The National Programme for Information Technology (NPfIT) by HC120913175347

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									The National Programme for
  IT in the NHS in England
            (NPfIT)
      Richard Granger
      Director General


      September 2004
            Context
The NHS serves 52m people in England.
In 2002-2003 it dealt with:
  – 325m consultations in primary care (each
    person visits their GP an average of 6 times
    a year)
  – 13m outpatient consultations
  – Almost 5.6m people admitted to hospital for
    planned treatment
  – Nearly 13m people attended A&E
  – 4m emergency admissions
  – 617m prescription items issued
Digital Information leads to
            Health
In the NHS in England:
• 10.8% of patients on medical wards
  experience an adverse event, 46% of
  which were judged to be preventable
• One third led to greater morbidity or death,
  this means almost 1,300 hospital deaths
  each year could be prevented
• An average of 8.5 additional days
  unnecessarily spent in hospital
• If the data from a sample of trusts are
  extrapolated across the NHS, this costs
  almost £2 billion each year
• 12% of adverse events were related to
  medicines use
               Our aim

• To deliver a 21st Century health service
  that is better for patients, citizens, clinicians
  and people working in the NHS through the
  efficient use of Information and
  Communication Technology

• To improve the convenience, quality and
  safety of patient-centred care by ensuring
  that those who give and receive care have
  the right information, at the right time
The IT ‘No Needless ….’ List

 • No needless harm

 • No needless inaccuracy

 • No needless clinical tests

 • No needless approximation

 • No needless inefficiency

 • No needless bureaucracy
SMain:




          National Programme for IT
         A ten year £6.2bn programme to deliver four
         key elements:
             – NHS Care Records Service
                • National Patient Record Spine
                • Local Service Providers
             – Electronic appointment booking
             – Electronic Transmission of
               Prescriptions
             – Underpinning IT Infrastructure and
               network
                Shopping...
  • rapidity
  • creation of a multi-supplier contestable post
     award framework
  • appropriate risk transfer
  • completion/service risk remains with the
     contractor
  • additional capacity
  • clear understanding of what we want to buy
  • ensure applications and systems perform before
     we buy them
  • buy things that work together
  • cope effectively with change
  • equitable approach to intellectual property rights
www.dh.gov.uk/PolicyAndGuidance/
InformationTechnology/NationalITProgramme/fs/en
                         Suppliers
  National Application        National Infrastructure
  Service Providers           Service Provider




 Local Service Providers

 North West & West                    North East cluster
 Midland cluster                      Accenture
 The CSC Alliance                          Eastern cluster
                                           Accenture
Southern cluster
                                       London cluster
The Fujitsu Alliance
                                       Capital Care
                                       Alliance, led by BT
                      What the NHS will see
July 2004                  Jan 2005                Jan 2006                    Jan 2007                 Jan 2008




   Choose and Book (2004 on)

     NHS Care records Service (Security, messages, personal demographics)


            GP IT (QMAS)



                   PACs (phase 1)     (phase 2)          (phase 3)



                       LSP bundles (NE and E)


                                        Electronic Transfer of Prescriptions


                                        GP to GP transfer


                                        LSP bundles (North West/West Mids)


                                                  LSP bundles (London and Southern)


                                                    NHS Care Records Service - clinical records start


                                                                      NCRS - future releases
  LSP bundles - examples
IT package solutions to support:
• Maternity bundle
• Theatre management bundle
• Patient Administration System bundle:
  - Master Patient index
  - Clinical data repository
  - A & E tracking
  - Registration, admissions, discharges & transfers
  - Bed management etc
• Clinical support bundle
  - Results reporting
  - Order communications
  - Clinical noting and correspondence
  - Discharge summary
              Value
This will be achieved by:
•   Avoiding multiple procurements
•   Significant reduction in time taken on
    procurement and acquisition costs
•   Reduced unit costs for applications and
    systems e.g. PACS
•   Ensuring that multiple national
    suppliers maintain on-going post award
    competitive pressures at the time of
    any change, extension or renewal
  Value, an example : PACS
Technology to capture, store, display
and distribute medical images
• far less waiting for X-rays and scans to
  be processed and checked
• reduced costs as there will be no films
  and less storage space and resource
• taken over 5 years to get PACS in 25
  trusts. Roll out to 142 trusts by March
  2006 and all 178 by March 2007
• average price of total PACS system
  reduced by 50% with 71% pricing
  reduction on disc storage and 82% on
  PACS servers
Nationwide Security


      Authentication
           What are we building?
            Electronic Booking
               www.chooseandbook.nhs.uk

 Create referral request
                                          Referrer
                                          or Booker
                                                          
                                                          BMS
                                                                Create referral
                                                                request
     Book appointment       EBS          (via Primary
                                        Care System)            Book
   Create referral letter                                       appointment

   View booking status                                          Create

     Request advice &
                                           Booker             referral letter
                            EBS         (via New NHS      BMS
             guidance                    Network: N3)


  Book appointment                                              Book

Change appointment                       Patient via
                                           Internet
                                                               appointment

                            Internet   & Unique Booking   BMS   Change
View booking details                        Ref No              appointment
     Electronic Booking

