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Department of Health Government Major Project Portfolio data, September 2014 (CSV)
Updated 25 June 2015
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| Project name | Better Care Fund | Brighton & Sussex University Hospitals NHS Trust (3Ts Programme - The development of a leading teaching, trauma and tertiary care centre) | Broadmoor Redevelopment Programme | BT LSP (London) | BT LSP (South) | care.data | Care and Support Implementation Programme | Childhood Flu Immunisation Programme | CSC LSP Delivery Programme | Death Certification | E&N Herts NHS Trust - Lister Hospital ('Our Changing Hospitals' Phase 4 Programme) | Electronic Prescription Service (EPS) Release 2 | Francis & Compassionate Care programme | General Practice System of Choice (GPSoC) Replacement | Genomics Programme | Health Visitor Programme | Liaison and Diversion Programme | Mersey Care NHS LIFT scheme (TIME - To Improve Mental Health Environments) | National Pandemic Flu Service | National Proton Beam Therapy (PBT) Service Development Programme | NHS Choices | NHS e-Referral Service | NHS Electronic Staff Record Reprocurement Project | NHS Pension Re-let Project | NHS Procurement Efficiency Programme | NHSmail2 | North Tees & Hartlepool Foundation Trust - New Hospital Development | Nursing Technology Fund | Papworth Foundation Trust - New Papworth Hospital | PHE Science Hub | Pre-Pandemic Vaccine | Health and Social Care Network (Formerly Public Services Network for Health (PSNH)) | Rotavirus Immunisation Programme | Royal Liverpool & Broadgreen ('World Class Hospitals; World Class Services - Renewing the Royal Liverpool University Hospital') | Royal National Orthopaedic Hospital (RNOH) NHS Trust PFI Project | Sandwell and West Birmingham Hospitals NHS Trust - The Midland Metropolitan Hospital Project | Shingles Immunisation Programme | South Acute Programme | Spine 2 | Summary Care Record (SCR) | SUS Transition |
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| Department | DoH Non Capital | DoH Capital | DoH Capital | DoH Non Capital | DoH Non Capital | DoH Non Capital | DoH Non Capital | DoH Non Capital | DoH Non Capital | DoH Non Capital | DoH Capital | DoH Non Capital | DoH Non Capital | DoH Non Capital | DoH Non Capital | DoH Non Capital | DoH Non Capital | DoH Capital | DoH Non Capital | DoH Non Capital | DoH Non Capital | DoH Non Capital | DoH Non Capital | DoH Non Capital | DoH Non Capital | DoH Non Capital | DoH Capital | DoH Non Capital | DoH Capital | DoH Capital | DoH Non Capital | DoH Non Capital | DoH Non Capital | DoH Capital | DoH Capital | DoH Capital | DoH Non Capital | DoH Non Capital | DoH Non Capital | DoH Non Capital | DoH Non Capital |
| MPA 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 MPA Annual Report) | Amber/Red | Amber/Green | Green | Amber/Red | Amber/Red | Red | Amber/Red | Amber | Amber/Red | Red | Amber/Green | Amber | Amber/Red | Amber | Amber | Amber | Amber | Amber/Green | Red | Amber | Red | Amber | Amber/Green | Amber/Red | Amber/Red | Amber | Green | Amber | Amber/Green | Amber | Amber/Red | Red | Green | Green | Green | Amber/Green | Green | Amber/Green | Amber | Amber | Amber/Red |
| Description / Aims (From GMPP data) | • Demographic change creates unprecedented challenge. In just 15 years’ time, the number of over-65s will have grown 50% and the number of over-85s will have doubled. The fact that a child born in Britain today has a one in three chance of reaching 100 years of age means this challenge will only get harder. • Ministers therefore concluded that, to ensure the sustainability of the care we provide, we have to change our focus from simply treating illnesses, to keeping people well and living independently for as many years as possible and integrate our health and social services. • To drive this they have decided to pool budgets between CCGs and Local Authorities to encourage them to work together and drive the integration agenda forward. • Local areas first submitted their BCF plans (detailing how pooled budgets would be planned to be spent in that area) in April 2014. However the quality and aspiration of these plans was not as expected and as a consequence the BCF Task Force was set up on the 7th of July 2014 to work with local areas to improve the quality of plans, assess them and provide assurance to ministers. The objective of the policy is to accelerate the local integration of health and care services to deliver better outcomes for patients and service users. The Task Force has a narrow focus and its objectives are as follows: • Oversee creation of, assurance and sign off plans across the country which utilise the opportunity of the pooled funds to best effect and support achievement of the purpose; • Support the system to prepare for delivery of plans By the end of October 2014 all 151 plans will have been assessed and assured against the agreed set of national conditions. They will be given an assessed status of either: approved; approved with support; approved with conditions; or not approved. The assessment and assurance process will seek to deliver plans that will include: • A clear analytically driven (i.e. risk stratified) understanding of where care can be improved by integration (of budgets, commissioning, care processes or services) • A clear and evidence based plan of action, developed with all local stakeholders (CCG, LA, HWBB, NHSE, acute and non-acute providers and primary care providers) • A coherent and believable delivery chain with clear local management and accountability arrangements • A credible way of tracking the impact of interventions, and taking remedial action as necessary • P4P mechanisms that are agreed and support delivery of the SR settlement and NHS settlement Given that not all plans will achieve fully approved status, it has already been proposed and approved by the Task Force Programme Board that the Task Force be extended beyond October to support areas to get their plans to a fully approved state and help areas prepare for April. The Task Force is currently scoping this Phase 2 of activity which will run from November 2014 through to March 2015. Phase 2 will include the following objectives: • To have the majority of plans fully approved and ready for implementation • To align the BCF plans with BAU NHS and Local Government planning processes • Support local areas to prepare for and focus on the delivery of BCF plans • Communicate a strong narrative to the public, and health and social care staff on the value of Integrated Care • Alignment with other health and social care integration initiatives • Prepare for and take part in longer term policy development such as the next spending review Task Force Phase 2 benefits are still being analysed however they are expected to include the raising of the profile of the integrated care agenda with the public and health and social care staff, and a level of assurance around the strength of the implementation of plans in local areas in preparation for April 1st 2015. Post March 2015 there will still be much work to be done in order to release the benefits to patient care that the Better Care Fund aims for. CCGs and Local Authorities are free to use their share of the funding to promote integration as they see fit. However, they should meet some national conditions to ensure a minimum level of consistency throughout England. Conditions include ensuring 7 day health and social care services, preventing unnecessary hospital admissions and reducing delayed transfers of care, to making sure one lead professional is accountable for all of a person’s care throughout the new integrated system. It is currently unclear whether post March 2015 work will be overseen and monitored via existing structures within Local Government and the NHS or if there will be some requirement for further work or support from a central team such as the Task Force. The current Task Force currently has no scope or remit post March 2015. | 1. Replacement of the Barry Building at the Royal Sussex County Hospital. The building was opened in 1828 and contains 200 medical and care of the elderly beds (with circa 5% single rooms), plus the main hospital imaging department and other diagnostic and treatment facilities; 2. The transfer of the regional neurosciences centre from Hurstwood Park (on the Princess Royal Hospital campus which is also part of the Trust). The building is over 70 years old. The project will create the capacity to treat patients from Sussex in Sussex (many currently travel into London); 3. The creation of a Major Trauma Centre for the South East region in line with policy; 4. The expansion of the Sussex Cancer Centre to enable Sussex patients to be treated in Sussex for non-surgical procedures; 5. Provision of teaching and research facilities for Brighton & Sussex Medical School. | Redevelop Broadmoor High Secure Hospital to replace Victorian accommodation which presents high levels of inherent risk to the safety of patients and staff and has been declared by regulators, including the Care Quality Commission, as 'not fit for modern mental health services'. The new hospital will provide a total of 234 beds (210 commissioned, 24 decant) in 10 new wards and 6 existing wards in an adjacent unit built in 2003. It will also provide two support buildings: an entrance building to control all access/egress for the site and a central building to house all ward activities and administration. The programme includes the realignment of the site boundaries and the sale of surplus land/buildings to support programme funding. | The purpose of the BT Local Service Provider London programme is to support IT enabled transformation in the NHS in London to create a more efficient, joined-up and patient-led health service. The key objectives of the programme are to: - Provide patients with more choice and control over their patient records; - Create a health service centred around the patient with health information following patients where they are receiving treatment; - Provide health professionals and patients with better access to information and enhance the quality of clinical information so that decisions about patient care and treatment can be made quickly and efficiently based on secure and up-to-date healthcare records; - Help health professionals deliver better patient care by improving the way NHS staff connect with each other across organisational boundaries and provide them with faster, easier access to reliable electronic patient information; - transform the way information flows around the health service and help to provide