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Complexity

Developing a city ‘blueprint’ Alastair Cartwright Director of Informatics Leeds Clinical Commissioning Groups. To maximise the value and delivery of public services in a city there’s a lot of ‘joining up’ to do….

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Complexity

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  1. Developing a city ‘blueprint’ Alastair CartwrightDirector of InformaticsLeeds Clinical Commissioning Groups

  2. To maximise the value and delivery of public services in a city there’s a lot of ‘joining up’ to do…..

  3. 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 Fundetc.

  4. Complexity In practical terms, joining up…..-Teams-Departments-Functions-Organisation-Services-Sectors-Organisations-Cities

  5. In technology terms, joining up…..People – Process – Technology

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

  7. “Patient/Citizen” “The Leeds £”

  8. ‘Blueprints’ have been useful…………

  9. BUT FIRSTJoined up governance………(circa 2012)

  10. Health and Wellbeing Board via Health and Social Care Transformation Board Commercial and Academic links Leeds Informatics within the governance for Health and Social Care transformation Leeds Informatics Board Local Authority CTO Chair – Dr J Broch CCG North, Chair City-wide Leadership Office Primary Care Senior GP/s LTHT Executive ASC Senior Officer Children’s Senior Officer CCG Senior Officers City-wide Clinical leader LYPFT Executive LCH Executive Informatics Director Programme Manager • Partners: • CCGs x 3 • Leeds Teaching Hospitals • Leeds Community Healthcare • Adult Social Care • Leeds City Council • Leeds and York Partnership FT • Primary Care City-wide Programme Management Group Variable resources inc. Project Management, expert advisors/specialists, admin, Finance LCC IT Senior Reps from Local departments Local Informatics departments and resources

  11. ‘Blueprint’ 1 (circa 2012)

  12. Monitoring/ commissioning system Improved Contract Mgt Improved needs assessment Needs assessment Improved health intelligence Data Warehouse Event linkage Costing analysis Risk Stratification Contract and additional data flows Knowledge Management Data Protection/Caldicott/Sharing ‘Plan on a Page’ - Building blocks to achieve the Leeds informatics ‘Vision’ Pathway Management/Visibility/Clinical Decision Support Telecare and Telehealth Patient/client access to records Between organisations Leeds Care Record e-messaging Order Communications Risk Stratification Summary Care Record (SCR) Programme/Project Management Business Analysis and process re-design IT Infrastructure linkages inc. LCC city-wide facilities e.g. ‘superfast cities’ Interoperability standards Research Paper-light processing inc. Digitised/e-records NHS Number Wireless technology Integration Engine Mobile working IG Toolkit Provider organisations LTHT Full range of integrated clinical systems Social Care Full range of strategic systems Independent and 3rd sector systems YAS LYPFT Full range of integrated clinical systems LCH Full range of integrated clinical systems Primary Care Hosted nationally compliant systems

  13. This common framework enabled……..

  14. Monitoring/ commissioning system Improved Contract Mgt Improved needs assessment Needs assessment Improved health intelligence Data Warehouse Event linkage Costing analysis Risk Stratification Contract and additional data flows Knowledge Management Data Protection/Caldicott/Sharing ‘Plan on a Page’ - Building blocks to achieve the Leeds informatics ‘Vision’ Pathway Management/Visibility/Clinical Decision Support Telecare and Telehealth Patient/client access to records Between organisations Leeds Care Record e-messaging Order Communications Risk Stratification Summary Care Record (SCR) Programme/Project Management Business Analysis and process re-design IT Infrastructure linkages inc. LCC city-wide facilities e.g. ‘superfast cities’ Interoperability standards Research Paper-light processing inc. Digitised/e-records NHS Number Wireless technology Integration Engine Mobile working IG Toolkit Provider organisations LTHT Full range of integrated clinical systems Social Care Full range of strategic systems Independent and 3rd sector systems YAS LYPFT Full range of integrated clinical systems LCH Full range of integrated clinical systems Primary Care Hosted nationally compliant systems

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

  16. TRANSFORMATION PROGRAMMES HWB ENABLING GROUPS West Yorkshire Workstreams ICE Children’s Urgent Care Finance Task Group (DOFs) Julian Hartley Leeds Health and Social Care Transformation ‘Portfolio’ Board Cancer Stroke Informatics Board Jason Broch Strategy Group PMO Workforce Phil Corrigan/Bryan Machin Elective Care Simon Stockill/ Susan Robins Adult Integrated Care and Prevention Andy Harris Ian Cameron Goods & support services Chris Butler Growing up in Leeds Nigel Richardson/ Matt Ward Urgent Care Nigel Gray/Jason Broch Effective admission & discharge Phil Corrigan/ Sandie Keene Quality Improvement with Leeds University Gordon Sinclair Estates Group Chris Butler Operational group In-patients Identification and risk stratification Emergency admission avoidance Best Start Estates Communications and Engagement Group Rob Kenyon/Phil Corrigan/ Primary prevention Population management Family support Improving hospital discharge Outpatients including diagnostics Supplies Emotional and mental health System development Pathway development Cancer Community beds service Primary CareGordon Sinclair Complex needs Integrated system change Pioneer Rob Kenyon Best transition into adulthood Self-management BCF Matt Ward/Dennis Holmes Prevent entry into Care

  17. ‘Blueprint’ 2 (circa 2012)

  18. Simplification and refinement: 3 TIERS of delivery: ‘primary’ use’ of data ‘secondary use’ of data Time Tier 1 Tier 2 Tier 3

  19. 6 features of a transformational Informatics platform: Strategic requirements for transformational change.…….. • 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

  20. ‘Blueprint’ 3 (circa 2013)

  21. Complexity In practical terms, joining up…..-Teams-Departments-Functions-Organisation-Services-Sectors-Organisations-Cities

  22. Overlay:

  23. ‘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

  24. 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

  25. - QUESTIONS -

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