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Nottinghamshire Health and Social Care IT Summit Report v1.0

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Nottinghamshire Health and Social Care IT Summit Report November 2017

Using Technology, Enabling change, improving care


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Contents Contents .................................................................................................................................................. 1

Background ............................................................................................................................................. 3

Introduction ............................................................................................................................................ 3

Event Purpose ......................................................................................................................................... 3

Attendees ................................................................................................................................... 4

Setting the Scene .................................................................................................................................... 4

Welcome and introductions, Sam Walters ................................................................................ 4

Nottingham and Nottinghamshire Sustainability and Transformation Partnership, Roz Howie

................................................................................................................................................... 5

Joining up health and care: Establishing an Accountable Care System, Rebecca Larder and

Centene ...................................................................................................................................... 6

The Mid-Nottinghamshire Alliance, Neil Moore ........................................................................ 6

Local Digital Roadmap (LDR) Update, Andy Evans and Ben Halliday ...................................................... 7

Improving Access to Health for Children, Young People and Young Adults ........................................... 7

Assistive Technology .................................................................................................................. 9

Assist - NICE Award Winning Model .......................................................................................... 9

Workshops ............................................................................................................................................ 10

Local Digital Roadmap Exercise ............................................................................................... 11

Do you agree with the priority areas identified? ..................................................................... 11

What do your organisations need to do to deliver the highlighted workstreams priorities? . 11

What challenges to delivery will your organisations encounter?............................................ 11

Are there other (more urgent?) projects that might impact the successful delivery of the

LDR? ......................................................................................................................................... 11

Assistive Technology Discussion Session ................................................................................. 12

Marketplace .......................................................................................................................................... 13

Event closure and Feedback ................................................................................................................. 13

Summing up ............................................................................................................................. 13

Closing remarks ........................................................................................................................ 14

Conclusion ............................................................................................................................................. 15

Next Steps from You….. ........................................................................................................... 15

Special Thanks .......................................................................................................................... 15

Appendix 1 – List of Delegates .............................................................................................................. 16


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Status Version Date Amendment History Author

Draft 0.1 January 18 Initial Draft Rosie Atkin

Draft 0.2 January 18 Amended based on feedback Rosie Atkin

Final 1.0 February 18 Finalised Report Rosie Atkin


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Health and Social Care IT Summit

Background

The Five Year Forward View and Personalised Health and Care 2020 describes the commitment by the health and care system and the Government to use information and technology and make sure patient records are digital and interoperable by 2020. In 2015 a process began requiring health and care organisations to develop Local Digital Roadmaps (LDR) which set out how these footprint areas will achieve the ambition of a paper free and fully interoperable health and care by 2020. Initially 73 Local Digital Roadmap Footprints were submitted but this was later reduced to 65 as some footprints combined in order to align more closely with Sustainability and Transformation Plan (STP) footprints.

Annually since 2013 Nottinghamshire health and care providers have attended the Annual IT Summit. This event has helped shape and define the strategy and digital vision for Nottinghamshire. Work on Nottinghamshire’s Local Digital Roadmap (LDR) commenced in November 2015 at the fourth of these annual events enabling Nottinghamshire to develop clear strategic digital plans to support the delivery of National Policy requirements as well as local strategic transformation.

Annual IT Summits are held in order to further develop, refine and review our strategic plans by testing whole system priorities and enabling stakeholder engagement and input to help shape future strategy development.

Introduction This report documents the output of the 6th Annual Connected Nottinghamshire Health and Social Care IT Summit, which took place November 2017. An event which brought together a wide audience of IT leads, Transformation Programme and Project leads, Clinicians, Health and Social Care leads, Commissioners, patient representatives and carer groups, third sector representatives and providers and academic subject matter experts.

Event Purpose The health and care system is going through a period of significant transformational change with an increasingly challenging financial environment, cost savings and efficiencies are affecting the whole health and care economy. In order to ensure that the digital agenda across Nottinghamshire is providing the key technological enablers to support whole system change and support the delivery of Nottinghamshire’s Sustainability and Transformation Plans (STP), an event was held on Tuesday 21 November 2017 which focussed on how technology and Nottinghamshire’s digital strategy could support transformation across the STP and the two delivery units; the Accountable Care System (ACS) in Greater Nottingham and the Alliance in Mid Nottinghamshire. The purpose of the day was to give attendees a chance to reflect on the last 12 months, how we have used information and IT as an enabler to improve patient care and experiences across our services and how we will meet the

https://www.england.nhs.uk/wp-content/uploads/2014/10/5yfv-web.pdf

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/384650/NIB_Report.pdf

https://www.england.nhs.uk/stps/about-stps/

https://www.england.nhs.uk/stps/about-stps/


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challenges of the 2020 vision; closing the key gaps around health and wellbeing, care and quality and finance and efficiency over the next 3 years.

