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GREATER MANCHESTER HEALTH AND SOCIAL CARE PARTNERSHIP

STRATEGIC PARTNERSHIP BOARD Date: 30 June 2016 Subject: Enabling Health and Social Care Reform through Information Report of: David Dalton (Chief Executive Salford Royal)

Steven Pleasant (Chief Executive Tameside MBC) Stuart North (Chief Officer, Bury CCG) Geoff Little (Deputy Chief Executive Manchester City Council)

PURPOSE OF REPORT

This paper is intended to provide GM HSC Strategic Partnership Board with an update on the work to date on Information, Management and Technology (IM&T) element of the Enabling Better Care transformation theme. The paper summarises the key elements of the developing GM IM&T strategy, outlines the two key priority GM programmes of activity (information sharing and the development of a single view of the resident) and identifies the potential funding opportunities including access to the national Digital Transformation Fund and capacity requirements to support the implementation of the strategy and its priorities

Members of the Strategic Partnership Board are asked to provide comments on the paper which will be used to further develop the IM&T Strategy. In particular views are sought on the proposed funding options and mechanisms for galvanising capacity to deliver at scale across GM.

RECOMMENDATIONS: The GM Health and Social Care Partnership Board are asked to:

1. Note the work to date on the development of a GM wide IM&T Strategy in support of the wider GM Strategic Plan, ‘Taking Charge’ and comment on the approach set out in this paper

2. Agree to GM-Connect and the role out of DataWell as two of the GM priorities within the IM&T GM strategy

3. Agree to the funding proposal as a combination of alignment of existing organisational budgets and funding through the national DH Digital Transformation Fund which will combine with GM Transformation Fund investment in new service models.

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4. Agree to the process for identifying and releasing capacity in the GM system to support the implementation of the GM IM&T Strategy

CONTACT OFFICERS: Vicky Sharrock GM Health and Social Care Partnership Vicky.sharrock@nhs.net??

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1. Background

Shared information and the ability of all staff to understand the holistic needs and strengths of residents and service users is fundamental to the successful delivery of the GM Strategic Plan. This shared information is essential to implementing our Locality Plans and new models of care through proposed Locality Care Organisations. The information we hold across our organisations belongs to the individual residents it relates to. Agreement to sharing information gained through consent of those individuals is key to integration at the locality and neighbourhood level, supporting people where they live. This different way of viewing information and the importance of sharing data is key to a new relationship between citizens and public services. Our employees therefore need to feel supported to work in this way by our collective leadership. 2. Locality Plans As work has progressed on the development of the GM IM&T Strategy a national requirement for the development of locality digital roadmaps was launched by NHS England. GM responded to this requirement collectively and is working across the sub region to develop a GM wide Roadmap which is informing our overall IM&T strategy. To support the digital roadmap requirement NHS England released a self-assessment consisting of a structured and detailed questionnaire across three broad categories:

• Readiness – covering topics such as Strategic alignment, Leadership, Resourcing and Governance;

• Capabilities – covering eg: Records. Transfers of care, Medicines Management, Remote and Assistive Care;

• Infrastructure which includes Wi-Fi, mobile devices, single sign-on and business continuity

All GM providers have completed this assessment and we are currently expanding this work across primary care and social care. The outcome of these collective assessments will enable each locality to draw together a locality level understanding of digital maturity in the place. These assessments will be aligned with the IM&T requirements of the new service models within each Locality Plan. Along with proposals for workforce and estate the IM&T proposals within each Locality Plan will be a key test of how plausible and deliverable the plan is. As part of the development of the social care contribution to GM and locality transformation programmes, Directors of Social Care have started to set out the key IM&T infrastructure required to support this work. This includes business intelligence (including a consistent approach to risk stratification / citizen engagement), data sharing and common information governance and developing the digital interface to

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support contact and demand management. These areas are being built into the wider work. At the locality level, new service delivery models will focus on the person as an individual and how they can best use their strengths and skills to become more independent and contribute to their communities. IM&T has the ability to support this asset based approach to service delivery, enabling people to stay well and be more in control of their own lives through improved access to and ability to update their own records as well as providing access to local directories putting people in touch with local services in their place. Investment from the GM Transformation Fund will be tied to agreements between the locality and the SPB Executive, specifying the success measures for improved services and savings. In addition investment from the national Digital Transformation Fund (see below) can be tied to specific IM&T improvements across GM which will enable service improvements and savings. The combination of these specific success measures will provide the means of reporting back progress to DH on the use of any potential Digital Transformation Funding accessed by GM. 3. IM&T Commitments within Taking Charge At the GM level the GM Strategic Plan made specific commitments to using information and technology to:

