting Jason Coleman Cluster Lead JColeman@trinityhospice.org.uk Dr Julia Riley Cluster Clinical Lead julia.riley@rmh.nhs.uk Southern Cluster South East Region- - South West Region- Peter Thomson Peter.Thomson@rowcroft- hospice.org.uk - Chris Halling-Brown CHalling- Brown@prospect-hospice.net Northern Cluster North West Region- Liam McCarthy lmccarthy@sah.org.uk North East Region- Darren Harvey DarrenHarvey@stoswaldsuk.org Midlands Region- Tony Colson tony.colson@bsmh.org.uk Eastern Region- Darren Holmes Darren.Holmes@stbarnabashospice.co.uk Steering Group Dr Steve Plenderleith s.plenderleith@helpthehospices.org.uk

9. Proposed Meetings Annual National Meeting – September/October –Organised by Help the Hospices –National speakers on new areas of interest –Followed by Steering Group Meeting Cluster Group meeting – March/April –Formal in part, summary produced, may be followed by informal session –London –Southern –Northern Regional Meetings – November/December - June/July –Informal, mentoring/networking group –SE, SW –NW, NE, Midlands, Eastern –London

10. I am writing to ask for your help in addressing some of the barriers that hospices, as key voluntary sector providers of palliative and end of life care, are encountering in gaining connection to the NHS IT network. Help the Hospices is the national membership body for hospice care, representing almost 200 independent hospices across the UK. We work to help our members to deliver the very best care for patients and their families through education, training and support, as well as providing a national voice for the hospice movement. I enclose, for your information, a list of hospices within your region. Hospices play a major role in the delivery of local services to those approaching the end of life. They provide holistic support to people facing a terminal diagnosis, and supply over 75 per cent of specialist palliative inpatient capacity within the healthcare system, by working closely in collaboration with NHS clinicians. Many hospices have been trying to establish a connection with the NHS network since the National Programme for IT began. Their success has been variable, depending often on the interest and good will of local IT professionals within the NHS. Others have faced significant barriers where professionals have either lacked interest in working with organisations outside the NHS or have been unsure whether they have the permission to develop such links. The latest guidance from the Department of Health on information management (Guidance on Preparation of Local IM&T Plans for 2008/09) clearly articulates an expectation that localities will work with NHS organisations on these issues. It stated that in developing local IT plans there is a need to “develop information sharing arrangements with independent sector providers of NHS funded care”. We hope that this unambiguous reminder will encourage greater local dialogue and progress in all areas. Palliative and end of life care is also receiving increasing attention from Government, with the development of a national End of Life Care Strategy, and recognition within the NHS Operating Framework and the emerging NHS Next Stage Review. A key part of improving and developing end of life care in all communities will be the technological infrastructure which supports the process. The availability of up-to-date patient information for all providers of palliative and end of life care is crucial to delivering service improvements. I hope that you will be able to clarify with those working to implement the roll out of the NHS IT network in your region, including PCTs in your area, that they can and must engage with hospices and ensure connection to the network. A letter to the SHA’s NHS Operating Framework 2008 -09

11. NOW

12. CfH Digital Information Governance Team Hospice Requirements Information Governance Management 101, 102, 103, 105, 106 107, 109 (if applic.), 110, 111, 112, 113 Confidentiality and Data Protection Assurance 201, 202, 203, 204, 205, 206, 208, 210, 214 (if applic.) Information Security Assurance 301, 303 (smart cards if applic.), 305, 306, 307, 308, 313, 314 (if applic.), Clinical Information Assurance 401, 403, 405 Not 603 FOIA Tie in with Healthcare Commission standards?

13. THANKS - Policies St Catharine’s Hospice Saint Francis Hospice St Mary’s Hospice St Oswald’s Hospice Farleigh Hospice Rowcroft Hospice Katharine House Hospice N London Hospice Southport & Ormskirk St Peter’s Hospice Pasque Hospice More Needed Library

14. Software Review RiO – A good work in progress. Infoflex – update needs writing up. SystmONE & Crosscare – need updating. Palcare – Struggling with new MDS.

