Integrated Care Solutions for Improved Patient Outcomes

Black Country ICS SHcR Programme Dudley LMC 04/11/2022 Graham Westgate Interim SHCR Programme Lead Black Country Integrated Care Board

Shared Care Record The Shared Health and Care Record is a way of bringing together all separate records from the different organisations involved in your health and care. Features Doesn t replace any existing systems; e.g. EMIS, Docman Read only view, doesn t overwrite source data Through Single Sign On (SSO) removes need for multiple logons Direct access via primary systems, e.g. EMIS, TPP, Mosaic, Rio, Medway No noticeable impact on EMIS performance Supports ICS and PCN ways of working Supports MDT meetings Enabler for Population Health Foundations for an Electronic Palliative Care Coordination System for End of Life patients across BC(and WB)

How CareCentric Works: The Solution 1 2 3 4 For direct care access from all care settings, by patients, social care users and service providers from all care settings, by patients/social care users, service providers and commissioners. Users from all care settings contribute data on individuals in their care via a proven messaging extract engine to a secure data store where it is held The Source Systems The Data Store Integration Management The Users Clinical Portal Integrated Digital Care Records GPs, Clinicians, Social Care Health Professionals GP Systems MiG CareCentric Gateway Acute Systems PAS, EPR, Departmental Patient Portal Access to own care record Extract Messaging and Individuals Integration Engine CareCentric Data myCareCentric Store Mental Health Clinical Forms Forms, Alerts & Workflow CareCentric Pathways GPs, Clinicians Social Care Health Professionals Community Social Care CareCentric Highway CareCentric Data Store 3

Data Feeds 206 GPs GP Nightly Emis, TPP extracts MIG Practices Hospital Activity (Outpatient, Inpatient & Emergency), Pathology & Radiology Results, Clinical Letters, Medications Acute Trusts Realtime HL7 CareCentric Adults Social Care Social Care Children's Social Care (Next phase) Nightly CSV file transfer Community Health Community Health Nightly CSV file transfer Adult Mental Health Mental Health Nightly CSV file transfer 4

Why. Benefit Measure Stakeholder What is the benefit? How to measure? Who benefits? Reduction in Practice Staff time dealing with patient information requests in and out of GP Practices Data visible at point of care Patient and the Clinician As a clinician you will be able to view the data on a patient which is stored by a partner organisation anytime/anywhere Data visible at point of care Patient and the Clinician Reduction in decision to admit Decision to admit Patient and organisations Patient not having to repeat their story Patient experience Patient Patient safety reducing adverse events, safeguarding New safeguarding alerts Patient Speed and reassurance of clinical decision making Number of repeat tests Patient and the Clinician Reduction in pathology tests Pathology tests Patient and organisations Reducing prescription errors Prescription errors Patient and organisations

GP Benefits Reduction in Practice Staff time dealing with patient information requests in and out of GP Practices Improved access to Mental Health and Community information Potential benefits when linking with WMAS and Secondary Care: Report when a patient is taken to/discharged from Hospital Provide updates on Meds, essential when a patient returns home Possibly help to prevent safeguarding issues Improved immediacy of information to underpin timely appropriate discharge into the ICS service Examples where staff have had to call hospital admission numbers to find out patient information Improve service delivery and perception of a joined up Health and Social Care Service through a reduction in repeat questions Earlier identification of known involved workers across health and social care will contribute to a better holistic service and contribute towards integrated working like one

Programme Scope Phase 1 Primary Care data feed Walsall GP Practices Wolverhampton GP Practices Dudley GP Practices Sandwell GP Practices West Birmingham GP Practices (BSOL ICS) Acute MPI/ADT/EDD Royal Wolverhampton Walsall Dudley Group Sandwell & West Birmingham Mental Health BCHFT SSO Primary Care/Acute/Mental Health Analytics Direct Care

Sequence of Activities Spine Demographics Reporting Service (SDRS) Feeds All GP Data loaded with daily deltas being loaded Need to capture right to objects Provider MPI data loads and deltas Occurs after GP data so patient data is not visible for those that registered right to object Single Sign On can be enabled* Both Provider and Primary Care *Can be configured in advance of Provider MPI data loads Black Country Integrated Care Board

Challenges experienced and impact on the delivery Boundary Changes BSOL West B ham GP Practices moving from BCWB to BSOL extracts to OHC LIVE issue (July 22 Nov 22) West Birmingham SDRS data feed from NHS Digital delayed escalated TPP data quality queries identified through robust testing Graphnet resources contended through delivery due to scale of the programme (Graphnet data upload schedule contended, database and system specialists capacity etc) UAT resources availability Resources/time to configure SSO

