December 2021 NEWS & VIEWS FROM THE C&I TRUST DIGITAL TEAM
Introduction by Jeff Boateng
Executive Director of Digital Services & Informatics There is a lot of activity happening in the Digital team at the moment and I would like to thank the whole team for their hard work and dedication in working towards achieving our goals. I hope you find our updates helpful. If you have any comments or feedback, please do not hesitate to get in touch by emailing me at Jeffrey.boateng@candi.nhs.uk
Our Digital Strategy so far…. Last month, the Trust Board received an update on the progress that has been made in delivering the Digital Strategy. The Strategy has been running since February 2020 and a lot has been achieved in that time, especially in light of the pandemic. Whilst the Strategy has been running, there have been a number of strategic changes within the NHS; Integrated Care Systems are being developed and NHSX (who look at how digital services are delivered across the wider NHS) have also launched a digital framework called What Good Looks Like (WGLL), and our Community Mental Health Transformation is also underway. Internally, a large number of projects are currently running which will aid our infrastructure improvements and will help to improve access to clinical information to ensure that staff and service users are safe. The Board has been updated on our progress and has congratulated the Digital team for moving things forward over the past 20 months and acknowledged that things are still improving. There is more to be done and updates of new projects will be shared with staff across the Trust as they happen. I would like to conclude with the following reflection from myself and Dr Laurine Hanna, Chief Clinical Information Officer: Digital is a way of working that touches us all – clinicians, service users, administrators and managers alike. Here are the Digital principles we have learnt and lived since the original Strategy for C&I was published in February 2020:
• We have understood that technology cannot just be dropped into a service or team – digital is about people – and their needs must be understood and designed in order to make a success of any digital endeavour.
Many basic elements of Trust infrastructure have been replaced or improved – we are making considerable investments into our IT.
• As we go forward, we must continue to review our clinical systems with the same level of standards and governance throughout to support high quality of care to our service users. • We need a proactive representative between staff and digital services to engage with those using clinical systems. They will working with representative user groups to influence and inform crucial elements of the technology we use - particularly training and configurations. • Finally, we understand more than ever the importance of multidisciplinary working – people with technical skills working day in day out with clinical and operational colleagues as #oneteam to make stuff better #peoplebeforetechnology #C&Idigital. Going forward, we will be reviewing the Trust Digital Strategy in the new financial year to ensure that it still meets our needs. We will engage with staff across the Trust to understand the needs and requirements of teams and get an idea of what digital means to you. If you have any initial thoughts, then please do get in touch.
Are you a Digital Angel in the making? With the momentum in digital evolution happening within the Trust, the Digital team have been talking about setting up a community of angels who will support us to shape things in their areas. I use the term “angel” because it symbolises the fact that someone is investing their time in the organisation to support it’s aspirations. When you add “digital” to it, it symbolises someone who wants to be progressive of a digital future – namely the Digital Angel! We are really excited to be developing this, but we want to do it jointly with all of you. We are keen to talk to you and hear your thoughts about what this could look like. We want to share content that will help people get comfortable with technology, provide courses that are of interest and stimulate knowledge sharing of good practices. If you are interested then please get in touch with @Wyatt, Dean (Chief Nursing Information Officer) @Okpanachi, Evelyn (Interim Associate Director for ICT) or @Hanna, Laurine (Chief Clinical Information Officer) via email or MS Teams.
Digital Inclusion Scheme The Trust is running a Digital Inclusion Scheme to support service users who are digitally excluded. Digital exclusion refers to not having access to digital devices and/ or internet connectivity, or perhaps lacking the skills or confidence to use them. This is a growing inequality that has been made worse by the COVID-19 pandemic. Through the scheme, we are able to offer three key areas of support: • We are running a Tablet Loan Scheme to provide service users with devices • We are working with individuals to source an appropriate and affordable internet connection • We can provide short or long-term, ongoing technical support to help service users to gain the skills and confidence to navigate the digital world. This is through our partnership with AbilityNet AbilityNet are a charity who offer a range of IT support services, and their specially trained volunteers can provide free technical support for as long (or as little) as needed. A referral can be made for one, or more, of the above (e.g. you can refer someone for digital support even if they have their own device). Visit the Digital Inclusion page on the intranet for more about this scheme and to access the referral form. https://intranet.candi.nhs.uk/ict-support/ict-projects/ digital-inclusion-scheme If you have any questions, please feel free to email DIO@candi.nhs.uk or call 020 3317 7107.
