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DH Government Major Project Portfolio data, September 2015

Updated 7 July 2016
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Project Name BT LSP care.data CSC Local Service Provider (LSP) Delivery Programme Electronic Prescription Service (EPS) Release 2 General Practice System of Choice (GPSoC) Replacement Health & Social Care Network NHS Choices NHS e-Referral Service NHSmail 2 100,000 Genomes Project Care and Support Implementation Programme Childhood Flu Immunisation Programme Health Visitor Programme Liaison and Diversion Programme National Pandemic Flu Service National Proton Beam Therapy (PBT) Service Development Programme NHS Electronic Staff Record Reprocurement Project NHS Pension Re-let NHS Procurement Efficiency Programme PHE Science Hub Visitor and Migrant NHS Cost Recovery Programme
Department DH DH DH DH DH DH DH DH DH DH DH DH DH DH DH DH DH DH DH DH DH
IPA RAG rating (A Delivery Confidence Assessment of the project at a fixed point in time, using a five-point scale, Red – Amber/Red – Amber – Amber/Green – Green; definitions in the IPA Annual Report) Amber Amber/Red Amber/Red Amber Amber/Green Amber/Red Amber/Red Amber Amber/Red Amber/Red Amber/Green Amber Green Amber Amber/Red Amber/Green Amber Amber Red Amber Amber
Description / Aims To support IT enabled transformation in the NHS in the South to create a more efficient, joined-up and patient-led health service. This will be achieved by delivering modern IT systems and services to the NHS in a flexible, efficient and effective way to enable trusts to tailor solutions to support local needs and priorities. Care.data is a programme of work which aims to increase the range and detail of information that is collected across Health and Social Care services, then to securely connect that information together and make it available to those who plan NHS services, as well as to researchers, clinicians, medical charities and businesses that support the NHS to make services better. The Programme delivers the LSP contract for IT services across to health and care organisations in the North, Midlands and East of England including delivery of the strategic electronic patient record system (Lorenzo) and the safe and secure exit of all non-Lorenzo deployed services by July 16. The Electronic Prescription Service enables prescribers - such as GPs and practice nurses - to send prescriptions electronically to a dispenser (such as a pharmacy) of the patient's choice. This makes the prescribing and dispensing process more efficient and convenient for patients and staff. GPSoC Replacement Project: Continued funding for the provision and development of the GP clinical IT systems used in all practices in England by appointing a range of suppliers to a procurement framework, offering GP practices a choice of systems from a diverse market Health and Social Care Network (HSCN) is the programme set up to deliver services to succeed the current Health Network provided through the N3 service contract which expires in March 2017. The scope of this return is limited to the NHS.UK alpha project as the NHS Choices Live Service programme is no longer under the portfolio of the GMPP.To meet the commitments outlined in the National Information Board and recommendations from an IPA review of the NHS Choices programme, the SRO has set up a digital design team to develop;* An agreed, clear vision for NHS.UK* An approved plan for the next phase* A clear plan to set and uphold standardsThe NHS.UK Alpha project will be governed and funded as part of NHS Choices at this pre programme inception phase, but is likely to become a programme in its own right. Deliver NHS e-Referral Service to support paperless referrals and a paperless NHS by 2018, as a centrepiece of NHS England’s response to the Government’s Digital First and transparency initiatives. The NHSmail 2 project will identify a solution and deliver a replacement to the existing NHSmail service. The primary aim of this programme is to deliver the Prime Minister's commitment to sequence 100,000 whole human genome samples by December 2017. The Project has four specific aims: to bring benefit to patients and create a genomic medicine service for the NHS; to enable new scientific discovery and medical insights; to create an ethical and transparent programme based on consent; to kick start the development of a UK genomics industry. A major change programme across 152 local authorities to deliver the reforms to the adult social care system set out in the Care Act 2014. To extend the current flu programme to children aged two to less than 17 years as part of DH legal obligations, under the 2010 NHS Constitution. To expand and transform the health visiting service to: improve health and wellbeing outcomes for under-fives; reduce health inequalities; improve access to services; improve the experience of children and families. To safely transfer the commissioning of 0-5s public health services to local authorities on 1 October 2015. Investing in Liaison and Diversion services to screen, assess and refer offenders at the earliest possible point of the criminal justice system into relevant treatment and support, with information from assessments subsequently fed into the criminal justice process to be used to inform decisions about justice outcomes, charging, prosecution and sentencing. To re-procure the National Pandemic Flu Service to ensure that a complementary service to primary care remains ready to be mobilised to enable the rapid distribution of antivirals to symptomatic individuals in the event of a pandemic. To develop a full Proton Beam Therapy service in England. The NHS Electronic Staff Record (ESR) provides payroll and HR services to all NHS organisations in England and Wales, apart from two English NHS Trusts. The NHS ESR Re-procurement Project was previously established to replace the expiring McKesson UK contract to provide this service. A new contract was awarded to IBM in December 2014. Day-to-day management of the contract and service delivery is undertaken by an NHS Central team, reporting to the SRO. To replace the NHS pension contract that is to expire, ensuring there is no break in the Secretary of State’s ability to meet statutory requirements to offer the NHS Pension scheme. Will support the NHS to harness its purchasing power, reduce variations in prices paid for products of the same quality, share best procurement practice, and improve its procurement capacity. The programme, previously called Chrysalis, transferred to Public Health England on 31st March 2013. The vision under PHE has continued to develop and builds upon and strengthens the strategic case for an integrated public health service, as well as address the urgent re-provision of facilities currently at Porton. The business case is based on the delivery of a “hub and spoke” model for public health science in PHE, with a preferred option to co-locate Porton research, Colindale and London HQ functions onto a site in Harlow Essex. The improvement of recovery for healthcare costs realised by the NHS in the treatment of immigrants and visitors to the UK. This is from both EEA and non-EEA members states.
