1. The NIMM – Local benefits and experience

2.  Am I providing a good service?  Is it a cost effective service?  If you don’t have measures in place how will you know?

3.  All NHS Trusts are subjected to measurement and comparison, whether by SHA or Monitor  Information on Trusts’ performance is made public  Most clinical services are measured and accredited already  All start with fairly simplistic measures and develop  Why should IT/HIS services be any different, since IT enabled developments like PACS underpin clinical services 24/7

4.  Provider of a shared service, but could not provide evidence of best practice performance or cost effectiveness  Undertaken unofficial benchmarking with other local HISs  Some pockets of good practice – Health Records and Clinical coding accreditation  What have the Roman’s done for us?  How Much!&*!!  If you don’t improve we will take our business elsewhere  Need to take the heat out of the system  The question of a Value for Money HIS was fast becoming an unanswerable taboo

5.  If we can’t prove we are any good, or cost effective, at least provide transparency  Provided customers with a break down of individual service costs and their share of that service  Started by using simplistic metrics, such as: ◦ The number of PCs ◦ The number of end users

6. Proposed share of HIS funding for Financial Year 2009/10 Budget Centre Name Source of evidence for the share of service Budget centre codeBudget Value HIS valuation of work carried out for each Organisation South Devon Healthcare FTTorbay Care TrustDevon PCTDevon Partnership Trust %Value% % % HIS Baseline Costs 2009/10 Clinical RecordsHealth Records Tab16400£768,37894% £719,048.13 2% £13,984.48 5% £35,268.55 0% £0.00 Clinical Records ManagementHealth Records Tab58100£224,89994% £210,460.48 2% £4,093.16 5% £10,322.86 0% £0.00 HIS GraphicsNot Shared74630£39,3730% £0.00 0% £0.00 100% £39,373.00 0% £0.00 Informatics SupportCore Admin systems users75320£227,12081% £183,285.84 11% £25,664.56 7% £16,352.64 1% £1,589.84 Web SupportNot Shared74609£24,429100% £24,429.00 0% £0.00 0% £0.00 0% £0.00 Clinical CodingHealth Records Tab19300£204,20994% £191,098.78 2% £3,716.60 5% £9,373.19 0% £0.00 InformationInformation Team Tab19000£318,51183% £263,090.09 9% £28,347.48 7% £23,251.30 1% £4,140.64 General IT ContractsActual IT Invoices75319£1,017,366 58% £593,938.27 13% £136,428.78 23% £234,299.39 5% £52,699.56 IT Operations Non PayIT Operations Summary Tab74601£80,615 70% £56,430.50 16% £12,898.40 11% £8,867.65 3% £2,418.45 IT Operations ProjectsIT Operations Summary Tab75113£41,380 73% £30,207.40 12% £4,965.60 10% £4,138.00 5% £2,069.00 Desktop Operations TeamIT Operations Summary Tab75110£593,788 64% £380,024.32 19% £112,819.72 13% £77,192.44 4% £23,751.52 Servers TeamIT Operations Summary Tab75111£429,233 79% £339,094.07 15% £64,384.95 5% £21,461.65 1% £4,292.33 Networks TeamIT Operations Summary Tab75112£202,847 70% £141,992.90 11% £22,313.17 18% £36,512.46 1% £2,028.47 HIS Corporate team & ServicesCore Admin systems users74603£379,38781% £306,165.31 11% £42,870.73 7% £27,315.86 1% £2,655.71 HIS Projects & TrainingCore Admin systems users75340£279,775 81% £225,778.43 11% £31,614.58 7% £20,143.80 1% £1,958.43 Actual HIS Budget figures as of July 2008 £4,831,31075.9%£3,665,04410.4%£504,10211.7%£563,8732.0%£97,604 Add Pay Inflation & A4C Banding AdjustmentsESR System £226,38280.4%£182,0119.8%£22,1188.6%£19,5591.2%£2,694 HIS Baseline for 2009/10 Pre LDP £5,057,69276.1%£3,847,05510.4%£526,22011.5%£583,4322.0%£100,298 Acute 3% CRESSee CRES 2009/10 Tab £144,365100.0%£144,365.000.0%£00.0%£00.0%£0 Add Pay Inflation & A4C Banding AdjustmentsESR System £226,38280.4%£182,0119.8%£22,1188.6%£19,5591.2%£2,694 Add Trust applied overheads at an agreed 20%South Devon Healthcare Ledger £966,26220.0%£733,00920.0%£100,82020.0%£112,77520.0%£19,521 New Baseline for 2009/10 - Post LDP £6,105,97175.6%£4,617,70910.6%£649,15811.7%£715,7662.0%£122,513

8. ◦ Health and Social Care Information Centre ◦ Monitor ◦ Healthcare Commission ◦ ATOS ◦ National Computing Centre ◦ SOCITIM ◦ Gartner ◦ NIMM ◦ FIMM ◦ Microsoft

9. ◦ ASSIST / UK CHIP ◦ BCS (HIF) ◦ UKAS ◦ National Computing Centre ◦ SOCITIM ◦ NHS HIS - Clinical coding & Health records model already exists

10.  Can we agree on one standard tool  It should enable meaningful comparison with Industry wide tools, not just the NHS  Can we start simply and develop incrementally  Don’t mandate it until the pilot sites are happy it is fit for purpose  Can the newly created Benchmarking club be the forum for developing the tool

11.  PC Operating system & patch management  PC Operating system platform standardisation  Single Sign On  Software Asset Management  On the above we scored 3 to 4, depending on the customer

12.  Organisations receive assurance of good performance, best practice and VfM  HIS/IT providers can address areas in need of improvement and have sources of evidence to help  We, the internal IT providers, can demonstrate our ability to provide world class IT services, as good as any other sector (the grass is not always greener on the private sector side, but can we prove it?)  We have evidence to demonstrate our service is fit for purpose  Benchmarking and accreditation will support local cases for IT investment

13.  Integration of health and social care is where the big patient benefits will come  CfH/Spine are looking to develop the interoperability of software  We should look to enable the NHS to get best value out of the vast NHS infrastructure and enable all NHS employees to work flexibly  Accreditation of Infrastructure to common standards should provide organisations with assurance that it can provide open access to all NHS employees who happen to be working on their site

14. Any Questions?