improved and innovative patient services in London. All IT deployments and upgrades are now complete and the programme is working to i) maximise the benefits that customer NHS Trusts derive from these systems and ii) work with NHS Trusts and suppliers to ensure a safe and orderly exit from the BT Local Service Provider arrangements in advance of contract end on 31 October 2015. | The purpose of the BT Local Service Provider South programme is to support IT enabled transformation in the NHS in the South to create a more efficient, joined-up and patient-led health service. The key objectives of the programme are to: - Provide patients with more choice and control over their patient records - Create a health service centred around the patient with health information following patients where they are receiving treatment - Provide health professionals and patients with better access to information and enhance the quality of clinical information so that decisions about patient care and treatment can be made quickly and efficiently based on secure and up-to-date healthcare records. - Help health professionals deliver better patient care by improving the way NHS staff connect with each other across organisational boundaries and provide them with faster, easier access to reliable electronic patient information - transform the way information flows around the health service and help to provide improved and innovative patient services in the South. All IT deployments and upgrades are now complete and the programme is working to i) maximise the benefits that customer NHS Trusts derive from these systems and ii) work with NHS Trusts and suppliers to ensure a safe and orderly exit from the BT Local Service Provider arrangements in advance of contract end on 31 October 2015. | The NHS has some of the best information systems in the world. Since the 1980s, we have been collecting information about every hospital admission, nationwide. This information is brought together at the Health and Social Care Information Centre, where it is anonymised. The information has been invaluable for monitoring the quality of hospital care, for planning NHS services, and for conducting research into new treatments. Whilst we have this type of information for some care provided outside hospitals, there are significant gaps meaning that it is not possible to see a complete picture of the care that individuals receive. NHS England has therefore commissioned a programme on behalf of the NHS, public health and social care services to address these gaps. Known as the care.data programme, this initiative will ensure that there is more rounded information available to citizens, patients, clinicians, researchers and the people that plan health and care services. Our aim is to ensure that the best possible evidence is available to improve the quality of care for all. | The Care and Support Reform Programme is the most significant and far-reaching programme of reform in adult social care undertaken in over 65 years. It will have a profound impact on the way the care and support system works, the responsibilities of local government and partners, and the rights, outcomes and experience of people who need care, carers and their families. The 'Caring for our future' White Paper published in July 2012 set out a wide ranging set of proposals that provide the framework for transforming care and support including: refocusing the care system onto prevention and early intervention; strengthening integration across the care and wider support system; empowering people through transparent information on the quality of the care; supporting communities and neighbourhoods to play a more active role; embedding person-centred care and supporting carers; creating a vibrant, sustainable market to support choice; a commitment to implement a cap on care costs. The new system will promote people’s well-being by enabling them to prevent and postpone the need for care and support, and put them in control of their lives to pursue opportunities, including education and employment, to realise their potential. The programme supports realisation of the vision for care and support set out in the White Paper by: • delivering the legal framework, including the Care Act 2014, regulations and statutory guidance. • ensuring that appropriate local government implementation plans are in place for April 2015 and April 2016 milestones and providing assurance on state of readiness. • providing national leadership and practical support for implementation, including communications materials, specifications (e.g. data standard and interoperability requirements) and learning and development. Implementation of the programme occurs in two phases. Phase 1, introduced from 1 April 2015, will see the implementation of a large number of generally lower-risk reforms that will have the greatest effect on the provision of care and support. Phase 2 changes, introduced from 1 April 2016 will see the implementation of a smaller number of higher-risk reforms, related to funding of care and support and the creation the cap on care costs. Together these reforms represent a major change programme across 152 local authorities and their partners. | Influenza is a viral infection of the respiratory system. For some people, especially older people, young infants and people with underlying health conditions, it can cause serious even life-threatening complications and death. The impact of influenza on the population varies widely from year to year due to changes in the virus. However, one recent estimate considered by the Joint Committee on Vaccination and Immunisation (JCVI) suggest that each year, on average, approximately 0.75 million people may consult their GP, approximately 27,000 people may be hospitalised and 4,700 people may die in England because of influenza. Currently the programme provides influenza vaccination on the NHS for people aged 65 years and older and those aged under 65 with certain underlying health conditions (e.g. those with chronic respiratory disease, chronic heart disease, pregnant women etc). JCVI has recommended that the current flu programme is extended to children aged 2 to less than 17 years. DH has a legal obligation, under the 2010 NHS Constitution , to offer new vaccines to the public that are recommended by JCVI and which are shown to be cost effective. The evidence reviewed by JCVI suggests that the extension to the current seasonal flu programme might result in around a 40% reduction in the death and hospitalisation figures shown above across the population, although there is large uncertainty either way in this estimate. For this reason, JCVI recommends that the impact and cost effectiveness of the extended programme be reviewed within five years of the introduction to assess whether the expected benefits have been realised. | The key objectives of the programme are: • To manage a safe withdrawal from the existing CSC Local Service Provider contract in a way that empowers local choice, protects patients and is value for money; • Assure the investment cases of NHS Trusts who choose to invest in CSC’s electronic patient record system Lorenzo and to provide support to broker the relationship between these NHS Trusts and CSC during the IT service deployment; • Maximise benefits from the investment over the remaining life of the CSC Local Service Provider contract; and maximise the Return on Investment the Department of Health achieves from the existing deployed and future planned services; and • Take opportunities to drive up value for money. | UK wide changes to the death certification process are in development, with England and Wales proposing a unified approach to all deaths not investigated by the coroner. A new system of scrutiny of deaths to address weaknesses identified by the Shipman Inquiry and more recently among others, the Francis Inquiry into poor care at Mid Staffordshire. In England and Wales, the introduction of medical examiners into the process will provide independent scrutiny of all deaths not investigated by the coroner. Medical examiners, appointed by local authorities in England and by local health boards in Wales, will either confirm the cause of death stated by a doctor or refer the death to the coroner for investigation. For all deaths scrutinised by a medical examiner, the cause of death will be explained to the bereaved and an opportunity offered to raise any concerns, which will be acted upon. In addition to safeguards for the public, anticipated wider benefits include more accurate certification, better quality of mortality data for service planners, appropriate referral of deaths to the coroner and the ability for doctors and coroners to readily have access to general advice from medical examiners in relation to a particular death. | This is the fourth and final stage of the Our Changing Hospitals Programme which enabled full consolidation of all acute services onto the Lister site in October 2014. The programme formed the heart of the organisations strategy and addressed a number of clinical and financial challenges:- allowing us to achieve best clinical practice and improve outcomes and productivity; providing the means for our response to the challenging economic conditions through QIPP; create a mass of clinical and specialist staff to sustain a wider range of high quality services and introduce new technologies; facilitate modernisation of our facilities and improve patient experience whilst enabling reductions in estate and related costs through reshaping the QEII site; to offset the income loss and support the revenue consequences of the capital investment on the Lister site. | The Electronic Transmission of Prescriptions Programme is delivering the Electronic Prescription Service which is a national service that has its origins in government policy initiatives from 1998. With 1.7 million prescriptions generated every working day in England and a predicted annual rise of 5 per cent, the Electronic Prescription Service provides an alternative means of generating and processing the growing number of prescriptions. The NHS Electronic Prescription Service enables prescribers, such as GPs and practice nurses, to send prescriptions electronically to a dispenser (such as a community pharmacy or dispensing appliance contractor) of the patient’s choice. Dispensing contractors can subsequently send electronic reimbursement endorsement claims to the NHS Prescription Service. The main aims of the Electronic Transmission of Prescriptions programme are: o To enable the electronic transmission of prescription data in England between: - Prescribers (GP, nurses, supplementary); - Dispensing contractors (community pharmacy, dispensing doctors and dispensing appliance contractors); and - Reimbursement Agencies (e.g. the Business Services Authority’s NHS Prescription Services). o To facilitate the efficient, convenient and accurate dispensing of medication to patients. The scope of the programme covers all primary care prescribing and dispensing (excluding Schedule 2 and 3 controlled drugs) and supply of medicines, drugs, appliances and chemical reagents by authorised dispensing contractors. Secondary care prescriptions issued for dispensing in the community are also within scope o To enable the NHS Prescription Service to re-engineer their processes to increase capacity and reduce the unit cost of processing prescriptions. The Electronic Prescription Service has to date delivered Release 2 Phase 3, which allows patients to nominate a pharmacy of their choice, at which to receive their prescription electronically. The move to Phase 4 will allow a patient to take their prescription token to any pharmacy for dispensing (as they do with their paper prescription today) with the ability to nominate a specific pharmacy continuing for those patients who prefer the service. | The programme combines a wide range of measures to: (a) address the specific recommendations of the public inquiry into Mid Staffs NHS Trust (b) respond to patient, public and parliamentary concerns about whether care in the NHS, and to an extent in social care, is sufficiently consistent in the provision of safe, effective, respectful and compassionate care. Drawing on a range of policy instruments, it combines strong national leadership signals with improved institutional and professional regulation; radical transparency on performance; enhanced arrangements for identifying and addressing failure; improved leadership capability focused on safety and compassion; a stronger voice for patients within the care system; support for staff to raise concerns safely; support for staff to manage more effectively the emotional burden of care. In short, to transform the culture of the health and care system generally and to give patients a more reliable expectation and experience of high quality care. As a multi-faceted programme at both national and local levels there is no single measure of success, but rather a broad range of indicators – clinical outcomes, patient experience, staff attitudes, staffing levels, safety incidents, how well led an organisation is, and how likely the staff would be to recommend it to friends and family among others – which combine to give a broad dashboard on quality for individual institutions, care pathways and which combine to give a national picture. Based on the Nuffield study (see http://www.nuffieldtrust.org.uk/ratings-review ), the Ratings regime under development by CQC will be the key instrument for assessing progress against the multiple impacts that the programme is seeking to achieve. While we and CQC have commissioned evaluation and research to understand better the impacts of the programme on its broad and complex aims, it is unlikely that these will provide a simple assessment of success for the programme or a moment at which a classical programme could close down the work as completed. | The objectives of the proposed investment in a replacement for General Practice System of Choice are: • Establish commercial and management arrangements for GP IT that facilitate an open and informed market over the life of this investment; • Support delivery of efficiency savings in General Practice by facilitating better use of existing GP IT and by adopting more mobile working technology and patient facing transactional services over the life of this investment; • Develop new IT functionality that responds to the evolving needs of patients, practices and commissioners and the wider NHS. In particular, develop interoperability to deliver information to point of care, provide data to support commissioning and improve care pathway management; and • Improve security of patient data by providing practices with the option to migrate to centrally hosted services over the life of this investment. | 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 government set out three key objectives for genomics in the next phase of its Strategy for UK Life Sciences published in December 2012 which can be categorised simply as health, wealth and growth: * to harness the potential of genomics technology by the NHS to improve patient outcomes and healthcare – health; * to maximise the opportunities for research and translation of research findings into health and economic benefits for the UK – health and wealth; * to support the growth of UK genomics and bioinformatics companies including SMEs by enabling the creation of genomic platforms for innovation – wealth and growth. | In its 2010 Coalition Agreement, the Government committed to increasing the number of health visitors by an extra 4,200 FTE above the May 2010 baseline by April 2015. Ministers want the extra capacity to bring with it the ability for local teams to improve public health outcomes for the under-fives, with health visitors having the time to provide parents with critical health and development advice, and to connect families to the array of health and wider community resources that help them to give their children the best start in life. As part of the Government’s Health Visitor Programme, a commitment was made to improve the quality of services offered to parents and families in the early years of a child’s life. It has been shown that high quality early intervention, prevention and support is vital to giving children the best start in life. The expansion of the health visiting service is intended to deliver a four-tiered model of health visitor delivery of the Healthy Child Programme to all, with support for all parents and early help when needed. It aims to: improve access to evidence-based interventions; improve the experience of children and families; improve health and wellbeing outcomes for under-fives; and ultimately reduce health inequalities. Commissioning of health visitor services will transfer to Local Authorities on 1 October 2015. It is essential to the sustainability of the programme that commissioning of public health services for 0-5s is effective and embedded alongside the commissioning of other early years services. A multi-agency task and finish group was established in June 2013 to plan and deliver the transfer. This was superseded in September 2014 by a full programme board. | The aim of the Liaison and Diversion programme is to improve health and criminal justice outcomes for offenders (or suspected offenders) with mental health, substance abuse, personality disorder, learning disabilities and other vulnerabilities. This should be achieved by 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, so that information from assessments is subsequently fed into the criminal justice process and can be used to inform decisions about justice outcomes, charging, prosecution and sentencing. This fits with the strategic aims and objectives (offender rehabilitation to support reduced offending, and improved health and wellbeing outcomes) of each of the departments involved. It is accepted by the Coalition Government that this direction of travel supports the business needs, as it was anticipated that early intervention and investment in health services for offenders across England will save money through reduced ongoing impacts on the criminal justice system. The programme is led within NHS England, which has responsibility for commissioning L&D services. Policy work is being taken forward by a cross government programme, funded through the SR settlement to DH and involving DH, Ministry of Justice and the Home Office, working with NHS England and Public Health England. HM Treasury approved the Outline Business Case in 2013 and trials of a standard service specification commenced in April 2014 (the programme transferred to NHS England on 1 April 2014). | The TIME Project is a multi-phased £130m project which will eventually deliver 285 mental health beds in four/five sites across North Merseyside. Phase I comprises a new 80 bedded unit on the old Walton General site (£25m) and an 85 bedded unit in Edge Lane/Old Swan (£27m). The Phase I buildings are being procured under the NHS LIFT Initiative in conjunction with Liverpool and Sefton Health Partnership (LSHP). Phase II will follow but may be procured via other routes. The new accommodation will be single room en suite with access to outside and therapy spaces. It will replace functionally unsuitable accommodation currently based on a number of disparate sites. This will release significant land for sale. The two Phase I schemes have now been designated for separate Financial Close, with Edge lane/Old Swan expected to be at least one year behind. Financial Close for Walton was achieved in February 2013. This return covers Phase I only with only the Walton aliment currently scheduled. | The aim of the project is 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 patients. | To develop a full PBT service in England that delivers the following aims and objectives:- 1) to ensure that all patients, for whom evidence supports PBT as the most clinically effective treatment, receive treatment within a clinically appropriate service specification and to nationally agreed standards. 2) to ensure that services provided enable the continued development of the technologies involved and that workforce and training issues are appropriately addressed. 