PMO updates Here is a quick update on some of the key digital projects and new projects happening in the Trust, including the recent C&I Targeted Investment Fund (TIF) application.
The MPLS/New Data Network Project We have now completed Phase 2 of the Multi-Protocol Label Switching (MPLS) project to improve the speed of our networks. New Primary and Secondary Data Network lines have been installed at all sites listed in the Estates Redevelopment Programme and Lowther Road. Phase 3 will cover all other Trust sites including St Pancras Hospital and Highgate. The business case for phase 3 has been approved by the Executive team and the procurement stage is close to completion.
WiFi installations WiFi installations have been successfully installed on eight Trust sites. These are Jules Thorne, Regis Road, Holloway Road, St Pancras Hospital (SPH) - North East Building, Finchley Road, Forest Road, Margarete Centre and Camden Mews. The WiFi deployments at Southwood Smith, Finsbury Health Centre, Greenland Road and Surbiton are planned to take place between December 2021 – February 2022. We are currently working with BT to carry out the WiFi improvements at SPH on the fourth and second floor in the East Wing. If you are still experiencing problems with the Trust’s WiFi, please log the incident via the Service Desk or the IT Self Service Portal, which you will find on the homepage of the intranet.
The InTune project The InTune project has been successfully completed. All Trust devices, mobiles and tablets, have been moved over from the old device management system, Mobile Iron, onto the more resilient and secured cloud base solution called InTune, a system that enables us to manage Trust mobile devices, their security and how they are used.
The EMIS (clinical application to manage patient records) Phase one of the EMIS project is near to completion. A daily data feed has now been set up which sends information from EMIS to our data warehouse. Service managers will now be able to run reports on referrals, appointments, Care Plans and whether teams are hitting their targets. External reports for commissioners can also be created through the system.
New projects
Three new exciting projects are in the process of moving into the initiation stage.
Trust Integration Engine The Trust is procuring an Integration Engine, a software suite that allows us to share clinical information seamlessly with other NHS organisations. This lays the foundation for the delivery of consistent, efficient and high-quality patient care. This supports the OneLondon programme which aims to make patient information easily accessible across regions and North Central London.
Patients Know Best (PKB) This is a system that provides a personal health record (PHR) platform to enable patients to manage their health and wellbeing by having access to data shared by their healthcare services. A Project Manager has already been assigned and the business case is being written.
Targeted Investment Fund (TIF) The London Digital Team has confirmed that the C&I bid for three additional schemes has been in principle preapproved awaiting formal confirmation. These are Patients Know Best (see above) and Attend Anywhere – Video Consultation and Speech write. These projects will move into delivery once the budget is confirmed and made available.
Informatics updates The Data Quality Maturity Index (DQMI)
Karthik Chinnasamy, Associate Director of Performance and Information
A monthly publication by NHS Digital intended to highlight the importance of data quality in the NHS. It provides healthcare providers with timely and transparent information about their data quality and focuses on the quality of set of core data items identified as being important to commissioners and regulators. The overall DQMI score for C&I is 96.9% (latest published) against a target of 95%. Taking into account all the NHS Trusts across the country, C&I are in the 13th position - only one other NHS Trust in London that is ahead of us (97%). The Informatics team continues to work closely with our services to address gaps in recording within patient records to improve data quality.
Vaccination Dashboards There has been a lot of focus across the Trust around access to COVID vaccination data of both our staff and service users. The Informatics team has been liaising with several internal and external stakeholders to ensure accurate vaccination data is available for clinical and operational teams. In order to achieve this, three vaccination dashboards (two for service users and one for staff) have been created to help teams to target those who have been identified with Serious Mental Illness and have not had their vaccination, as well as identify uptake of the vaccination amongst staff. We are currently in the process of including information around booster dose uptake, as well as flu vaccination uptake within these dashboards using the HealtheIntent platform.