Departmental commentary on actions planned or taken on the IPA RAG rating. Since the delivery confidence assessment, all NHS trusts within the BT Local Service Provider programme have safely and securely transitioned their systems from the central Local Service Provider service to locally-contracted replacement services, thereby concluding the exit programme. Decommissioning of the Local Service Provider service commenced in January 2016, following which the programme will be formally closed. The Delivery Confidence is based on latest Major Projects Authority Project Assurance Review which assessed the delivery confidence as Amber/Red. The pathfinder stage of care.data was delayed by the National Data Guardian's review for consent/opt out, as announced by Secretary of State for Health on 2 September 2015. Good progress continues to be made across all other aspects of the Programme, however, it remains under intense scrutiny, operating without an approved business case and managing significant risks. The Outline Business Case for Phase 1 of care.data is in development and the plan is to obtain all required approvals by April 2016. Work has continued to develop the strategy for the national rollout of linked datasets and stakeholders have been engaged. Materials, including patient facing communication materials and a practice toolkit are ready for use in pathfinder areas; subject to amendments that may be required following the outcome of the National Data Guardian's review. The CSC Local Service Provider Programme has three major components: (1) Delivery of Lorenzo (strategic electronic patient record system) – All 11 NHS organisations approved for Department of Health funding have implemented the Lorenzo product. Further deployments may be approved during 2016 subject to value for money assessments. (2) Supporting benefits delivery at organisations with a significant focus on recovering the previous position and reaching a break-even point by programme end. (3) Safe and secure exit of all 2,700 non-Lorenzo deployments by July 2016. This is an area of major focus and risk as identified in the Major Projects Authority Project Assessment Review which reported in April 2015. Significant progress has been made since the review with 10 of the 11 recommendations addressed with cross system support to the actions, including absolute clarity on post-contract responsibilities and 96% of organisations with exit planning information in place. An assurance of Action Plan review was undertaken in November 2015 which demonstrated significant progress against the April 2015 Project Assessment Review. All recommendations are complete including planning framework and commercial agreements. The rating was confirmed by the outcome of the Major Projects Authority Gate 5a review in December 2015. Recommendations, which cover the top risks (A need for more robust planning, a clearer timeline and dependencies for the prerequisites, including Controlled Drugs and Business Continuity), were made to aid the programme in progressing towards successful implementation of Phase 4. An action plan to achieve review recommendations was worked up in January 2016 and work continues following approval of a Tolerance Exception Report, which sought funding to deliver the revised full scope including pre-requisites for Phase 4. Release 2 contains both phase 3 and phase 4, which will allow all prescriptions to be sent electronically without requiring a patient nomination. Progress has also been made on Completion of Service Model Review - for which development of the implementation plan is now underway; updating and agreeing Terms of Reference for the Programme Board; and putting a benefits realisation strategy, methodology and associated data gathering processes in place. As of November 2015, 5,556 GP Practices had deployed technology for the Electronic Prescription Service. This brings deployment up to 73.1%. Estimated prescription claims made using the Electronic Prescription Service in October 2015 was 34.8% - ahead of a forecast of 29% and a year-end target of 33%. The overall assessment of delivery confidence is AMBER/GREEN based on the Senior Responsible Owner's current view (as at Q2 2015/16) and due to the following main risks and issues that are being managed: • An Addendum to the Business Case is continuing through the approvals process. • Resource capacity within Health & Social Care Information Centre continues to be under planned against requirements, specifically business analysts, account manager and commercial roles. • Principal Clinical System supplier delivery progresses at pace. However, some suppliers are rebaselining delivery plans, as a result of their move to a new technology platform. • With regard to the Interface Mechanism, engagement with existing suppliers and potential new suppliers is underway in order to bring more suppliers through the delivery pipeline. To date there are 56 suppliers at various stages of engagement within the pairing process. • For the GP Connect (Common Interface) project, the possibility of using middleware to implement Application Programming Interfaces and facilitate the pairing process is being investigated via a Proof of Concept. Since the 2014/2015 report, the Health and Social Care Network programme has undergone a Major Projects Authority Programme Assurance Review at the request of the Senior Responsible Officer in January 2015 and a subsequent Major Projects Authority Gate 2 review in September 2015. The Programme was assessed as a Red delivery confidence status during the Programme Assurance Review and subsequently improved to an Amber/Red status at the Gate 2. Following each review the Programme has addressed the recommendations provided via action plans with regular reviews by the Programme Board, which incorporates permanent Major Projects Authority membership. Both reviews noted the considerable progress that had been made by the Programme but also noted further work that was required to increase the delivery confidence of the Programme. The reviews also noted the resource pressures that the Programme had operated under and that the short timeline available for delivery represented a severe challenge. Several recurring themes of review recommendations have been identified and these have provided a particular focus for the Programme Team. They include Communications and Stakeholder Engagement, Governance and Programme Controls, Procurement Strategy and Solution Design works. All have since received comprehensive review and assurance to ensure that they are fit for purpose. Following quarter two 2015/16 and the Gate 2b review the Programme has made considerable progress to address the recommendations whilst continuing its progress towards delivery of the Health and Social Care Network. The Programme successfully navigated a tightly planned assurance and approval cycle for the Outline Business Case which resulted in its formal approval in December 2015. Following this the Programme continued to develop its plans and designs in order to deliver a successful, safe procurement phase in 2016 that will enable the transition from N3 to a stable future state that meets the needs of users and stakeholders. NHS Choices is the official website of the National Health Service in England and is the UK's most visited health website. A digital design