The aims of the day were to;

- Introduce the ACS and Alliance programmes across Nottinghamshire and update on Nottinghamshire’s Sustainability and Transformation Plan, as well as providing an introduction to a number of key transformation programmes taking place across Nottinghamshire

- Update on progress made against Nottinghamshire’s digital agenda, in particular the five work streams identified in Local Digital Roadmap to support the Sustainability Transformation Plan

- Identify the benefits of working across wider stakeholder groups

Attendees

The event was attended by the following organisations/representatives:

- Patient/carer group representatives

- Clinical IM&T Champions/leaders

- GPs

- Social Care IM&T Champions/leaders

- Third Sector representatives

- Local authorities representatives

- Strategic leads for business Transformation Programmes

- Academic Subject Matter Experts

- Commissioners (health and social care)

- Secondary Care

- Primary Care

- Community Care

- Strategic leaders in IM&T

- Senior Managers responsible for: Information, Infrastructure, IM&T Project or Change

Management

Setting the Scene

Welcome and introductions, Sam Walters The event was opened by Sam Walters, Chief Officer for Greater Nottingham CCGs (Rushcliffe, Nottingham West, Nottingham North and East and Nottingham City). Sam welcomed all attendees and commented on what 6th annual Nottinghamshire Health and Social Care IT Summit would be focusing on. She highlighted that the event would provide a great opportunity to celebrate how technology can enable transformation across health and care in Nottinghamshire, and provide time for delegates to consider future digital requirements to support whole system change in line with ambitions of the STP.


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Nottingham and Nottinghamshire Sustainability and Transformation

Partnership, Roz Howie Roz Howie, Deputy Managing Director for Nottingham and Nottinghamshire Health and Care Partnership set the scene by providing an introduction and overview of Nottinghamshire’s Sustainability and Transformation Partnership (STP). Roz referred to the last year’s summit where David Pearson introduced the notion of a Sustainability and Transformation Plan and how this had now transformed into a partnership for delivery. She went on to discuss the aims for addressing gaps under Health and Wellbeing, Care and Quality, Finance and Efficiency and Transforming Culture. Summarising that Nottingham and Nottinghamshire was already at the forefront of innovation, and, that transformation was already underway.


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Joining up health and care: Establishing an Accountable Care System,

Rebecca Larder and Centene Rebecca Larder, Director of Transformation delivered a highly informative presentation on the

Accountable Care System (ACS) alongside colleagues from Centene. They discussed the objectives of

the ACS and Centene’s role in supporting Greater Nottingham’s transition to a new system of care.

They highlighted the part that IT plays within the ACS looking towards improved infrastructure.

The Mid-Nottinghamshire Alliance, Neil Moore Neil Moore, Associate Director of Commercial Development provided an overview and update on

the progress of the Alliance and Better Together Programme. He explained the background and Key

aims of the Alliance, as well as Development plans for whole-system, sustainable services.


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Local Digital Roadmap (LDR) Update, Andy Evans and Ben Halliday Andy Evans, Programme Director and Ben Halliday, LDR Workstream Lead for Connected Nottinghamshire gave an update on the progress made over the last 12 months on the Local Digital Roadmap and how its five workstreams support the Sustainability Transformation Plan and the strategic delivery of the ACS and Alliance.

They discussed the history of the LDR including last year’s outputs and achievements, and looked

towards what progress had been made across Information Sharing, Infrastructure and Digital

Maturity.

Improving Access to Health for Children, Young People and Young

Adults Rachel Walker, Service Manager – Mentoring Transitions, Access to Health and Prisons lead for the Carers Federation attended with a number of young people involved in their mentoring scheme Future Pulse. Future Pulse is a mentoring service which provides a voice for children and young adults and aims to improve access to health services and empower young people to help shape health services across Nottingham. More information about the work of Future Pulse can be found on their website https://futurepulsenottingham.wordpress.com/ The young people talked about their experiences of accessing health and care services in Nottinghamshire, shared their views about how they whished to be communicated with and their opinions on information sharing. Within the presentation, attendees were able to watch a heart-warming video the group had produced by the young people; the video will be available on the Connected Nottinghamshire website soon. Following this a question and answer session took place, questions of which are noted below;

Information Sharing Workstream

Digital Maturity Workstream Infrastructure Workstream

Where have we got to: - Portal - MIG - GPRCC

Where have we got to: - Nottinghamshire generally

scores well in the national assessment.