3) to deliver improved outcomes by ensuring that patients have access to high quality modern radiotherapy techniques comparable to those used in other European countries, to improve patients' experience by minimising any long term side effects of treatment. In particular to :- a) develop a PBT service that meets the objectives as stated in the SOC December 2011 b) oversee the facilities projects to ensure that the two sites develop a service that meets Commissioner's specifications to time and budget c) monitor the facilities projects financial governance arrangements to ensure that it delivers value for money d) manage the transition from an overseas service to a service in England e) identify and manage the impact of the PBT service on other clinical services f) develop a national clinical network g) ensure that a research strategy is in place that informs the future development of the service h) manage the impact of workforce across radiotherapy services. | NHS Choices (www.nhs.uk) is the digital channel for the NHS. It receives over 43m unique visits every month and usage of the site has grown annually since launch. NHS Choices allows users to access comprehensive, clinically valid information on health conditions and information about health and social care services and performance. NHS Choices is designed to meet the requirements of those with health or care needs, either directly (e.g. patient or service user) or indirectly (e.g. carer). It will focus on the following objectives responding to core user needs, including: • Prevent ill health and promote good health: e.g. I want to improve my health and/or wellbeing or avoid past experiences of poor health; • Promote early intervention: e.g. I have a symptom, I need help; • Reassure and give confidence: e.g. I have a diagnosis or question related to my care, what do I do; • Access to services or treatment: e.g. I need a service, how do I choose and access it; and • Motivate: e.g. I have an illness and I am not involved in planning my care. A programme of transformation is required to develop a service which meets these objectives. The current service has not changed substantively since launch in 2007. NHS England and the Health and Social Care Information Centre are developing a plan for delivery of this transformation programme as well as a definition of the scope of the minimum viable service. In parallel, NHS England is developing the business case to secure investment for the capability and capacity required to undertake transformation activity and maintain the minimum viable service. | This project is about the provision, development and implementation of a new NHS e-Referral Service to succeed the existing Choose and Book service in line with NHS e-Referral Service vision and a significant broader set of strategic drivers. The vision positions the new NHS e-Referral Service as a flagship programme to support paperless referrals and a paperless NHS by 2017, and as a centrepiece of NHS England’s response to the Government’s Digital First and transparency initiatives. The NHS e-Referral Service project has the following scope: • Achieving 100% 'paperless' referrals and bookings in the NHS; • Launch vision of what the NHS e-Referral Service is aiming to be. After launch of the vision there will be a by period of research, communications and engagement with patients, users and stakeholders; • Go live of the NHS e-Referral Service to support the NHS and Patients, as a 'like for like' replacement of the existing Choose and Book service that currently supports the NHS and Patients. This includes software development, migration of existing data (such as patient referrals and Hospital Services) and transition activities; • A range enhancements and developments to NHS e-Referral Service in line with research completed with patient and professional users within the NHS and Social Care; • A replacement national Telephone Appointment Line function for patients to book appointments, following closure of NHS Direct; • Transition, exit and de-commissioning of the existing Choose and Book and The Appointment Line services to the new NHS e-Referral Service; • Ongoing support of the live NHS e-Referral Service after implementation to ensure resolution of any issues impacting delivery of the service to patients and NHS users; and • Programme and Service Management from the Health & Social Care Information Centre covering all aspects of delivery, including supporting business change, communications and stakeholder engagement. | 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 service is provided by McKesson UK under a contract with the Department of Health (DH) which expires in August 2014. . The NHS ESR Reprocurement Project has been established to replace this expiring contract ensuring that there is no break in the ability of the NHS to pay and manage its employees and to ensure that the service is enhanced and improved to meet the future needs of the NHS The project will ensure the ongoing provision of pay services to the NHS and that these services are provided in the most effective and efficient way following the expiry of current contracts. Aims • ensuring that NHS organisations continue to have access to efficient, effective and sustainable solutions to undertake at least the core services currently provided by ESR, including ensuring the continuity of service for NHS staff in relation to their remuneration. • ensuring that the organisations continue to achieve the benefits from the current service, documented in the OGC benefits report in 2008 and drive additional benefits from any further investment. • enabling DH, Ministers, Health Education England and Local Education and Training Boards (LETBs) and other bodies to have timely and accurate macro level data about the NHS workforce such as numbers, profile and skills. • providing assurance data to the reformed system that a trained workforce is in place to enable supply side management of appropriately trained and skilled health and care workforce. | The NHS Pension scheme is available to all current and past NHS Employees and has circa 2.2 million members. Currently administered in a co sourced model, through two providers, Equiniti Paymaster and the NHS Business Services Authority (NHSBSA, an ALB to the DH), the Equiniti Paymaster element is due to expire in July 2016. This project has been established to replace the contract that is to expire, ensuring there is no break in the SofS's ability to meet its statutory requirements to offer the NHS Pension scheme. The project will ensure the on-going provision of a pension service to the NHS and that this service is provided in the most effective and efficient way following expiry of the current contract. The specific aims of this project are to:- a) deliver a service that does not adversely affect NHS Pensions business performance and allows continuity of the 1995, 2008 and 2015 pensions service; b) adopt a fit for purpose commercial solution ensuring sufficient flexibility to accommodate transformational change; and c) improve the experience of employers and employees. In delivering these objectives, the project will aim to:- 1) make provisions for the forthcoming expiry of the contract which covers the functions currently carried out by Equiniti Paymaster and outsource the remainder of the pensions function currently provided in-house; 2) transform the current administration service, to improve customer experience and increase efficiency; 3) ensure the revised pension administration service is agile to change; 4) ensure that the procurement delivers efficient innovative solutions for managing the cost and process of change and delivers a structure which creates coherent incentives for engagement and innovative thinking from all parties; 5) ensure that the resultant systems meet current and future needs and are value for money; 6) ensure that the service is fully and effectively aligned with relevant policies to create value in the delivery of policy as well as within operational services; and 7) support the platform upon which DH workforce can develop future Total Reward Strategies. | The NHS spends over £23 billion every year on goods and services (which typically accounts for around 30 per cent of the operating costs of each NHS Trust) and around £44bn on staff. In the financial year 2011-12 and in 2012-13, non-pay expenditure in Trusts increased beyond the rate of general inflation. In August 2013, DH published a report “Better Procurement, Better Value, Better Care“, which proposed, amongst other things, that a Programme should be established to help NHS trusts deliver £1.5bn efficiency savings. The NHS Procurement Efficiency Programme received Phase 1 funding to obtain resources to mobilise the Programme in December 2013, and further interim funding arrangements to maintain Programme progress, were agreed with HMT 15th August 2014. The Programme aims to: • deliver a series of cost saving initiatives with the NHS in the short-medium term; • improve data, information and transparency within the NHS; • establish a clinically led approach to medical devices that will deliver opportunities for efficiency and establish a best practice approach to strategically managing these categories across the country; and • provide leadership, coordination and direction to help modernise procurement in the NHS, embedding world class procurement to increase efficiencies, capability and capacity across the NHS. In June 2014, Lord Carter was appointed by the Secretary of State for Health as Chairman of the Procurement & Efficiency Board. He recommended that a Project should be established to identify hospital efficiency metrics that might help NHS Trusts to identify possible efficiency savings. In parallel, work is continuing on identifying and securing savings through partner organisations such as NHS Supply Chain and Crown Commercial Services. | NHSmail provides a secure email, calendar, directory, fax and SMS text service provided for the NHS in England and Scotland to over 900,000 registered users. Further, NHSmail provides a national relay service which enables NHS organisations in England, Scotland and Wales to communicate. SMS text services provided are used extensively by NHS organisations with over 4.8 million SMS text messages sent each month. Services are centrally funded and are currently free to health and care organisation's at point of use. NHSmail is a fully operational service, for which demand remains strong. High user satisfaction ratings and strong support from the National Stakeholder Engagement Group and National NHSmail Forum suggests a desire to continue a secure email service for the NHS in some form. The continuation of a need, along with a number of other key infrastructure projects, was confirmed in a Department of Health announcement on 22nd September 2011. The existing NHSmail contract was executed on 1st July 2004 for a 9 year term; it expired on 30th June 2014 with transition contract arrangements in place through to Mar-15 and further funding to be signed off in the next business case. The currently contracted supplier for this service is Vodafone. The aim of the NHSmail 2 project is therefore to identify a solution and replace the existing single NHSmail service by Jun-16 by working with Crown Commercial Service to get a number of secure email providers onto a Managed Email framework which will allow NHSmail to run a further competition to procure a replacement service provider from the framework including an integration service that will ensure that @nhs.net emails are directed to the correct