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1 Information Gateway

By Holly Palmer,2014-07-11 15:47
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1 Information Gateway ...

    Evaluation of Invest to Save Budget

    Case Study Report Project 2/54 Partnership in Action Barnsley Information Gateway

    ISB Case Study Report: Project 2/54 - Partnership

    in Action Barnsley - Information Gateway

    Background to the project and history of partnership working

    1.1 The key focus of this project is to establish a common source of shared information that can

    be used to deliver more effective, more user focused and more cost efficient services on

    behalf of the existing Partnership in Action Barnsley (PIAB). The project lead is Barnsley

    Metropolitan Borough Council. Membership of Partnership in Action Barnsley comprises a

    number of agencies across the health and social community which deliver over ?70m of

    services between them on an annual basis:

    ? Barnsley Metropolitan Council

    ? Barnsley Health Authority

    ? Barnsley Community and Priority Services NHS Trust

    1? Barnsley District General Hospital NHS Trust

    ? Two Primary Care Groups (PCGs).

    1.2 In April 2002 the two PCGs, Barnsley Health Authority and Barnsley Community and

    Priority Services NHS Trust will merge to form a Primary Care Trust (PCT). The Joint

    Agencies Group (JAG) oversees PIAB using powers delegated by Barnsley Metropolitan

    Borough Council and Barnsley Health Authority.

    1.3 By April 2002, integrated teams will deliver all the above health and social care services

    financed by pooled budgets. To achieve a co-ordinated and integrated service, staff and

    officers from different organisations will need to work in partnership. The necessary changes

    to working relationships is a challenge to PIAB organisations and the aim is for the

    ‘Information Gateway’ to facilitate and support this process.

    1.4 Currently the different agencies that make up PIAB have different computer and management

    information systems. This project will support the integration of the information from these

     1 Whilst not officially a PIAB member they are considered one for the purposes of this project

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    Evaluation of Invest to Save Budget

    Case Study Report Project 2/54 Partnership in Action Barnsley Information Gateway

    disparate IT systems, meaning that client information can be consolidated and can be

    presented in a consistent format. The direct beneficiaries of the project are staff working in

    social and health care services who will be able to access more comprehensive and up-to-date

    information on their clients and the myriad of services they might be receiving. This in turn

    will have a knock on impact and should improve the level and nature of services that clients

    receive.

    1.5 The transition to new working arrangements will be supported through the creation of the

    ‘Information Gateway’ which will create the common information source. This ‘Gateway’

    will have a number of specific functions:

    ? bring together records from the Council’s Social Services Department and National

    Health Service

    ? enable single personal records to be created from information provided by all the

    agencies IT systems

    ? provide a common source of information for the planning and delivery of services

    along ‘care pathways’ created by the joint commissioning process

    ? provide information quickly and in an easily usable form ? in future improve accessibility to information from a wider information ‘community’

    including services such as housing and education.

    1.6 This particular project focuses on the delivery of services to older people. The main focus

    will be sharing information between those working within Older People’s Services and the

    impact of that data exchange upon working practices.

    1.7 The project received confirmation of funding from the ISB Unit in May 2000. Approximately

    one-third (34%) of project costs amounting to ?480,000 are being met by Barnsley

    Metropolitan Borough Council and Barnsley Health Authority with the remainder (918,000)

    coming from ISB funding via the Department of Health.

    1.8 The partnership strongly believes that this project goes beyond the idea of joint

    commissioning of services. The project seeks to integrate services within an integrated whole

    system. The final bid document identifies that other partnerships around the country have

    integrated some of their services, however, it argues that there is no evidence of that any have

    taken a whole systems approach to such a wide range of services as this project will.

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    Evaluation of Invest to Save Budget

    Case Study Report Project 2/54 Partnership in Action Barnsley Information Gateway

    1.9 The partnerships has identified that this project is innovative in a number of ways, particularly

    in terms of service delivery and the application of new technologies. They highlight a

    number of specific areas such as:

    ? integration of information not a new challenge but something that is nevertheless

    complex. Existing data sources need to be reconciled and a new system needs to be

    able to serve a wide range of purposes

    ? streamlining services the development of a single assessment process, a single care

    record and single review system, ultimately supported by the information gateway

    whilst seeming to be simple common sense will transform the delivery of services

    for both patients and providers

    ? making sense of information gathered the common information source is a

    powerful tool for analysing performance and benchmarking

    ? electronic delivery of services the system will use the latest technology to create

    and rationalise files. It will greatly increase the electronic delivery of information

    ? security and confidentiality to challenge the Data Protection and Caldicott

    principles as part of the integration of information systems.

    1.10 Funding levels within the partnership were such that a project of this scale and nature would

    not have gone ahead without ISB funding. The Partnership in Action Barnsley would have

    proceeded but would have been a much slower piecemeal approach. Essentially the concept

    of the ‘Information Gateway’ was being discussed in Barnsley but until the ISB bidding

    round there was no funding available to take it forward at the level required.