- Use of key sharing tools increasing (include figures/graphs)

Where have we got to: - Implemented new

networks - Improved Wi-Fi across the

patch - Public access Wi-Fi delivery

Where are we going: - Community wide

capacity/resource management and flow process

Where are we going: - We need to strengthen

o ePrescribing o Increase usage

Where are we going: - Creating the LDR WES –

(Warranted Environment Specification)

- Putting cyber security at the centre of what we do

- Improving service provision and delivery

https://futurepulsenottingham.wordpress.com/


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What is the future of health/ care

services in terms of IT?

It would be good to have a choice of using

different methods of communication, not

just phones calls, but texts and emails too.

Patients with learning difficulties could

have an app which they log into on a daily

basis to record their emotions.

How would you like to communicate

with your GP and have you ever been

asked to give feedback whilst at the GP?

Sometimes we can feel rushed in a 10

minute appointment; it can be hard to

ask the questions that needed to be

asked. It would be useful to have a

mechanism to ask these questions before

or after the appointment.

Would you like to access health records online and would you like

to be responsible for who can access these?

It would be useful to access health records online and who was

actually accessing these records in organisations. It would help

because we could point out inaccuracies and correct any mistakes;

there is just a worry about the security.

.

How might the NHS better share

messages through Social Media

such as Facebook and twitter?

Using social media is a lot better

than providing paper which might

be thrown away.

Are you comfortable with how your

information is stored?

Sharing is okay but we would like to

know when and where information is

being shared and who to.

Would you use health apps to

support your care?

A health app to help express how I

was feeling before going into an

appointment would be helpful, it

would take the pressure off.

Do you have any concerns

around privacy of sharing

information between people

who deliver your care?

Although it is a concern, we

know that sharing information

is helpful for us. Nice to know

that if we went into hospital,

consultants would have the

right information they needed.


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Assistive Technology Andy Evans delivered a thought provoking presentation on Assistive Technology and Supporting the STP Transformation with Technology Enabled Care on behalf of Wendy McLellan, Assistive Technology Workstream Lead for Connected Nottinghamshire. Andy described how Assistive Technology aligned with the LDR and STP in transforming and supporting Technology Enabled Care. He provided an overview of the AT roadmap and outcomes which were being aimed for;

Assist - NICE Award Winning

Model Michelle Turton, Housing Needs Manager, Mansfield District Council delivered a presentation to the room on the early medical discharge scheme provided by the Advocacy, Sustainment, Supporting Independence and Safeguarding Team (ASSIST). The scheme helps and supports patients and citizens within the Mansfield and Ashfield district to remain independent through intervention and re-ablement. Michelle discussed unique elements and what the scheme included in terms of support with assistive technology, later highlighting the achievement of winning the NICE Shared Learning Awards 2017.


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Workshops

The afternoon session included a number of exercises which required attendees to focus and reflect

on topic areas discussed, support and define key system wide priority areas for delivery over the

next 12 months and beyond.


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Local Digital Roadmap Exercise Delegates worked in groups and were asked to consider the priority areas identified under the Local Digital Roadmap and how these linked back to business needs for the ACS and Alliance. The following four questions were put to groups;

Do you agree with the priority areas identified?

Majority of groups agreed with the priority areas identified, however delegates wanted greater emphasis on the granular context of what contributes to the

priorities as they felt this was not wholly clear.

What do your organisations need to do to deliver the highlighted workstreams priorities?

- Decision making process for legal organisations and access to any pooled

budgets - Resources/ skills to deliver the basic services that contribute to the

priorities - Training and support - Better joined up approach to IG across the community - Communication and engagement with the public and ensuring feedback is

received through multiple mechanisms - Ensuring cyber security and completing assessments before hand - Need Connected Nottinghamshire to provide clear direction on which

systems are concentrated on - GP systems need aligning - Base level involvement at community level - Resources for technical change and business change - Data quality and real-time data entry - Identifying the real/ biggest problems and finding practical simple solutions - Developments that give use more than just transferring information from

paper to PC e.g. o decision support tools o alerts to patient status o wider set of data from different agencies o Making frontline staff jobs easier and quicker, more efficient and

effective. 4G wireless provision for community use

What challenges to delivery will your organisations encounter?