Data Quality Improvement Group (DQIG) There is a consensus amongst Trust leadership to swiftly address data quality issues, and a bi-monthly DQIG group is currently in place to address concerns across the Trust. The membership of this group includes Information, Divisions, Contracts and Finance plus any other leads on an as-required basis. As part of actions from these meetings, the Informatics team conducts regular sessions with operational and performance leads to ensure clinical and operational importance of data quality metrics is maintained.
Clinical Record Interactive Search (CRIS) Our Trust is keen to empower researchers with the data they need to develop life-changing treatments, models of care and insights. We also want to support the Trust’s research agenda through provision of robust data and technology. To address one of the Trust’s key priorities of ‘Research and Innovation’, CRIS is a research database hosted by SLaM (South London and Maudsley NHS Foundation Trust) which contains an anonymised version of C&I patient data. The data gets sourced from C&I’s EPR (Electronic Patient Record) system CareNotes, processed at C&I’s data warehouse and eventually transferred to SLaM. Once the data transfer is complete, the approved researchers within C&I analyse the content using a number of specialist tools and techniques. The average refresh period of the data until March 2021 was yearly. The data warehouse team has now brought this down to quarterly. This helps the Research team to work on population-based research projects such as looking for links between family history and particular illnesses using latest set of information.
Data Security and Protection Toolkit (DSPT) Mahwish Noor, Head of Information Governance and Data Protection Officer
IG Training Thank you to those who have completed their mandatory IG training. The Data Security Awareness IG training is part of our Core Skill set that must be completed by all staff on an annual basis. If you are due your training, you must complete it via ESR here or attend one of the live interactive MS teams sessions by contacting cyber.security@candi.nhs.uk
Check your emails! The highest number of data breaches in the Trust are related to breach of confidentiality. For example, an email sent to the wrong service user or staff member. Please take care when sending emails. For further information, visit the Data breaches section on our intranet.
These courses are free and can be found on ESR, but you have to search for them as they are not part of your mandatory core competency requirements. If you feel that your team would benefit from these courses being made mandatory, please speak to the training team. If you have any problems accessing your ESR or any of the modules, please contact LearningOD@candi.nhs.uk
Subject Access request guidance for staff A new Standard Operating Procedure that provides guidance for staff on how to deal with Subject Access Requests has been created by the Information Governance team. Visit the intranet to find out more.
Information asset management An information asset is a body of information, defined and managed as a single unit so it can be understood, shared, protected and exploited effectively. All our assets and associated information is held in an Information Asset Management system called FLOWZ. The IG team will be contacting all asset owners asking to validate the information we already hold. If your team are introducing any new systems or software email us cyber.security@candi.nhs.uk so that we can decide if the asset needs to be added to FLOWZ.
Phishing Alert!
Specialist IG training The following Information Governance e-learning courses are now available to you. These courses are mandatory for staff working in the Trust Digital team, but all permanent members of staff can access them.
• Data Protections and Data Protection Impacts Assessments (DPIA)
• Freedom of Information (FOI) • Cyber Security & Information Governance for IT Teams • Records Management and Data Quality • Subject Access Requests (SAR) The courses are designed to give you an insight into how information Governance is involved in the work you do and provide opportunities to improve your understanding in data protection based on the UK General Data Protection Regulations (UK GDPR).
A member of the finance department at an NHS Trust received an email purporting to have been issued by another NHS Trust requesting payment for outstanding invoices. The staff member noted that although the email appeared to be from a known contact within the other Trusts finance team, the email had in fact been received from the domain @nhns.net. It was identified that the second NHS Trust had also received emails purporting to have been issued by members of the finance department of the first NHS Trust from the same domain. If you suspect an email is a phishing attack, do not open it and do not click on any links, send it to ICT.ServiceDesk@ Candi.nhs.uk If you have already opened it and clicked on links before realising it was not genuine, then let IT know what you have done so that they can take immediate action. Please report to Datix also as an incident.