    Project initiation, design and specification

    1.11 The partnership’s bid document determined a number of outputs they wished to result from

    the ‘Information Gateway’ project.

    ? a common information system across five programme areas

    ? integrated planning and delivery of services

    ? a single assessment process

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    Evaluation of Invest to Save Budget

    Case Study Report Project 2/54 Partnership in Action Barnsley Information Gateway

    ? a single visible record for each client

    ? fully trained staff committed to the new working systems ? a single collated database for need analysis

    ? common definition of service need for benchmarking

    ? working documents for dissemination to a wider audience.

    1.12 As can be seen from the above, the ‘Information Gateway’ is a vision of how the partnership

    would like to see information systems integrated and services developed. There have been a

    number of changes in personnel over the lifetime of the project as well as a number of

    changes in direction. The project has required a long development process which has

    involved the identification of a private sector partner to help the partnership design a system

    that will help them reach their vision and support them at the implementation stage.

    1.13 A number of project risks are identified in the project initiation document:

    ? failure to recruit and retain staff of the right quality ? finding solutions to security and confidentiality of information ? cultural resistance to new working practices, e.g. setting up multi-disciplinary teams ? individual resistance to the introduction of new technology ? practical difficulties with the deployment of emerging technologies ? selecting, procuring and implementing the required systems including the potential

    delays in agreeing contracts/partnerships arrangements with the private sector and

    delivery targets being met

    ? delays in assembling the funding package.

    1.14 The same document outlines the ways in which these risks will be minimised. However,

    whilst delays in the procurement process were identified as a risk they have nevertheless

    occurred this is outlined in more detail below. Other risks are an integral part of the

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    Evaluation of Invest to Save Budget

    Case Study Report Project 2/54 Partnership in Action Barnsley Information Gateway

    implementing the new systems, and as part of the procurement process potential partners have been asked to detail how these risks will be minimised.

    1.15 Throughout the development process of this project the partnership has also consulted with staff working in partner agencies who will be the key beneficiary of the new ‘Information Gateway’. This has been an important part of ensuring that staff understand the project and

    the impact it will have on the way in which they work in the future.

    1.16 During the first year of the project the Council initially led the vision and had to go out to the different partnerships and agencies to make sure people bought into the project and were committed. An important part of this process was ensuring that people were working towards the same agenda and have a common understanding of the vision and what the project is trying to achieve. This has taken time as people are working in different organisational contexts with different procedures and using different terminology for key areas such as procurement. All the different agencies involved in the partnership had slightly different procurement processes and it was important that everyone understood the system that was going to be used, which takes time when so many agencies are involved.

    1.17 The process of involving a private partner has been a complex one that has taken over eighteen months. There has been a sense that the government is promoting partnerships with the private sector and this is supported as part of the ISB bidding process. However, this is not so simple in practice, especially where there is a contractual arrangement and a procurement process that has to take place as per local government requirements. The partnership was not able to simply invite a private partner to join them because they had to go through a formalised procurement process. With hindsight the partnership believe it would be easier to establish a relationship with a private sector provider prior to bidding for funding, were this practical, or indeed acceptable under competition and procurement regulations.

    1.18 Barnsley Metropolitan Council led on the procurement process which was heavily bound by legislation. The size of the potential contract required them to issue an OJEC notice. The partnership at this stage had narrowed down their vision but needed support with the fine tuning and wanted to see what the private sector could offer. Therefore, the OJEC notice was not an invitation to tender per se, it was a prospectus that invited organisations to outline how they would deliver the partnership’s vision.

    1.19 There were two parts of the vision that potential partners had to address, firstly the IT solution and secondly, how they would deliver change management. Organisations were encouraged to work in consortiums with a lead partner if this would lead to more practical ways of

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    delivering the desired solution. The partnership received 111 requests for information from

    the OJEC notice which resulted in 59 expressions of interest being returned by June 2001. 1.20 From this response the partnership were able to long list 10 organisations who were invited to

    take part in the second stage of the process. A core team of the partnership were involved in

    the selection process, with specialists forming sub groups to comment on specific areas such

    as the IT solutions. Further and more detailed information was requested from organisations,

    particularly where a consortium was being proposed. As part of this, the partnership held an

    open day to meet people, present their vision and answer questions. 1.21 The second stage proposals were received in August 2001 but holidays and other

    commitments meant there was some slippage experienced in the procurement timetable. By

    this stage the partnership were able to shortlist three potential organisations and issue them an

    invitation to negotiate. At this point organisations were required to provide solutions based

    on specific case studies related to service areas, as well as health and social services as a

    whole, by January 2002.

    1.22 During January the three organisations were asked to come in and present their proposals in

    more detail and answer questions from the partnership. Best and final offers for delivering

    the vision were submitted by bidders in early February. At the time of writing the preferred

    partner - W S Atkins - has been agreed and ratified via the Council’s Cabinet.

