Bromley PCT - nlondon.bcs.org

Bromley PCT - nlondon.bcs.org

Deployment of Connecting for Health PACS Bromley PCT A Programme Managers viewpoint Geoff Broome March 2006 Agenda Context and roles PACS: Why bother? Lessons and challenges What was hard work

What would we do differently What we could have been better at Questions March 2006 Projects in context old world Supplier Trust Requirements Responses and delivery Your

project Support and standards Information Authority March 2006 Approval and performance management SHA Projects in context new world Trust

Department of Health Legacy supplier Strategic Health Authority Your project Local

Service Provider (LSP) Connecting for Health (CfH) Cluster LSP supplier March 2006 Projects in context new world it gets worse! Trust

Department of Health Legacy supplier Strategic Health Authority Your project Local

Service Provider (LSP) Connecting for Health (CfH) Cluster LSP supplier March 2006 Context and roles (1) PACS was an afterthought in national

programme no Trust level input to negotiations anything in too hard/ risky or cant assess column given to Trusts Trusts categorised as S/M/L CCA role between supplier and Trust contractual risk and margin management had to sign off changes without knowledge of context March 2006

Context and roles (2) Cluster role was CCAs client programme management with CfH interests driving them Trust role bigger than anticipated not always clear negotiated by others March 2006 Context and roles (3) Philips role

supplier with hands tied behind back forced to work through CCA no direct contact with the Trust allowed March 2006 PACS: Why bother? (1) Strategic flexibility/ position to grow, distribute diagnostic services better (more multi-disciplinary) practice ease of getting others involved many risks held outside Trust level Patients want (expect) it may influence GPs referring behaviour

Clinicians wanted it decision support system better (flexible) working conditions for staff (recruitment/ retention) Qudos March 2006 PACS: Why bother? (2) It is working and is free to air (albeit with large project costs) Will differentiate Trusts that have it as forward thinking for a while at least Ultimately will improve departmental efficiency with knock on effect in wider

hospital investigations/ radiology department employee cancelled appointments/ repeat tests due to mislaid images Average Length of Stay (ALOS) March 2006 PACS: Why bother? (3) If you are not doing anything else you will learn about the programme Some of the lessons are being learnt and should make later projects easier! March 2006

What was hard work (1) Agreeing plan (inc. technical details) and who owns it roles, governance, configuration management Getting through CCA/ cluster to the supplier many more relationships to be managed Educating CCA about the NHS role of doctors and the need to listen to them clinical risks and why we try and minimise them March 2006

What was hard work (2) Educating CCA (in particular) about the need to get user acceptance for systems to work Getting past the contractual in order to deliver an acceptable local solution Stopping them presumptively closing re acceptance and moving on to new projects managing the move to later phases support in a business as usual world March 2006

What was hard work (3) Identifying all users and roles Gaining respect for role of Project Board and ensuring that suppliers and cluster do not circumvent it March 2006 What would we do differently (1) Engage non-Radiology users earlier Think about partner relationships which may be impacted especially if you are a supplier of diagnostic services

Have better test plans and insist on them Engagement of operational management earlier and in more detail, especially re workflow design March 2006 What would we do differently (2) Engagement of information governance specialists earlier to ensure access policies and disaster recovery issues are tackled Agree business plans with clear funding sources and contingencies before the

project starts including backfill Think about how junior doctor rotation should be managed vis a vis training March 2006 What we could have been better at (1) Analysing Trust side responsibilities and ensuring we had the funds and capability to deliver Communications especially outside Radiology Allocating dedicated training facilities

Watching our audit trail and ensuring good configuration management on our side March 2006 What we could have been better at (2) External relationship building differentiating the must win battles from nice to haves being prepared to help external parties Getting specification nailed down, changes were difficult to agree, caused delays and were expensive

March 2006 Summary take home messages (1) Insist on role as customer but dont try to fight on all fronts at once try to understand and come to terms with the supplier/ cluster/ SHA/ CfH side use PRINCE2 to make sure that suppliers stay focussed on your agenda and managerial attention on issues is sustained keep the focus on your Project Make sure you manage your own side well, do not give them weapons

be persistent and be prepared to repeat yourself or change audience do not select purely administrative project managers March 2006 Summary take home messages (2) Pick strong and knowledgeable Senior User(s) or Business Change Managers expose all external parties to vociferous but articulate users listen to them, but be willing to challenge appropriately in right setting

Its our programme lets fix it March 2006 Questions ? March 2006

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