• Understand resident needs, and develop services more efficiently and effectively

• Ensure people to have greater access, ownership and responsibility over their own data

• Share data and information across organisations on a daily basis to support integrated multi-agency case management

• Use technology to support self-management

• Generate multiple ways for people to interact with the health and social care system

• Use information more effectively across organisations

• Reduce duplication

• Ensure speedy access to the right service

• Work with the wider public sector on the implementation of our information sharing strategic programme GM-Connect

In response to these commitments GM has developed an approach to IM&T focused on our relationships with citizens, the service changes within the GM themes and the Locality Plans. 4. GM IM&T Principles, Priorities and Programmes 4.1 Principles Over time there is an ambition for convergence towards commonality of systems across GM and in doing so providing consistent user experience, single services, standards and pathways. It should be recognised however that this will take time, with some

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organisations across GM able to move towards an agreed GM architecture sooner than others based on their current position. The aim is for all staff across the GM health and social care system to have access to information about residents and service users which recognises unique strengths of individual people, their families and their communities. This GM IM&T strategy will therefore put residents and patients at the centre. It starts with the need for better services; the technology serves that purpose. This will ensure services support choice, control and independence with a focus on early intervention and prevention, providing better support to those who need it. The GM IM&T Strategy will enable residents to have greater access, ownership and responsibility over their own data. It will generate multiple ways for residents to interact with the health and social care system. Staff will be empowered through holistic electronic patient records available at the point of care, creating a more nuanced and therefore efficient and effective health and social care system. To achieve this ambition, the GM Information Management and Technology strategy is focused around five key principles: Empower:

• Citizen empowerment – increased use of technology assisted care services including text, secure messaging and video conferencing. Development of single patient portal across GM giving citizens the ability to view and permit access to their own health and social care data.

Connect:

• Connectivity anywhere – expansion of existing wireless network across all health and social care locations and reduction in duplication across network infrastructures

• Foundation infrastructure – consolidation/federation of directories across GM, supporting the ability to share; the adoption and expansion of virtual infrastructures; expanding the use of communication and messaging technologies amongst organisations and care professionals.

Integrate:

• Electronic shared record – shared GM record across all organisations to support accuracy in service provision and reduce risk including GP, acute, community, mental health and third sector information supported by the creation of a GM wide master patient index

• GM information governance and approach to sharing – to enable the right information, in the right place at the right time

• Electronic records – GM wide digitisations; expansion of electronic referral and booking systems to standardise and simplify patient flows and expansion of electronic document sharing to allow correspondence to be shared across organisations

• Consolidated applications – creation of an infrastructure that allows for shared Picture Archiving and Communication System across GM and shared pathology results with central storage

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• Standards adoption – standard referral pathways, shared and consistent alerts and reporting and agreed consistent language across all organisations.

Collaborate:

• Consolidated IM&T services – creation of merged teams across skill areas and applications

• Optimise organisations – consistent and collaborative procurement, asset and resource optimisation

Understand:

• GM wide data analysis – working across GM with joint datasets to understand population level requirements and to support analysis by wider organisations with GM based research. This GM level analysis will also enable how we commission services in the future and needs therefore to be built on quality data and consistent standards.

4.2 Priorities To make progress on the application of the above principles, the priorities are:

1. Use GM-Connect to put in place the information governance and data sharing agreements across the GM health and social care system, based on the GM Public Service Reform principles emphasising a different relationship between public services and citizens and an asset based approach. The application of GM-Connect underpins the bottom-up and top-down approaches in points 2 and 3 below.

2. Understand the full range of IM&T system developments needed for a comprehensive approach to enabling delivery of clinical and financial sustainability by 2020/21. This is captured by the diagram in section 4.3 below. More input is needed over the next few weeks by the localities and the other themes of the GM Strategy to ensure their requirements are met.

3. Secure investment to support the development of place-based IM&T systems and architecture for integrated working at the locality level (i.e. not starting with a single top down system). A number of examples of systems being developed within localities are given within this paper but more work is needed over the next few weeks to understand the proposals across all localities as Transformation Fund proposals come forward.

