Developing a city ‘blueprint’

Julie Oxley

Head of Information Management & TechnologyLeeds City Council

To maximise the value and delivery

of public services in a city there’s a lot of ‘joining up’ to do…..

Some strategic ‘joining’ between health and social care…..

- Health and Well Being Board

- Joint Health and Well Being strategy

- Joint Strategic Needs Assessment

- Better Care Fund

etc.

In practical terms, joining up…..

-Teams-Departments-Functions-Organisation

-Services-Sectors-Organisations

-Cities

Complexity

In technology terms, joining up…..

People – Process – Technology

To account for all of this, need to make the shared case for change and begin to speak a common language

“Patient/Citizen”

“The Leeds £”

‘Blueprints’ have been useful…………

BUT FIRST

Joined up governance………(circa 2012)

Leeds Informatics within the governance for Health and Social Care transformation

Leeds Informatics Board

City-wide Clinical leader

City-wide Leadership Office

Chair – Dr J BrochCCG North, Chair

Informatics Director

LTHTExecutive

ASCSenior Officer

Children’sSenior Officer

LYPFTExecutive

LCHExecutive

CCGSenior Officers

Variable resources inc.Project Management, expert advisors/specialists, admin, Finance

City-wide Programme Management Group

Programme Manager

Local Informatics departments and resources

Commercial and Academic links

Senior Reps from Local departments

Health and Wellbeing Boardvia

Health and Social Care Transformation Board

LCC IT

Primary CareSenior GP/s

Local AuthorityCTO

Partners:- CCGs x 3- Leeds Teaching Hospitals- Leeds Community Healthcare- Adult Social Care- Leeds City Council- Leeds and York Partnership

FT- Primary Care

‘Blueprint’ 1 (circa 2012)

‘Plan on a Page’ - Building blocks to achieve the Leeds informatics ‘Vision’Pr

ovid

er o

rgan

isati

ons

Betw

een

orga

nisa

tions

e-messaging Summary Care Record (SCR)

Data Protection/Caldicott/Sharing

IT Infrastructure linkages inc. LCC city-wide facilities e.g. ‘superfast cities’

Order Communications Risk Stratification

Risk Stratification

Contract and additional data flows

Costing analysis Event linkage

Needs assessment Improved Contract Mgt

Primary CareHosted

nationally compliant

systems

Interoperability standardsPaper-light processing inc. Digitised/e-records

NHS Number

LTHTFull range

of integrated

clinical systems

LYPFTFull range

of integrated

clinical systems

LCHFull range

of integrated

clinical systems

Wireless technology

Mobile working

Social CareFull range

of strategic systems

IG Toolkit

Programme/Project Management Business Analysis and process re-design

Knowledge Management

Improved needs assessment Improved health intelligence

Mon

itorin

g/

com

mis

sion

ing

syst

emPatient/client

access to records

Independent and 3rd

sector systems

Leeds Care Record

Integration Engine

Telecare and TelehealthPathway Management/Visibility/Clinical Decision Support

Data

Warehouse

Research

YAS

This common framework enabled……..

‘Plan on a Page’ - Building blocks to achieve the Leeds informatics ‘Vision’Pr

ovid

er o

rgan

isati

ons

Betw

een

orga

nisa

tions

e-messaging Summary Care Record (SCR)

Data Protection/Caldicott/Sharing

IT Infrastructure linkages inc. LCC city-wide facilities e.g. ‘superfast cities’

Order Communications Risk Stratification

Risk Stratification

Contract and additional data flows

Costing analysis Event linkage

Needs assessment Improved Contract Mgt

Primary CareHosted

nationally compliant

systems

Interoperability standardsPaper-light processing inc. Digitised/e-records

NHS Number

LTHTFull range

of integrated

clinical systems

LYPFTFull range

of integrated

clinical systems

LCHFull range

of integrated

clinical systems

Wireless technology

Mobile working

Social CareFull range

of strategic systems

IG Toolkit

Programme/Project Management Business Analysis and process re-design

Knowledge Management

Improved needs assessment Improved health intelligence

Mon

itorin

g/

com

mis

sion

ing

syst

emPatient/client

access to records

Independent and 3rd

sector systems

Leeds Care Record

Integration Engine

Telecare and TelehealthPathway Management/Visibility/Clinical Decision Support

Data

Warehouse

Research

YAS

Allowed Informatics to be a key part of joined up ‘transformation’ ………(circa 2014)

West Yorkshire Workstreams

Leeds Health and Social Care

Transformation ‘Portfolio’ Board

Pathway development

Integrated system change

Primary prevention

Identification and risk

stratification

HWB

Growing up in Leeds

Nigel Richardson/ Matt Ward

Elective Care

Simon Stockill/ Susan Robins

Adult Integrated Care and Prevention

Andy HarrisIan Cameron

Urgent CareNigel

Gray/Jason Broch

Effective admission

& discharge Phil Corrigan/ Sandie Keene

Goods & support servicesChris Butler

System development

Population management

Operational group

Community beds service

Improving hospital

discharge

Emergency admission avoidance

Cancer

In-patients

Family support

Best transition into adulthood

Complex needs

Emotional and mental health

Best Start

Supplies

Estates

ICE

Strategy Group

ENABLING GROUPS

TRANSFORMATION PROGRAMMES

PMO

Self-management

Children’sUrgent Care

Cancer Stroke

Prevent entry into Care

Informatics Board

Jason Broch

Quality Improvement

with Leeds University

Gordon Sinclair

Estates GroupChris Butler

Finance Task Group (DOFs)Julian Hartley

Communications and

Engagement Group

Rob Kenyon/Phil

Corrigan/

WorkforcePhil

Corrigan/Bryan Machin

Primary Care Gordon Sinclair

PioneerRob Kenyon

BCFMatt

Ward/Dennis Holmes

Outpatients including

diagnostics

‘Blueprint’ 2 (circa 2012)

Simplification and refinement:

3 TIERS of delivery:

Clinical Integration

Clinical Support Tools

Business Intelligence

Tier 1

Tier 2

Tier 3

‘primary’ use’ of data

‘secondary use’ of data

Time      

Strategic requirements for transformational change.……..

6 features of a transformational Informatics platform:

• Centred around patients or individuals • Common data definitions• Covers all types of care • Relevant parts of the clinical record can be accessed by all

parties involved in care• Templates and expert systems to support appropriate and

consistent quality of care• Information collected and extracted to support holistic

analysis and intelligence

‘Blueprint’ 3 (circa 2013)

In practical terms, joining up…..

-Teams-Departments-Functions-Organisation

-Services-Sectors-Organisations

-Cities

Complexity

Overlay:

Clinical Integration

Clinical Support Tools

Business Intelligence

‘Blueprints’ 2 and 3 have enabled:

- Case to establish a city Intelligence Hub- Case to progress citizen-driven health agenda- Strengthened the city PSN case- Recognition that more is required than ‘simply’ integration- Formed part of our ‘Tech Fund 2’ bid [LCC led]

- Forms our dialogue with other Pioneer cities- Dialogue around Better Care Fund- Basis for a more formal exploration on end-user compute opportunities

Recommend the use of shared (and evolving) models/blueprints to form the basis for:

- Common language (internal and external)- Common goals- Engagement across sectors- Development of business cases- Programme of delivery- Governance framework

- QUESTIONS -