team has been working on an 'nhs.uk' which is a project to transform NHS Choices into a multi-channel platform for the whole health and care system which will provide a single access point, focussed on ensuring people can safely self care and when appropriate connect directly to the services they need. NHS e-Referral Service go-live successfully completed 12-15 June 2015. The live service experienced some periods of poor performance initially after go live; with much more stable service thereafter. GPs, the national (telephone) appointment line and Patients booking themselves gave positive feedback, however some Provider Trust Hospitals were impacted. Most issues were resolved by a series of releases throughout 2015. Ongoing review and process improvement is underway at a programme level to ensure future rollouts are simplified. Future phases of the Programme are being systematically planned, reviewed and socialised with stakeholders. As the service is now stable, the focus is shifting to business change and digital take up activity. The recommendations of the Gate 4 Major Project Authority review, held in April 2015 (Amber/Green Delivery Confidence), continue to be actioned by the programme. Since the review progress has been made with the approval of the Business Change Strategy that now focuses on uptake and benefits; building capability and capacity of the Programme team; development of a stakeholder engagement roadmap; refreshment of the development plan and the inclusion of Agile methodologies; introduction of digital feedback mechanisms; and completion of lessons learned review. The Major Project Authority's Gate 4 review in September 2015 raised concerns that the Programme was out of financial tolerance with Department of Health limits (specifically £1m in year) which needed addressing. The financial impact had been caused by delays to the migration from NHSmail 1 to NHSmail 2. The review also helpfully identified areas of improvement, for example in informing customers of the transformation. The Programme has addressed the concerns raised by the review including agreeing a financial baseline. A Major Projects Authority Assurance of Action Plan review took place in February 2016 to demonstrate this. The first stage of the Programme (active directory co-existence) has gone live and future go-lives are planned for 2016, with the first email account planned for migration from the service by April 2016. As per the agreed change request, the NHSmail 2 project end date has been amended from March 2020 to February 2021 in order to preserve the generation of 60 months of benefits and align the contract with the agreed 5 year term. RAG rating reflects that fewer sequences have been completed than expected at this stage. SRO & Programme Director continue to monitor the situation and proactively challenge delivery partners (e.g. Genomics England on informatics and NHS England on Genomic Medicine Centres (GMCs) providing samples) via project Steering Group and Assurance Board. Ministers, No 10 and IPA understand current status and delivery challenges relating to this world-leading project. This reflects the progress made by local authorities on implementation of Phase 1 and the decision to close the programme in March 2016. There are robust closure plans in place for the programme and the Programme has been replanned and rescoped to remove Phase 2 of the reforms from the programme. The change in programme scope removed much of the risk which contributed to an A/R assessment in the IPA Review in April 2015. This is an accurate assessment at this stage, given the programme's scale and ambition. IPA reviews in February and July 2015 made useful recommendations for improving governance, management information and contingency planning, which are being implemented. The 2015/16 season will see flu vaccine offered to children in primary schools (years 1 and 2) for the first time and the programme board is focused on supporting delivery partners in this endeavour. We expect vaccine supply to be in place in time to meet school schedules. A lessons learned exercise will be undertaken over the coming months to inform planning and rollout for subsequent seasons. In the Q2 2015/16 GMPP report, the SRO rated the programme as Green because the workforce expansion and service transformation elements of the programme had already been successfully delivered, and the transfer of 0-5s public health commissioning was fully expected to be safely delivered, with LAs becoming legally responsible for providing 5 key health checks as set out in Regulations, on 1 October 2015 as planned. At the end of Q2 2015/16 most of the risks relating to the 0-5 commissioning transfer flagged at Q1 had passed, partly as a result of work undertaken to respond to recommendations from the June 2015 IPA Gateway 4 review. All of the LA allocations were finalised and published by 29 July 2015. The risk around data & information was mitigated by the successful implementation of an interim reporting system. The majority of the communications plan had been delivered with a small amount of planned post-transfer activity to take place after Q2. The 0-5 Public Health Commissioning Transfer Programme Board had previously received strong assurance on sender and receiver readiness and there was no evidence of any issues arising once the transfer had taken place. The Board had been satisfactorily assured that everything that could be done on sustainability of programme benefits had been done prior to closedown, with the ownership of benefits passing to a new governance group in PHE in the post-transfer period. A very small number of LA provider contracts were still to be signed/novated at the end of Q2, but this did not impact on the transfer, and the contract process was expected to be completed shortly after the transfer took place. The most recent Gateway Review in August 2015 gave a delivery confidence of Amber. Whilst significant progress has been made since the previous review and the Programme was considered well placed to achieve its objectives of service rollout to 100% of the English population, uncertaintly around the outcome of the Full Businss Case remains. As recommended following the review, the Programme will take into account new emerging factors around service integration and market development when finalising the Full Business Case. Phase 1 involves the replacement of the existing online service with a new system developed internally and the replacements of the existing telephony infrastructure. Work to replace the telephony service is progressing well and it is expected that sufficient capacity to support a pandemic response will be available at the transition point of 1st December Technical development of the replacement system is making good progress with promising early iterations and strong performance in initial volumentric tests. . An initial mock assessment of the service against the GDS service assessment criteria has identified a number of areas for improvement which are now planned to be incorporated within future development. Substantial discussions around the appropriate long term hosting platform requirements are taking place and a future procurement of the long term host is planned through the GCloud framework: it is likely that this will not be ready untill early 2016, and the service