15. IGSoC – Information Governance Toolkit HELP ! LPfITLondon IG Group meets every 2 months 3.4.08, 29.5.08, 31.7.08 @ 14:00 - to attend please contact london.communications@nhs.net Invite from Stephen Elgar london.communications@nhs.net Others – by the time these slides go out.

16. NEXT

17. Hospital Systems PACS INFO Prescrip -tions Community Systems Secure NHS e-mail Clinic Booking NELH N3 Spine Activity Data 30 IGSoC Requirements Hospice Specific e - Prescribing Laboratory Results EPR SNoMed CT e - Staff Record

18. ESR Electronic Staff Record Do hospices need it ? Can we have it?

19. Education, Training and Development (ETD) series replaces ECDL NHS ELITE (eLearning IT Essentials) NHS Health (eLearning for Health Information Systems) NHS National Learning Management System (NLMS), linked to the Electronic Staff Record (ESR). Electronic Staff Record http://www.esrsolution.co.uk/ Microsoft NHS Resource Centre

20. Secure NHS e-mail PACS Community Systems Laboratory Results Activity Data EPR SNoMed CT e - Prescribing INFO Prescrip -tions Northern Clusters  Lorenzo by another name  Part of the LSP contract ? London  RiO being rolled out to PCT’s & Mental Health Trusts RiO  Is it available for hospices? Southern  Millennium for all!  ACSS

21. ACSS Set up to cover specialities and areas of NHS IT need, not covered in the original LSP contracts. Tendering has just closed for companies applying for eligibility to supply to specialities within Lot 2. Long list of companies involved available on their website. –TPP not there –CSE Servelec are. -Additional Supply Capability & Capacity Framework Lot 2 Clinical Information Technology Services

22. Service Category Hospice Care: (2.8) Objective of this Service Category: This Service Category encompasses the requirements for hospice services Details removed as document not available for publication – yet.

23. ACSS Further Info needed Potential for bulk buys Who negotiates for hospices and who pays SHA ?- SHA ? LSP ?- LSP ? HtH ?- Hospice ? Clusters ?

24. Freedom of Information Act 2000: Designation of additional public authorities Consultation document Cost implication or just another requirement 603

25. THE FUTURE More Ideas Welcome !

27. Help the Hospices/ICT Hub IT Survey 2008 Seminar 18 March 08

28. Agenda Introduction The survey results ◦ Basic hospice demographics ◦ The IT team ◦ IT governance ◦ IT infrastructure ◦ Business and system applications ◦ Security ◦ Hot topics ◦ Skills, training and support Next steps

29. IT Survey 2008 Objectives To enable HtH and its Hospice Connect cluster groups to focus on those areas where hospices most need help To enable HtH to establish which common services and suppliers are being used, to apply leverage and gain value To provide Hospice IT teams with useful sector data to benchmark against

30. HOSPICE DEMOGRAPHICS

31. Hospice Income 52 17 15 6 Total replies = 90

32. Number of IT Users 30 28 20 8 12 Total replies = 98

33. IT TEAM

34. Team Size Of those with an in-house team, about 70% have 2 or less IT staff. Average number of staff increases in line with number of users: 8 Total replies = 85

35. Managed Services Type of Managed Service # who use this (total replies = 90) Desktop maintenance/fault fixing46 (52%) Printer/copier maintenance/fault fixing59 (66%) Server/network maintenance/fault fixing69 (77%) Hosted applications31 (34%) Helpdesk/Service desk41 (46%) Specialist help for projects on an ad-hoc basis 59 (66%) Consultancy when no in-house expertise2 (2%)

36. Managing User Requests Activity # who use this (total replies = 87) We have a Helpdesk/Service Desk30 (35%) Users just email, phone or visit the IT team64 (74%) We log all issues to resolution33 (38%) We can do remote IT support for fault fixing50 (58%) We can do remote software installations/upgrades 31 (36%) We have a Service Level Agreement for user requests/issues 19 (22%)