IT Service Delivery Update IT service introduction The Service Delivery team’s key areas of work are the management of IT services, ordering hardware and software, contract management and associated invoice processing. We work closely with the IT Project Management Office, Infrastructure and Desktop Support teams to deliver value to the Trust.
IT Amnesty Thank you to everyone who returned unused Trust devices as part of our IT Amnesty which has been a great success. We saw a record level of devices returned in September of 81 and in October 83.
New IT Self Service Portal • A new online IT Self Service portal has now been launched which enables staff to self-log incidents and order IT equipment and software. Staff are also able to track the progress of their requests in the system as the team work on them. To access the portal, click on the purple Self Service Portal button on the homepage of the intranet. You will also find a Self Service Portal icon on your desktop.
RTAL PO
In July, we launched our IT Service Level Agreement’s (SLA’s) which outline what level of service staff should expect from our team when they are working on an incident or request. Our SLA’s are shown below.
ERVICE S F
IT SEL
Our SLA’s
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We want to provide a strong digital service and infrastructure that supports staff in delivering high quality, safe care, to our service users. We aim to ensure that our teams get the support they need to deliver a strong digital service and infrastructure to ensure minimal downtime in the event of any disruption. Our goals are based on addressing key issues which concern our staff and service users around Trust Digital’s response, resolution and communication. This is by no means an exhaustive list, but it gives a high-level indication of the many areas we are focusing on. Situation
Resolution
The Key Trust issues are:
Addressing these Issues:
• Desire to increase the transparency of Trust’s Digital
• Create an effective internal structured service level
department with expected service support levels by having
agreement (SLA) between Trust Digital and the organisation
an agreed SLA agreement.
and set realistic expectations that enables Trust Digital to
• Improve structure, formalisation, or standardization in the way Digital Services are supported to reflect response and
manage those expectations.
• Improving email notifications to end users that have logged
resolution times to any issues reported by end users within
issues with Trust Digital on the expected response and
the organisation.
resolution times.
• Users of Digital services experience frustrations with the current support as there is lack of clarity of expected timescales for response and resolution times.
• End users have service level support expectations that at times are not be achievable by Trust digital department and lead to a misunderstanding that there is lack of Support and creates a perception that nothing is being done.
• Create an SLA that clarifies expectations to reduce Trust Digital and organisation end user friction.
• An SLA that will determine that impact and urgency of issues logged by each user with Trust Digital to ensure the appropriate service level approach.
• Monthly, Quarterly, and annual Service review meetings to measure trends on achieved or breached SLA’s as part of continual service improvement and acting where improvements are needed.
IT Service Desk Update Incidents Opened per MONTH
P
Report Title: Incidents Opened per MONTH The Service Desk received a high level of calls throughout the months of August, September and October with a Run Date and Time: 30-11-2021 13:25:28 Greenwich Mean Time considerable rise during October. This is shown by the number of incidents opened in the chart below. In relation to this, Run by: Paulette Brown you will see inTathe second chart, the number of incidents that has been resolved and closed has also risen. With more calls ble nam e: incident being taken by the Service Desk, we continue to work hard to provide a high level service to staff across the Trust.
1.1 Overall INCIDENTS Closed per MONTH
P
Report Title:
1.1 Overall INCIDENTS Closed per MONTH
Run Date and Time:
30-11-2021 13:32:27 Greenwich Mean Time
Run by:
Paulette Brown
Table name:
incident
This chart showing the incidents closed on the IT Service Desk for Aug to Oct 2021 Run By : Paulette Brown
Call Volume, Answer Rate & SLA 2600
100% 90%
2500
80% 2400
70%
30-11-202160% 13:32:27 Greenwich Mea
2300
50% 2200
40% 30%
2100
20% 2000
1900
10%
Aug-21
Sep-21
0%
Oct-21
Aug-21 2185
Sep-21 2280
Oct-21 2523
Total calls Answered
2121
2183
2384
Candi Answered Rate %
95%
96%
97%
Candi Service Level in %
50.6%
46.7%
52.4%
Industry Answered Rate
88%
88%
88%
Industry Service Level %
97%
95%
97%
Total calls Offered
% Service Level
Telephone calls
The number of calls received from staff for each month is shown in the graph (right) in blue. The number of calls answered by the Run By : Paulette Brown Service Desk is shown in red. The orange line shows our Service Level Agreement (SLA) targets and answer rate in comparison (the blue line) with other Service Desks across the NHS. This means that we are meeting our SLA targets which were set out in July.