will plan on the basis of deployment on the interim hosting platform (which is currently being used for dev and test) should there be a pandemic in December 2015 or Q1 2016. Phase 2 involves the replacement of the associated back office systems that management collection points and stock management. Plans for Phase 2 are less well developed, and are expected to be formalised during Q4 FY15/16 for delivery in FY16/17. The Programme is assessed as being amber/green for the following reasons: • It remains on plan to treat the first PBT patient in 2018. • Costs are contained within the capital budget approved in July 2015. • All recommendations from the IPA Gateway Review 0: Strategic assessment, held on 22-26 September 2014, have been acted upon and completed. Since Q2 in 2014/15, the procurement phase to appoint building contractors and an equipment supplier has been completed. Capital funding of £250m was formally approved in July 2015, and contracts were signed with Interserve, BYUK and Varian. Work on site is well underway at The Christie and UCLH. Robust management controls are in place to manage the contracts and ensure delivery of the new facilities. The programme is large, complex and has several more years of complex construction to complete. Mobilisation planning is underway to design the new PBT service and its interface with existing services. The Trusts are working with NHS England and Health Education England to identify their workforce requirements, and recruit and train staff to run the new PBT service. New technology will be introduced to support rapid referrals into the new PBT service and the collection of patient outcomes data that will be used subsequently to develop the PBT service and inform research. Quality assurance measures are in place to ensure that the new PBT services meet nationally agreed standards. NHS England will formally commission the new service for 2018/19 and it will treat the first patients during summer 2018. The programme is closely managing risks associated with construction and build, using comprehensive and detailed programme plans, and regular assurance reviews. The ESR Contract with IBM details three distinct elements of activity: (1) OPERATE - IBM Interim Service delivery commenced in June 2015. A successful transfer of responsibility from ESRs previous supplier was achieved, and service has been stable to date. IBM will assume full responsibility for all aspects of ESR Service from 1 December 2015 - the date of contract expiry between DH and McKesson UK for residual services; (2) TRANSITION - A revised transition approach has been required following delivery issues with IBMs original transition plan. The revised approach is considered both simpler and less risky to service continuity, with the supplier performing smaller and controlled changes to the Service Infrastructure over a period extending throughout 2016. IBM have also secured rights to continue to deliver service using the previous suppliers facilities - effective 1 December 2015, thereby removing the need to physically move the data centre; (3) ENHANCE - following a number of challenges identified with building the initial enhancements for ESR, IBM notified of a delay to the delivery of the first tranche of solution developments. Re-planning is in progress. Following agreement to baseline the revised Programme Plan at the Hutton Steering Committee in September 2015, the Programme continues to focus on activities to ensure the Critical Path tasks are achievable and the Programme remains on track to deliver by July 2017. Three of the nine Service Component deliverables as part of the overall Pensions Re-Procurement Programme are being delivered within wider BSA Corporate Projects. Although the responsibility for delivery is within the scope of these Corporate Projects, the Pensions Re-Procurement Programme remains accountable for the delivery of the Pensions elements. As such the Pensions Re-Procurement Programme continues to work closely with each of the Corporate Project Leads to ensure the Pension related tasks/activities remain on track and appropriate assurances are given that critical tasks are progressing and delivering to planned key milestones. Over the coming months a significant amount of procurement activities and documentation require completion and the Core Programme Team will proactively manage these activities to ensure any slippages are addressed as soon as they are identified ensuring the Programme remains on track. Additional Business Analysts and Strategic Sourcing resources will be put in place to enable positive progression of these activities. A key success to date is the production of the Outline Business Case(OBC) which has been delivered earlier than planned which has enabled an early release of an initial draft of the OBC to external approvers. As written above, this work will be completed in March 2016 and the programme is expected to be closed on GMPP. The description and aims of the project as defined above no longer accurately reflects the scale and scope of the work being undertaken, and a major publication is due for February 2016. Activity to deliver the recommendations in each of the areas of the Procurement and Efficiency programme will be taken forward by specific projects and programmes, some of which (for example the Procurement Transformation Programme) are shortly expected to enter the GMPP in their own right. The Chancellor announced in September 2015 an investment of £350 million for the development of the Porton only "in scope" elements to the GSK site at Harlow. The Outline Business Case is based on the co-location of the other elements from Colindale and London based National functions and PHE headquarters. At the time of writing, these elements were being considered as part of the Spending Review in November 2015. Non-approval of the other elements would cause a significant delay due to re-design etc., hence the Amber delivery confidence. As at Q2 2015/16, any delay in an overall OBC decision also raises risks around potential loss of the GSK site and supply chain interest. These have been actively managed and the Chancellor's September announcement provided significant mitigation but the risks at the time also supported an Amber assessment. The programme delivery status is rated as amber. This is because, while all projects are progressing well with some having being completed and now being transitioned to business as usual, overall programme risk is rated as amber/red because the programme is reliant on a shift in the culture across NHS organisations towards one which is focussed on identifying and charging chargeable patients, if it is to reach its trajectory goals. As at Q2 2015/15, the programme has one high and two medium impact issues, which could have impacts on the ability of the programme to deliver. These are: that the impact assessment sent to the Senior Review Committee reflected a lower than expected net benefit of extending charging (high); getting cross-Government clearance of the extending charging consultation (medium); and concerns around future leadership from ALBs (medium). It is not anticipated that these issues would lead to a cost or schedule overrun. A number of recommendations were made at the last review to which the Programme has responded positively and to IPAs satisfaction.
