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					          Project W087 (Health Visitor & School Nurse Migration to NCRS)




          orcestershire ealth                                                rogramme

                     Health Visitor & School Nurse Migration to
                                                NCRS (W087)

                                                                                            Project Brief
Purpose of this Document
The purpose of this document is to provide information enabling a full and firm foundation for the initiation of the project.
The contents are extended and refined into the Project Initiation Document which is the working document for managing
and directing the project.
The Project Brief is a key document in its own right. It is the basis of the Project Initiation Document, which gives the
direction and scope of the project and forms the `contract` between the Project Management Team and corporate or
programme management.
Any significant change to the material contained in the Project Brief will thus need to be referred to corporate or
programme management.
The document should be assessed against the following quality criteria:
         Does it accurately reflect the Project Mandate?
         Does it form a firm basis on which to initiate a project (Initiating a Project (IP))?
         Does it indicate how the Customer will assess the acceptability of the finished product(s)?

Version History.
      Version                             Issue & Circulation Date                           Brief Summary of Change
                                                                                     Draft for comment by Project Board & ICT HoDs.
     01              Draft (20th May 09)
                                                                                     Audit is incomplete.
                                                                                     Update to schedule, prioritisation of teams and
     02              Final (2nd Jun 09)
                                                                                     inclusion of initial audit material.

                     Chris Greening, ICT Programme Manager (chris.greening@nhs.net) (01905 760105)
     Contact         Worcestershire Health ICT Services
                     Worcester Royal Hospital, Charles Hastings Way, Worcester, WR5 1DD


Sign Off.
           Name                                      Title                                              Signature
                         Worcestershire PCT (CEO)
     Paul Bates
                         SRO – Worcestershire ICT Programme Board

                         Worcestershire PCT (Associate Director Provider Services)
     Marie McCurry
                         Project Executive




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Contents
1.     Memorandum of Understanding ........................................................ 3
2.     Ensuring a Project is Managed Effectively ....................................... 3
3.     Project Background ............................................................................ 3
4.     Project Adoption ................................................................................. 4
5.     Immediate Next Steps ......................................................................... 4
6.     NCRS – Overview ................................................................................ 5
7.     Current Systems & Interfaces ............................................................ 5
8.     Outline Business Case, Outputs, Capabilities & Benefits ............... 6
   8.1   Outputs, Capabilities & Benefits ........................................................ 6
   8.2   Outline Business Case ...................................................................... 8
   8.3   Project Outputs .................................................................................. 8
   8.4   Capabilities ........................................................................................ 8
   8.5   Benefits.............................................................................................. 8
9.     Approach ........................................................................................... 10
10.    Scope ................................................................................................. 11
   10.1 Systems ........................................................................................... 11
   10.2 NCRS Functional Modules .............................................................. 11
   10.3 System Interfacing ........................................................................... 11
   10.4 NHS Number Programme................................................................ 11
   10.5 Information Governance & Smartcards............................................ 13
   10.6 Access to NCRS by Trusts & Other Organisations .......................... 14
   10.7 Sites................................................................................................. 14
   10.8 Staff Groups .................................................................................... 14
   10.9 ICT Equipment................................................................................. 14
   10.10 Specific Exclusions ...................................................................... 15
11.    Business Continuity ......................................................................... 15
12.    Product Breakdown Structure ......................................................... 15
13.    Outline Implementation Plan ............................................................ 15
14.    Project Organisation ......................................................................... 16
15.    Initial & Main Points of Contact (Project) ........................................ 17
16.    Post Go-Live Application Support (Generic): ................................. 20
17.    System Training ................................................................................ 20
18.    Communications ............................................................................... 20
   18.1 General Activities ............................................................................. 20
   18.2 The Path to Commitment ................................................................. 20
   18.3 Key Messages ................................................................................. 21
   18.4 Communication Outcomes .............................................................. 22
   18.5 Production and Sign Off of Communication Materials ..................... 23
   18.6 Key Media for Communications ....................................................... 23
19.    Financials........................................................................................... 23
20.    Initial Risks & Issues Identified........................................................ 24
21.    Appendices ........................................................................................ 28




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1. Memorandum of Understanding
Projects are only successful when a set of critical factors come together to create the required
products that will, at some point in the future, deliver the business benefits originally envisaged in
the business case. The types of critical factors include:
      defined and measurable business products.
      an organisation structure, with defined responsibilities, to sponsor and manage the project.
      a defined amount of resources.
      a corresponding set of activities to achieve the business products.
      a finite and defined life cycle.
The above are not a guarantee of success but they will reduce failure.
As the projects Worcestershire ICT Services undertake cross a number of organisations
containing numerous administrative and clinical teams, it is critical that each of those
organisational components are clear about their roles and responsibilities in the project and fulfil
their tasks and obligations in a timely manner. The project Brief is one of the first steps in
establishing a common understanding as to what is to be achieved in the project; the Project
Approach as to how that goal will be achieved.
By authorising this Project Brief via the (sponsoring) Trust Executive(s) as well as the Project
Executive (responsible for the ultimate delivery of the project), the Trust(s) are indicating that all
the necessary Trust resources to fulfil the project are guaranteed and available as defined.

2. Ensuring a Project is Managed Effectively
The National Audit Office (NAO)1 published a report regarding the National Programme for
Information Technology (NPfIT). The ICT based projects in the Worcestershire NHS are either
directly or indirectly (through interim or transitional work) associated with the findings of this report
and as such take account of its findings and work toward implementing its findings at a local level.
As mandated by the Office of Government Commerce (OGC) and highlighted as best practice in
NAO and associated bodies, PRINCE2, will be used as the project management method.
The principles that will be followed in this project are expanded in Appendix 1 and by adopting
this project those involved are agreeing to adhere to those principles.

3. Project Background
Health Visitors and School Nurses (HVs and SNs) within Worcestershire do not currently have
shared access to electronic patient based information, using a mixture of paper and stand alone
electronic data to capture demographic, referral, caseload and contact information.
The scope of the project only covers children as the patient group.
Following an options appraisal in 2006, the Child Health Project Team recommended the use of
the Community Child Health (CCH 2000) IT System for HVs, SNs and other community staff
working with children. This did not take place and the decision has now been taken that the NHS
Care Records Service (NCRS) is the means by which contact, referral and caseload information
should be collected from HVs and SNs for operational and activity management reporting
purposes.
It is not expected that NCRS will provide all the activity management reporting information
required. An aspect of this project is to determine what NCRS can provide, what the gap is and
which system will fulfil that missing information gap.

1
    http://www.nao.org.uk/publications/0506/department_of_health_the_nati.aspx



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NCRS has already been deployed in Worcestershire for community and mental health staff. At
the time of writing this information was not available.

4. Project Adoption
Worcestershire ICT Programme Board is responsible for formally adopting a project and
accepting it into the Programme. A priority for the project is applied to the project based upon an
indication of the association of the project with national or local service initiatives, the scale of the
project, the clinical outcomes anticipated and whether the project is specific to a single Trust or
covers multiple organisations.
The priority (1 is high) is then used to indicate such things as the level of governance oversight
and specifically the skill and experience level of the project manager that is applied to the project.
This project has been given a Project Priority of 4 ( Medium - Trust Clinical Improvement).
A project route is also applied to the project for internal auditing purposes. The route for this
project is Route 3 (Local Service Priority).