30-11-2021 13:25:28 Greenwich Mean
CNIO update – NHS.net off-boarding update Lets focus on the NHS.net offboarding as we near the transition date of 14 January 2022. Please ensure that you complete the following key actions:
1.
Apply an email signature / out-of-office message so that it goes out in all communications about the change of email addresses – there are templates for this on the Digital IT intranet pages / reach out for links if you cannot find it
2. Register for Egress so that you can use the subject line encryption in Outlook, for when sending to unsecured email addresses (e.g. to service users/carers personal email addresses) and when receiving encrypted email
3. Dean Wyatt, Lead Nurse for ePMA and Chief Nurse Information Officer
Ensure activities in the Transition Checklist have been completed, such as updating procedures, informing contacts, familiarising the team with the new way of working
4. A key recommendation is to have an agreed procedure in use to explain how the use of the shared mailbox is governed, as I know that teams have significant variation in their processes
There are some examples of good practice that I can share, please email me dean.wyatt@candi.nhs.uk if you would like these to base your own from. In 2022, I am keen to learn more about robotic process automation (RPA) and how we can apply it to our clinical work to reduce the admin burden and “busy work”. If you want to learn more about Office 365 in general, there is a working group that looks at using products and services available to us with our Office 365 subscriptions. As this project draws to a close, I look forward to focusing on Population Health Management using HealtheIntent, a population health platform which provides multi-level system visibility and provides advanced population analytics. This is possibly the most exciting development I have seen in all my years of working within clinical informatics, a real gamechanger in improving the health and wellbeing of those with Severe Mental Illness, more on this in the next edition!
Infrastructure News Update Egress In December we will be implementing Egress. As part of the offboarding from NHS.net we are implementing Egress to allow staff to send information securely. Emails containing personally identifiable information (PII) after offboarding will need to be sent via Egress. Egress is an additional encryption tool that must be used when sending emails to personal or unsecured email addresses. For example, service users and carers personal email addresses, or to other organisations that do not have a secure accredited email service. This ensures that confidential data can only be opened by the recipient and assures that information is kept confidential when in transit. Users will receive a step-by-step guide on how to do this when they need to.
Multi-Factor Authentication (MFA) In December we will be implementing Multi-Factor Authentication. To ensure we comply with Secure Mail Standard we are putting in place Multifactor Authentication. Multi-Factor Authentication (MFA) is when a user must provide two or more pieces of evidence to verify their identity to gain access to an app or digital resource. MFA is used to protect against hackers by ensuring that digital users are who they say they are. The goal of MFA is to create a layered defence that makes it more difficult for an unauthorised person to access a target, such as a physical location, computing device, network, or database. All C&I staff will already have their first factor of authentication which is the password element of logging onto Trust systems. When MFA feature is turned on, users will need to register a mobile phone that can receive the second factor notification or by using an app to, generate a onetime passcode. The notification can be delivered as an SMS Text message or via a Mobile Application “Authenticator” which can be downloaded from the App Store.
The ICT Service Desk This team acts as the single point of contact between ICT services and staff. This is where you can submit enquiries, log incidents, get help and request changes. To report an IT issue please use the new IT Self Service Portal on the intranet or the contact details below, with your name and details of the issue/fault. Your request will be logged automatically and you will receive an automated email which includes your reference number, which we recommend you keep a note of. Telephone: 020 3317 7200 Email: cinhsft@service-now.com
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