- Information sharing - Competing priorities - Technological barriers: Firewalls between organisations and access to

shared systems for users - Money and resource - Resistance to change/ accepting change - Myth- busting on what organisations are doing and not doing - Engagement - Sharing agreements - Avoiding duplication

Are there other (more urgent?) projects that might impact the successful delivery of the LDR?

- Winter pressures/ capacities with staffing and not meeting other targets - STP/ ACS - Matching the LDR to the STP and aligning to trusts - MIG access - Change management - Development of local WES with an appreciation of national standards


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Assistive Technology Discussion Session

The second exercise of the day asked delegates to reflect on the Assistive Technology strategy and whether this worked for their individual organisations,

groups were asked to consider what would help to support their Assistive Technology and Technology Enabled Care plans.

Does the AT strategy work for you and your organisation?

- It does in PICs, currently using FLO

- Sometimes there are AT champions but difficult to roll out to the masses

- Good whilst it’s supported, there are often short term projects

Has your organisation agreed the priorities for AT,

if so what are they?

- Doesn’t appear to have been considered, it

would be helpful to understand if there was an

AT strategy

- Unsure whether organisations have an agreed

approach/ strategy What would be most helpful to support your AT and TEC plans?

- Takes time to adopt due to infrastructure, sometimes there is no buy in from

staff. Support around this would be helpful.

- Consistency

- Understanding what’s out in the system, it’s not about “toys” it’s about

enablement

- Where AT is invested, savings elsewhere might be produced. How is usage

incentivised

- Lack of knowledge of options available – need shared learning / best practice

- Identifying patterns for individual care requirements

- Centralised co-ordination role/ helpdesk that has the resource/ knowledge of

what is available

- There should be a standard set of kit that shouldn’t be changed all the time for a

small reason

- Sharing and adopting AT that’s worked in other areas

How can we facilitate/help?

- Communication and awareness

- Shared learning

- How does it link into other workstreams

- Work with developers to design products to

deliver a pathway benefit

- All levels need to agree and sign off

- Central facilitation team

- Transformation need time to allow the

headspace to plan and deliver

#allowtransformation


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Marketplace Throughout the day exhibit’s displaying demonstrations of key systems utilised across health and

care in Nottinghamshire including; GP Repository for Clinical Care (GPRCC), F12 and the

Nottinghamshire Community Health and Care Portal were available for attendees to view. This

provided an optimal opportunity for attendees to ask questions on further development and

implementation in person.

Event closure and Feedback

Summing up Dr Jeremy Lewis, Lead for In Hospital Care and Dr Nicole Atkinson, Lead for Out of Hospital Care provided a summary of the day. Dr Lewis commented on his experiences with using several systems such as the CareCentric Portal and the Medical Interoperability Gateway (MIG), he reflected how these systems supported services in hospitals and his keenness to embed systems such as these round the County. Dr Lewis concluded his comments by highlighting the importance of clinical engagement and the utilisation/ development of existing technology within the system. Dr Atkinson reflected on how IT shaped her working day, referring to the Out of Hospital workstream and how boundaries were being pushed to help shape and transform services. She commented on how IT was trying to improve patients and citizens lives; referencing toward electronic discharge for patients on the day, stating the littlest of steps has the biggest impact on day to day work. Dr Atkinson concluded her summary by praising the work Connected Nottinghamshire and other organisations were doing to drive plans forward.


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Closing remarks Andy Evans closed the event and thanked all attendees for their input into the day, he went on to discuss next steps; advising a report based on the discussions of the day would be produced and circulated to stakeholders. Delegates were asked to complete a feedback form based on the format of the day. An overview of the results are detailed below, in addition to this a more detailed report of the days feedback is also provided http://www.connectednottinghamshire.nhs.uk/media/1456/feedback-form-results.pdf

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The event met theagreed objectives

The introduction tothe STP and the local

direction of travel wasuseful

The overview andintroduction of theAccountable Care

System (ACS) gave mea greater

understanding of thisdelivery unit and how

it supports the STP

The overview andintroduction of theAlliance gave me a

greater understandingof this delivery unitand how it supports

the STP

The recap andobjectives of the LocalDigital Roadmap (LDR)set out the ambitions

of the agenda tosupport the STP clearly

It was useful to hearyoung people'sexperiences of

accessing health andcare services across

Nottinghamshire

The session onAssistive Technologywas useful and gave

me a greaterunderstanding of howAssistive Technologycan support self-care

Re

spo

nse

s

Health and Social Care IT Summit Feedback

Strongly Agree Agree Neither Agree nor Disagree Disagree Strongly Disagree

http://www.connectednottinghamshire.nhs.uk/media/1456/feedback-form-results.pdf


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Conclusion Based on conversations throughout the day and the common themes identified in the afternoon

activities a number of key requirements were identified in order to shape Nottinghamshire’s digital

strategic plans.