5. Immediate Next Steps
In addition to the signing off of this Brief the following steps are necessary to provide a firm base
for the project to move towards initiation. They are not necessarily all the steps necessary, which
will be contained in the Initiation Stage Plan.
1. ICT Services to confirm post project operational Application Support arrangements.
2. PCT to confirm availability PCT data entry clerks to transfer child details from existing systems
   onto NCRS. This is a critical resource and a potential bottleneck to the successful completion
   of the work to the desired PCT schedule.
3. PCT to confirm that the use of NCRS is deemed fit for purpose for the recording of activity and
   for the information requirements by the PCT. The PCT have indicated that NCRS is their
   preferred system but at the time of writing no assessment has been made that confirms that it
   fulfils their full activity reporting requirements.
4. ICT Services to complete technical infrastructure survey, including:
        a. Desktop PCs, particularly smartcard enabled keyboards.
        b. Network printers
        c. Network points - it is noted from the initial audit (Appendix 8) that additional sockets
           are being requested in locations that have only recently been upgraded.
        d. Power points - it is noted from the initial audit (Appendix 8) that additional sockets are
           being requested in locations that have only recently been upgraded.
    It was agreed at the meeting of 2nd Apr 09 that Jenni Stephens would complete this work.
    However, at a meeting on 29th May 09 (between Chris Greening and Marie McCurry) it was
    requested that ICT Services take over the audit.
5. ICT Services to confirmation additional training resources required as a result of compressed
   timescales and that schedule can be met.
6. ICT Services to confirmation additional technical resources (desktop and networking) required
   as a result of compressed timescales and that schedule can be met.
7. PCT to confirm that that additional technical equipment funding is available.
8. PCT to agree and map information reporting outputs against systems, to ensure all service
   requirements are met.
9. Project (Service) Lead (Elaine Jones) to arrange following meetings:



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        a. Project Kick Start Meeting:
                  A one off initial meeting of both the Project Board and Project Team to walk
                   through the project Brief so that everyone understands the scope of the project.
                  Chaired by Project Executive (Marie McCurry).
                  The meeting should take place week commencing 8th Jun 09.
                  2 hours
                  ICT Services will manage the agendas and notes on behalf of project.
        b. Project Board Meetings:
                  Chaired by Project Executive (Marie McCurry).
                  Every 4 weeks
                  Start week commencing 15th Jun 09.
                  1 hour.
                  ICT Services will manage the agendas and notes on behalf of project.
        c. Project Team Meetings:
                  Chaired by Project (Service) Lead
                  Every week
                  Start week commencing 15th Jun 09.
                  1 hour
                  ICT Services will manage the agendas and notes on behalf of project.

6. NCRS – Overview
A major part of the National Programme for Information Technology (NPfIT) is the NHS Care
Record Service (NCRS). Each patient‟s electronic NHS Care Record is made up of two parts:
       A locally held record - where treatment is provided such as at a GP surgery or hospital.
       A summary record - of important details both demographic eg: name, address and medical
        eg, allergies, medication, test results and held on the Spine. The Spine is a national,
        central database where summary patient records are stored. When fully implemented,
        local records will automatically upload important information to the summary patient record
        on the Spine.

7. Current Systems & Interfaces
School Nurses and Health Visitors currently record detail on a range of electronic and paper
based systems. It is necessary to identify and map the range of systems and the data items that
provide this information as well as which systems will continue to provide the data items required.
A prime output from the project is to ensure that the PCT can accurately record, as a secondary
use of the clinical data collected, activity information for statutory reporting as well as financial
purposes. It is therefore critical that there is confirmation that either the NCRS or a mixture of the
NCRS and the other electronic systems provide the full range of data items to the PCT
Information Dept to enable them to create the reports necessary. This is the responsibility of the
PCT System Manager and the PCT Information Dept. The scope of this project does not extend
to creating the management reports. This forms part of the PCT Information Depts operational
work in relation to the Business Intelligence tool.



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The business processes for HVs and SNs are detailed in Appendices 2 and 3.

8. Outline Business Case, Outputs, Capabilities & Benefits

    8.1        Outputs, Capabilities & Benefits
    It is important to highlight that although ICT supports service change it can rarely be a change
    agent in isolation. Technology, although important in assisting with efficiency gains, can only
    support service development a certain distance. To take advantage of the new capabilities
    gained from exploiting the technological products delivered by projects, service
    reconfiguration must be involved to ensure that enhanced effectiveness of service delivery is
    gained. ICT can provide the tools and assist with enhanced capabilities, but it is the service
    that exploits these to gain the benefits over time.




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         Typical Project & Benefit Management Processes




                                                       Phase  0                              Phase 1                           Phase 2                            Phase  3                          Phase4                     Phase  5                           Phase 6                          Phase 7
                             Pre Adoption           -------------                        -------------                      -------------                      -------------                     -------------            -------------                       -------------                    -------------
                                                    Project Adoption                      Initiate Project                  Design & Deploy                   Prepare for Go Live                   Go Live               Verification Period                  Project Closure                Post Project Review




                                                                            PRC                                 PRC                                PRC                                PRC                                                          PRC                              PRC                               PRC
                                                                             1                                   2                                  3                                  4                                                            5                                6                                 7




                                                                                                   Detailed products,
                         Outline service                                                          outcomes & benefits                      Benefits plans in place, including                                                                                         Progress towards outcomes & benefits
                                                     Outline project products
                          outcomes &                                                                     identified.                      metrics, baseline figures and benefit                                    Products verified                                  monitored against plan, optimised and
                                                            identified
                        benefits identified                                                       Initial benefit metrics                         owners & actioners.                                                                                                              reviewed.
Key Benefit Activities                                                                                   identified.
& Documentation
                                                                                                     Project Initiation Document                                                                                                                                         Configuration Audit Report
                                                                     Project Brief                                                                                          Updated benefits plan.                                        Deployment Verification                                            Post Project Review
                         Service Business Case                                                        (PID) – containing benefit          Updated benefits plan.                                                                                                               (for products)
                                                                  Next Stage Plan (for                                                                                    Acceptance Criteria Plan for                                    Report for products and                                          Benefits Realisation Plan
                       Service Proposal / Mandate                                                 statements & metrics and quality       Test strategy for products                                                                                                       Customer Acceptance
                                                                       Initiation)                                                                                                products                                                 handover processes                                                       Review
                                                                                                                  plan                                                                                                                                                             Report




                                                                                                                     “We believe that Digital Dictation can
                                             “We‟d like this project to reduce the                                                                                                   “Plans are now in place to achieve                                                                 “The system has been delivered. The post
                                                                                                                    reduce the backlog of letters requiring
                                             delay in getting letters to patients by                                                                                                the targets we have set – baselines                                                                   project state of the service is now being
       Example                                reducing the backlog in the typing
                                                                                                                    transcribing by 90% and that no letter
                                                                                                                  should wait more than 24 hours to be sent
                                                                                                                                                                                    have been measured and owners of                                                                    measured and the benefits being assessed”
                                                              pool”                                                                                                                         the plans identified”
                                                                                                                                     out”




  benefits_managagement_process_simple_v01.vsd




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    8.2        Outline Business Case
    The PCT (Provider) services have indicated that the current contract management information
    available on activity stemming from School Nurses and Health Visitors is inadequate. The
    information also falls short in relation to statutory returns.
    The PCT believe that NCRS is adequate (potentially in conjunction with other system
    information) for the above reporting functions as an interim to the deployment of Lorenzo
    functionality.