4. At the same time secure investment for DataWell as the overarching GM system for integrated shared records across health and social care. All localities and individual organisations within localities will be able to connect their systems to DataWell. In this way GM will converge to a common IM&T architecture by building from where organisations are now and with better services as the driver.

5. Accelerate the implementation of digitally based applications that deliver step improvements in productivity in the processes of care. For example the Salford Control Centre.

4.3 Programmes The diagram below outlines how the full range of elements of the GM IM&T Strategy come together to create an ambitious potential architecture. Some of these areas of work are

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fundamental to the delivery of locality plans and the commitments in the GM Strategic plan (such as shared information and single view of the resident) others may form part of a longer-term strategy and will be progressed in furtutre years implementation.

GM Wide Health and Social Care Single View of the Resident

Health and Social Care resilient network

Wifi/Free

Wifi

Federated Active

DirectoryBYOD

Data

Security

Information

Standards

SPINE

Integration

Licencing

Shared/

Interoperable

Electronic

Records

Single

Shared

PACS/VNA

Expansion of

Existing

Systems

GM Unified Communications (VOIP/Presence/Video)

Consolidated

ApplicationsConsolidated IM&T Services

GM CONNECT

Information Sharing & Governance

Shared

Analytics

Common

Citizen

Portal

Directory of

Services

Desktop/

Virtual

Desktop

Shared

Resource

Optimisation

Research

And

Development

Common

Governance

Data

CentreServerStorage

Disaster

Recovery

Business

ContinuityCloud Compute

EmailConnectivity

Anywhere

Collaboration

Tools

Record

Digitisation

Shared

Clinical

Services

GM Master Person Index

Digital Referral

Pathways

Technology

Enabled Care

Services/Inter

net of things

GM

Sta

nd

ard

s/Q

ua

lity

Co

llab

ora

tio

n/C

on

solid

ati

on

Secure

Messaging

Fundamental to the delivery of the GM IM&T strategy and achievement of the GM ambition for health and social care reform at the locality and GM levels are two key programmes of activity that need to be delivered consistently and at scale, facilitating cross boarder / organisational working:

• GM Information Sharing Approach - Implementation of GM-Connect across the health and social care IM&T strategy, as the agreed approach to information sharing at the GM level

• Establishment of a consistent, single view of the resident In implementing these two key programmes, understanding and improving the quality of the data and information held across our systems is essential. Implementation of consistent standards for information across GM will therefore form a fundamental part of our overall approach. Similarly ensuring interoperability across systems will enable GM to bring together information across organisations within localities and at the GM level.

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5. GM Information Sharing for Health and Social Care - GM-Connect GM-Connect is a new data sharing commission created by the Greater Manchester Combined Authority (GMCA) with the mandate for data sharing across the conurbation. It will do this by exploring and supporting opportunities for using data sharing to create better value, more timely intelligence for professionals and residents alike, creating a real opportunity to improve service delivery. Consent to share information will be built into this programme of activity to ensure it aligns with our principles around empowering citizens to take ownership of their information and how it is used to drive service improvements to them as individuals as well as at the locality and GM levels. It is essential that as GM develops this wider information sharing broker across public sector organisations, our Health and Social Care IM&T activity is clearly aligned to the requirements of this wider programme. This will ensure that both health and social care information can feed into the wider GM activity and also those professionals in health and social care organisations can benefit from access to wider information around the individual they are caring for (given appropriate permissions). GM-Connect will initially focus on three priority areas:

• The development of ‘problem solving based’ Information Governance capability,

• Foundational standards for sharing data across GM, and

• The procurement of various technology capabilities which are required in order to progress the programme.

In order for GM-Connect to demonstrate its potential and build trust with partners, a number of quick wins have been identified. These include:

• Co-develop information sharing standards and governance models: learning from Trafford’s Care Co-ordination Centre, Rochdale’s Federated Social Care System and Salford’s Integrated Social Care System. Greater Manchester Police in particular is making strategic investments in ICT modernisation including analytics and information sharing creating timely opportunities for alignment.