provider, its customer organisations and their individual users; a central directory and government gateway service. | New Hospital Development at Wynyard, Teesside - To respond to both the local health needs, national policy developments, and implement a key recommendation of the Independent Reconfiguration Panel's Report published in 2008. The Trust, in partnership with its stakeholders, has planned to implement through the' Momentum - Pathways to Health Care Programme' care closer to home with a new hospital facility that is fit for purpose for the provision of modern acute care services. This will deliver a patient-centred and clinically driven local NHS responsive to the needs of the local people, delivering the best quality care available in an integrated and efficient way, in first rate facilities as close to home as possible. The scheme is anticipated to cost circa £272m (excluding VAT) - this is to be funded from a £100m capital contribution from the Treasury and the balance (£172m) to be funded from PF2. | The launch of the Nursing Technology Fund has come, in part, as a response to the Government’s commitment to reduce the burden of bureaucracy on nurses and midwives. The Fund will also allow them to use connected information and new technology to join up and improve services, make better informed decisions and deliver safer, more integrated care. The projects funded by the Nursing Technology Fund are envisaged to deliver a range of benefits for nurses and midwives helping them: * improve patient outcomes through access to information and resources at the point of care; • spend more quality time with individual patients with a heightened level of acuity and dependency; • reduce unnecessary journeys and overall amount of time spent travelling; • significantly reduce multiple collections, transpositions and duplication of data; • significantly streamline care processes by eliminating non-value adding steps; and • improve access to services and reduce waiting time as a result of releasing time to care. | Papworth Hospital NHS Foundation Trust is one of the UK’s leading cardiothoracic hospitals and an internationally recognised heart and lung centre. It provides services to a core catchment population of approximately three million in Norfolk, Suffolk, Cambridgeshire, Mid and North Bedfordshire and surrounding areas and receives referrals for certain sub-specialties from throughout the UK. The current site dees not provide the ability for the hospital to use the accommodation flexibly and the infrastructure is deteriorating. The Trust developed a Clinical Vision for the development of its services in conjunction with Addenbrooke’s Hospital, the Norfolk, Suffolk and Cambridgeshire Strategic Health Authority (now part of NHS Midlands and East), PCTs and other key stakeholders. The delivery of the vision is best achieved by the development of the new Papworth Hospital on the Cambridge Biomedical Campus with more integrated, improved services for patients as a result of the partnership with Addenbrooke’s Hospital and the University of Cambridge School of Clinical Medicine. Therefore the main purpose of this project is to relocate the Papworth hospital to the Cambridge Biomedical Campus. | The programme previously called Chrysalis evolved under the Health Protection Agency (HPA) from a new build on the Porton site to co-location of Porton elements (research, health protection services, and corporate services), along with two other major HPA sites on a single site in the vacated GSK Science Park at Harlow. HPA’s Chrysalis Programme focused on the urgent re-provision of the ageing, high security, high containment specialist microbiology laboratories at Porton Down that are a key part of the nation’s defence against novel and dangerous microbiological pathogens such as pandemic flu, Ebola, anthrax and many others. The programme transferred to Public Health England (PHE) on 31st March 2013. An independent due diligence review carried out for PHE supported the continued investigation of Harlow and allowed PHE to continue to explore Harlow as an option for the Outline Business Case (OBC). The vision under PHE has continued to develop and builds upon and strengthens the strategic case for an integrated public health service. The business case is based on the delivery of a “hub and spoke” model for public health science in PHE.The “hub and spoke” model identifies the two core purposes within PHE: - The national source of advice and expert science on protecting and improving the public’s health - The local provider of key public health functions and the application of expert advice on public health interventions to local government and the local NHS | The aim of the project is to consult with subject matter experts on the feasibility of pre-pandemic vaccine (stockpile) and its effectiveness and, dependent on the outcome, procure further pre-pandemic vaccine to replace the existing stock that could expire at any time from July 2015 onwards (the company have retested the stock and extended the expiry date to July 2015. This date could be extended further, by testing for potency from this summer onwards). | The programme has recently been renamed as the Health and Social Care Network, formerly called the Public Sector Network for Health. This is to reflect that the future network will support the growing information needs of a more integrated health and social care environment. Health and Social Care Network is the programme set up, on behalf of the health and social care sector, to enable the provision of a network solution across the Health and Social Care landscape. Key deliverables will be the exit from the existing contract, disaggregation of the services, transition to a range of suppliers and ultimately the transformation of services to a digital, internet based platform, whilst aligning with Government Information and Communication Technology and Digital Strategies; including a reduction in the cost in comparison with the extant solution. The programme is currently undertaking a reset and review on its future direction, and is going through a discovery phase working with subject matter experts to create a Blueprint that contains a strategic roadmap, target operating model and recommendations for a replacement network solution. A Programme Mandate and Programme Business Case have been created to develop the roadmap, into a focused and appraised strategic delivery case. The Programme Business Case is progressing through the approvals route. | Background: Rotavirus infection is the commonest cause of gastroenteritis in children under five years of age worldwide. Rotavirus infection in the UK is seasonal, occurring mostly in winter and early spring. In England and Wales an estimated 130,000 episodes of rotavirus-induced gastroenteritis occurred each year prior to the introduction of immunisation in children less than five years old and approximately 12,700 of these children were hospitalised. In 2011 the Joint Committee on Immunisation and Vaccination (JCVI) advised that the Department of Health should introduce a rotavirus immunisation programme if the vaccine could be procured at a cost effective price. Following negotiations with the manufacturer, the price paid for rotavirus vaccine resulted in the vaccination programme being cost effective. Objective: The overarching objective of the rotavirus immunisation programme is the reduction of rotavirus-induced gastroenteritis in England. Scope: The scope of the project is limited to England and includes all the elements required to successfully deliver a rotavirus vaccination programme. Benefits:: the programme is delivering: • rotavirus immunisation for babies added to the national immunisation schedule; • a reduction of rotavirus-induced gastroenteritis: and • a reduction in the burden on the NHS by reducing hospital admissions and visits to GPs caused by rotavirus-induced gastroenteritis. | A new Royal Liverpool University Hospital procured under the Private Finance Initiative. The scheme will address service delivery and building infrastructure concerns. It will secure the future provision of high quality service for the local population, together with specialised services for Cheshire, Merseyside and beyond and support world class research and teaching in partnership with the University of Liverpool. This will be achieved through the implementation of a Clinical Services Delivery Model, the development of services outside hospital, redeveloping or utilisation of facilities at Broadgreen Hospital and redeveloping the Royal Liverpool University Hospital. The existing hospital also presents a significant business continuity risk arising from serious issues concerning fire safety and the engineering structure. | The Trust is the largest specialist orthopaedic hospital in the UK and continues to be regarded as a world leader in the field of orthopaedics despite its ageing and dysfunctional site. The proposed facility has a capital value of approximately £40m and will include a mixture of approx 100 inpatients beds (Adult Acute and Children and Young People's Services); - Therapy areas for both inpatient service areas; - A new main entrance; - Inpatient and complex imaging. The new Healthcare Facilities will deliver improvements to clinical adjacencies, forming a main entrance 'hub' in the centre of the existing site, thereby commencing a process of site rationalisation that will deliver improved patient outcomes including: Improved privacy and dignity for patients as the project will deliver 50% single rooms for adults; Improved utilisation of beds as the single sex agenda and infection control will be easier to manage; Improved access to Imaging as the department will be planned to meet current and future activity and changes in technology; An attractive and modern environment to attract and recruit world-class professionals to train and work at the Trust; | The development of a new acute hospital on a brown field site in the Grove Lane area of Smethwick( in Sandwell) to replace the current Sandwell General and City Hospitals, as part of the wider changes to health and social care within the health economy being undertaken in the Right Care, Right Here Programme. This will result in a major shift of care away from the acute hospital into community settings, major investment in new community and primary care facilities and the state of the art new single-site acute hospital proposed in the OBC. The SoS has authorised use of compulsory purchase powers and the site has been acquired. The OBC has been approved and procurement has