    8.3        Project Outputs
    The outputs (specialist products) initially identified for this project are provided below. The
    Project Initiation Document (PID) will contain a fuller project plan and list of specialist products
    that will allow the key stakeholders to assess progress of the project and the delivery of the
    project products.
              Use of NCRS to capture:
                  o   Patient demographics (where not already available from the Spine)
                  o   Referrals
                  o   Caseload
                  o   Contacts
               The screens that both HVs and SNs will use are provided in Appendix 4.
              Closure of existing paper processes to store information that can be captured via
               NCRS.
              Closure and archiving of any standalone databases.
              Confirmation of which NCRS data items captured fulfil PCT information requirements
               for managing 18ww reporting for this particular area of the service.
              Determining which other systems will be used for particular management reporting
               requirements.

    8.4        Capabilities
    The key capabilities expected from the work are provided below. The PID will contain metrics
    that will specifically identify whether, in the short to medium term, these outcomes have been
    delivered.
              for information to be stored once only in a single location and accessed and assessed
               from any appropriately secure location by a health professional with appropriate
               access rights.
              to access shared information (administrative or clinical) by relevant staff at the same
               time thereby reducing delays in making appropriate clinical decisions.
              to report for contractual and audit purposes on fuller (coded) information that had
               previously been held in disparate paper and electronic.

    8.5        Benefits
    The key benefits expected from this limited pilot project are provided below as well as set out
    in draft format in Appendices 5a & 5b. The PID will also contain metrics that will specifically
    identify whether, in the medium to longer term, these benefits have been realised. A Benefits
    Realisation Plan will form a management product deliverable.


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    The benefits from those capabilities, based on technology combined with business change
    over a period of time are anticipated to include:
     1. Overall - Information entered into and retrieved from a single location is likely to be fuller
        than that being stored on paper and in standalone systems. It is therefore more likely to
        be useful as a shared resource for health professionals in the care of patients, containing
        the only and latest information that should be available about the patient. This should
        result in better decisions being made about the care of the patient with better care
        outcomes and subsequently higher patient satisfaction.
     2. Benefits for Patients and the Public:
        a. Access to a single shared record makes information more easily available for all staff
           involved in the care of a patient, not just the person who initially entered the data,
           making diagnosis more reliable and providing fuller treatment options based on fuller
           information. This will lead to more appropriate and quicker treatment which should
           lead to better clinical outcomes.
        b. As planning of care is held centrally this makes the process of administrating and
           managing care more efficient. This should lead to more time being made available for
           direct patient care which leads to better clinical outcomes.
        c. As information should only be entered once on the system there is less repetition of
           administrative and assessment information. This reduces unproductive time and
           increases time for direct patient care.
        d. Information is only accessible on the system via an electronic card specifically
           assigned to that health professional (smartcard). The health professional can only
           access areas of the system to which he / she has been assigned permissions (Role
           Based Access Control). This is more effective confidentiality than current paper
           records and should give confidence to patients and the Public that their clinical
           information is only being used for the purposes it was intended.
        e. Information that is held in a standardised and coded format is less likely to be
           misinterpreted. In combination with the fuller patient record available in the electronic
           case note this should lead to a reduction in medical error which translates into better
           patient care.
     3. Benefits for NHS Staff:
        a. Easier to access up-to-date information, 24 hours a day, seven days a week to enable
           efficient diagnosis and treatment. This makes working practice easier giving the
           health professional greater confidence that their decision making is based on more
           complete information.
        b. As information should only need to be entered once on the system this should reduce
           the frustration staff can feel at having to duplicate information as opposed to using
           their professional skills on direct patient care.
        c. As information is held electronically fewer records should be lost enhancing the
           professional nature of the service.
        d. The ability to access the patient‟s health care records in more than one place at a time
           reduces the need for staff to travel to locations where information is available. Where
           possible information will follow the health professional. This reduces wasted time for a
           scarce (i.e. clinical time) resource.
        e. Shared records allow better and easier communication and referrals between care
           professionals resulting in more direct working relationships between professionals and
           subsequent dialogue between care regimens.
     4. Benefits for the NHS:


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        a. Improvements in the quality of information, the enhanced outcomes that are derived
           from clinicians having better information and the increased satisfaction of patients
           results in greater confidence in health services.
        b. Efficient delivery of safe, high quality care allows more direct care to be provided to
           patients, reducing time and wastage on non clinical activity.
        c. Cost and time savings from cutting down the amount of paper stored.
        d. Better quality data for planning, audit, fraud detection, research and performance
           management.
    The metrics for assessing that the above have been delivered will be set out in the Project
    Initiation Document (PID) and assessed in a formal post project review, approximately 6
    months after Business Go Live. However, in brief these will include:

9. Approach
The basic approach for the implementation of NCRS will be:
   Piloting the deployment of specific screens (see outputs) in a specific team.
   Assessing the outcome of the pilot for appropriateness against the anticipated capabilities and
    benefits.
   Roll out to remaining HV and SN teams. The team priority list is provided in Appendix 6.
   Assessing activity outputs of NCRS against expected activity management data items.
The project will be led by a service based project lead (Elaine Jones). The day to day project
management will be led by Elaine Jones. Further organisational detail is available in a later
section.
The project will be supported by Worcestershire ICT Services Programme & Project Management
Department in relation to ICT controls and project liaison between the various ICT based
services.
Change Management will play an important role in this project. Examining current working
practices, assessing these against best practice and then working with the service and its
stakeholders to finalise an agreed revised (or confirmed) new set of processes will play a
significant part of the early stages of the project. This is the responsibility of the Change
Manager(s).
Other aspects of the approach known at this stage include:
   End User Training will be provided by the ICT Services Training Department.
   Access via smartcards. A process will need to be created to sponsor and issue smartcards to
    those users. The PCT is responsible for issuing and managing this process.
   IT Operations provided by Worcestershire Health ICT Services 1st, 2nd and 3rd Line Support
    Departments.
   Application Support is provided by ICT Application Support.
The PCT has confirmed (e-mail of 20th May 09) that as far as can be ascertained the reporting
requirements for the services have been identified and will be covered by either child health,
NCRS or other paper systems. Furthermore, the PCT will work to agree and map information
reporting outputs against systems, to ensure all service requirements are met.
The Responsible Officer and “Owner” of the project is the Project Executive (Marie McCurry).
The project methodology will be PRINCE2 as specified in Section 1.




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10.     Scope

    10.1 Systems
    This project covers the deployment of NCRS for Health Visitors and School Nurses.

    10.2 NCRS Functional Modules
    This project covers the deployment of the following NCRS screens (and detailed in Appendix
    4) for both HVs and SNs:.
        1. Patient Registration:
                a. Patient Detail.
                b. Personal Carer.
                c. GP.
                d. Carers.
                e. PDS.
                f. Sensitive.
        2. Patient Referral:
                a. Details.
                b. Decision.
                c. Coding.
                d. Activity.
                e. Caseload.
        3. Caseload:
                a. Caseload Entry Details.
        4. Patient Contact:
                a. Contact Details.
                b. Referral.
                c. Coding.

    10.3 System Interfacing
    NCRS is interfaced to the “Spine”. The Spine is part of the NHS Care Records Service, which
    is creating an electronic care record for all England‟s 50 million plus patients. Each patient‟s
    electronic NHS Care Record (NCRS) comprises full local records, held on computer where
    treatment is provided (such as the GP surgery or hospital) and a summary record of important
    details both demographic (eg: name, address) and medical (eg, allergies, medication, test
    results) held on the Spine. The Spine is a national, central database where summary patient
    records are stored. When fully implemented, local records will automatically upload important
    information to the summary patient record on the Spine.

    10.4 NHS Number Programme
    Safe clinical treatment of any given patient relies on the information held, on paper or in an
    electronic form, being particular and pertinent to that patient.