• Establish GM-Wide Information Sharing Tool: GM-Connect is procuring a web based information sharing and governance tool for all of GM. This web-based tool can accommodate up to 1000 partner organisations and will establish one consistent approach for sharing and tracking information agreements across GM

In addition GM-Connect will focus on some specific service areas including sharing absentee data across Local Authorities, supporting the roll out of the new operating model for children’s services across health and social care and the development of a GM wide victims’ portal. GM-Connect has system wide sponsorship at the highest levels including the GM Wider Leadership Team, GM Reform Board and the Health and Social Care Partnership Board Executive. Building on this we have ensured strong links with the GM-Connect governance through the GM IM&T Enabler group with cross representation on each.

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6. Consistent, single view of the resident Across Greater Manchester there are a number of systems currently in use or planned to be implemented to facilitate the bringing together of information around the individual. As part of our wider reform activity and ambition for shared information it is important to consider how these systems, will link to support GM wide sharing of health and social care information and link with GM-Connect to support wider cross public sector sharing. Continuing to progress multiple systems will require a number of connections to be made at the GM level to enable the wider sharing agenda. However the delivery of a GM wide approach that does not require individual organisation to replace existing systems but that can support the delivery of integration will provide immediate benefits, improve services and provide a route towards convergence towards single systems in the future. In addition to operational service delivery benefits that will arise through such an approach, the amalgamation of shared information at the GM level is also essential in order to be able to inform strategic commissioning decisions, drive service improvement / transformation and the delivery of efficiencies. In order to get to this consistent approach there are a number of steps we need to undertake:

• Understand the current systems in place and their capabilities

• Identify a joint set of GM requirements / standards to work towards with view to promoting a health and social care information broker distinct from any individual record or case management system

• Identify and assess potential solutions to arrive at an agreed GM approach

• Map the route toward convergence including interoperability with GM-Connect Across GM we already have an understanding of the systems in place. Some of these systems have been developed locally whilst others are being used as a tactical short term solutions as longer term proposals are developed. Many of these systems are in place in multiple localities which could provide an opportunity for clustering in the short term. In addition the AHSN is currently in pilot phase of DataWell, a platform that could provide a GM wide solution to information sharing (see below for more information) Given the inter-dependencies between this GM opportunity and the single approach to information governance highlighted above, a joint set of standards / requirements for a single view of the resident are being developed along with the GM-Connect team. This will ensure any standards adopted through the health and social shared IM&T strategy will align and are interoperable with those of the wider reform work. DataWell DataWell is a platform that will enable integrated shared records across health and social care. It has the ability to enable practitioners to access a complete picture of the individual they are working with, helping them to see the whole needs of that individual not just those

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they are presenting with at any one time. This will facilitate better, more co-ordinated care across organisations to tackle multiple and often complex needs. DataWell is a programme of activity led at the GM level by the AHSN. The programme has been developed in such a way that all GM health and social care organisations within GM can join. A cross-organisation procurement process was undertaken to establish the agreed provider, a partnership arrangement between Lumira, IBM and EY. Given this approach and building on the AHSN as a membership organisation, all health and social care organisations across GM are able to join the DataWell programme without the need for further procurement. The current funding model has a central GM element which is funded through AHSN budget. In addition there is a contribution requirement for any organisation joining DataWell. The funding model for the pilot phase is in place however the ongoing funding model for wider GM roll out is dependent on increasing numbers of organisations committing to participate in the programme. As a result there is currently a break clause in the contract in October 2016. A new funding model, potentially linked to the national Digital Transformation Fund (see below) would ensure sustainability of the programme and would overcome the need for individual contributions from participating organisations. DataWell itself consists of two complementary programmes: DataWell Exchange and DataWell Accelerators. DataWell Exchange DataWell Exchange will use national standards and act as an information broker across organisations in GM. As individual organisations come on line with DataWell they will have their own individual ‘node’. These are designed to share data with other ‘nodes’ through a process of validating data requests against information sharing agreements and individual consent. The safeguards within DataWell ensure individual organisations maintain local control of the data they hold and who it is shared with at the same time as empowering individuals to have greater control over their own information. Six pilot sites for DataWell have been identified (Central Manchester CCG, Central Manchester Foundation Trust, Salford Royal Foundation Trust, Salford CCG, The Christie and UHSM). GM is currently targeting 50% of the population to be covered by DataWell by April 2017. However there is the potential to accelerate this programme of activity to drive greater coverage within the same timescale. This would require additional investment and resource capabilities for the DataWell programme itself but also for the delivery of some of the IM&T strategic priorities that will enable individual organisations to connect to DataWell. In addition successful delivery of DataWell requires appropriate information governance across GM, creating a dependency on the GM-Connect programme. GM wide implementation of DataWell Exchange will also open further opportunities for the use of ‘big data analytics’ informing future service provision and targeting and commission decisions and generating a more effective overall health and social care environment in GM. To enable us to use this information in this way GM will need to develop consistent data standards that are implemented across all organisations. This will ensure the quality of our data and support accurate decision making.

