Symphony SCR Highlight Report V1.8 Page 2 of 5

SYMPHONY SCR HIGHLIGHT REPORT – Pennine Acute Trust Project Manager Wendy Sibley Report Date 01/07/2010

The NHS Summary Care Record (SCR) provides information to support care where no information is currently held about a patient, for example in emergency departments, out-of-hours settings, treating temporary residents, and emergency admissions to secondary care. It enables clinicians to access key clinical information about that patient from anywhere in England subject to the appropriate access controls.

SCR Release 1 started the creation of the SCR by sending a GP Summary to the Spine. Release 2 builds on the functionality already delivered to expand the content of the SCR to include reports such as Emergency Department reports, Outpatient reports and others.

The Ascribe Symphony SCR system will be one of the first systems developed to deploy Release 2 functionality within an Emergency Department care setting. The functionality will be enhanced to provide access for staff to view an existing SCR, and to send an Emergency Department report to the SCR.

There will be a phased release of the Ascribe Symphony SCR system.

Phase A will include Smartcards Authorisation and Authentication and Integrated viewing of the GP Summary on SCR within Symphony, with basic PDS validation of patients.

Phase B will include the ability to allow staff to view ED Discharge Summary reports and upload these reports to the Spine.

Phase A & B will be released at the same time. The target go live date for Symphony 2.29.1.3 is 7th July 2010. The functionality to allow users to perform patients’ demographic searches on the Spine will be made available to all 4 sites. Only Symphony users at Fairfield General will be able to view the Summary Care Records and upload Emergency Discharge letters to the Spine. The uploading of the Emergency Discharge Letters functionality will not be available immediately after go live. It will only be available 3 months after go live.

Phase C will be the complete PDS integration, where staff with appropriate access controls will have the ability to view any document downloaded from the Spine, perform legal override of the permission to view and management of staff’s access controls for patient consent.

The final Phase D will see the release of the functionality relating to sealed documents within Ascribe Symphony SCR.

Status Now + 3mths Commentary Project Size: SIGNIFICANT Lifecycle Stage: Milestones Baseline Forecast Actual Slippage RAG Overall Status G G Go Live date 7th July 2010. Symphony 18/11/2009 18/11/2009 G upgraded to UAT is still ongoing and expected to be v2.22.4.7 from completed on 25th June. v2.22.4.5 Progress G G Symphony upgraded to v2.28.1.2 from v2.22.4.7 Training is still ongoing and expected to be Trust and 19/11/2009 23/11/2009 19/11/2009 G completed on the 7th July 2010. Ascribe Agree on Change Freeze Costs G G No known issues. Upload a live 23/11/2009 30/11/2009 19/11/2009 G copy of DB, Having a discussion with CFH and Printed Outputs, Benefits G G Bournemouth about collaborative working to Reports, Views realise benefits. & CDS extract Initial pre-fetch response times is routines to approximately 10 – 15 secs in Test Ascribe FTP Environment. The Live environment has a Server Risks & Issues A G better hardware specs and therefore this Ascribe upload 19/11/2009 18/01/2010 04/02/2010 13 G figure is expected to improve significantly. If all changes and ManDays not, the Trust will have to activate rollback rework on PAT plan. Test Governance G G In terms of project control and status environment

039059660125803ab94e515e84655663.doc Page 1 of 5 reporting, there is no known issue. PAT Commence 30/11/2009 08/02/2010 05/02/2010 G Tests, Accept Jackie Milner’s secondment has been and Sign Off extended verbally by Ann Rhodes. Ann Staff/Resource A A Rhodes will be speaking with Keeley Gibbons about making this position permanent. Clinicians and Users G G No known issues. PAT 2.28.1.2 Go 09/02/2010 10/02/2010 10/02/2010 Sign Off G Live, Sign Off 04/05/2010

Symphony upgraded to v2.29 from v2.28.1.1 (A & B only) Acceptance and 09/02/2010 30/04/2010 30/04/2010 G Sign Off future state workflow processes Approve PID 19/10/2009 21/12/2009 22/01/2010 G Approve 19/10/2009 30/09/2010 G Investment Case Acceptance and 07/12/2009 11/05/2010 11/05/2010 G Sign Off Data Cleansing – Symphony PMI and PDS and PAS PMI Procurement of 04/01/2010 15/12/2009 G Hardware and Software DevMac Issued 06/11/2009 30/04/2010 06/05/2010 1 month G to Ascribe Symphony SCR for Phase A and B Install and 15/01/2010 15/02/2010 15/02/2010 G Configure New Hardware Ascribe deliver 10/02/2010 15/03/2010 15/03/2010 G software and release notes for 2.29 phase A and B. Install and Configure Test client and Server machines on Trust Site Implementation 15/02/2010 05/04/2010 26/04/2010 3 Weeks G into Sandpit for Test Servers Acceptance and 17/02/2010 25/06/2010 G Sign Off all tests – functional and non functional Acceptance and 04/12/2009 14/05/2010 28/5/2010 2 weeks G Sign off Training 039059660125803ab94e515e84655663.doc Page 2 of 5 Plans and Documents All users trained 17/05/2010 08/07/2010 G Configure 10/02/2010 15/06/2010 15/06/2010 G Firewalls and Register Endpoints for all production servers for connectivity to Spine completed Install Smartcard 12/01/2010 31/03/2010 31/03/2010 G Hardware & Configure smartcard software for all production workstations (450) completed Ensure all 23/11/2009 05/07/2010 G Symphony Users have workable smart cards (Roles and SDS Identifier added to Live User Account) Review 22/03/2010 05/07/2010 G Operational Readiness Rolling out and 02/04/2010 07/07/2010 G Go Live Phase A and B Symbol pick up R A G Summary :Key Achievements & milestones (since last report) Summary: Planned Achievements & milestones (before next report)

  UAT Completed for Symphony SCR 2.29 – 28th June 2010.