37. IT GOVERNANCE

38. IT Budgets Operating Budget Capital Budget 1513 26 24 5 8 44 19 11 1 Total replies for both = 83

39. IT Decision Making 48 40 57 9 6 Total replies = 75

40. IT Strategy 24 21 2513 Total replies = 83

41. Policies and Agreements Top 3 in place ◦ Data Protection: 79 (95%) ◦ Use of Internet/Email: 69 (83%) ◦ Information Security Policy: 59 (71%) Top 3 planned ◦ Communications Policy: 20 (25%) ◦ Information Security Policy: 18 (22%) ◦ Internal Service Level Agreement: 17 (21%) Total replies = 83

42. Compliance Top ‘aware and compliant’ = Data Protection: 71 (87%) Top ‘aware and planning response’ = Freedom of Information: 29 (35%) Top ‘unaware’ = Email Retention: 26 (32%) Total replies = 82

43. Management Processes Top ‘have in place’ = incident/problem management: 47 (59%) Top ‘planning’ = asset management: 22 (28%) Top ‘no and not planning’ = change management: 28 (35%) Total replies = 80

44. IT INFRASTRUCTURE

45. Hardware Servers Desktops Laptops PDAs Printers/copiers Network equipment

46. Suppliers The Top 4 (total replies = 76) Dell30 (21%) HP25 (17%) Local16 (10%) Misco8 (5%) Reason for using current suppliers response (total = 78) Price66 (85%) Quality65 (83%) Good customer service55 (71%) We’ve used this supplier for a long time28 (36%)

47. Hospice Connect Cluster Groups Total replies = 52 NorthernSouthernLondon Already involved 16 (31%) 13 (25%) 9 (17%) Intend to be involved 8 (15%) 3 (6%) 6 (12%)

48. BUSINESS AND SYSTEM APPLICATIONS

49. Most Common Applications Desktop = XP: 71 /77 Server = Server 2005: 63 /70 Email = Exchange 2003: 44 /71 Human Resource = bespoke: 13 /74 Payroll = Sage: 36 /75 Finance = Sage: 52 /74 Fundraising = Donorflex: 35 /75 Patient & Family Info = Palware: 30 /77 Lottery = Sterling Members: 26 /73

50. SECURITY

51. DR/Business Continuity Response % Response count Our critical business applications have a ‘warm start’ backup (eg mirrored, clustered, replicated servers) 51%36 We keep spare equipment so that we can quickly rebuild if necessary 28%20 Our users have agreed that there will be no formal business continuity/DR measures 0%0 We have a documented Disaster Recovery IT Plan32%23 We have an alternate location available for IT if our main location is lost 27%19 We have a UPS to cover at least our critical systems82%58 Total replies = 71

52. Data Back-ups Response % Response count We have a process of daily/weekly/monthly back-ups 88%68 Our back-ups are automated66%51 We back-up to tape only44%34 We backup to hard drive (instead of or as well as tape) 34%26 Our backups are securely stored off-site68%52 We regularly practice data restores39%30 Total replies = 77

53. Security Measures In PlacePlanning Anti-virus protection on desktops and servers 76 (100%)0 (0%) Malware checking for external emails 53 (70%)3 (4%) Malware checking for internal emails 36 (47%)5 (7%) Hardware firewall(s) 62 (82%)1 (1%) Software firewall(s) 56 (74%)2 (3%) Website filtering/restrictions 44 (58%)5 (7%) Management of portable memory units (Eg memory sticks, iPods) 14 (18%)17 (22%) Anti-spam 64 (84%)2 (3%) Total replies = 76

54. HOT TOPICS

55. The Top Five Planned... Already have/use Will implement in next 12 months Will trial/pilot in next 12 months NHS Connect 14 (21%)15 (22%)18 (27%) Application implementation/ major upgrades 11 (16%)28 (41%)2 (3%) DR/BC 22 (32%)21 (31%)4 (6%) VoIP/IP telephony 10 (15%)2 (3%)16 (24%) Remote working 30 (44%)10 (15%)7 (10%) Total replies = 68