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DataWell Accelerators DataWell Accelerators will create new industry partnerships and pilot opportunities to generate added value through knowledge, capability and efficiency, informing the development of new types of service and creation of new intellectual property. The knowledge brought together across GM through the accelerators will enable GM to diffuse innovation more quickly from locality pilots to the GM level. Three specific pilot areas have been identified as DataWell Accelerators:

• Patient access and consent management – DataWell will not only provide individuals with a more complete view of their record it will support individuals to manage their consent for access to that record, directives and care plans. Testing models of patient ownership and consent will provide balance and enable flexibility in information sharing paths to help future proof the GM information sharing ecosystem against legislation changes or the necessity to create new consent models in the future and provide learning opportunities for other areas outside GM. Shifting the ownership and access to information to the patient will also support individuals to manage specific long term conditions such as diabetes.

• Pathology – GM wide access to patient pathology results for clinicians, enabling access to all test requests and results for individuals. This will support a better informed workforce, allow automated monitoring across health, reduce duplication and allow patients to view their own results. Significantly this will also enable a more holistic view of patients improving effective treatment and reducing the potential for errors and missed opportunities.

• Genomics – DataWell supports the 100,000 Genomes research and clinical transformation programme by developing a mechanism to transfer study data between 100k Genomes Study Centre and their partner sites. In doing so this will also support inward referral of patients for clinical care.

GM is working with HSCIC, Connected Health Cities and Health Innovation Manchester in the delivery of these pilots to ensure the adoption of principles for improving health research in line with the objectives of Data4Health. In doing so we will ensure holistic data integration, improve effectiveness and efficiency, allow commissioners to reduce unwarranted variation, identify and target areas of needs and evaluate care in near real time. Transforming the productivity of processes of care through Digital Control/Command Centres Healthcare is a process driven industry. It lags behind other industries in the application of data to drive efficiency and the reliability of the processes of care. Many other process driven industries have used operational research techniques to deliver transformational improvements in productivity and through this make a step change in costs and reliability. GM has developed an approach to command centres, in Trafford, Rochdale and Salford. The Salford approach has attracted national attention. The belief is that it can act as a

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national exemplar for the development of command centres across the care continuum and is seen as an investible proposition by NHS England. A hospital’s ability to operate in a more efficient and effective manner can be attributed to teamwork, following best practices / guidelines, and having the ability to make the right decisions in a timely manner. However, the use of accurate, timely, and rich data for improving processes, decision making, and teamwork is minimal. A Command Centre is a capability where operations and clinical teams are jointly informed in a co-location environment, with information (retrospective, real-time, and predictive) that is structured and available in a timely manner. This transforms capacity utilisation (staff, equipment, beds, theatres etc) through more effective decision making. GM, at Salford, has undertaken a proof of concept that is evidencing transformational changes in staff, bed and theatre productivity. The GM concept of a command centre has the following components that, together, drive transformation:

• Automated information flows and scheduling to enable optimised patient flow

• Tools that provide clinical and operational staff with prediction of capacity requirements of patient demand so that they are able to pro-actively manage capacity (emergency and elective demand)

• Tool that visualises unwarranted exceptions to agreed clinical pathways, so that proactive action can be instigated.

• Co-location of clinical and operational decision makers so that they can optimise the use of data and the above tools.

7. Benefits of Delivering the GM IM&T Strategy

IM&T is a key business enabler for the Health and Social Care economy in GM. In addition to direct benefits through systems convergence, the GM IM&T Strategy will enable the GM system to unlock the targeted benefits of the other transformational themes. These indirect benefits are often unattributed to the IM&T activity behind the scenes but are no less important when considering investment opportunities. Implementation of the GM IM&T strategy will strengthen the availability and quality of both clinical, financial and activity data across health and social care. This will support improvements in business intelligence enabling GM to respond to statutory reporting requirements and topic based reporting to inform GM and locality commissioning activity and strategic planning. High level benefits of delivering the GM IM&T Strategy have been categorised into those relating to residents, professionals and organisations across GM: Resident Benefits (Service users families and carers): GM residents will have more convenient access to public services and greater knowledge about the services available to them. It will support the vision for residents to provide information to GM only once, reducing the number of interactions and duplication of efforts between the resident and public services, and leading to fewer service delivery errors and improved interactions with the GMCA.