Assumptions Dependencies

 Because of the four phase release by Ascribe for version 2.29 Symphony SCR, the Trust It is important to bear in mind that the success of this project is constraint by the lack of enthusiasm will first be deploying Phase A and B, followed by Phase C and then finally Phase D. by GP practices and PCT within catchment areas to get their PIP done. However, the sentiment is  The functionality that allows users to update the Spine’s PDS details via the Symphony improving as a result of continuous effort from CFH. The latest figures to date 18th November 2009 application will not be available for the initial phases (Phase A to Phase D) of the 2.29 provided by representative from North West SHA are:- deployment.  Bury PCT - 143,000 records uploaded (80% of Population) by January 2010  The Spine’s environment is an exact replica of the Sandpit environment.  Oldham PCT – 24,000 records (10% of Population) by May 2010 (that is practices they  CFH Compliance testing will be completed within planned timescales. currently have signed up) There is an expectation that they will get at least twice that  Ascribe will install and configure Symphony SCR 2.29 in the Trust Local Test Environment amount in the very near future.  Manchester PCT – Are very keen to PIP patients, before March 2010. Currently, they 039059660125803ab94e515e84655663.doc Page 3 of 5 Risks (since last report) Issues (since last report)

 If the current 4 hour rule (registration to admission/discharge/transfer) is breached more  The success of this project is very much dependent on the GP Summary uptake programme frequently than before the new system is implemented, users’ experience for Symphony and PIP relating to SCR especially at Bury PCT, Oldham PCT, Manchester PCT and HMR PCT. SCR will be compromised. This scenario is contributed by the change in business This will increase the outage of the project and have an impact on the deployment strategy processes to implement the Permission to View SCR and seeking permission from patient adopted by the Trust. The latest figures published by Northwest SHA are:- to send discharge letters to GP via the Spine. In addition, the simple PDS tracing – both • Bury PCT - 143,000 records uploaded (80% of Population) by January 2010 manual and auto may also contribute to the increase number of cases failing to meet the • Oldham PCT – 24,000 records (10% of Population) by May 2010 - that is practices they 4 hour ADT target. currently have signed up , hopefully they will get at least twice that amount • Manchester PCT – Are very keen to PIP patients, before March 2010, can’t give figures on  The frequency of uploading of the GP Summaries onto SCR may also have an impact on upload yet. the quality of the SCR that is coming across to Symphony. If the information is outdated • HMR PCT – currently not going to PIP till May 2010. or inaccurate or incomplete, this may affect users’ confidence in the information presented to them by SCR in Symphony. If this happens, users will not utilise the SCR  Data synchronisation between the Spine and Ascribe Symphony SCR may potentially create functionality to help them make decisions. more data quality issues.

 The signed off functional, design and technical specification were developed with very This functionality uses the Spine’s PDS (Demographics Information) and PSIS (Clinical minimal involvement from key stakeholders at the Pennine Acute Trust. Moreover, the Information). documentation does not provide sufficient information (table structures, data dictionary, services and other middleware components etc) as to how the entire Symphony SCR The data quality issues are around the following areas: solution actually works. There is therefore this danger that the assumptions made in these specifications may pose a big change necessary to be introduced into the four sites • NHS Number and NHS Number Status. Currently, Symphony is not able to update the NHS and users may not be able to accept these changes quickly enough. This means that the Number Status in PAS because the inbound messages to PAS from DAD do not capture the project costs may escalate significantly in order to make the solution work for PAHNT. status value. The inbound messages into PAS will be modified to update NHS Numbers from Symphony but not status values. Symphony will not process status values delivered by outbound messages from PAS.

• Addresses from Spine’s PDS may not be compatible with the format used in local systems. This could potentially corrupt the address information on PAS via inbound update messages from DAD. Ascribe is modifying the AScR component to handle this.

• The process to update patients’ demographics within Symphony would automatically undo

039059660125803ab94e515e84655663.doc Page 4 of 5 Outstanding Actions Outstanding Change Requests

 Require a deployment meeting with both CFH and Ascribe and also involve tech team  Sue Goulding is in the process for negotiating a change request for the inbound messages into from tech support and data centre. PAS via Trust Interface engine to hold the NHS Number status code value – these messages are triggered as a result of new patient registration in Symphony. Order has already been placed in Jan 2010. Sue Goulding is still in the progress to negotiate the start and delivery date of this piece of work. The proposed delivery date is 12 months later.  A change request has been issued to IT development to modify the inbound messages into PAS to include NHS numbers from Symphony. This is to ensure that the outbound messages from PAS will not wipe out the NHS numbers within Symphony for all new patient registration.

Summary of financials Spending Trajectories Allocate Budget £0K April 2009 £0K Current Yr to Date Capital Expenditure £0K August 2009 £0K Expected spend as of 31/03/2010 £0K December 2009 £0K Project Carry Forward to 2010/2011 £0K March 2009 £0K

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