56. SKILLS, TRAINING AND SUPPORT

57. User Competence and Training Competence: ◦ Most are ‘Reasonably competent’: 36 /77 (47%) Training: ◦ Most done by the IT Team: 36 /75 (48%)

58. IT Staff Training: ◦ Most common: reading/self-study: 50 /58 (86%) Formal qualifications: ◦ Most common: technical: 27 /64 (42%) ◦ ‘None’ is the same... Pressure of work ◦ Most common: ‘Busy’: 37 /62 (60%)

59. Support for IT Team somelots would like to have Internal support25108 Local PCT8317 Umbrella groups (such as Help the Hospices) 14210 IT groups (such as British Computer Society) 905 Mentoring (from internal person) 511 Mentoring (from external person) 924 Total replies = 53

60. WHAT NEXT?

61. Next Steps Complete the summary results report and issue to responders Complete recommendations report Agree an action plan Implement actions! A similar survey may be done in 2009

63. N3 Introduction & Background

64. What is N3? New National Network for the NHS N3 connects all NHS locations to allow digital sharing and exchange of information. NPfIT – February ‘04 – BT awarded contract as network integrator. –Live for 4 years now. Probably the largest network in Europe. Coverage for England & Scotland.

65. NPfIT contracts LSP NISP N3 NASP EBS NASP NCRS

66. The Value of N3 Metcalfe's law states that the value of a telecommunications network is proportional to the square of the number of users of the system (n²). N3 has >34,000 sites with over 500,000 users.

67. Savings from N3 NAO report 14th March 08 –The Department of Health said that of savings totalling £208m, N3 generated £192m, with digital imaging and scanning saving a further £14m and software licensing and hardware maintenance contributing £617,000.

68. N3 Service options for Hospices The question of resilience

69. N3 Hospice Configuration Local Network N3 Customer Router Backup via ISDN N3 Core Network DSL Network ISDN IPstream Central Primary via IPstream Max Premium

70. N3 Service options for Hospices GPRS Mobile Community network 256K to 1G sites (GP to Hospital) 8M to 1G data centre (LSP, NASP) N3 core Hospice Internet ISP and remote VPN (Home working) VPN Gateway

71. Hospice Catalogue Services N3-9-6 IPstream primary + 128kb/s ISDN backup line N3-2-53 IPstream primary + 256kb/s ISDN backup lines N3-2-54 2Mb/s Private Circuit primary + IPstream backup N3-9-5 IPstream primary No backup line N3-9-6

72. Prices (subject to site survey and vat) Installation Monthly Rental £ 1,220£ 31(£2,336 3 yr) £ 1,620£ 75(£ 4,320 3yr) £ 4,220£ 155(£ 9,800 3yr) £ 9,580£ 705(£34,960 3yr) N3-9-6 N3-2-53 N3-2-54 N3-9-5

74. Set-up & Configuration of N3 Connection NameKaushik Roy TitleTechnical Consultant NOT TO BE SHOWN OUTSIDE OF N3SP

75. British Telecommunications plc Registered office: 81 Newgate Street, London EC1A 7AJ Registered in England No. 1800000 www.n3.nhs.uk Topics for Today N3 Network Overview Connectivity Options An Example Solution Design Questions & Comments

76. British Telecommunications plc Registered office: 81 Newgate Street, London EC1A 7AJ Registered in England No. 1800000 www.n3.nhs.uk Access: N3 / Internet Care HistoryCare PlansCare Services NHS CRS CRS SpineCAB ETP PACS CRS = Care Records Service CAB = Choose and Book ETP = Electronic Transfer of Prescriptions PACS = Picture Archiving Communication System N3 Network Overview

77. British Telecommunications plc Registered office: 81 Newgate Street, London EC1A 7AJ Registered in England No. 1800000 www.n3.nhs.uk N3 Network Overview Access to the following applications: NHS Email, CAB, PACS, ETP, Clinical Records, etc. Access to local community applications - through your local PCT Internet Access What does the access to the N3 network give you:

78. British Telecommunications plc Registered office: 81 Newgate Street, London EC1A 7AJ Registered in England No. 1800000 www.n3.nhs.uk N3 Network Overview The N3 network is based on 58 PoP locations throughout England & Scotland Each PoP location is an interconnection of thousands of individual connections Each PoP is connected to the BT MPLS network to provide a private network with any-to- any connectivity

79. British Telecommunications plc Registered office: 81 Newgate Street, London EC1A 7AJ Registered in England No. 1800000 www.n3.nhs.uk N3 Network Overview

80. British Telecommunications plc Registered office: 81 Newgate Street, London EC1A 7AJ Registered in England No. 1800000 www.n3.nhs.uk Connectivity Options Most connectivity options are based on a catalogue system This offers various bandwidths and different levels of redundancy Bandwidths options range from ADSL to Gigabit Ethernet Bespoke designs are also available

81. British Telecommunications plc Registered office: 81 Newgate Street, London EC1A 7AJ Registered in England No. 1800000 www.n3.nhs.uk Connectivity IPStream Typical Consumer Broadband but for Business Use Downstream bandwidth between 288kbps and 8128kbps Upstream Bandwidth between 64kbps and 832kbps

82. British Telecommunications plc Registered office: 81 Newgate Street, London EC1A 7AJ Registered in England No. 1800000 www.n3.nhs.uk Connectivity IPStream Based on Max Premium service from BT Wholesale Rate Adaptive – bandwidth related to distance from nearest BT Exchange No QoS guarantees – QoS can be applied to packets However no guarantee that packets will not be dropped within BT Wholesales network However Max Premium will be prioritised over residential broadband

83. British Telecommunications plc Registered office: 81 Newgate Street, London EC1A 7AJ Registered in England No. 1800000 www.n3.nhs.uk Connectivity: N3-9-5 Non-Resilient Connectivity Single Cisco 1801 Router at Customer Site Single IPStream Connection to N3

84. British Telecommunications plc Registered office: 81 Newgate Street, London EC1A 7AJ Registered in England No. 1800000 www.n3.nhs.uk Connectivity: N3-9-6 Resilient Connectivity Single Cisco 1801 Router at Customer Site Primary IPStream Connection to N3 Secondary ISDN at 128kbps

85. British Telecommunications plc Registered office: 81 Newgate Street, London EC1A 7AJ Registered in England No. 1800000 www.n3.nhs.uk Connectivity: N3-2-53 Resilient Connectivity Single Cisco 2811 Router at Customer Site Primary IPStream Connection to N3 Secondary ISDN at 256kbps

86. British Telecommunications plc Registered office: 81 Newgate Street, London EC1A 7AJ Registered in England No. 1800000 www.n3.nhs.uk Connectivity: N3-2-54 Resilient Connectivity Single Cisco 2811 Router at Customer Site Primary 2Mbps private circuit Connection to N3 Secondary IPStream

87. British Telecommunications plc Registered office: 81 Newgate Street, London EC1A 7AJ Registered in England No. 1800000 www.n3.nhs.uk Connectivity: N3-2-56 Resilient Connectivity Single Cisco 3825 Router at Customer Site Primary 10Mbps Ethernet Connection to N3 Secondary IPStream

88. British Telecommunications plc Registered office: 81 Newgate Street, London EC1A 7AJ Registered in England No. 1800000 www.n3.nhs.uk Connectivity – What You Get Managed Service N3 Operations 0800 085 0503 HSCR Bandwidth utilisation Reporting N3 Portal Access Full Access to N3 - Internet and Applications

89. British Telecommunications plc Registered office: 81 Newgate Street, London EC1A 7AJ Registered in England No. 1800000 www.n3.nhs.uk Connectivity – What we need Power – 240V AC 24 x 365 Rack Space – eg., Cisco 1801 1RU Space and Power for Access Circuits: IPStream/PSTN, ISDN, Private Circuit or Ethernet Physical Security of equipment LAN port to connect N3 router