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Benefits for our professionals: Professionals in the various public services will have relevant and timely information at their fingertips when they need it. Through information sharing and the tools available to facilitate this, they will be better equipped to have inter-services collaboration. Organisation – Benefits: Public services will be able to analyse data at GMCA level i.e. cross services, forecast and optimise resource allocation and in turn experience reduced staff turnover. Through inter/intra service collaboration, public services will produce better outcomes for residents. 8. Understanding funding requirements and opportunities In understanding the investment required to deliver the GM IM&T strategy we need to consider the GM level activity but also the locality investment required to improve digital maturity and ability to align with the GM priorities outlined in the paper above. It is clear significant work is required to arrive at an accurate understanding of the funding necessary to deliver the GM IM&T strategy over a 3-5 year period. These include:

• Detailed understanding of the GM and locality level activity required to deliver the various aspects of the GM IM&T strategy and ambition

• Understanding of the timescales within which these need to be implemented

• Sharing current locality IM&T strategies and investment plans to highlight activity already underway that will deliver improvements in digital maturity of our localities

• Developing business plans for each of the areas of development including cost benefit analysis

The funding required to deliver the strategy will include short term capital investment in addition to longer term revenue funding. Although there is further work required to complete a detailed understanding of the funding required over the next 5 years it is clear this is a considerable investment at both the GM and locality levels. In identifying funding there are a number of potential considerations:

• Existing organisation budgets – across GM all of our organisations have existing IM&T budgets and investment strategies. These should form a considerable contribution to both the short term investment requirements but also to the longer-term revenue implications. It is recognised that through the process of developing local digital roadmaps in response to the national requirement, and given these plans form a significant element of the overarching GM IM&T strategy, there will already be a significant amount of alignment.

• GM IM&T request to the GM Transformation fund – given the nature of the GM Transformation Fund being revenue focused, GM will not be able to use this fund to support capital elements of the IM&T strategy. There is potential however for the GM Transformation Fund to support any potential revenue elements of IM&T proposals, provided they meet the agreed fund criteria.

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• Locality plan request to the GM Transformation Fund – the locality elements of the overarching GM IM&T strategy and the locality digital roadmaps will form part of each locality’s health and social care implementation plan. This will therefore form part of each localities investable proposition and request for support from the GM Transformation Fund. In understanding these requests we need to ensure there is alignment to the GM ambition and strategy. As localities will go through this process at different times, depending on their readiness, this should be taken into consideration in terms of providing overarching support and capacity to ensure those organisations who are already digitally mature are able to progress whilst those who have further to travel are not hampered and unable to link with the GM work. As with the GM aspects of the IM&T strategy outlined above, any locality IM&T elements within locality plans will also need to satisfy the GM Transformation Fund criteria and be revenue rather than capital costs.

• DH Transformation Funding – The DH Transformation Fund is a £4.2bn fund which will run over a five year period. A significant proportion of this funding has been allocated to support ongoing programmes of activity at the national level. It is understood the residual element of the fund will be used to support local digital NHS programmes of activity.

DH is keen to work with GM to understand how the national funding can help to deliver significant steps forward in digital maturity and paperless NHS at scale. GM is currently having discussions with DH and NHS England to clarify the process for access to this funding. It is likely this will take the form of a jointly developed memorandum of understanding. This will set out a GM proposal for implementing a series of agreed outcomes relating to priorities within the GM IM&T strategy. In addition there will be a requirement for GM to outline, within the MoU, clear plans to achieve the National Information Board priorities. If successful this will secure substantial capital funding for IM&T during 2016/17. Given the options outlined above, the most appropriate route for funding the GM IM&T strategy is a combination of existing IM&T budgets, access to the national DH Digital Transformation Fund for capital investment into systems and the GM Transformation Fund to invest in new service models which these systems will support. 9. Capacity to deliver It is clear that significant progress has already been made at the GM level on the development of an agreed strategy for IM&T to enable the wider GM Strategic Plan. To date this has been achieved partly through a limited resource within the GM Health and Social Care Partnership but more significantly through capacity from across the wider GM system. Although it is acknowledged this approach generates ownership and challenge across the system resulting in a more robust strategy, there are currently no agreements in place that would ensure regular access to this resource. As we move into the next phase of activity on IM&T we need to have clarity over capacity requirements and agreement over availability of key resources. As with other transformation areas within the GM strategy, the GM system needs to take collective responsibility for the delivery of agreed programmes of activity. To ensure this is