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    The delivery of patient care is now often shared across a number of clinical areas and NHS
    providers, so delivering safe patient care requires information related to a patient to be linked
    up and flow between these NHS clinical or business areas. The NHS Number was specifically
    developed in the last decade to support unique patient identification; it is the only National
    Unique Identifier in operation in the NHS at this time. The NHS Number is already included in
    most of the NHS Commissioning Data sets.
    The national NHS Number Programme mandates the use of NHS Number in a number of
    areas, including correspondence. The NCRS project will ensure that the relevant standards
    are adhered to and will form part of the specialist product output of the project, specifically
    around the following:
    System Conformance

                Reference                                       Standard
                              Applicable Systems must be capable of storing the NHS Number on patient
           NN-SC-SR-01        records.
                              Applicable Systems must record the verification status of each recorded
           NN-SC-SR-02        NHS Number.
                              Applicable Systems must allow users to find a patient record using the
           NN-SC-SR-03        NHS Number as the only search criterion.
                              Applicable Systems must allow users to find a patient record using the
           NN-SC-SR-04        NHS Number as part of the search criteria in conjunction with other
                              demographic information.
                              Applicable Systems must allow users to find a patient record without using
           NN-SC-SR-05        the NHS Number as part of the search criteria.

                              Applicable Systems must include the NHS Number in any Patient
                              Identifiable Data sent electronically, with the following exceptions:
                                       • the NHS Number is not available at time of transmission
                                       • it is not possible for the receiving system to be
           NN-SC-SR-06        developed/configured to accept the message
                                       • the use of the NHS Number is not in conflict with other
                              requirements or policies.

                              Only verified NHS Numbers should be sent electronically.

                              Applicable Systems must display the NHS Number on any screen showing
           NN-SC-SR-07        Patient Identifiable Data (if available). The verification status of the NHS
                              Number should also be displayed.
                              Applicable Systems must include the NHS Number on all hard-copy
                              outputs containing Patient Identifiable Data (if available at time of output).
           NN-SC-SR-08        Additional patient demographic information must also be included. Only
                              verified NHS Number should be output.
                              Applicable Systems must only display and print the NHS Number in 3 3 4
           NN-SC-SR-09        format (e.g. 123 456 7890).
                              Applicable Systems must allow the NHS Number to be input, into the
           NN-SC-SR-10        appropriate data input field on the screen, as 10 digits with or without
                              spaces.
                              Applicable Systems must validate (both format and check-digit) the NHS
           NN-SC-SR-11        Number when input.
                              Applicable Systems should be capable of reporting all patient records
           NN-SC-SR-12        which do not have a verified NHS Number recorded.
                              Applicable Systems should be capable of reporting where the same NHS
           NN-SC-SR-13        Number (verified or not) is recorded on more than one patient record.



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                              Applicable Systems should also include a bar coded or RFID equivalent of
           NN-SC-SR-14        the NHS Number on all hard-copy outputs containing Patient Identifiable
                              Data.


    Human Behaviour & Business Process Requirements

                Reference                                       Standard

                              The patient’s NHS Number should be determined at the beginning of (or
           NN-SC-BR-01        prior to) the episode of care, where possible and practical.
                              When supplied, the NHS Number should be used to find a local electronic
           NN-SC-BR-02        patient record.
                              When the NHS Number is used to retrieve an electronic record other
           NN-SC-BR-03        demographic information supplied must be used to confirm the patient’s
                              identity and that the record retrieved belongs to that patient.

                              Where the source of the record/data was not the PDS, batch or manual
                              tracing of missing or non-verified NHS Numbers must be done as soon as
                              possible after:
           NN-SC-BR-04         the creation of the local record ;
                               a change to, or the addition of, the NHS Number on the local record;
                               or a change to traceable demographic information on the local record.
                              Data quality processes must be in place to resolve electronic patient
           NN-SC-BR-05        records where the same NHS Number (verified or not) is recorded on more
                              than one record.
                              The parent or guardian must be given the NHS Number of and newborn
           NN-SC-BR-06        child following allocation via the statutory notification of birth (through NHS
                              Number for Babies Service (NN4B)) or the PDS.
                              The patient’s NHS Number should always be included as part of all
                              communications, correspondence and filing systems involving Patient
           NN-SC-BR-07        Identifiable Data. Additional patient demographic information must also be
                              included with the NHS Number. Only verified NHS Number should be
                              output.


    Awareness, Communications and Training Requirements

                Reference                                       Standard

                              NHS provider organisations must promote the importance and use of the
           NN-SC-CR-01        NHS Number to all staff.
                              NHS provider organisations must promote the importance of the NHS
           NN-SC-CR-02        Number to all patients.
                              NHS provider organisations must have processes in place to ensure that
           NN-SC-CR-03        patients know their NHS Numbers and are able to supply them when
                              presenting to or contacting any NHS provider organisation.
                              NHS provider organisations must ensure all staff are trained in the correct
           NN-SC-CR-04        use of IM&T systems, human behaviours and business processes required
                              to support this Standard.


    10.5 Information Governance & Smartcards
    Role Based Access Control (RA) via a smartcard is required for accessing NCRS.



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    Issuing of smartcards is the responsibility of the PCT.
    Smartcards are required for training and therefore must be issued as a priority and priotised in
    line with the Go Live prioritised schedule.
    The RBAC codes required for accessing NCRS are detailed in Appendix 7.

    10.6 Access to NCRS by Trusts & Other Organisations
    The system will be accessed by staff within the Worcestershire PCT (Provider) Trust.

    10.7 Sites
    The sites at which NCRS will be accessed are set out in Appendix 8.

    10.8 Staff Groups
    Health Visitors and School Nurses specifically working in the school environment will access
    the NCRS. The staff list is provided in Appendix 8.

    10.9 ICT Equipment
    This project does not assume that existing desktop equipment, networking or networked
    printers are fit for purpose. An audit will therefore be necessary of existing and anticipated
    new equipment and form a specific stage in the project. An initial audit is available in
    Appendix 8.
    Advice has been sought on which desktop PCs are compatible with NCRS2:
                      Compatible                           Not Compatible                         To be Determined
               Dell 520                               Dell 255                                Dell DCNE
               Dell 630                               Dell 260                                Dell SK3205
               Dell 745                               Dell 270                                HP Compaq
               Dell 755                               Dell 280

    Concern has been expressed over the availability to a printer. The basic principle for printers
    is that the county is moving to networked printers where possible. These will be made
    available in communal work areas. Where a request for an individual printer is received this
    will be assessed by the Project Board.
    Where equipment is not fit for purpose or new equipment is required, this will be drawn to the
    attention of the Project Board to consider whether the costs are acceptable within the
    business case of the project.
    It is noted that where the additional hardware is required the IT Operational resources
    required to deploy the equipment, potential new connections to the network and power
    sources will also need be considered.
    Where equipment is required by non Worcestershire organisations no funding will be made
    available unless specifically agreed by the County ICT Programme Board. Where equipment
    is agreed this will only constitute pump priming and ongoing maintenance or replacement will
    not be available.
    Where doubt exists about the purchase of equipment this will initially be drawn to the attention
    of the Project Board and escalated, if necessary, to the County ICT Programme Board.



2
  At the time of writing the hardware audit was incomplete – the various types of desktop PC may therefore not be complete and the
table updated. Laptops will need to be assessed individually.