commenced. | Background: shingles is caused by the reactivation of the chicken pox virus in a person with a dormant chicken pox infection. Shingles incidence is highest in older people as the incidence of shingles increases with age. Prior to immunisation being introduced in the UK, there were estimated to be around 790 to 880 cases per 100,000 people, an estimated 30,000 cases of shingles for people aged 70 – 79 each year. In 2010, JCVI advised that a universal shingles programme should be implemented for people aged 70 years to 79 years inclusive if a licensed vaccine was available at a cost effective price. The Department of Health (DH) has a legal obligation, under the 2010 NHS Constitution, to offer new vaccines to the public that are recommended by JCVI and which are shown to be cost effective. Objective: The overarching objective of introducing shingles vaccination is the reduction of shingles and associated sequaelae in England. Scope: The scope of the project is limited to England and includes all the elements required to successfully deliver a shingles vaccination and catch up programme. Benefits: The programme is delivering: (1) sustained improvements in public health; (2) a reduction in burden on the NHS by reducing the need for treatment and (3) a cost effective health intervention. Status: shingles vaccination was introduced on 1 September 2013. In 2013/14 shingles vaccination was offered to 70 year olds (the routine cohort) and 79 year olds (the catch-up cohort). In 2014/15 shingles immunisation is being offered to all those aged 70, 78 and 70. The catch-up programme will be continued progressively in future years so that all people aged 70-79 years are offered shingles vaccination. | The South Acute Programme was established in Autumn 2011 to deliver clinical systems for Acute providers in the South of England. The systems, procured locally by providers through this programme, will replace outdated legacy systems and manual processes for the capture of clinical information, enabling a number of benefits to providers, including; reducing the reliance on paper based process, improving safety of care and increasing operational efficiency and effectiveness. Providers are working in 6 collaborative groups, each with their own scope, in order to procure and implement systems aligned to local informatics strategy and priorities, with DH providing some central funding to support these local investments. The service/system scope of each collaborative comprises: Group A - Electronic Prescribing and Medicines Administration (EPMA); Group B - Electronic Document Management and a Clinical Portal; Group C - Community-wide ePrescribing and a clinical hub; Group D - An enhanced Patient Administration System (PAS) and a Maternity system; Group E - An Integrated Clinical Information System; and Group F - Clinical Document Management. | The Spine 2 programme covers the work required to develop replacement Spine services (a collection of national applications, services and directories that support the NHS in the exchange of information across national and local NHS systems), their transition from the existing Spine services and Spine 2 operation and support services, covering the period 1st April 2012 to 31st March 2018 The main objectives of the Spine 2 programme are to: • Maintain continuity of Spine service from the end of the current contract, through any transition of change of supplier(s), to the end of the period covered by the business case; • Increase the number of external organisations able to connect and develop services on behalf of health and social care providers; • Reduce the cost and timescale of introducing changes to the Spine services; and • Reduce the annual cost of providing the service. | The Summary Care Record supports patient care by providing healthcare staff in urgent and emergency care settings with the essential medical information they need to support safe treatment. The Summary Care Record includes a defined set of key patient data for every patient in England except those who choose not to have one. The overarching aim is that the Summary Care Record will contain only significant aspects of a person’s care, those deemed to deliver benefit to a patient when receiving urgent and emergency care. When a patient’s Summary Care Record is first created it will contain details of: Medications; Adverse reactions; and, Allergies from the patient's GP record. Patients have a choice to opt out of the Summary Care Record at any time and must give permission for clinicians to view their Summary Care Record. To support this, a Summary Care Record public information programme involves making patients and NHS healthcare staff aware of the Summary Care Record. This includes sending a personalised information pack to all GP registered patients, over the age of 16. | This Project comprises the Information and Communication Technology systems, services and staffing required to complete the ‘replatforming’ of Secondary Uses Systems (i.e. transfer the application software and data from the existing BT service into new service arrangements) and thereafter provide a live operational service until June 2016, when the payment of hospital activity (along with other healthcare activity within the scope of national NHS tariff policies) will be taken over by a new strategic National Tariff System. It also includes the development and delivery of an annual software release (Release 15) to update Secondary Uses Systems for the 2015/16 financial year tariffs and rules. |
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| Departmental commentary on actions planned or taken on the MPA RAG rating. | The MPA RAG rating was Amber/Red at Q2 2014. There were major risks and issues that are apparent in a number of areas around plan submittal and quality and aspirations around plans: 1) The timescales set for local areas to submit plans which are of the required quality and aspiration are challenging which may lead to the number of plans that are 'not approved' being larger than what was hoped for by many stakeholders 2) The timescales during which the Task Force could provide support to areas was short therefore there was a risk that plans may not substantially change in quality from the previous submission 3) The local settings in which plans were being developed were complex with many and varied stakeholders (social care, local Government, NHS, HWBs, CCGs) and development of a robust and quality plan requires agreement across sectors All of these issues and risks were actively managed and actions included: • Plan improvement support over the summer for local areas included webinars, regional clinics, practical guides and intensive hands on support. • A Governance Structure to feed key decisions was set up and included regular meetings with the SoS Health, a X Ministerial Board and BCF Programme Board. • Three Checkpoints gave some visibility of area readiness to submit plans and the results were fed into support arrangements, with any changes being made that were appropriate • Five Fast Track areas submitted plans at the end of August and were ‘approved with support’ via the National Consistent Assurance Review process (NCAR). • All remaining BCF plans were submitted and went through the NCAR process, receiving approval statuses. • The Taskforce was extended to continue into Phase 2, running from the end of October to the end of March. The objectives for this phase were to plan and develop the detail for support offerings and assurance for local areas post NCAR results. Progress to date: Since Q2, all plans not fully approved in October have been resubmitted following the delivery of support to areas not fully approved: areas in the 'approved' and 'approved with support' categories were mainstreamed into NHS England and LG mechanisms to enable them to progress with implementation. Those areas in the 'approved with conditions’ and ‘not approved’ categories worked with a team of Better Care Advisors and experts from a PA-led consortium to support them to strengthen their plans, break through issues and resubmit plans. As of 26th January 2015, of 150 plans: 120 have been fully ‘Approved’; 4 are categorised as ‘Approved with Support’; the remaining 26 plans have been resubmitted and are currently undergoing the Nationally Consistent Assurance Process with a formal outcome on the 6th February. An escalation process is in place for areas who fail to reach either ‘Approved’ or ‘Approved with Support’ categories in this final wave of resubmissions. A KMPG-led consortia of experts has been engaged to lead implementation support nationally, with support being led regionally by NHS England regional leads with local government colleagues. The current Taskforce currently has no scope or remit post March 2015 but work is underway to develop plans for a core team, resourced jointly by NHS England, DCLG, DH and LGA, to continue supporting the success of the Better Care Fund centrally. | The MPA RAG rating was Amber/Green at Q2 2014. The Trust has undertaken, with its Programme Board, a RAG assessment of the "Common Causes of Project Failure" in relation to the progress of the project at Q2. The Programme Board discussed this in detail and were clear about the RAG ratings which were provided for each category. Once all the ratings were taken together, the overall assessment was Amber/Green: many of the key points had been addressed in the preparation for FBC approval, based on the OBC approval which was granted in May 2014. The key areas of higher risk/lower confidence rating related mainly to stakeholder engagement and support (given that the commissioner landscape has changed significantly since commissioners provided the original OBC support letters). There has been extensive engagement with commissioners through a NHS England Area Team-led Commissioner Oversight Forum to ensure that commissioners are sufficiently engaged with, and involved in, the assumptions relating to activity and income which underpin the Business Case. Since May 2014, the NHS Trust Development Authority has convened a National Programme Board and National Working Group which includes commissioners and approving bodies to ensure that all key stakeholders in the process are working together. | The MPA RAG rating was Green at Q2 2014. The Delivery Confidence assessment was Green on the basis that this was an extremely well run project and successful delivery appeared highly likely. There were three recommendations relating to: confirmation that conditions attached to the FBC had been satisfied; ensuring the planned additional resources were in