90. British Telecommunications plc Registered office: 81 Newgate Street, London EC1A 7AJ Registered in England No. 1800000 www.n3.nhs.uk Solutions Design Thanks to Darren Holmes, Head of ITC for St Barnabas Lincolnshire Hospice St. Barnabas consists of a 7 smaller sites and 1 main site Solutions Design uses both non-resilient IPStream and Private Circuit connectivity

91. British Telecommunications plc Registered office: 81 Newgate Street, London EC1A 7AJ Registered in England No. 1800000 www.n3.nhs.uk Solution – St. Barnabas Site NamePost CodeNearest BT Wholesale PoP ConnectivityDistance (straight line) in Km Nettleham RoadLN2 1RELincolnIPStream w. no backup1.08 Hawthorn RoadLN2 4QXPrimary: N3 PoP Secondary: LincolnLincoln 2Mbps private circuit w. IPStream backup Primary: 6 Secondary: 3.2 Cardinal CloseLN2 4SYLincolnIPStream w. no backup1.92 Boston Day HospicePE21 9NBBostonIPStream w. no backup1.76 Gainsborough Day Hospice DN21 3ADGainsboroughIPStream w. no backup1.93 Spalding Day HospicePE11 3GDSpaldingIPStream w. no backup1.28 Sutton-on-Sea Day Hospice LN12 2LLSutton On SeaIPStream w. no backup849m Boston Welfare Support PE21 9HHBostonIPStream w. no backup722m

92. British Telecommunications plc Registered office: 81 Newgate Street, London EC1A 7AJ Registered in England No. 1800000 www.n3.nhs.uk Solution – St. Barnabas

93. British Telecommunications plc Registered office: 81 Newgate Street, London EC1A 7AJ Registered in England No. 1800000 www.n3.nhs.uk Solution – St. Barnabas What kind of bandwidth can you expect from an IPStream connection? Quick DIY guide http://www.samknows.com/broadband/ http://www.samknows.com/broadband/

94. British Telecommunications plc Registered office: 81 Newgate Street, London EC1A 7AJ Registered in England No. 1800000 www.n3.nhs.uk Setup & Configuration Thank you for your time.

95. Agenda TimeSpeaker 13.45CFH Information Governance – Statement of Compliance David Stone, CFH & Dr Kevin King, CFH 14.45A hospice experienceDr David Butler, Consultant in Palliative Medicine Countess Mountbatten House, Southampton 15.15Next stepsJohn Ellis, N3SP 15.35Q & A 16.05Finish

96. Information Governance Connecting Hospices Workshop BT Tower 18th March 2008

97. Information Governance Creating the environment Organisational Controls Physical Measures Personal Behaviour

98. Information Governance Key stakeholder drivers Care Record Guarantee IG Statement of Compliance IG Toolkit

99. Information Governance Stakeholder satisfaction - IG Hospices Department Of Health NHS CFH N3 PCT Commissioners N3SP NHS CFH IG N3 SP Programmes Healthcare Commission SHAs CPNI MI5

100. Information Governance Contact David Stone – Communications Manager 0113 397 3698 07947 052704 david.stone@nhs.net

101. Information Governance Information Governance Statement of Compliance Migration Programme (IGSoC) Hospice Training Information Governance and IT Security Dr Kevin J. King IGSoC Processing Manager Information Governance Statement of Compliance Migration Programme 18th March 2008

102. Information Governance Contents Objectives What – Integrating Quality Assurance Why – Quality Assurance View Document Details – Quality Assurance View Information Governance IT Security IGSoC IT Security Headlines Typical Specifics (1 to 3) One Computer Model Actions for One Computer Computer Interchange Contacts Help! - Information Sources (1 to 12) Help! - Summary

103. Information Governance Objectives To focus on:  The IGSoC Process Document Set  Information Governance  IT Security  Proposed ‘Single Computer’ Set-Up To provide:  A guide to sourcing information  An overview of headline subject areas  Some specifics from a QA perspective  Discussion on Information Governance Toolkit (IGT) Requirements (questions and answers at end of day)