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    10.10 Specific Exclusions
       The project does not cover those services specifically covering Older Peoples Services.
       The following screens will not be used:
        1. Patient Registration:
            a. Alias.
            b. Deceased.
            c. Other.
        2. Patient Referral:
                a. Clinical.
                b. Accrued.
                c. Cancer Details.
                d. Patient Pathway.
        3. Patient Contact:
                a. Notes.
                b. Recurrence.
                c. Other Carers.
                d. Waiting List.
       Creation and production of management reports from systems external to NCRS. This
        project will only ascertain which data items from NCRS will contribute to PCT
        management reporting.
       Deployment of other systems to fulfil the PCT information management requirements.
        The project is to deploy sections of the NCRS system pertinent to HVs and SNs.
       Mobile networking and access (e.g. 3G) to NCRS is excluded from this project. It should
        be noted that it was agreed that options would be investigated as a secondary output of
        the project.
       Access from non NHS sites is excluded from this project.

11.     Business Continuity
Any project involving a move from paper to electronic means (full or partial) needs to consider
what procedures and processes need to be in place in the event of a failure of the electronic
system.
Business continuity, including application support disaster recovery, methods for start up /
checking shortfall / entering and checking status of backlog will require consideration and will
form a specific stage in the project.

12.     Product Breakdown Structure
A PBS will be developed as part of the PID.

13.     Outline Implementation Plan
A detailed implementation plan will be developed in stages throughout the life of the project. This
will be managed by the Service Lead (Elaine Jones) in conjunction with the ICT Project Manager
(Jon Bennett) who will liaise with the various ICT sections.


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It is noted that the PCT wishes to have rolled out NCRS to the HV and SN Teams by the close of
Nov 09. The ability to achieve this will be dependent on the timely completion of data entry and
migration of existing patient demographics and caseload. However, it is also dependent on sign
off of plans, booking of relevant ICT tasks (business change, training, IT equipment deployment)
in a schedule already heavily booked and, the release of clinical staff for training as required etc.
The delay in any one of these areas may have a detrimental effect on the schedule.
The basic stages of the deployment (excluding project management stages) are:
1. Deploy Pilot:
        a. Finalise team details.
        b. Finalise new processes.
        c. Assess & deploy hardware.
        d. Commence data migration
        e. Dispense smartcards.
        f.   Configure NCRS for end users.
        g. Train end users.
        h. Move to new ways of working.
        i.   Agree to go live.
        j.   Go Live.
2. Assess pilot & adjust processes accordingly
3. Repeat above with remaining teams in order of priority.
A detailed plan will be developed for the PID. This will incorporate Project Readiness Criteria
(PRCs are gateway style checklists). The use of Project Readiness Criteria (PRC) will determine
progression from one major phase of work to the next. The PRC checklist for this project is
available in Appendix 9 and will be regularly updated as the project progresses.
As the plan is undertaken in similar sets of stages for each team it is critical that each team
deployment is planned ahead of the actual work taking place. Slots for support by ICT Training,
ICT Application Support, data entry / migration need to be agreed in advance and the team leads
of those sections updated regularly on what the current status of the previous team deployment
is.
Support services such as hardware and smartcarding can take place at the start of the project but
again this must be planed with the relevant Team leaders.


14.     Project Organisation
The following structure is currently identified and recommended.




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Project W087 (Health Visitor & School Nurse Migration to NCRS)


                                                                                          Connecting for Health
                                                                                           Programme Board




                                                                                                  SHA
                                                                                            Programme Board




                                                        Worcestershire County                Worcestershire                      Worcestershire PCT
                                                        ICT Programme Board                      PCT                             ICT Steering Group




                                                                                  W087 Worcestershire Project Board


                                                                                                          Project Executive
                                                                                                           Marie McCurry

                                 Project Assurance
                                Ian McGregor (ICT)




                                                          Senior Supplier (NHS)           Senior User (SN)                  Senior User (HV)
                                                             Chris Greening                 Anna Dodds                       Helena Woods




                               PCT Business Manag‟t       Project Manager (ICT)                              Service Lead
                                 Jenni Stephens                Jon Bennett                                   Elaine Jones
      W087 Project Team




                                   ICT Training             Application Support         IT Infrastructure (Projects)             Networking
                                     Liz Taylor              Mary Heffernan                     Ray Rogers                    Simon Honeyborne



                               PCT Business Change         PCT Business Change            Access & Registration         Information Management
                                   Sue Downey                  Elaine Jones                  Jackie Kibberd                 Jonathan downes




                           W087_hvsn_ncrs_org_v02.vsd




15.                       Initial & Main Points of Contact (Project)
Project Board:

                          Project Executive is Marie McCurry
                                   Title: Deputy Director Provider services
                                   Tel: 01905 733677
                                   E-mail: marie.mccurry@worcspct.nhs.uk
                                   Address: Isaac Maddox House, Shrub Hill Road, Worcester, WR49RW

                          Senior User (Health Visitors) is Helena Wood
                                   Title: Professional Practice Facilitator (Health Visitors)
                                   Tel: 01527 66780
                                   E-mail: helena.wood@nhs.net
                                   Address: The Dow Surgery, William Street, Redditch, Worcestershire, B97 4AJ

                          Senior User (School Nurses) is Anna Dodd
                                   Title: Professional Practice Facilitator (School Nurses)
                                   Tel: 077 756 818 54
                                   E-mail: anna.dodd@nhs.net



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                Address: Catshill Clinic 17 The Dock, Catshill, Bromsgrove, B61 0NJ

        Senior Supplier (ICT) is Chris Greening
                Title: ICT Programme Manager
                Tel: 078 807 804 98
                E-mail: chris.greening@nhs.net
                Address: Isaac Maddox House, Shrub Hill Road, Worcester, WR49RW
        A description of the roles within the Project Board are provided in Appendix 10.

Project Assurance:

        Project Assurance (NHS) is Ian McGregor
                Title: Deputy Director ICT Services
                Tel: 01562 513 258
                E-mail: ian.mcgregor@nhs.net
                Address: ICT Services, Kidderminster Hospital, Bewdley Road, Kidderminster.

Implementation Team:
        Service Lead (Project Manager) is Elaine Jones
                Title: PCT Change Manager
                Tel: 079 205 017 37
                E-mail: Elaine.Jones@worcspct.nhs.uk
                Address: Isaac Maddox House, Shrub Hill Road, Worcester, WR49RW
                A description of the project manager role is provided in Appendix 11.
        ICT Lead is Jon Bennett
                Title: ICT Project Manager
                Tel: 079 187 318 82
                E-mail: jbennett2@nhs.net
                Address: Isaac Maddox House, Shrub Hill Road, Worcester, WR49RW
        PCT Service & Business Development is Jenni Stephens
                Title: Head of Service and Business Development
                Tel: 01905 733679 (31663)
                E-mail: Jenni.Stephens@worcspct.nhs.uk
                Address: Isaac Maddox House, Shrub Hill Road, Worcester, WR49RW
        PCT Business Change is Sue Downey
                Title: Change Manager
                Tel: 01905 7323442
                E-mail: Sue.Downey@worcspct.nhs.uk
                Address: Isaac Maddox House, Shrub Hill Road, Worcester, WR49RW



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Implementation Team (Specialist PCT Input):
        Data Entry Clerk(s) is tbc
                Title: <tbc>
                Tel: <tbc>
                E-mail: <tbc>
                Address: <tbc>