Project - Start Date (Latest approved start date) 18/12/2003 01/09/2012 23/06/2003 01/01/2003 26/01/2012 29/03/2012 03/08/2015 29/03/2012 29/03/2012 10/04/2013 04/06/2013 03/09/2013 31/10/2010 01/04/2011 19/03/2012 01/01/2012 10/06/2013 05/07/2013 01/09/2013 28/06/2013 01/09/2013
Project - End Date (Latest approved end date) 31/10/2015 31/03/2020 31/03/2023 31/12/2016 31/03/2015 01/04/2020 03/02/2016 31/03/2018 01/06/2020 31/12/2017 01/12/2016 01/09/2018 31/12/2015 01/04/2017 30/10/2016 31/12/2018 30/11/2015 21/07/2017 31/03/2016 31/03/2023 31/03/2017
Departmental narrative on schedule, including any deviation from planned schedule (if necessary) The BT Local Service Provider service was continued to 31 January 2016 to manage the business continuity and patient safety risks associated with contract exit. The final NHS trust transitioned to its replacement service on 30 November 2015. Decommissioning of the Local Service Provider service commenced in January 2016, following which the programme will be formally closed. Movement of scheduled dates for pathfinder and Phase 1 national rollout activities has occurred following the Secretary of State for Health announcement on 2 September 2015, as communications cannot begin with the public until the National Data Guardian’s review of the model of consent/opt out is complete. The Programme Business Case entered the assurance and approval process in February 2015, after being endorsed by the Programme Board. The case was reviewed by Department of Health Economists which led to a change of approach. A revised Programme Business Case is being developed. The Programme continues to deliver new deployments of the strategic electronic patient record system (Lorenzo) to planned schedule. For non-Lorenzo deployed services the programme remains on track for the majority of systems to have exited the contract by July 2016. The overall programme end date for Lorenzo systems remains as 2023. The rollout of EPS Release 2 to prescribing sites had been slower than anticipated and the BSA redundancies were not realised. It was expected that EPS Release 2 would be rolled out to 100% of prescribing and dispensing sites by the end of December 2009. In reality, as of December 2013, 91% of dispensing sites (pharmacies) and 16% of prescribing sites (GP practices) had EPS Release 2 deployed, and this increased to 98.2% of dispensing sites and 65.8% of prescribing sites as of September 2015. The factors which led to the lower than expected national rollout of EPS Release 2 were fully explored and documented in the Extension Business Case. The original Project End Date for the General Practice System of Choice Replacement Project was 31/03/15. An extension was requested and approved to extend the End Date to 31/10/15. A seven month extension was required because: • Supplier delays have impacted the delivery of Entry and Standard Requirements within required operational service dates. • Suppliers are late in the delivery of General Practice System of Choice Services specifically against Principal Clinical System and National Services (Summary Care Record and GP2GP) Requirements. • Current General Practice System of Choice Interface Mechanism pairing process has been limited due to delayed delivery of Principal Interface Management requirements, assurance of Subsidiary Supplier systems and the evolvement of supporting processes and test environments. This in turn may impact the ability to deliver Subsidiary Supplier pairings. • Programme and Commercial resource shortage is impacting the ability to deliver commissioned projects. The Programme is aiming for the project to move into Business As Usual following the approval our the Project Closure Report by the end of the financial year 2015/16. Following the reset of the Programme in 2014 the programme devoted considerable resources to planning the transition and transformation activities necessary to deliver on the Programmes goals and objectives. The outcomes from this work have been incorporated in the Health and Social Care Network Programme Business Case and Outline Business Case that have been approved by the Department of Health, Cabinet Office and HMT. This has resulted in a comprehensive view on the activities and associated timelines necessary to transition from the current N3 contract and to subsequently transform the services to a future internet enabled state by 01/04/2020. There is no deviation from schedule for NHS Choice Live Service. The NHS.UK project will operate in an agile way with a total of 24 sprints. The delivery team will agree the goals for the next sprint at the end of each sprint cycle. This will maintain momentum and ensure the team can deliver on objectives that will be set out in a project mandate and presented to the NHS Choices Programme board in July 2016. The project remains on target to complete at the end of 2017/18, although the delay in go-live means that the full project benefits will not be realised until after this date (September 2018). Utilisation currently stands at circa 50% - milestones are set to achieve 60% by September 2016, 80% September 2017 and 100% September 2018. The Programme encountered delays in the first go-live due to additional work required to ensure that the NHSmail service would migrate from the incumbent supplier to new without impacting the user community. The Programme agreed a new financial baseline with the Department of Health and closed this out commercially with the two suppliers involved. The implication was that users remained on NHSmail 1 for longer than planned before moving to NHSmail 2 which will operate for the agreed 60 month term. Planned delivery of project remains 31 December 2017. Key achievements this quarter include: GMCs continue to ramp up collection of rare disease samples, GENE Consortium given access to 300 linked datasets, and work continues to identify