Sheffield helps make data accreditation a local issue
Sheffield 2009
Primary Care Trusts (PCTs) have been working hard with practices to help them achieve data accreditation as part of the Information Management and Technology Directed Enhanced Service (IM&T DES). Over 1,000 practices had achieved accreditation by the end of September 2008, but the DES has not been possible for everyone.
Some PCTs have recognised that there has not been enough time for some of their practices to take part in the IM&T DES. Although in Spring 2008 the DES was extended by a year to March 2009, some PCTs had already begun to look at providing an alternative Local Enhanced Service (LES). One organisation that felt the LES route might be more appropriate for some of its practices was NHS Sheffield.
For NHS Sheffield, developing a LES (in liaison with its Local Medical Committee) has enabled it to encourage many of those practices that originally felt too busy, not ready or too pressurised to complete the DES. However, the ultimate goal of the IM&T DES or LES remains the same – practices whose data quality is of a sufficient standard to provide patient summary records for sharing.
Setting up the LES and working with practices
The LES is managed by Sheffield’s Data Quality Team, which comprises three PRIMIS+ facilitators: Jean Baxter, Janice Badger and Monika Akid. Each Data Quality Facilitator has a set number of practices to support, based around the practice-based commissioning consortia groups.
The team explained that it has had excellent support from both the PRIMIS+ helpdesk and their PRIMIS+ Learning Consultant, Angie Piesold. They have also worked hard as a team – planning and refining their strategy week by week to ensure they helped their practices as much as possible.
PRIMIS+ has been pleased to be able to help PCTs, practices and assessors throughout their preparations for the IM&T DES. PRIMIS+ resources, training and query sets will be just as relevant for practices undertaking the LES as the DES.
The practicalities of the LES
There are 91 general practices in the Sheffield area of which 54 have taken up the IM&T DES. The development of the LES has encouraged 17 of the 'remaining practices to continue their work to become paperlight, assess their data quality and work towards having their data accredited.
The LES is fundamentally similar to the DES, covering both Components 1 and 2 (please see below). However, NHS Sheffield has spilt Component 2 into two sections – ‘2A’ and ‘2B’ to give practices easier, ‘bitesize’ goals. The Sheffield team is encouraging practices to work towards all parts of the LES, but Component 2B is optional. Component 2B’s non-essential status highlights that the team understands that not all practices are ready for all aspects of the LES.
The LES is a 12 month contract until April 2009 and is not an easy route, although it allows a more realistic timeframe and approach than the DES. Practices undertaking the LES are required to prepare a plan in the same way as for the IM&T DES Component 1. For component 2A, the practice works with the Data Quality Facilitators to create a data quality action plan, run CHART reports (please visit www.primis.nhs.uk for more information on CHART and CHART Online), make the improvements outlined within the data quality action plan and complete the IG toolkit. If working towards Component 2B they must also achieve paperlight status and undergo a data accreditation assessment to the same standards as the IM&T DES.
The Data Quality Team firmly believes that the tasks in the LES are achievable by all practices. Sarah Cooper, Team Leader for Primary Care IT at NHS Sheffield, said: "Throughout the data quality action plan and work towards paperlight, practices are gaining a better understanding of their electronic patient records and how improving data quality supports improvement in patient care."
In all, 98% of the practices in Sheffield were already using the analysis tool CHART, developed by PRIMIS+. This was an advantage as CHART is the only tool mandated by NHS Connecting for Health to support the data accreditation process. It meant that practices did not have to factor in CHART training as well as all their other commitments.
Sarah explained that another added benefit to creating the LES was raising the profile both of the electronic health record and the need for excellent data quality to ensure safe patient care. She said the LES has boosted the level of satisfaction felt by practices as they achieve measurable and realistic goals, and that the process has fostered a stronger partnership between these practices and NHS Sheffield.
To further explain the work that Sheffield had undertaken, the Data Quality Facilitators entered a poster about the LES into the delegate poster competition at the 2008 PRIMIS+ Conference. The poster, entitled “The Sheffield Data Quality LES – with a little help from my friends”, outlined the team effort that was needed between NHS Sheffield, practices and PRIMIS+. This poster can be viewed on the conference section of the PRIMIS+ website.
Progress and lessons learned
As with all new processes, there have already been some difficulties to overcome and some lessons learnt. The team discovered that practices doing the LES were sometimes less computer-orientated or had gone through migrations or mergers recently. They were therefore already very stretched.
When practices had a big hill to climb to achieve the criteria, they needed a lot of motivation and encouragement, as well as face-to-face help and advice. For the facilitators, actually ‘getting a foot in the door’ at practices and setting time aside for them was crucial and timescales were always a factor.
The Data Quality Facilitators are now supporting practices to complete the action plan for Component 1, if they have not already done so, and also to look ahead at the requirements for Components 2A and 2B. Practices are drawing up data quality action plans to identify areas for improvement and are making changes to data recording to improve the quality of data. Those practices which are completing component 2B are also preparing for PCT paperlight approval. Currently, 17 practices are signed up to the LES. However, the Data Quality Facilitators continue to encourage further practices to review their data.
Details of the Sheffield LES
For the LES, the Sheffield Data Quality Team kept Component 1 the same as in the DES, but split Component 2 into two sections. Practices must complete Components 1 and 2A, but Component 2B is optional. Financial incentives are being managed on a local basis. The LES in Sheffield is divided as follows:
Component 1
-
Prepare practice plan on commitment to the LES
-
Nominate practice leads
-
Complete Training Needs Assessment and undertake a training log
-
Provide evidence of compliance
-
Issue smartcards and protocols
-
Apply for paperlight accreditation
-
Create an action plan to achieve Components 2A and B
Component 2A
-
Run CHART IM&T DES queries and upload to CHART Online, with support from the Sheffield Data Quality Team
-
Produce a data quality action plan, with support from the Sheffield Data Quality Team
-
Achieve data quality improvements as defined in the action plan (to be assessed by the Data Quality Team)
-
Work on agreed protocols
-
Complete the Information Governance toolkit, up to Level Two for IGSoC requirements
Component 2B
Background to the IM&T DES
As part of the changes to the GMS contract in April 2006, a DES was developed to facilitate the use of Information Management and Technology in supporting the delivery of the National Programme for IT.
A key objective of this DES is to support practices in achieving accredited data quality standards that are acceptable for sharing in the NHS Care Records Service. Once practices have achieved accreditation, they will be able to upload patient summary records to the Spine.
In July 2008, NHS Connecting for Health issued new operational guidance on the IM&T DES via the Strategic Health Authority Chief Information Officers.
The guidance followed the joint statement from NHS Employers and the British Medical Association’s General Practitioner’s Committee on 3rd April. Among other things, this joint statement confirmed that the IM&T DES general practice eligibility to receive one-off payments would continue in England for a further year, until March 2009.
General practices are only eligible for IM&T DES funding if they registered their intent to undertake the DES with their PCT before February 2007. At some PCTs, the decision to create a LES was taken in part to help those practices who did not meet that deadline.
Further information can be found at:
www.connectingforhealth.nhs.uk
For more information on the IM&T DES please visit:
www.primis.nhs.uk
Information on the Spine can be found at:
www.connectingforhealth.nhs.uk/resources |