Implementation Team (Specialist ICT Input):
        IT Planned Work Coordinator is Ray Rogers
                Title: IT Planned Work Coordinator
                Tel: 01562 823424
                E-mail: ray.rogers@worcsacute.wmids.nhs.uk
                Address: Worcester Royal Hospital, Charles Hasting Way, Worcester WR5 1DD
        IT Technical Support (Desktop) is Pravin Mistry
                Title: Head of 1st & 2nd Line Support
                Tel: 079 795 981 48
                E-mail: pravin.mistry@worcsacute.nhs.uk
                Address: IT Services, Worcester Royal Hospital, Worcestershire Acute Hospitals
                NHS Trust, Charles Hastings Way, Worcester, Worcestershire, WR5 1DD
        IT Technical Support (Network) is Simon Honeyborne
                Title: Head of 3rd Line Support
                Tel: 077 988 023 61
                E-mail: simon.honeyborne@worcsacute.nhs.uk
                Address: IT Services, Worcester Royal Hospital, Worcestershire Acute Hospitals
                NHS Trust, Charles Hastings Way, Worcester, Worcestershire, WR5 1DD
        Business Change (ICT) is Jas Cartwright
                Title: Head of Clinical Informatics
                Tel (Land): 01527 488039
                Tel (Mobile): 077 869 634 09
                E-mail: jas.cartwright@worcsacute.nhs.uk
                Address:    Information Services, Princess of Wales Community Hospital,
                Stourbridge Road, Bromsgrove, B61 0BB

        ICT Training is Liz Taylor
                Title: Head of ICT Training
                Tel (Land): 01527 488146
                Tel (Mobile): 078 766 527 31
                E-mail: liz.taylor@worcsacute.nhs.uk
                Address: Silver Birch, Princess of Wales Community Hospital, Stourbridge Road,
                Bromsgrove, B61 0BB


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16.     Post Go-Live Application Support (Generic):
        Application Support
                Application support is provided by ICT Services Application support.

17.     System Training
Training is provided by ICT Services Training.

18.     Communications
A fuller communications strategy and associated plan for the work will be developed as part of
project initiation. However, in outline it will describe how awareness will be raised, involvement
gained and ultimately, commitment to the project by those staff affected directly by the work.

    18.1 General Activities
    The success of the plan relies heavily on relevant staff groups within the project and
    associated clinical and management colleagues being identified as champions, supporting
    and directing those at operational level to understand, accept and commit their skills to the
    success of the project.
    The objective for communications and stakeholder engagement within this project is to
    engage all stakeholders proportionate to the level to which the project will affect them. The
    appropriate degree of engagement varies according to their role within each part of the
    project.
    The key objectives of the Communications & Stakeholder Engagement Strategy will be to:
           raise awareness of the project, particularly with reference to the benefits for a range of
            staff via the „What‟s in IT for Me?‟ approach.
           ensure that the project is seen as a service improvement challenge that enables the
            wider modernisation of healthcare services.
           ensure communications around the key messages are consistent throughout
            Worcestershire Local Health Community and that stakeholders have clarity around the
            different elements of the project, its implementation and what is required of them.
           ensure that stakeholders are listened to and that they have appropriate channels to
            feedback their ideas and concerns, raise issues, ask questions and find out more
            information.

    18.2 The Path to Commitment
    Worcestershire Local Health Community communications & stakeholder engagement will be
    focused on the effective engagement of stakeholders across the LHC. The graph below
    shows the three stages of engagement curve that differing stakeholder groups will be placed
    on.




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                                                                                   Commitment




                      Level of Engagement...
                                                                     Involvement




                                               Awareness




                                                           Time...




    The strategy has three elements aimed at taking stakeholders to the required levels of
    engagement in order to create the conditions for successful implementation of the project.
    These are:
         A GENERAL AWARENESS element which will take stakeholders to a common level of
          awareness of the project.
         An INVOLVEMENT element for those affected by the outcomes of the project, which will
          take them further up the curve, from awareness to involvement
         A COMMITMENT element for key stakeholders which will take them to full commitment
          at the top of the curve, particular for those who direct resources critical to the operation
          of the new system and service.
    The level of change required will vary for each stakeholder group and also within each group,
    dependant on the individual‟s level of involvement. The time needed to move groups through
    the stages of the engagement curve will vary. Communicating the right message at the right
    time to the right people will be critical in ensuring that the required level of project
    understanding and support is achieved.

    18.3 Key Messages
    There is a need to ensure that the key objectives of the project are realised by reinforcing the
    objectives through a series of key messages for each of the stages of stakeholder
    engagement.
    In the context of the proposed approach to engagement described above, these key
    messages can be expressed as answers to the following questions:

        Awareness
        General awareness for those involved in infection control activities.
         What is the project?
         Why is it being implemented?
         What does it hope to achieve?
         Who will it affect?
         How is it going to be implemented?
         What are the timescales?
         What will be the benefits?

        Involvement
        Specific messages for those that are involved in the project:


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           What is the new system?
           Why is it being deployed?
           When is it going to happen in our patch?
           How can we prepare?
           Who will be affected?
           What will it mean for those affected?
           Who will responsible for what?
           Are there any risks?

        Commitment
        Messages to engage the key stakeholders within project:
         Why should I (we) make the project one of my / our priorities?
         Why should we support the project?
         What is the impact of the project on the organisation?
         How will the project affect the way healthcare is delivered?
         Are there any risks?
         How will it affect me?

    18.4 Communication Outcomes
    The table below identifies the initial target audiences (stakeholder groups) for communication
    and engagement and the state of engagement required for each group. Communications will
    focus on these groups; identifying champions, promoting the benefits and providing current
    and relevant information to target groups. Communications will be two-way to encourage all
    staff to ask questions about, and to participate in the project.

    The required outcomes of the three elements of the strategy for the currently defined
    stakeholder groups are as follows:

   Target Audiences               Awareness                    Involvement                     Commitment
                                                          Are confident that the
                                                           project will address issues
                                                           that surround the use of
                                                                                          Are enthusiastic
                                                           care pathways
                                                                                          Are supportive
                                                         Are aware of local
                             Are aware                                                    Are empowered to act
                                                           timescales & have been
                            Feel informed                                                Are positive about working
                                                           engaged in creating plans
Implementation / End        Feel reassured                                                in different ways
                                                          Are clear about their role,
User Level                  Appreciate the need for                                      Feel actively engaged in
                                                           what they have to do, and
                             change                                                        the Project
                                                           (broadly) when and feel
                            Show a positive attitude      empowered to undertake         Act as champions to the
                                                           the necessary action.           staff in their depts and in
                                                                                           general
                                                          Feel a part of the overall
                                                           service transformation
                                                           process
                                                                                          Are enthusiastic
                                                          Are confident that the
                                                                                          Are supportive
                                                           project will deliver real
                                                                                          Pro-actively endorse when
                            Are aware                     benefits
                                                                                           appropriate
                            Feel informed                Are aware of local
                                                                                          Are working in different
                            Understand the “big           timescales
                                                                                           ways where appropriate
                             picture” of LHC Programme    Have realistic expectations
Senior Management                                                                         Are fully engaged
                             and the project               of local benefits
Level / Team Leaders                                                                      Are actively leading
                            Feel reassured               Are clear about their role,
                                                                                          Have assigned the project
                            Appreciate the need for       what they have to do, and
                                                                                           a high priority
                             change                        (broadly) when
                                                                                          Behave as champions
                            Show a positive attitude     Feel a part of the overall
                                                           service transformation         Are empowered to drive
                                                           process                         project forward through
                                                                                           difficult periods




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    18.5 Production and Sign Off of Communication Materials
    The materials produced for the project should be controlled in their sign off and subsequent
    distribution to ensure that accuracy of information is assured and commitment to each
    message gained:
       Draft material produced by the Project Manager with assistance from implementation
        leads.
       Material distributed for comment and QA to Project Board.
       Final draft material distributed by Project Manager