optimum method for extracting enough quality DNA from cancer samples. A decision has been made to delay implementation of Phase 2 of the reforms (the cap on care costs and the new appeals system) until April 2020, so they are now out of scope and will be taken forward by a new programme in due course. The programme continues to roll out in line with planning. Evidence from previous years will inform decisions about the pace of rollout in future years. The next IPA review is scheduled for July 2016. The workforce expansion and service transformation elements of the programme were successfully delivered by end-March 2015 as planned. The transfer of 0-5s commissioning was safely delivered, with LAs becoming legally responsible for providing 5 key health checks as set out in Regulations, on 1 October 2015 as planned. Whilst the Programme has remained on schedule (as amended in July 2013), completion of the Full Business Case has been delayed slightly due to the need to align work with the Spending Review and to address Gateway recommendations. The sequencing of full rollout presented in the business case has been amended to align with the expected spending review settlement resulting in full rollout by April 2020 rather than 2017 as originally anticipated. Key milestones reached during the past 12 months include the commissioning and mobilisation of a second wave of services taking service coverage above 50% of the English population, delivery of a workforce and training development plan in conjunction with Health Education England, delivery of a scoping document for the evaluation of trial services by RAND Europe, and work on service integration and market development by KPMG and the Offender Health Collaborative. Phase 1, the replacement of the existing on-line service, remains on track for delivery on 1st December 2015. Phase 2, the replacement of the associated back office services, remains scheduled for September 2016. The National Proton Beam service remains on schedule to treat the first patient in the Summer of 2018. It is now in the Mobilisation phase and has a clear suite of products/tools required to enable successful delivery. The ESR Contract with IBM details three distinct elements of activity: (1) OPERATE - IBM Interim Service delivery commenced in June 2015. A successful transfer of responsibility from ESRs previous supplier was achieved, and service has been stable to date. IBM will assume full responsibility for all aspects of ESR Service from 1 December 2015 - the date of contract expiry between DH and McKesson UK for residual services; (2) TRANSITION - A revised transition approach has been required following delivery issues with IBMs original transition plan. The revised approach is considered both simpler and less risky to service continuity, with the supplier performing smaller and controlled changes to the Service Infrastructure over a period extending throughout 2016. IBM have also secured rights to continue to deliver service using the previous suppliers facilities - effective 1 December 2015, thereby removing the need to physically move the data centre; (3) ENHANCE - following a number of challenges identified with building the initial enhancements for ESR, IBM notified of a delay to the delivery of the first tranche of solution developments, scheduled for April 2016. Re-planning is in progress to identify revised delivery dates during 2016. Following a period of re-planning carried out during Quarter 2, it became apparent that a revised approach to delivery of the Programme to meet expected timescales of July 2017 was required. This approach was documented, presented and agreed by the Hutton Steering Committee on 25/09/2015. As a result of the revised approach the Programme Plan was amended accordingly; although this changed the original reported milestone dates for key deliverables, it still ensured the original agreed delivery of the Programme by July 2017. Critical path activities remain on target with activities such as Pensioner Payroll Services Prior Information Notice (PIN) being issued to the Market within reported timescales, Supplier Bootcamps held as planned with an acceptable attendance/interest from the supplier market and the Outline Business Case being produced and issued for external approvals ahead of schedule. As defined above, the project remains on track to deliver to schedule by the end of March 2016. The OBC was submitted on time at the end of July 2014. A final decision by HMT/DH was delayed from September 2014 until after the General Election. The programme was working on the assumption of a decision by the end of July 2015 and the key risks were based on this forward plan. Based on this assumption, the subsequent objective is to ramp up and commence the next stage of design at the beginning of January 2016. As at Q2 2015/16 , DH Ministers had approved the OBC but HMT had yet to make a final decision. In the event, on 17 September 2015, an interim decision was announced by the Chancellor for the “Porton only” element to go ahead at Harlow, with the remaining scope of Colindale, Whitechapel and London HQ functions to be considered as part of the Spending review (SR) in November 2015. The Programme Board subsequently agreed that the readiness activities should continue on the assumption of a positive outcome from the SR for the full scope. As of Q2 '15/16, the delays had led to an 15 month delay in the programme. Initially the programme was due to close in March 2016. The Programme Board, following advice from the IPA, extended the programme in August, so that it would close in March 2017, with the current SRO agreeing to extend his term. This was to enable the team to continue to work with its Arm's Length Bodies and NHS colleagues to implement the changes brought about by the programme, and also to ensure a stable and safe transition of the programme when it closes.