place as quickly as possible; and, conducting a detailed review of service and technical commissioning plans following appointment of the contractor. The next Gateway review is Gate 4 (Readiness for Service) scheduled for November 2016, approximately six months before the patient moves in May/June 2017. | The MPA RAG rating was Amber/Red at Q2 2014. While the programme has a strong record in deploying/upgrading IT systems, there was concern about the early stage of planning for the migration of NHS Trusts to new locally sourced and managed services before the end of the BT Local Service Provider contract. Significant progress towards improved delivery confidence has been made in completing the remaining deploying activity and planning for contract exit: • The programme team has refocused on Exit and is working closely with all NHS Trusts and Suppliers to support transition plans for migrating away from BT Local Service Provider services and to identify and manage associated risks; • There is a better understanding of the requirements for contract exit with one NHS Acute Trust and three NHS Community and Mental Health Trusts having successfully exited the BT Local Service Provider service; • All NHS Community and Mental Health IT deployments and upgrades have been delivered; and • All NHS Acute Trust IT deployments have been delivered with the remaining handful of upgrades forecast to be delivered on time. Note: The BT Local Service Provider (London) Programme and the BT Local Service Provider (South) Programme operate through a single Programme Board have been assessed by the Cabinet Office's Major Projects Authority as a joint assessment. | The MPA RAG rating was Amber/Red at Q2 2014. While the programme has a strong record in deploying/upgrading IT systems, there was concern about the early stage of planning for the migration of NHS Trusts to new locally sourced and managed services before the end of the BT Local Service Provider contract. Significant progress towards improved delivery confidence has been made in completing the remaining deploying activity and planning for contract exit: • The programme team has refocused on Exit and is working closely with all NHS Trusts and Suppliers to support transition plans for migrating away from BT Local Service Provider services and to identify and manage associated risks; • There is a better understanding of the requirements for contract exit with one NHS Acute Trust and three NHS Community and Mental Health Trusts having successfully exited the BT Local Service Provider service; • All NHS Community and Mental Health IT deployments and upgrades have been delivered; and • All NHS Acute Trust IT deployments have been delivered with the remaining handful of upgrades forecast to be delivered on time. Note: The BT Local Service Provider (London) Programme and the BT Local Service Provider (South) Programme operate through a single Programme Board have been assessed by the Cabinet Office's Major Projects Authority as a joint assessment. | The MPA RAG rating was Red at Q2 2014. In February 2014, NHS England announced a six month extension to the proposed roll out of the care.data programme in order to raise awareness, listen and act on the views of patients, health professionals and key stakeholders, and to discuss both the benefits and risks involved. This enabled time to be taken to raise awareness of the benefits of data sharing for purposes beyond direct care and the safeguards in place to secure patient data and to ensure the public are aware of their choices and are informed on how they can ‘opt out’ of care.data should they wish to do so. The outcome of the engagement was the message that clarity was required about how personal information would be used, what information would be collected and how patients would be communicated to on their right to ‘opt out’. Additionally, it was clear that consideration should be given to the support required by GP practices to meet the fair processing requirements and successfully communicate these messages to support the introduction of care.data, and to implement care.data through a phased roll-out. The first stage of this phased roll out will take the form of a discovery stage working with up to 250 pathfinder GP practices. This approach will allow NHS England and the Health and Social Care Information Centre to work with a smaller number of GP practices to ensure that the programme understands what is required to support GP practices in meeting fair processing responsibilities and ensure patients are aware of how their data will be used and the choices available to them - this is referred to as the pathfinder stage. The ‘pathfinder stage’ has been established as a project within the care.data programme, it will provide key information from which the programme team can learn and assess the impact before progression into a wider roll-out. No data will be extracted from GP practice systems – including during the ‘pathfinder’ until such time that the national data guardian is satisfied. The Cabinet Office's Major Projects Authority rated delivery confidence as Red in view of the Programme needing to clarify, agree and communicate the programme scope; appoint a full-time Senior Responsible Owner; reconstitute the Programme Board with a clear role and responsibilities; approve explicit go/no go criteria; agree and clarify finances; assign owners to key risks; and recruit key personnel. Action taken by the Programme includes changing the Programme Board membership with a clear role, responsibilities and Terms of Reference; scheduled meetings at clear decision points in the programme; Programme Board approved explicit go/no go criteria to ensure that delivery plans are viable before the pilot rollout commences; and priority given to the recruitment of key personnel in order to move forward to a more controlled and stable phase of delivery. Care.data plan to achieve the following in order to move towards an improved rating for the programme: • Complete the Programme Business Case assurance and approval process; • Complete the pathfinder stage of the first phase of the programme and secure approval to proceed to further roll-out; • Plan national roll out of the primary care extract to deliver primary-secondary care linked dataset, including development of an outline business case; • Determine priority datasets for inclusion in the programme and initiate appropriate workstreams; and • Further enhance programme planning and risk management to ensure dependencies on other national programmes are well understood and managed. | The MPA RAG rating was Amber/Red at Q2 2014. Because of the complexity of the Programme and the indirect nature of the delivery mechanisms, as well as the separate and inherent risks to local government arising from fiscal constraint, the Delivery Confidence at this point remains as: Amber/Red. The recent rating reflects strong support and commitment across the system, but also the residual challenges to local authorities and risk profile. The Amber/Red rating reflects greater complexity, uncertainty and the risk of diversion during 2015. The Programme has made good progress and 2015/16 delivery is now more secure. The Care Bill achieved Royal Ascent in May 2014 becoming the Care Act 2014, regulations and guidance underpinning the reforms that come into effect in April 2015 were published in October 2014, including agreement of the funding for local government of the new burdens from the changes. The tripartite partnership between DH, LGA and ADASS at the heart of the programme continues to be a strong one and a major asset to the Programme. The partnership with the LGA and ADASS ensures shared ownership and implementation of a programme management approach to assure delivery. An assurance and implementation support strategy has been agreed that combines oversight, monitoring and assessment at all levels with a commitment to target resources appropriately to tackle risk. Steps we have taken to address the risk to date risk include the provision of £19m direct to local authorities to build programme management capacity and support engagement in assurance, with £4m of funding for local authorities in addition to £2.7m provided to establish nine regional delivery partnerships to support local implementation. We have also made a significant investment in a range of implementation support products that support local authorities and providers to prepare their workforce for the changes and assist communication. Good progress has been made with implementation of an action plan to address MPA recommendations, as well as in delivering the Programme Plan. Programme Management has been strengthened and lessons from Phase 1 are being applied to reduce risk to delivery for Phase 2. Improvements in the transition from policy development to implementation have been identified and are being applied to Phase 2. We recognise the risk that the uncertainty caused by the election and Spending Review may undermine efforts to deliver Phase 2, however we are confident that we are developing plans and contingency options to do everything within our control to manage this uncertainty and encourage preparations to allow implementation Phase 2. | The MPA RAG rating was Amber at Q2 2014. The review resulted in an Amber rating and a set of recommendations relating to readiness for the 2014/15 flu season. The recommendations highlighted that planning, structures and communications needed to be strengthened. An action plan has been produced which details the progress that has been made against the recommendations. Apart from one recommendation they have all been completed. The outstanding recommendation will be completed before the May 2015 deadline set by the MPA. Planning for the 2015/16 flu season started in October 2014 and communications will be available far earlier than in previous years. | The MPA RAG rating was Amber/Red at Q2 2014. The project is assessed Amber / Red due to the challenge and complexity involved in exiting the CSC Local Service Provider contract by July 2016 . The key actions being taken to reduce the risk to contract exit and drive up delivery confidence include development of a clear “paths to exit” for each organisation and deployed system including engagement between suppliers and organisations; support to put in place procurement frameworks for replacement systems; facilitating the early exit from contract; early transition of the Local Service Provider GP estate to the GP Systems of Choice Framework; and agreeing exist support arrangements with the supplier. Risk remains in enacting the