    18.6 Key Media for Communications
    All communications are to be branded “W087 Health Visitor & School Nurse Migration to
    NCRS”. This is to ensure everyone associates all communication with the same product.
    Suggested regular communications are below:
    1. Website
           Purpose: To incorporate all materials for the project, including a FAQ section and
            contact details to the Service Project Manager.
           When: ASAP after adoption
    2. Project Update Newsletters (Example Newsletter in Appendix 12)
           Purpose: Rolling update.
           When: As soon as practicable then as and when necessary
    3. E-mail Notices
           Purpose: Specific updates on current project status and required activities
           When: As soon as practicable, then as and when necessary
    4. Departmental / Team Meetings
           Purpose: Specific updates to wards. Face to face contact.
           When: As soon as practicable then as and when necessary

19.     Financials
At the time of writing the financials for the project were not available.




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20.      Initial Risks & Issues Identified
The project will follow the Office Government & Commerce (OGC) format for Management of Risk. Below are identified initial risks and issues to be
assessed and where possible managed prior to formal start-up of the project. These will be transferred to the formal risk log for management throughout
the project.
                 Risk                               Impact                     Likelihood                                   Mitigate By                                              Owned By
                                                                                            1.   Ensure scope states what functionality will / will not be available.
                                                                                            2.   Existing processes continue until system is considered fit for
                                                                                                 purpose.
                                                                                            3.   Project Executive & Senior Users to contribute to expectation
                                                                                                 management.
                                     System implementation is rushed                        4.   Change management work-stream within project.
 Ref W087001 - Expectations not      with a resulting staff backlash as                     5.   Plan to be generated an early stage of project and communicated
                                                                                1 (High)                                                                                 Project Executive
 met.                                issues are encountered /                                    to stakeholders.
                                     functionality not delivered.                           6.   Adequate planning mechanisms – iterative planning sessions
                                                                                                 between senior management prior to formal start-up.
                                                                                            7.   Communication Plan defines series of regular, targeted and
                                                                                                 variety of types of communication techniques to ensure staff
                                                                                                 affected by change are kept up to date of plans, actions, their role
                                                                                                 in project and impact of desired changes.
                                                                                            1.   Training Plan - developed to establish range of training availability
                                                                                                 options to maximise access to training. Plan to identify all those
                                                                                                 requiring training (by type (e.g. Basic Desktop / Super User /
                                                                                                 Standard) and a progress report regularly produced on those
                                                                                                 having been trained.
                                                                                            2.   Training coverage to be confirmed to maximise access, as well as
                                     Benefits not realised. Delays to                            communicated to stakeholders.
 Ref W087002 - Training -
                                     project implementation. System not                     3.   Project based personnel contact points to be made available at
 Difficulties over attendance at                                                1 (High)                                                                                 Project Executive
                                     used to full potential. Staff revert to                     each desktop during duration of project with procedure for
 training.
                                     previous methods.                                           emergency calls included.
                                                                                            4.   Communications Plan – developed to produce a framework that
                                                                                                 maximises the impact of communications ensuring staff are given
                                                                                                 adequate warning over training requirements and how to access
                                                                                                 training, ensuring line managers are aware of need to plan for the
                                                                                                 release of staff to be trained (standard mail merge letter to be
                                                                                                 produced) and that staff actually attend training.
                                     System not able to be signed off.                      1.   Benefit metrics to be agreed as part of start up.
                                     Required functionality not                             2.   Outcome metrics to be agreed as part of start up.
 Ref W087003 - Project outputs not
                                     delivered, clinical risk, non             2 (Medium)   3.   Service functionality agreed as a primary stage within project and      Project Manager and Senior Users
 defined and agreed
                                     achievement of benefits, time and                           formally signed off.
                                     cost over-run                                          4.   Functionality and associated outputs used as a formal measure of
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Project W087 (Health Visitor & School Nurse Migration to NCRS)

                 Risk                                    Impact                   Likelihood                                   Mitigate By                                            Owned By
                                                                                                    project progress.
                                                                                               1.   Outputs to be agreed as part of start up.
                                                                                               2.   Technical specification agreed as a primary stage within project
                                          Product inadequate for service,                           and formally signed off.
 Ref W087004 - Software required
                                          credibility falls, solution not taken                3.   Functionality and associated outputs used as a formal measure of
 to meet objectives & deliverables                                                2 (Medium)                                                                              Senior Supplier (NHS)
                                          up by users, costs rise to make fit                       project progress.
 not defined and agreed
                                          for purpose.                                         4.   Formal launch of product not to take place until Project Board
                                                                                                    happy with system functionality and reasonable success of
                                                                                                    project.
                                                                                               1.   Pilot
                                                                                               2.   Communication Plan – to articulate changes in working practice
                                                                                                    that will occur as a result of the introduction of new service
                                                                                                    processes and supporting clinical system.
 Ref W087005 - Switch over to new
                                          Loss of credibility to project, user                 3.   Transition Plan to be developed.
 ways of working fails across certain
                                          disillusionment as benefits                          4.   Communications to be backed up by information on training, post
 sections / departments.                                                           1 (High)                                                                               Project Executive
                                          unrealised for those where switch                         go live support and updates on benefits when they start to be
 (Difficulties in disengaging from
                                          over has been successful.                                 accrued to highlight worth of change over.
 current processes)
                                                                                               5.   Benefits Plan to specify metrics to be used to monitor progress
                                                                                                    towards desired benefits.
                                                                                               6.   Identified Champions to ensure that staff are adequately updated,
                                                                                                    trained and provided access to support available in use of system.
                                                                                               1.   Roles formally identified and trained.
                                                                                               2.   Formal point of contact advertised for end users to notify relevant
                                                                                                    parties of data quality issues identified during and post project.
                                                                                               3.   Regular checkpoints and progress reporting to highlight potential
                                                                                                    issues early on.
                                                                                               4.   Creation of Local Deployment Framework as a specific stage in
 Ref W087006 - Lack of formally           Problems with data quality entry                          plan to highlight need for high level quality.
 agreed new business processes in         result in issues of excessive                        5.   Lessons Learnt published regularly and advertised as formal
                                                                                  2 (Medium)                                                                              Senior Supplier (NHS)
 current project fail to highlight need   communication to clarify / confirm                        document to capture where issues have been encountered in pilot
 for high levels of data quality          data.                                                     and lessons learnt.
                                                                                               6.   Training Lessons Plans – developed to highlight (a) benefits of
                                                                                                    electronic capture over maintaining paper based systems
                                                                                                    including version control / configuration management, (b)
                                                                                                    reduction in duplicate entry necessary with system use, and (c)
                                                                                                    the reduction of associated communications necessary when
                                                                                                    equivalent basic data entered on system.
                                          Decreasing credibility of solution                   1.   Pilot
 Ref W087007 - System Failure             and falling away in user take up,                    2.   Although system uptime is expected to be high, a Continuity Plan
                                                                                   1 (Low)                                                                                Senior Supplier (NHS)
 (Contingency / Continuity Planning)      excessive system down time.                               is required in event of system failure. To include start up
                                          Reversion to paper based                                  processes for getting back-data into system from period of down-
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Project W087 (Health Visitor & School Nurse Migration to NCRS)