2015/16 Budget (£million) £59.89 £4.19 £237.73 £4.96 £87.32 £166.95 £0.00 £27.00 £29.32 £50.00 £512.10 £69.28 £0.41 £34.80 Data exempt under Section 43 (2) of the Freedom of Information Act (2000) £52.15 £47.10 £2.50 £18.50 £197.25 £4.00
2015/16 Forecast (£million) £82.77 £4.10 £115.70 £7.83 £82.13 £87.38 £0.00 £30.77 £28.40 £27.40 £354.50 £69.28 £0.41 £34.80 Data exempt under Section 43 (2) of the Freedom of Information Act (2000) £52.15 £45.30 £2.50 £18.50 £135.56 £3.00
Variance Budget / Forecast %age 38.20% Budget variance less than 5% -51.33% 57.86% -5.93% -47.66% Budget variance less than 5% 13.98% Budget variance less than 5% -45.20% -30.78% Budget variance less than 5% Budget variance less than 5% Budget variance less than 5% Data exempt under Section 43 (2) of the Freedom of Information Act (2000) Budget variance less than 5% Budget variance less than 5% Budget variance less than 5% Budget variance less than 5% -31.28% -25.00%
Total budgeted whole life costs (£million) (including Non-government costs) £1,743.03 £0.00 £2,294.07 £77.73 £309.43 £748.20 £0.00 £131.16 £133.03 £160.00 £18,619.20 £348.00 £654.31 £199.10 Data exempt under Section 43 (2) of the Freedom of Information Act (2000) £1,247.26 £267.00 £10.84 £71.90 £10,447.57 £10.50
Departmental Narrative on Budget / Forecast variance for 2015/16 where more than +/- 5% Costs for service transition and contract exit, which were not included in the original baseline, have been incurred in 2015/16. Budget variance less than 5% The 2015/16 forecast is lower than budget due to the budget including NHS Trust costs which are not included in the actual and forecast and the forecast deployment and services charges being lower due to fewer deployments, revised scope of deployments and interim date changes. The increase in budget for 2015/16 is due to the approved change request for the Phase 4 pre-requisites, including Pharmacy Training, Business Continuity and Controlled Drugs, which is additional activity, covered in the Tolerance Exception Report/Change Request. Budget figures from the Appointment Business Case (17 March 2014) include contingency in FY15/16, but contingency is not included in the forecast figures. Clinical Commissioning Group costs have been included in the forecast at the rate given in the business case. Two different sets of variances have arisen since the Appointment Business Case was approved due to contract negotiations were still ongoing during the approval of the Appointment Business Case, and as a result of delays to the delivery of the new services. Further reductions will follow as a result of restrictions to subsidiary module deployments between now and Dec 2016 which are needed to ensure that the costs remain within the business case allocation for the follow on term. The budget was allocated according to the original plan which expected exit and transition to be taking place throughout 2015/ 2016. The programme has been considerably delayed while it's strategic direction was reviewed and reset. As a result this budget allocation is no longer relevant. The budget figure is as per the Strategic Outline Case and envisaged a completed transition to the Public Service Network for Health (as was) and does not include any N3 spend. The recently approved Health & Social Care Network Outline Business Case provides an up to date view on the programme financials. Budget variance less than 5% The £3.7m overspend in 2015/16 is due to the delay of go-live from 2014/15 to 2015/16 so reflects the delay in incurred costs. This also contributed to the £7.1m underspend in 2014/15. Budget variance less than 5% Main project spend relates to sequencing costs. As fewer samples have been collected by GMCs than expected, fewer whole genome sequences have been completed and hence actual spend has been lower than forecast. The forecast RDEL figure for 15/16 has been reduced to reflect changes in the programme budget following the delay to Phase 2. The RDEL figure for 15/16 also previously included £146m for preparation for Phase 2. The £146m will remain with local government, however the majority of that funding (aside from 10% which remains allocated to LAs to meet any obligations made when planning for the cap) will not remain with the programme. Final decisions are still to be made about the purpose of that funding. Budget variance less than 5% Budget variance less than 5% Budget variance less than 5% Data exempt under Section 43 (2) of the Freedom of Information Act (2000) Budget variance less than 5% Budget Variance less than 5% Budget variance less than 5% Budget variance less than 5% The positive variance is driven by the slippage in the assumed Outline Business Case decision date. There were no costs, other than staffing costs, prior to 14/15. Due to late publication of the implementation plan, the budget for 14/15 was re-forecast, from £6.5million to £1.5million. Actual spend was £1million, as less than expected was spent on the CRST and the IT changes, with £0.5m returned to the central pot. The budget for 15/16 has been reforecast from £4m to £3m.
