1. Electronic Patient Record (EPR) Programme Our Journey with IMS Maxims 10 June 2015 Sara Wall, EPR Delivery Manager Stuart Hill, Senior Project Manager

2. Background 600 bed medium size District General Hospital Originally used South West Swift PAS (like all other South West Trusts from Gloucester to Cornwall) NPfIT - Cerner Millennium in December 2007 BT LSP contract - expires 31 October 2015

3. Lessons Learned from NPfIT Front-line staff engagement is essential - IT enabled not IT lead programme Suppliers software alone cannot transform the NHS - we need to up our game and do this for ourselves! It’s all about people and relationships - software is increasingly looking the same We know all this so why do we keep doing the same old things and expecting different results?

4. Procuring our EPR Objective options appraisal “was there anything out there worth changing from what we already had?” Competitive Dialogue - 18 month process Procurement team - Operational and IT staff Complex shortlisting process Suppliers: 50 - 11 - 8 - 5 - 1 Usual OBS but Site Visits, References, Demonstrations, Market Stalls and Dialogue with 5 suppliers!

5. “Was there anything out there worth changing from what we already had?” Value for money - limited cost of change if remaining with incumbent Functionality to meet our needs but agile for the future Commercial arrangement that would support not restrict us Supplier that we could work with - not a standard customer/supplier relationship?

6. Obtaining Board sign-off Detailed Business Case - scrutinised by the Trust Board - did we have the appetite to change? Community of Interest Company (CIC) - NHS England assurances? Board approval - 19 March 2014 Contract signed 28 April 2014 Go live 28 th September 2015

7. Why Open Source? Why Not? No licence costs You simply have the options: Traditional software support (Supplier) Developing skills in house (Trust / CIC) Mixed economy Tactical and strategic solutions - open architecture / APIs provide options to integrate with other systems Flexibility for the future

8. Implementation in Phases Phase 1 transition to replace existing Cerner legacy Replace existing PAS, Theatres and A&E systems by September 2015 Contingency is to have existing systems in place until 31 st October 2015 Subsequent phases will be subject to formal change control, with a full analysis of benefits We have choice and control over the future EPR phases within the programme

9. What are we doing different this time…. Our Project Team is largely drawn from front line staff, playing key roles Consultants Pharmacist Nurses Admin Manager Small number of formal project managers Significant engagement across the organisation to inform system design

10. How does this work in reality? Benefits: Knowledge of the business Networks and links Engagement and trust with peers Ownership Product that is already being well received Challenges: Inexperience of large projects Scope creep Drive for perfection Contention between project controls and operational desires

11. What else are we doing different this time…. Pursuing a true collaborative partnership with IMS – from top to bottom within the organisations Maxims user Trusts and NHS England have formed a Community of Interest Company (CIC) Significant opportunity for NHS Trusts and Clinicians to develop new functionality to be shared across the NHS for free.

12. Can technology save the NHS?