Facilitating a new Primary Care System

1. PRIMIS Facilitating a new Primary Care System Dawn Friend Charlotte Warburton Fifth Annual Conference 11 – 12 May 2005 Piecing Together the Future Dawn Friend

2. Facilitating a new primary care system Dawn Friend Primary Care NPfIT Project Manager Greater Peterborough Primary Care Partnership Charlotte Warburton Business Change and Training Lead Accenture Dawn Friend

3. Overview • Local background • The practice • Migration activities • Where are we now? • Challenges, challenges, challenges Dawn Friend

4. Greater Peterborough and NPfIT • NPfIT Local Health Community • GPPCP (2 PCTs and Adult Social Care) • Local (foundation) Acute trust • GPPCP • 33 GP practices (plus 1 RAF base and 1 prison) • PRIMIS team since 2000 (currently 3 people) • 1 ‘early adopter’ GP practice, with migration of other practices planned to start 2005 • Primary Care ‘think-tank’ group (GPs and PMs) and Primary Care project board Dawn Friend

5. Early adopter project • P1R1B project (with Central Norfolk LHC) • Practice signed-up • PID written with Accenture • ‘Go live’ date planned end Nov 2004 • Accenture project team and local project manager • Project activities planned from October NB - Things don’t always go to plan… Dawn Friend

6. The practice • Westwood Clinic • 2 GPs (senior partner is PEC chair) • Practice manager vacancy • Struggling clinical system (Torex 6000 4b) • Slow, problems, no contract manager/QMAS • Accenture offering Torex Synergy based product • Fewer training issues anticipated Dawn Friend

7. Migration activities • Baselining • ‘Kick off’ meeting • Business change workshops • TNA and role mapping • Registration Authority (RA) • Exeter reconciliation • Data migration activities • New equipment (PCs) & N3 connection • Hardware & software testing • Helpdesk arrangements • Communication (staff & patients) • Testing (pre and post cutover) • Training and post go-live support Dawn Friend

8. Baselining – forming the ‘as is’ • Huge spreadsheet! Lots of information required by Accenture business change lead • Site info, functionality, IT, staff, data migration, templates & reports, business change, training needs… • We did not want to ask the practice about all of it – especially with no practice manager in post… Dawn Friend

9. So what do we already know? • Site, IT, current system – Practice IT Support Analyst and primary care team • Who might know about practice staff, roles, use of system, templates, reports, training needs, business processes…? Any ideas…??? Dawn Friend

10. ….our friendly neighbourhood PRIMIS team! • Worked with Accenture BC lead to discuss baseline information – knew a lot already (after 4 years!) • Met with practice and Accenture to work through remaining information required • Supporting and taking some of the pressure off the practice staff, for baseline and other forthcoming activities… Dawn Friend

11. ICI - kit and connections! • 3rd party hardware and desktop support contract with standardised desktop • Rollout of new kit • Testing PCs and software (eg LSP, RA) • N3 connected (eventually!) • Moving to local shared services helpdesk as first line at NPfIT go live (liaison with LSP and National service desk) Dawn Friend

12. ‘Kick off’ meeting • Whole practice team • Local NPfIT team • PRIMIS team • Accenture project manager, leads, and product specialist • Demo of Torex product • Business change workshops Dawn Friend

13. Accenture - business change approach As-Is process gathering: Understanding of current practice ways of working; roles and responsibilities, application usage, data capturing templates, reporting capability. Local impact assessment: Gap Analysis of current and future ways of working, identification of change areas and individuals impacted. Business Change Plan: Action plan listing interventions and recommendations to implement new ways of working Communications: Communications plan identifying key messages, timing, owner and feedback mechanism Dawn Friend

14. Gather “As Is” Data Conduct Gap Analysis / Impact Assessment Review To Be Solution Agree Impacts /Gaps Create Business Change Plan Accenture – Business Change Activities As Is Data Gathering Local Impact Assessment Business Change Plan • Review of solution by practice staff • Thorough review of solution by Change Champion - ½ day • Update gaps / impacts • Assess practice’s existing features and processes • Review practice templates and reports • Conduct detailed review of practice processes • Identify likely gaps and impacts on organisation • Develop draft recommendations for addressing impacts / gaps • Create full list of impacts / gaps • Agree with rest practice • Finalise recommendations • Develop action plan to implement recommendations • Assign responsibilities (Practice/PCT/ LSP) • Understand budget & time implications • Change Champion & Key practice Stakeholder sign off Business Change Plan Dawn Friend

15. Training needs and roles • Identify all users (not staff) - 13 practice employees, but 25 users. • Basic computer skills TNA • questionnaire, and less formal ‘local knowledge’ of staff by practice/PRIMIS • Identify user role and current system access • Clinical system role mapping - joint effort • IT trainer understood the product training modules • PRIMIS facilitator and practice understood the current access and team roles • Map current user roles to Accenture training modules (or sections within modules) Dawn Friend

16. Training • IT trainer attended Accenture TTT course • Wasn’t familiar with GP systems • (At the time) no ‘play’ system available for training • PRIMIS team arranged visit to a friendly Torex practice to ‘play’ with Mickey Mouse. Test training scenarios in a ‘real’ system. • PRIMIS team would support trainer • eg questions & queries at early sessions • Training plans • Using the role mapping, training plan developed for each user Dawn Friend

17. Data migration • Added complication of 4-byte to 5-byte • Planned for PRIMIS team to factor in Read code training (4-5 byte differences) • Initial data migration reports – code conversion issues, demographic issues • Exeter reconciliation – 18 field Dawn Friend

18. Things don’t always go to plan… • End October project put ‘on hold’ • Keeping the practice engaged • Concentration on making existing system workable • Working with Torex - response times, technical problems, QMAS! • Accenture alternative GP system now available • Practice have choice – Torex or Phoenix • Support practice to make choice the choice - demonstrations and discussions • Then we will get back with the plan! Dawn Friend

19.  ?   ?  ?  ?  ? -------------------------------- -------------------------------- ?  Migration activities • Baselining • ‘Kick off’ meeting • Business change workshops • TNA and role mapping • Registration Authority (RA) • Exeter reconciliation • Data migration activities • New equipment (PCs) & N3 connection • Hardware & software testing • Helpdesk arrangements • Communication (staff & patients) • Testing (pre and post cutover) • Training and post go-live support Dawn Friend

20. Challenges for general practice…. • New IT systems… • Understanding functionality • Data migration • Data quality (and nGMS) • Security (RA) • Training & support • … but much more than ’just’ new IT systems! • Concept change (a new service) • Working with LSP colleagues • Business change • This is all about people! Dawn Friend

21. Thank you Dawn Friend Primary Care NPfIT Project Manager Greater Peterborough Primary Care Partnership dawn.friend@greaterpboropcp.nhs.uk Charlotte Warburton Business Change and Training Lead Accenture Dawn Friend