    What may come next?
•   Patients booking via the internet into primary care
•   Services delivered via Digital TV
•   Linked appointments
•   Transport requirements
•   Primary-to-primary booking
•   Tertiary booking and referral
•   Follow-up appointments
•   Clinical assessment services
•   Onward referrals
 What are we building?
NHS Care Records Service
• A single electronic health care record for
  every individual in England:
   – a comprehensive life-long history of patients’ health
     and care information, regardless of where and when
     any by whom they were treated
   – providing healthcare professionals with immediate
     access to summary of care encounters and clinical
     events held on a national data repository. 52m patient
     records
   – supporting the NHS to collect and analyse information,
     monitor health trends and to make the best use of
     clinical and other resources
   – essential information held at local level where most
     care is delivered.
  What are we building?
New National Network (N3)
• A combination of Broadband connections and
  network services to link all NHS organisations in
  England with specialist applications and wider
  Internet applications
• Orders already placed for the first 3,300 Broadband
  connections for the NHS
• NHS will represent 10% of all Broadband usage in
  Britain
• In longer term data circuits will provide voice
  services to make phone lines redundant and
  increase savings
• Over the next 7 years new contract will save an
  estimated £900m compared to existing NHSnet
  contract
n3@nhsia.nhs.uk
             Today’s Challenge

Front line
systems                       LSP    GP system   GP system   PAS
             E-Booking NCRS
and national                   1         1           2        1
applications



Testing       Standards - Compliance - Performance - Connectivity




NPfIT
Testbeds       Sandpit 1          Sandpit 2           Sandpit 3
                                Planning
Summary of Planning information                       North West
                                                      1.
                                                      2.
                                                           Carlisle
                                                           Blackpool
                                                                                                                                                                                           East Midlands
                                                                                                                                                                                           1.
                                                                                                                                                                                           2.
                                                                                                                                                                                                Nottingham
                                                                                                                                                                                                Derby
                                                      3.   Liverpool                                                                                                                       3.   Leicester
                                                      4.   Manchester                                                                                                                      4.   Northampton
                                                                                                          North

16,000 Primary and Secondary Sites                    North East
                                                      1. Newcastle-upon-Tyne
                                                                                                  1       East                1                                                            East of England
                                                                                                                                                                                           1.   Norwich
                                                      2. Middlesbrough                                                                                                                     2.   Peterborough

12,000 dentistry sites                                Yorkshire & The Humber
                                                      1.   York
                                                                                         North
                                                                                         West
                                                                                                                  Yorkshire &
                                                                                                                                              2
                                                                                                                                                                                           3.
                                                                                                                                                                                           4.
                                                                                                                                                                                                Cambridge
                                                                                                                                                                                                Bedford
                                                                                                                                                                                           5.   Ipswich
                                                      2.   Leeds                                                  The Humber                                                               6.   Luton
                                                      3.   Wakefield
                                                      4.   Barnsley                                                                                       1                                West Midlands

Approximately 38,000 sites not
                                                                                              2
                                                      5.   Sheffield                                                          2
                                                                                                                                                                     7                     1. Wolverhampton
                                                      6.   Rotherham                                                                  3                                                    2. Birmingham
                                                      7.   Hull                                                           4                                                                3. Coventry

including Pharmacy sites                                                                  3
                                                                                                          4
                                                                                                                                  5
                                                                                                                                              6
                                                                                                                                                                 East
                                                                                                                                                               Midlands
There are 10 significant milestones per                                                                                               2
                                                                                                                                                  1




site, which represents in excess                                                                              1
                                                                                                                  2
                                                                                                                              3
                                                                                                                                                  3
                                                                                                                                                                             2
                                                                                                                                                                                                       1



                                                                                                   West                                                                                         East of
of 380,000 milestone. Each site will                                                              Midlands                                                4
                                                                                                                                                                     4
                                                                                                                                                                                     3
                                                                                                                                                                                                England
                                                                                                                                                                                                           5

have in excess of 100                                                                                                                     1
                                                                                                                                                                         6




implementation activities which will                                                                  2
                                                                                                                      1
                                                                                                                                                      2               LONDON


generate 380 million activities.                                                        South West
                                                                                                                                          6
                                                                                                                                                                     3                   South East

                                                                                                                                                                                 4
                                                                                                                                                      5
                                                                               4                                  3

                                                                                   South West                                                                 South East
                                                                        5          1.   Swindon                                                               1.   Oxford
                                                                                   2.   Bristol                                                               2.   Reading

 Approximately 112,000 milestones                                                  3.
                                                                                   4.
                                                                                        Bournemouth
                                                                                        Exeter
                                                                                                                                                              3.
                                                                                                                                                              4.
                                                                                                                                                                   Guildford
                                                                                                                                                                   Brighton
                                                                                   5.   Plymouth                                                              5.   Portsmouth
 and activities for National System                                                                                                                           6.   Southampton



            Programmes

       Choose
                     Spine       N3       ETP   CONTACT                 PACS
       & Book
       Our vision


A digital health service that is
        fit for the future

								
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