    1.23 The project was initially funded for two years with the core of funding being used to pay for

    the IT solution required. However, they been given clearance by the Department of Health to

    extend the project to a third year and roll over the funding that has not been spent. The

    underspend has resulted from the delays in the procurement process which has meant the

    partnership have only recently identified the private sector partner they will contact with.

    Direction and management of the project

    1.24 The project is managed on a day-to-day basis by council officer who is dedicated to the

    project on a full-time basis. The project manager reports on a monthly basis to the project

    board which in turn reports to the joint agency group (JAG).

    1.25 Other agencies have nominated members of staff to be involved in the project on a part-time

    basis so it is additional to their existing role. This has the potential to cause difficulties

    because for staff from other agencies this project does not always have the same priority

    because they are not working on it on a full-time basis.

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    Evaluation of Invest to Save Budget

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    1.26 The Project Manager has submitted 6-monthly progress reports to the Department of Health

    who are the sponsoring department.

    Project outcomes

    1.27 The original proposal document outlines a number of the project outputs and suggests the

    related outcomes the Partnership expect to arise as a result of the ‘Information Gateway’

    project:

    Outputs Implications for users and services

    (outcomes)

    Single assessment process with a Services:

    single care manager Streamlined, more efficient and responsive a

    more effective process

    Users:

    Less strain and anxiety when accessing services

    Multi agency multi disciplinary As above

    reviews

    Single patient records Services:

    ? More efficient data handling both in creating

    and updating records

    ? Less time spent in chasing and assembling

    information

    ? Eliminates duplication of information

    ? Better information = better care plans

    Users:

    ? Better care plans and less strain at a

    particularly vulnerable time. Single point of entry and care Services:

    pathways Better co-ordination and more effective care

    packages. More productive use of existing

    resources

    Users:

    Easier to understand the social/healthcare

    system, greater control over processes leading to

    greater independence and confidence when

    accessing services Common information source Services:

    ? Cost efficient data handling capable of

    meeting future demands

    ? Better links between different agencies

    ? Shared information will promote better care

    plans

    ? More effective performance review and

    benchmarking

    Users:

    ? More holistic better tailored care programmes

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    Evaluation of Invest to Save Budget

    Case Study Report Project 2/54 Partnership in Action Barnsley Information Gateway

    Better communication within and Services:

    between agencies and other service More co-ordinated services = more effective use

    providers of resources

    Users:

    Better co-ordinated care = less stress and anxiety

1.28 A number of the quantifiable outcomes outlined above are complex to measure e.g. less stress

    and anxiety experienced by service users. However, the intention is to attempt to measure

    these success factors through consultation with service users once the ‘Information Gateway’

    has been implemented. This is likely to involve an initial baseline study of clients’ views,

    experiences and expectations of current services so they are able to benchmark progress.

    1.29 As part of the negotiation and contracting procedures with the private sector partner the

    partnership is identifying the means by which they will measure the outcomes of the project

    following its implementation.

    1.30 A prediction of the financial benefits gained from this project was outlined by the partnership

    in the proposal document. One example of this is that they estimated that by having a single

    assessment process operational in the third year they would see savings of ?123,000 across

    the partnership (based on assessment times being reduced by half). They also estimate that

    ?2.59m of expenditure would be incurred over 5 years if this project did not go ahead,

    because of continuing inefficiencies.

    1.31 The measurement of the financial benefits gained from the ‘Information Gateway’ is an

    important part of this project and the partnership is currently deciding how it can most

    effectively quantify these as part of the evaluation process.

    Additionality, longer term effects and value for money

    1.32 The partnership has predicted the longer term effects of this project on both service deliverers

    and users of the project and will track these as part of the evaluation process. The same

    applies to the issue of value for money. It is unlikely that these questions can be fully

    answered until the project has been implemented and operational for at least one year. The

    partnership intend to disseminate their experiences of this project as widely as possible.

    1.33 This project has had a positive impact in helping the agencies to understand each other’s

    cultures and operational processes. There is a belief that this project has started to get service

    providers to ‘think out of the box’ and look at more creative ways of working in other areas.

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    Evaluation of Invest to Save Budget

    Case Study Report Project 2/54 Partnership in Action Barnsley Information Gateway

    1.34 A number of key lessons have been learnt with relation to future partnership working.

    Critical success factors include:

    ? ensure all partners are clear about roles and responsibilities at the start of the project

    ? make sure all parties understand the ‘vision’ and what is trying to be achieved

    ? have clear line management responsibilities across agencies

    ? ensure that senior staff have bought into the project this is especially important

    when decisions need to be made quickly.

    Administrative and accountability issues

    1.35 As previously stated the sponsoring department (Department of Health) has had very little

    involvement with this particular project. The current project manager was not involved at the

    bidding stage so was unable to comment on the management of this process by the Treasury

    1.36 The partnership has attended events held by the Treasury’s ISB unit which were found to be

    particularly useful. They were able to learn from the experiences of projects from ISB Round

    1, particularly around procurement. This shared experience alerted them to potential pitfalls

    and helped them to minimised risk and slippage in some areas of the project’s development.

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