Departmental Narrative on Budgeted Whole Life Costs Electronic Patient Record systems were deployed at 80 NHS trusts during the lifetime of the BT Local Service Provider programme. Due to trust mergers, the final deployed estate was: 17 trusts and 170,000 users of the Cerner Millennium Electronic Patient Record system (acute care setting); and, 39 trusts and 150,000 users of the Servelec RiO Electronic Patient Record system (community and mental health care setting). The programme also supported all NHS trusts to safely and securely transition their systems from the central Local Service Provider service to locally-contracted replacement services. The whole life cost of the programme is forecast to be 1% under budget on completion. Budgeted whole life costs are unchanged from quarter two 2014/15. Financial information will be available on the whole life costs once the Programme Business Case and Phase 1 Outline Business Case have been approved. The total actual / estimated programmes whole life costs is £2,007.90 million of a total budgeted whole life costs of £2,294.07 million. This includes the costs to deploy and run critical clinical IT systems to health and care organisations across the North, Midlands and East of England including the strategic electronic patient record system (Lorenzo) and 2,700 non-Lorenzo clinical information systems. There is now a significant reduction in forecast costs compared to budget because the rollout of Electronic Prescription Service Release 2 to prescribing sites was slower than anticipated and NHS Business Sservice Authority redundancies, which had been budgeted for centrally, will not now take place. The whole life cost for the General Practice System of Choice Replacement project over the initial term to December 2016 is £309.4m including contingency & inflation as per the Business Case. The Business Case costs include contingencies and Clinical Commissioning Groups costs. The whole life cost is set to reduce as a result of contingency not included in the forecast, finalisation of Contract negotiations and as a result of delays to the delivery of the new services. The budgeted whole life costs are based on the N4/Public Service Network for Health Strategic Outline Business Case and have now been superseded. Whilst reported as the baseline the actual/forecast position on costs is substantially lower and is reflected in later reporting. The transformation budget has not yet been established  but is expected to be agreed in July 2016. Forecast expenditure to 2017/8 remains £27m below baseline (at £104m compared to Outline Business Case figure of £131m). £22m of these forecast savings are in revenue, with £7.2m already delivered to 2014/15 and an additional £6m in 2015/16, these are accredited to the delay in go live, with additional savings made through contracts management. Capital is ??forecast to be £5m under forecast to 2017/18, with the bulk of this saving to be within 2016/17. The costs cover Health & Social Care Information Centre admin costs (mainly staff) and Department of Health programme costs (Accenture, Vodafone and N3 contract costs). Whole life costs and benefits have increased to reflect that the NHSmail 2 service will run for 60 months from a later start date. The value for money ratio for the Programme remains unchanged and it operates within Full Business Case tolerances. Budgeted Whole Life cost is £160m - £140m for Genomics England and £20m for Health Education England. The whole life cost for the programme covers the period from 2013/14 to 2024/25. These are the baseline costs as set out in the Impact Assessment and are based on delivery of Phase 1 and 2 of the reforms. Actual costs will now change as a result of the delay to Phase 2. The programme for Phase 1 will close March 2016 and Phase 2 costs will be picked up in a new programme which will commence in April 2018. The budgeted WLC provides for rollout to all primary school years, i.e. as far as year 6. The WLC figure is informed by the number of children eligible for the vaccine, the vaccine price and the costs of administration (which is commissioned by NHS England). The WLC figure has been unchanged since Q2 14/15 and is consistent with actual costs incurred so far, but the existing vaccine contract expires in 2017/18 and future administration costs are also subject to some negotiation, which may affect programme costs. Decisions about rollout beyond primary schools would carry additional budgetary implications. Once rollout has been completed and the programme has ended, children will be vaccinated annually against flu as part of normal business. There are no budgetary issues to report and the figures stated are accurate. The vast majority of the programme whole life costs relate to spend on new health visitor posts and education & training to deliver the workforce expansion and service transformation objectives. The 2015/16 budget/forecast of £0.41m comprises a DH programme budget of £0.2m, a NHS England programme budget of £0.203m, and a PHE programme budget of £0.006m for setup of the interim national data reporting system. Budgeted whole life costs include the cost of providing services to 100% of the English population, together with non-recurring programme costs to develop services and provide commissioning and implementation support. Whilst these projected costs were accurate at 30/09/15 and reflected the assumption that full rollout would be achieved by 01/04/2017, projections have since been revised for presentation in the Full Business Case resulting in total costs of £380.2m over the remainder of the Spending Review period with full rollout being achieved by 01/04/2020. The increase in whole life costs reflects the extended roll out period rather than any increase in the cost of service provision. Data exempt under Section 43 (2) of the Freedom of Information Act (2000) Whole life costs are composed on capital account (CDEL) and revenue account (RDEL) spend. There is a large CDEL spend in the years to 2018/19 to build and equip the facilities along with a relatively small RDEL spend in this period which covers interest, staff not involved in the development of the centres and training of clinical and technical staff prior to service commencement. From the date of service commencement, costs will ramp up to an annual cost of around £50m per annum, which are required to run the centres and treat patients. All RDEL costs are to be paid for out of the NHS England budget for Specialised Services. Total budgeted whole life costs relate to Service Transition, On-going Delivery and Enhancements for the period Jan 15 to Aug 22. IBM are working with the Authority on replanning its activities regarding Transition, Enhance and Operate components of the contract. As a consequence, costs associated with the Contract are currently being reworked in line with the replanning activities. Total Budget Whole Life cost will remain as forecast, but in line with replanning activities there may be movements in annual budgets. Replanning activities are due to commence Quarter 3 FY15/16 which will result in a Contract Change Notice to reset the Contractual milestones and cost profile. The Whole Life Cost represents the investment required to deliver this project and excludes the current service running costs as per advice of the DH. Calculations are at a high-level; the OBC is in production and will refine the current estimation. The forceast total spend for 15/16 is now likely to be £14m (less than the forecast of £18.5m). This has been spent on procurement, workforce, model hospital and clinical productivity projects to support acute hospital trusts. The spend is being re-evaluated in the light of the Spending Review settlement and the handover of delivery and implementation to NHS Improvement, following the publication of Lord Carter's final report in early February. Whole life costs reflect the operating costs of the in scope activities covering the period of the programme plus a further 60 years. Costs for the 60 years are at 2023/24 prices. It has been agreed that the programme will continue for a further year - until the end of financial year 16/17.