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embedded in localities and individual organisations, partners need to be prepared to release capacity to work on these GM programmes of activity for the benefit of the whole system. In relation specifically to IM&T there are two key stages of activity we need to identify capacity to deliver:

• Short-term requirements – to develop the business case that will enable access to the nationally available funding as identified above

• Longer-term requirements – to support the implementation of the strategy itself Short-term requirements (2-3 months) We are currently working with Department for Health to understand their requirements for accessing the national transformation fund. Although this has not yet been confirmed it is clear our next steps need to include development of:

1. Specific GM programmes of activity to deliver the strategy 2. Pan-GM information sharing processes through GM-Connect, including the role out

of cross authority information sharing tool 3. Accelerated roll out plan for a GM agreed approach to single resident view by

connecting locality systems for integrated case management to the roll out of DataWell across GM

4. Action plans to achieve the National Information Board priorities across GM 5. GM Roadmap and locality Roadmaps embedded within the locality plans which

respond to the national requirements for digital maturity 6. Shared interoperability standards for health and social care relative to pattern,

schema, transport, and security aligned with GM-Connect information sharing process

7. Detailed cost benefit analysis and financial modelling These resource requirements should be sourced from within the GM system itself building on the capacity already used to support the development to date. This resource would however need to be released for an agreed amount of time to provide focused capacity for the next two to three months to ensure the greatest chance of GM accessing the nationally available funding. It is proposed once the individuals required to support this work are identified discussions with their respective organisations would follow to agree potential availability, taking consideration of local requirements. Enterprise, Information, and Security Architecture skills are currently unresourced within the IM&T and GM-Connect. Though progress has been made by leveraging scarce permanent and supplier resources already in the system, capacity to deliver the transformational standards and information sharing architecture is under resourced in the medium term. Additional architecture skills and capabilities will be required to execute both the short terms and long term information sharing processes to be co-developed by IM&T and GM-Connect.

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Capacity to deliver the cost benefit analysis element of this next phase is also a current gap. Although we do not yet have clarity over the cost benefit requirements of the DH business case process that will be used, this will inevitably form a fundamental component. Some preliminary analysis has been undertaken as outlined above, this will need to be built on to provide sufficient evidence for the business case. Given the current capacity gap around this area and the requirement to complete the work in a relatively short space of time, it is suggested we take advantage of the current framework arrangements in place to bring in additional external resource. A clear and focused brief for this work can be developed following once the detailed requirements for the business case have been identified. Longer-term resource requirements (3 months onwards) To ensure ownership across the system, the longer-term requirements to deliver the GM IM&T strategy itself should also be derived from the wider GM system, supported and co-ordinated by the GM HSC Partnership. It is proposed this should also be through discussion with individual organisations to release individuals for agreed amounts of time. However given the longer term nature of this resource requirement it is suggested this is done through a secondment process with clearly defined roles made available through an expression of interest process across all GM public sector organisations. This virtual team will have specific responsibilities for identified areas within the overarching GM IM&T programme. They will work with colleagues from across GM systems and provide a strategic steer in addition to technical expertise to support the implementation within localities and individual organisations. Central to the implementation of the GM strategy however is the capacity across GM, within each individual organisation. Ensuring alignment of locality strategies to the direction of the GM strategy and vision will be essential to GM achieving its collective ambition. GM-Connect will serve as a rallying point and coach for local authorities by augmenting existing standards and tools to help increase the opportunity to share. To support this locality based capacity will also need to be aligned to the achievement of for example locality digital roadmaps and the National Information Board priorities. Locality IM&T plans will need to form part of each of our locality plans and tracked as part of the overall monitoring of implementation. In support of this capacity and resource at the GM level (including any national transformation funding) may need to be allocated based on an understanding of requirements at the GM level but also considering requirements at a locality level to enable each locality to participate in GM wide programmes and to deliver against national requirements.