Following on from the invaluable contribution from all that attended the summit the next steps will

be;

- Publication of the event output report

- Undertake a review of the LDR by 31st March 2018 ensuring;

o key requirements identified on the day have been captured and shape the next

iterative of the LDR

o alignment with requirements of the STP, ACS and Alliance to ensure that digital

plans enable business transformation

- Set up Workstream to support the delivery of Assistive Technology and Patient and Citizen

Access to Information and Records

Next Steps from You….. We would love to hear your feedback on any aspect of the Health and Social Care IT Summit, please contact [email protected]

Special Thanks We would like to take this opportunity to thank everyone who attended the event; your input into these events is instrumental in enabling the development of system wide digital plans.

We would also like to thanks to all Sam Walters, Roz Howie, Rebecca Larder and Centene, Neil Moore and Michelle Turton for their presentations.

With special thanks to Rachel Walker, Tessa Hullett and all the young people from Future Pulse who made the day extra special!

mailto:[email protected]


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Appendix 1 – List of Delegates

Name Organisation

Alan Welsh NHIS

Alexis Farrow Connected Nottinghamshire

Andrew Fearn Nottingham University Hospitals

Andrew Haw Nottinghamshire Healthcare Trust

Andy Hall Rushcliffe CCG

Andy Spencer Nottinghamshire Healthcare Trust

Annie Meakin Nottinghamshire LMC

Brian Hancock Nottingham North and East CCG

Carl Davies Rushcliffe CCG

Chip Centene

Chris Beadle Nottingham University Hospitals

Chris Ward Patient

Debbie Drape Rushcliffe CCG

Dominick Ferguson Nottinghamshire Healthcare Trust

Donna Hadley EMAHSN

Fliss Moir Nottinghamshire Healthcare Trust

Gina Holmes Mansfield and Ashfield CCG

Ian Trimble Connected Nottinghamshire

Jeremy Lewis Nottingham University Hospitals

Jodie Armitage Nottingham University Hospitals

John Stephenson

Jules Willams NHIS

Kalpesh Raithatha Connected Nottinghamshire

Katya Anthony Nottingham University Hospitals

Kay Fairy Nottingham University Hospitals

Loretta Bradley Nottingham City CCG

Louise Hemment Nottinghamshire County Council

Maria Ward Nottinghamshire County Council/ D2N2

Mark Parry CityCare

Mary Whetstone NHIS

Michelle Turton Mansfield Council

Mike Press NHIS

Neil Moore Mansfield and Ashfield CCG

Nick Coulton NHIS

Nicky Render PICS

Nigel Glossop Nottinghamshire Healthcare Trust

Nikki Turner Nottingham University Hospitals

Oliver Christie NHSD

Paul Brandreth Nottinghamshire County Council

Phil Brough NHSE

Rebecca Larder STP

Rosie Atkin Nottingham West CCG

Rosie Gilbert Nottinghamshire County Council

Ruth Lloyd Mansfield and Ashfield CCG

Sam Walters Rushcliffe, NNE and NW CCG

Sarah Day NHSE

Sean Hall Future Pulse Volunteer

Sean Higginbottom Nottinghamshire County Council

Sergio Pappalettera Nottingham North and East CCG

Siyanda Mkwell Nottinghamshire Healthcare Trust

Stephen Andersen PICS

Stephen Murdock Rushcliffe CCG

Steve Jennings-Hough Nottinghamshire County Council

Sue Batty Nottinghamshire County Council

Terry Lock Patient

Tinu Akinyosoye-Rodney Nottingham City CCG

Wendy Lippmann Nottinghamshire County Council

Wendy McLellan Connected Nottinghamshire

Andy Wilson Nottinghamshire Healthcare Trust

Matt Howden Nottingham University Hospitals

Lee Willerton Nottingham University Hospitals

K Peters Nottinghamshire County Council

Joannah Montgomery Nottingham City CCG

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