                Risk                               Impact                   Likelihood                                   Mitigate By                                               Owned By
                                     solutions. Benefits unrealised                           time and clarification of which data being entered at point of failure
                                                                                              was captured / lost.
                                                                                         3.   Continuity Planning to be a specific stage within Plan.
                                     The PCT are required to deploy
                                     data entry clerks to migrate child
                                     demographic information from                        1.   PCT to confirm data entry clerk availability.
                                     existing systems onto NCRS ahead                    2.   Scheduling of clerks to be actively managed by service lead in
 Ref W087008 – Data Entry Clerk
                                     of the cut-over for the team about      1 (High)         conjunction with ICT Project Manager.                                    Project Executive
 Availability / Scheduling
                                     to use the system. If this is not                   3.   Other support service (e.g. ICT Training, Application Support etc)
                                     undertaken the team will be unable                       to b updated on progress of data entry migration.
                                     to use the system and the schedule
                                     will drift.
                                                                                         1.   Audit to identify potential candidates for basic desktop training
                                     Where staff are let down by a lack                       ahead of system training.
 Ref W087009 - System Not Used –     of basic PC skills this leads to                    2.   Updates to be sent out and posted on commonly viewed areas to            Service Lead in discussion with HV /
 Staff Skills Inadequate (Basic      frustration in use of main system      2 (Medium)        highlight use of NCRS.                                                   SN Team Leaders, ICT Project Lead
 Desktop PC Skills)                  and most likely to revert to paper                  3.   Invitation to Training letter to be sent to relevant staff involved      & ICT Training Manager
                                     based systems.                                           should highlight the benefit from basic PC skills training available
                                                                                              prior to system training.
                                     Plan is driven by supplier (ICT) and                1.   Executive identified (Marie McCurry)
                                     not by customers’ needs,                            2.   Project Board led by service management and clinical staff
                                     potentially leading to activities                   3.   Project Manager is service led (Elaine Jones).
                                     being missed from plan or not done                  4.   Supported by ICT Project Leader (Jon Bennett).
 Ref W087010 - Project Plan not      to the quality required. Project                    5.   Ownership of adequately developed plan to be signed off by
                                                                             3 (Low)                                                                                   Project Executive
 owned by Customer                   implementation subsequently poor                         Project Executive.
                                     with potential for outputs not                      6.   Supplier (ICT) has provided outline template. This will be used as
                                     correctly implemented and                                framework from which detailed plan will be developed.
                                     outcomes / benefits not being fully                 7.   Plan will now be adapted for local use by Project Manager in
                                     realised.                                                discussion with ICT Team Leader.
                                     Staff lack confidence to use system                 1.   Executives to stress to users the importance of using the system
                                     in intended manner. Potential                            and that usage will be monitored and addressed if poorer than
                                     reversion to paper based systems,                        expected.
 Ref W087011 - Staff not allocated
                                     or only certain users use the                       2.   Training Plan to ensure coverage and progress in training is
 adequate time to take up new                                               2 (Medium)                                                                                 Project Executive
                                     system resulting in poor overall use                     evenly spread across locations.
 system.
                                     of system and resource                              3.   Backup / refresher training / materials to be made available post
                                     implications when active users not                       training. Super Users to monitor use of system on dept / ward
                                     available.                                               post go live to ensure that consistent use by all ward staff.
                                     Project loses credibility, critical                 1.   Proposal was developed by service.
 Ref W087012 - Lack of
                                     blockages not removed, decisions                    2.   Recruitment of appropriately engaged Project Board Members
 engagement by users on Project                                              3 (Low)                                                                                   Project Executive
                                     not made in a timely fashion                             supported by ICT. Brief contains JD’s for Project Board roles.
 Board
                                     System not able to be signed off,                        Brief highlights that Project Board cannot delegate ownership of
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Project W087 (Health Visitor & School Nurse Migration to NCRS)

                 Risk                                Impact                 Likelihood                                 Mitigate By                                               Owned By
                                    required functionality not delivered,                     their decision making to Service Project Manager.
                                    clinical risk, non achievement of                    3.   Purpose and clear benefits of using a controlled mechanism to
                                    benefits, time and cost over-run                          manage project is relayed and agreed.
                                    Resources not properly deployed,
                                    project end date not maintained,
                                                                                         1.   Ensure appropriate technical staff committed to relevant work
                                    costs not controlled.
                                                                                              streams.
                                    Particular impact where ward staff
 Ref W087014 - Lack of                                                                   2.   Confirmation of technical support being gained by ICT Programme
                                    out of normal working hours are
 engagement by operational                                                  2 (Medium)        prior to official project start up.                                    Senior Supplier (NHS)
                                    unable to access the system mainly
 technical IT staff                                                                      3.   Ensure details of out of hours support identified prior to start up
                                    through forgotten log in details.
                                                                                              and this is in the communications plan and listed under contact
                                    This will make staff revert back to
                                                                                              sheets next to each PC.
                                    paper based systems losing
                                    desired benefits of project.
                                    Benefits not realised. Whole point
 Ref W087015 - Absence of a                                                              1.   Benefits Realisation an identified work stream within the project      Project Manager supported by Team
                                    of undertaking project becomes          2 (Medium)
 formal benefits realisation plan                                                             plan as well as an agreed outcome within the pilot.                    Manager
                                    moot.
                                                                                         2.   The PCT has agreed to map what the system is capable of
                                                                                              providing to match local planning standards and contract
 Ref W087016 – System does not      Capabilities in management
                                                                                              information requirements. To this the PCT will identify gaps and
 provide information required for   reporting not gained. Financial
                                                                            2 (Medium)        which alternative systems / methods will be used to fill those gaps.   Project Executive
 management / contract reporting    returns not gained due to lack of
                                                                                         3.   The PCT Information Dept is responsible for then bringing that
 purposes                           accurate activity information.
                                                                                              information together into a meaningful set of management
                                                                                              information. This is outside the scope of the project.




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Project W087 (Health Visitor & School Nurse Migration to NCRS)



21.      Appendices
Appendix 1 - Management of projects effectively (guidance note).


 Manging Projects
   Effectively
                       (double click icon to open file)


Appendix 2 – Health Visitor Business Processes.


  Health Visitor
Business Processes
                       (double click icon to open file)


Appendix 3 – School Nurse Business Processes.


   School Nurse
Business Processes
                       (double click icon to open file)


Appendix 4 – NCRS Screens.


   NCRS Screens
                       (double click icon to open file)


Appendix 5a – Draft Health Visitor Benefits.


Draft Health Visitor
     Benefits
                       (double click icon to open file)


Appendix 5b – Draft Nurse Visitor Benefits.


 Draft School Nurse
      Benefits
                       (double click icon to open file)


Appendix 6 – Team Deployment Priority List


 Team Deployment
    Priority List
                       (double click icon to open file)




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Project W087 (Health Visitor & School Nurse Migration to NCRS)


Appendix 7 – Smartcard / RBAC Process


 Smartcard / RBAC
    Processes
                        (double click icon to open file)


Appendix 8 – Audit (team details, hardware, training, smartcards) (datestamp = 2nd Jun 09)


   W087 - Audit
                        (double click icon to open file)


Appendix 9 – Project Readiness Criteria (PRC)


 Project Readiness
   Criteria (PRC)
                        (double click icon to open file)


Appendix 10 – Roles – Project Board


Roles - Project Board
                        (double click icon to open file)


Appendix 11 – Roles – Project Manager


   Roles - Project
      Manager
                        (double click icon to open file)


Appendix 12 – Example Newsletter


Example Newsletter
                        (double click icon to open file)


                           - - - - - - - - - - - END OF MAIN DOCUMENT - - - - - - - - - - -




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