104. Information Governance What – Integrating Quality Assurance What is the IGSoC Process? Application Form NACS Code Information Governance Toolkit (Acute Hospital Trust) Sponsorship Letter Logical Connection Architecture IGSoC Declaration Offshore Policy/ISMS Quality Assurance Process Audit Purpose Starts the Process (Register) Unique Identifier Self-Assessment of IG and IT Security Position Confirms Validity of Need Ensuring the Network is Fit for Purpose Commitments and Obligations Patient Identifiable Data Outside England Checking Up Fine Toothcomb

105. Information Governance Why – Quality Assurance View Why is the IGSoC needed by NHS CFH? Availability Confidentiality Integrity Protect Patient Identifiable Data Patient Confidence DPA for employee data Care Record Guarantee Why is the IGSoC needed by organisations? Access to digital services Service Delivery Industrial Good Practice Management of Public Image Focus on central and local DH Legal and Professional Obligations

106. Information Governance Document Details – Quality Assurance View Simple Stuff Application Form, look out for detailed business need, this helps NHS CFH assess submissions IGSoC, read carefully, follow all links and complete the obvious like date, signatory name and position, submit from correct mailbox, if IT Outsourcer involved they must also submit an IGSoC Sponsorship Letter, complete the obvious like date, NHS organisation name, signatory name and position and IP addresses More Complicated IG Toolkit, n requirements, long lead time activity, need to understand ISO 27001/2, conduct gap analysis, account for business need LCA, network topology, show relationship to N3, other networks e.g. corporate, Internet, tell how user and device access to N3 is reduced to a minimum Offshore Policy, if PID is stored or viewed outside England, includes back-ups

107. Information Governance Information Governance is a framework providing a consistent way for employees to deal with the many different information handling requirements, including: Information Quality Assurance The NHS Confidentiality Code of Practice Information Security Assurance The Data Protection Act (1998) Records Management The Freedom of Information Act (2000) It allows organisations and individuals to ensure that personal information is dealt with legally, securely, efficiently and effectively, in order to deliver the best possible care H. Cayton: IG must “provide sound policy, standard setting, independent oversight, monitoring, arbitration and enforcement”

108. Information Governance IT Security All based on: Availability Integrity Confidentiality Most recognised standard is ISO 27001/2 Other standards such as CobiT and ITIL help as can Basle 2, SOX, PCI A large part of Information Governance

109. Information Governance IGSoC IT Security Headlines Network Access Management User Access Management Policies S/W H/W Maintenance Asset Management Audit Controls Legal Compliance Stop network intrusion external and internal Stop unauthorised user activity N3, PID, Password etc. Downloads, Hardening Protecting What/How Making sure IGSoC, DPA, NHS Codes and Practices...

110. Information Governance Typical Specifics (1) Do this: DH Legal and Professional Obligations Penetration Testing Password Policy Asset Register Software Updates Risk Register Hardening and this: Offshore PID Security Incident Log Anti-Spyware Knowledge of Standards Monitoring Systems Anonymise PID Data IGSoC from Correct Mailbox IT Outsourcer (QA & IGSoC)

111. Information Governance Typical Specifics (2) and this: Logging Mobile Code PID Guidelines Audits Documentation in General External Audit Headline Issues Policy Expansion and this: Policy Range Security Policy Vulnerability Scanning Anti-Virus Updates BCP/DRP Devices Connected to N3 Data Protection Act Future Usage

112. Information Governance Typical Specifics (3) and this: IGT Guidance LAN Segregation LCA Update Legislation NHS CFH Contact Policy Deviation Numbers Policy Training RA Procedures and this: Review ISO 27001/2 Send IGSoC Software Download Sponsorship Letter Standards Certification Third Party Contracts URL Filter

113. Information Governance One Computer Model N3 Corporate Internet Associate Interchange: CD USB Hard Drive Hard Copy Fax E-mail Etc. Actions depend on Interchange N3 Router Actions required

114. Information Governance Actions for One Computer All the IG Toolkit Requirements are mandatory Pay attention to: Anti-virus and anti-spyware updates Security patch updates Operating system updates Productivity product updates (MS Office, Adobe etc.) Account administration Account monitoring Third party access Screen controls (password timeout, visibility) Clinical or business application updates

115. Information Governance Computer Interchange Is the one computer really standalone? No, not really, somehow updates are applied. And the likelihood is that data exchanged with N3 via The screen File transfer NHSMail may need to be used elsewhere on the corporate LAN, or even exchanged with other parties, so all the IG Toolkit requirements for the one computer apply to the Corporate LAN. An N3 or PID policy, signed by the relevant staff, is a good way to address some of the IG Toolkit requirements.