Impact on Delivery from Challenges Experienced Jul 22 Aug 22 Sep 22 Oct 22 Nov 22 Dec 22 Dec 21 Jan 22 Feb 22 Mar 22 Apr 22 May 22 Jun 22 1. Fair Processing Notice 2. Primary Care DSA 3. Secondary Care DSA 4. EMIS Enablement 5. TPP Enablement 6. Clinical Safety Workshops 7. GP Practices moving from BCWB to BSOL Data Reload Required 8. TPP Order by MLCSU 9. Provider UAT resources availability 10. Graphnet Resources (specialist resources and scheduled) 11. Competing priorities within providers

SSO* Configuring SSO as a readiness activity GP roll out offered to Primary Care all Dudley GPs invited, 3 responded to date Acute Trusts and BCHFT in advance of Graphnet change freeze window Benefits of Configuring SSO first Sites configured to access Graphnet in advance of all data Stakeholder engagement opportunities to keep informed over increasing richness of the record Black Country Integrated Care Board 11

SHCR Programme Timeline Train the Trainer complete Further training by training leads at partner organisations and Primary Care Facilitators to be progressed First Acute Trust data to move in to live . Decision to be made as to whether WHT or RWT will go live in advance of December 22 Total 206 practices, includes Black Country GP Practices EMIS & West Birmingham GP Practices EMIS Following issues with TPP extract has been securely transferred successfully to Graphnet for uploading TPP Data EMIS Reload for Sandwell GP practices Training& Communications TPP Data Extracted Final GP Data Load - WIP Acute Trust Data to LIVE GP Data Feeds Aug 22 Sept 22 Nov 22 Dec 22 Oct 22 Nov 22 Oct 22 Nov 22 Sept 22 Aug 22 Acute Data Feeds UAT Graphnet Change Freeze TPPTesting SDRS SSO Acute Trust single sign on in testing Planned to go live in advance December 2022 GP Practices being contacted with option to have SSO configured No changes will be made during December to the OHC platform i.e. data loaded, configuration changes etc Identified data quality issues. Documented output and established rationale for each. Acute Trusts data in to Test for UAT West B ham SDRS feed will completed Communications

Communications Increasing frequency of programme comms Notify stakeholders of challenges, issues impacting delivery Webpage consistent location for updates and status of the programme Increase comms and engagement closer to go live and as organisations data is loaded Promote good news and increase awareness Identify additional routes in to providers including appropriate forums to raise awareness LMC Practice Managers meetings Seek wider representation from large stakeholders

Black Country ShCR Programme Phases Phase 4: Phase 3: Phase 2: Phase 1: Acute data feeds increased Acute data feeds increased Social Care Adult Data & SSO Primary Care data feed Social Care Children Data & SSO Acute MPI/ADT/EDD Community Data feeds increased Analytics - Secondary Use DSA Mental Health Maternity feeds SSO Acute/Mental Health Next 12-month plan Hospices DSA Community Data feeds Primary care SSO rollout GP SSO Hospice Data feed & SSO Analytics Direct Care EPACCS DSA & Go live plan Patient portal review November 2022 Black Country Integrated Care Board 14

Risks Risk/ Issue Mitigation Uploading of GP extracts exceeds the planned period impacting first Acute Trust data move to live w/c 21st Nov (current risk score AMBER/Red 12) Request made to EMIS to reduce the SLA lead time to initiate the work, check point meetings increased in frequency to maintain oversight and early visibility of impacted timescales TPP SSO - When a deducted or deceased patient is accessed in SHCR through TPP SSO, an error is returned including SSO logon credentials (current risk score AMBER 10) - development lead time for Graphnet is an additional risk Alternative configuration to prevent username and password being published in the URL or divert to a logon page as opposed to receiving a 404 error. Due after 9th November 22 Increased communication and engagement, attend forums and present programme outline, benefits and status Stakeholder buy in (current risk score AMBER/Red 12) Risk of further slippage to the plan and delivery of the programme Engage early with providers to agree delivery of specific activities, gain commitment to planned dates, prioritisation above new requests received, management of specific risks that could impact delivery i. Issue 6 - Impact of issues on the timeline Time constraint as at 20/10/22, sufficient time to move one Acute Trust s data to live in advance of the Graphnet change freeze (December 22), float 0 days Schedule second acute to follow as soon as possible following the Graphnet change freeze during December

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