The NIMM – Local benefits and experience

Am I providing a good service?

Is it a cost effective service?If you don’t have measures in place how will you know?

All NHS Trusts are subjected to measurement and comparison, whether by SHA or Monitor

Information on Trusts’ performance is made public

Most clinical services are measured and accredited already

All start with fairly simplistic measures and develop

Why should IT/HIS services be any different, since IT enabled developments like PACS underpin clinical services 24/7

Provider of a shared service, but could not provide evidence of best practice performance or cost effectiveness

Undertaken unofficial benchmarking with other local HISs

Some pockets of good practice – Health Records and Clinical coding accreditation

What have the Roman’s done for us? How Much!&*!! If you don’t improve we will take our business

elsewhere Need to take the heat out of the system The question of a Value for Money HIS was fast

becoming an unanswerable taboo

If we can’t prove we are any good, or cost effective, at least provide transparency

Provided customers with a break down of individual service costs and their share of that service

Started by using simplistic metrics, such as:◦ The number of PCs◦ The number of end users

Proposed share of HIS funding for Financial Year 2009/10

Budget Centre NameSource of evidence for the share of

serviceBudget centre code Budget Value

HIS valuation of work carried out for each Organisation

South Devon Healthcare FT Torbay Care Trust Devon PCT Devon Partnership Trust

% Value % Value % Value % Value

HIS Baseline Costs 2009/10                     

Clinical Records Health Records Tab 16400 £768,378 94% £719,048.13 2% £13,984.48 5% £35,268.55 0% £0.00

Clinical Records Management Health Records Tab 58100 £224,899 94% £210,460.48 2% £4,093.16 5% £10,322.86 0% £0.00

HIS Graphics Not Shared 74630 £39,373 0% £0.00 0% £0.00 100% £39,373.00 0% £0.00

Informatics Support Core Admin systems users 75320 £227,120 81% £183,285.84 11% £25,664.56 7% £16,352.64 1% £1,589.84

Web Support Not Shared 74609 £24,429 100% £24,429.00 0% £0.00 0% £0.00 0% £0.00

Clinical Coding Health Records Tab 19300 £204,209 94% £191,098.78 2% £3,716.60 5% £9,373.19 0% £0.00

Information Information Team Tab 19000 £318,511 83% £263,090.09 9% £28,347.48 7% £23,251.30 1% £4,140.64

General IT Contracts Actual IT Invoices 75319 £1,017,366 58% £593,938.27 13% £136,428.78 23% £234,299.39 5% £52,699.56

IT Operations Non Pay IT Operations Summary Tab 74601 £80,61570% £56,430.50 16% £12,898.40 11% £8,867.65 3% £2,418.45

IT Operations Projects IT Operations Summary Tab 75113 £41,38073% £30,207.40 12% £4,965.60 10% £4,138.00 5% £2,069.00

Desktop Operations Team IT Operations Summary Tab 75110 £593,78864% £380,024.32 19% £112,819.72 13% £77,192.44 4% £23,751.52

Servers Team IT Operations Summary Tab 75111 £429,23379% £339,094.07 15% £64,384.95 5% £21,461.65 1% £4,292.33

Networks Team IT Operations Summary Tab 75112 £202,84770% £141,992.90 11% £22,313.17 18% £36,512.46 1% £2,028.47

HIS Corporate team & Services Core Admin systems users 74603 £379,387 81% £306,165.31 11% £42,870.73 7% £27,315.86 1% £2,655.71

HIS Projects & Training Core Admin systems users 75340 £279,77581% £225,778.43 11% £31,614.58 7% £20,143.80 1% £1,958.43

Actual HIS Budget figures as of July 2008    £4,831,310 75.9% £3,665,044 10.4% £504,102 11.7% £563,873 2.0% £97,604

Add Pay Inflation & A4C Banding Adjustments ESR System  

£226,382 80.4% £182,011 9.8% £22,118 8.6% £19,559 1.2% £2,694

HIS Baseline for 2009/10 Pre LDP    £5,057,692 76.1% £3,847,055 10.4% £526,220 11.5% £583,432 2.0% £100,298

Acute 3% CRES See CRES 2009/10 Tab  

£144,365 100.0% £144,365.00 0.0% £0 0.0% £0 0.0% £0

Add Pay Inflation & A4C Banding Adjustments ESR System  

£226,382 80.4% £182,011 9.8% £22,118 8.6% £19,559 1.2% £2,694

Add Trust applied overheads at an agreed 20% South Devon Healthcare Ledger  

£966,262 20.0% £733,009 20.0% £100,820 20.0% £112,775 20.0% £19,521

New Baseline for 2009/10 - Post LDP    £6,105,971 75.6% £4,617,709 10.6% £649,158 11.7% £715,766 2.0% £122,513

Microsoft Office Excel Worksheet

◦ Health and Social Care Information Centre◦ Monitor ◦ Healthcare Commission◦ ATOS ◦ National Computing Centre◦ SOCITIM◦ Gartner◦ NIMM◦ FIMM◦ Microsoft

◦ ASSIST / UK CHIP◦ BCS (HIF)◦ UKAS◦ National Computing Centre◦ SOCITIM◦ NHS HIS - Clinical coding & Health records

model already exists

Can we agree on one standard tool It should enable meaningful comparison

with Industry wide tools, not just the NHS Can we start simply and develop

incrementally Don’t mandate it until the pilot sites are

happy it is fit for purpose Can the newly created Benchmarking club

be the forum for developing the tool

PC Operating system & patch management PC Operating system platform

standardisation Single Sign On Software Asset Management On the above we scored 3 to 4, depending

on the customer

Organisations receive assurance of good performance, best practice and VfM

HIS/IT providers can address areas in need of improvement and have sources of evidence to help

We, the internal IT providers, can demonstrate our ability to provide world class IT services, as good as any other sector (the grass is not always greener on the private sector side, but can we prove it?)

We have evidence to demonstrate our service is fit for purpose

Benchmarking and accreditation will support local cases for IT investment

Integration of health and social care is where the big patient benefits will come

CfH/Spine are looking to develop the interoperability of software

We should look to enable the NHS to get best value out of the vast NHS infrastructure and enable all NHS employees to work flexibly

Accreditation of Infrastructure to common standards should provide organisations with assurance that it can provide open access to all NHS employees who happen to be working on their site

Any Questions?