116. Information Governance Contacts Dr Kevin J. King – IGSoC Processing Manager 0113 397 3666 07891 151304 kevin.king@nhs.net IGSoC Team 0113 397 3646 IGSoC@nhs.net

117. Information Governance Help! – Information Sources (1)

118. Information Governance Help! – Information Sources (2)

119. Information Governance Help! – Information Sources (3)

120. Information Governance Help! – Information Sources (4)

121. Information Governance Help! – Information Sources (5)

122. Information Governance Help! – Information Sources (6)

123. Information Governance Help! – Information Sources (7)

124. Information Governance Help! – Information Sources (8)

125. Information Governance Help! – Information Sources (9)

126. Information Governance Help! – Information Sources (10)

127. Information Governance Help! – Information Sources (11)

128. Information Governance Help! – Information Sources (12)

129. Information Governance Everything you need is on www.connectingforhealth.nhs.ukwww.connectingforhealth.nhs.uk Like an Intranet the HOME tab contains current articles e.g. IGSoC Afterwards moved to SYSTEMS and SERVICES tab Multiple links of interest on SYSTEMS and SERVICES tab Information Governance, NHS Number, NHSMail more… NHS Codes of Practice Records Storage DH Legal and Professional Obligations Knowledge Base Remember RHS menus and contact details Help! - Summary

130. IT Issues – an NHS View Dr David Butler Macmillan Consultant in Palliative Medicine Countess Mountbatten House Southampton University Hospitals NHS Trust

131. Setting the Scene SUHT main base - SGH Unscheduled Care Division Cancer Care Group

132. Setting the Scene

133. Specialist Palliative Care Service Based mainly at Moorgreen Hospital IT links via Southampton City PCT

134. Setting the Scene

135. SPC Service Catchment approx 710,000 2 PCTs (previously 5) In patient unit Day Care Community Service Hospital Palliative Care Team (SGH) Education

136. Setting the Scene

137. IT for SPC Pallicare (1999) Clinisys CIS Healthcare Linked to PAS / Chemocare / RTcare Terminals all areas and Winchester Hospital and SGH Chaplains Runs on Citrix

140. A patient Referral from GP on Friday 29 th Feb. Not known to me but had been in SGH. Discharged previous day Would it be appropriate to admit?

141. Pallicare System Link to PAS Possible use for Commissioning purposes

155. Conclusion Information on the hospital system enabled me to discuss the patient and agree admission was appropriate. Then provided information prior to admission and before notes arrived.

156. The Next Steps John Ellis N3 SFC Manager

157. Hospice Trial 4 Hospice’s Bespoke Different Solutions Results Product availability Stand Alone Site Multi-Site Hosted Site Multi Solution

158. N3 Helpdesk Introduction 0800 085 0503, Option 3 Mike Atrill Michael.atrill@bt.com John.3.ellis@bt.com 01977 595760 Connectivity Process: IG SOC Access Agreement

159. Calling Plan Product Options Set Pricing Options Advice on process Placing orders Advice on Implementation and timelines

160. Support IG SOC Team N3 Helpdesk Option 1 In Life Faults Option 2 Delivery Option 3 Helpdesk CRM and Service Portal

161. Review The objectives of today were to: Provide a description and background to N3 Benefits to a Hospice of being connected to N3 Present options available to a Hospice Overview and detailed Provide an opportunity for questions and answers Outline the next steps for up you to gain access to N3

162. Question Time

163. Thank you for your time today