activities involved as it requires the support and active involvement from all NHS organisations and future suppliers. | The MPA RAG rating was Red at Q2 2014. Recent positive developments on patient safety, involving key national bodies and local providers, make timely a review of proposals to introduce medical examiners. For example, NHS England, the Care Quality Commission, the NHS Litigation Authority, Monitor, and the NHS Trust Development Authority are providing a system wide support to local providers who have signed up to the campaign Sign up to Safety, with the ambition of halving avoidable harm in the NHS over the next three years and saving 6,000 lives as a result. | The MPA RAG rating was Amber/Green at Q2 2014. The scheme completed on timetable on 1st October 2014, within budget and with all planned workforce changes occurring per timetable | The MPA RAG rating was Amber at Q2 2014. The rated delivery confidence is Amber in view of the Programme needing to: • Focus on strategic risks and issues; • Restrict its Board membership; • Establish a Service Manager for the end to end patient experience; • Undertake a risk assessment; • Delineates deployment from business as usual; • Ensure an effective contract management process; • Resolve the controlled drugs and nomination issue; and • Appoint a Business Change manager. The move to Phase 4 has been delayed from April 2015 to allow time to undertake a number of key activities to improve delivery confidence. These are to ensure robust business continuity arrangements are in place, implement a more formal arrangement with dispensing system suppliers, a full review of the service model, more robust patient communications, implementation of schedule 2 & 3 controlled drugs, and consideration of providing refresher training to dispensers. A review of the Programme Board structure and other governance arrangements will also be completed. The most significant risk remains the outcome of the Home Office / Department of Health's three month public consultation to determine whether Schedule 2 & 3 Controlled Drugs should be brought into scope. The outcome could lead to a requirement for further technical changes. The programme will exceed 2014/15 business case target for GP roll out with a forecasted 51% of GP sites live by the end of the year (the Business Case target was 43%). Utilisation, based on total sites deployed, is forecasted to end the year at 40% (the Business Case target was 42%). Almost 97% of pharmacies have been deployed (the Business Case target was 96%) and the team continue to work with all eligible pharmacies to increase take up. 66% of Dispensing Appliance Contractors have been deployed (the Business Case target was 99%) with 88% expected to go live by the end of 2014/15. Further progress has been made in a number of important areas including dispensing system supplier contracts, filling vacancies in the Programme team and refresher training for pharmacy staff. | The MPA RAG rating was Amber/Red at Q2 2014. A system of assurance is in place with wider scrutiny of RAG ratings and milestones. This includes a regular agenda item on both the monthly Francis Assurance Board (FAB) and weekly Secretary of State Care Meeting with ALBs. Health Check review: Independent assurance to provide an assessment of the impact of the Francis Initiative to date and recommendations for improvement going forward. This is scheduled for the last week of January 2015. Work is now focusing on the three separate workstreams led by the Quality Improvement Team. These are: • Safety – delivery of the SofS's March announcements for patient safety and Hard Truths commitments such as the Sign up to Safety Campaign, Patient Safety Collaborative programme, as well as supporting a longer-term policy framework ensuring alignment of safety policy and initiatives. • Quality – developing a longer-term policy framework for quality improvement as part of the Strategic Work Plan. • Francis Assurance – assuring progress against Hard Truths commitments, particularly focused on delivering a One Year On report on 12th February 2015. | The MPA RAG rating was Amber at Q2 2014. Specific points contributing to the Amber Delivery Confidence assessment will need to be addressed to achieve a green delivery confidence. These are: Late delivery of Patient Facing Services and other new subsidiary modules under General Practice System of Choice which is likely to reduce the benefit delivered under the framework in 2014/15; A key objective of the new framework was to open up the market to smaller, subsidiary suppliers but the introduction of new services was delayed due to deficiencies in suppliers' offerings and a lack of HSCIC capacity to perform assurance activity and requirements definition; and Authority assurance activity for supplier services is being streamlined and requirements are being re-prioritised as mitigation against further delay. The Authority will shortly be revising the contract to reflect the new priorities and target dates for delivery. Suppliers are in the process of responding to ascertain what Principal and Subsidiary offerings (including global switch on) can be achieved by March 2015. All critical actions were completed after the Gate 4 review in September 2014. 3 essential actions are in progress, 2 of which require Programme Board sign off before they can be closed, which related to the refreshed vision for the service and levers to achieve it. The final action will be closed in March-15, which relates to capacity and capability of the team, with recruitment and other activities underway to close the previously identified gaps. The Lot 1 Interface Mechanism Operational Readiness was delivered 29 Oct 14 and Lot 2 Contracts were signed 5 Nov 14. . | The MPA RAG rating was Amber at Q2 2014. The MPA rating reflects the inherent risk in a project such as this but recommendations have been made to further assure the successful delivery of the ‘main phase’ of the programme which begins in 2015. Delivery partners are working together to refine the models that will be used for collecting data from the NHS Genomic Medicine Centres across the country. A cross-partner advisory group for communications has been established to ensure consistent messaging across the programme. A systematic method for learning and development is being devised and an event to explore the future benefits of genomics is planned for Q1 of 2015. | The MPA RAG rating was Amber at Q2 2014. The following actions are in place to ensure all is being done to deliver on the programme’s service transformation and workforce expansion aims, and to safely deliver the transfer of commissioning responsibilities for 0-5s public health services to Local Authorities on 1 October 2015: • Ensuring that those who start their health visitor training go on to become health visitors. • Reducing the number of health visitors leaving the workforce. • Maximising the FTE contribution to the workforce of newly trained health visitors. • Ensuring all relevant health visitors are counted properly towards the 4,200 FTE objective. • Putting a full programme board in place consisting of members from all key stakeholder groups to oversee delivery of, and manage risks to, the safe transfer of commissioning responsibilities for 0-5s public health services to Local Authorities on 1 October 2015. • Publishing Local Authority financial allocations through the Baseline Agreement Exercise. • Publishing draft regulations on mandated universal health visitor reviews. | The MPA RAG rating was Amber at Q2 2014. At the last review MPA found that considerable progress had been made and noted a number of key developments. These included approval by HMT of the OBC and subsequent ministerial announcement about the programme in January 2014, successful achievement of the key milestones to establish the pilots, developing the data strategy and smooth transition of the programme team from DH to NHS England. There was noted to be visibly stronger commitment at all levels to the programme which was assessed to be in good shape, and the review team sensed that the team was much better placed to successfully deliver the policy goals. Despite the significant degree of challenge and complexity associated with this programme, the review team found that all recommendations from the previous review had been addressed. It was recognised that more work is still required, particularly regarding ICT, workforce planning, communications and stakeholder engagement to ensure that these areas do not negatively impact the chances for successful delivery. The AAP Review Team noted that if active management attention was paid to them, there was no reason why the delivery confidence rating should not continue to improve further. In response to recommendations an ICT and data strategy has been produced, and detailed ICT and data requirements are in the process of being developed with the Health and Social Care Information Centre; a workforce planning project has been initiated with Health Education England to validate workforce assumptions, and to address skills and workforce supply issues; communications and stakeholder engagement have been strengthened with the production of a series of films focusing on service user experiences, which is published on the NHS England website; service user focus groups and a service user committee have also been put in place. A further review is planned, to assess the team's readiness to develop and present a Full Business Case (FBC) to HM Treasury later in the year. A Gateway 3 review is planned for August 2015 to assess the FBC immediately prior to its submission to HM Treasury. | The MPA RAG rating was Amber/Green at Q2 2014. Walton has now been renamed "Clock View". It is now complete and currently being commissioned, with the first patients moving in in February 2015. Gateway Review recommendations have been implemented, allowing the Trust to maintain its Amber-Green assessment. A further Gateway is being planned for Autumn 2015. | The MPA RAG rating was Red at Q2 2014. The main reason for the current MPA RAG rating relates to the need to agree a commercial strategy for the National Pandemic Flu Service that delivers in time to ensure service continuity. We are working with the Government Digital Service to agree this approach and to extend the contract to allow for the agreed procurement process to complete. | The MPA RAG rating was Amber at Q2 2014. A detailed Management Action Plan was developed in consultation with the key Programme stakeholders which identified specific actions to be taken to address the findings from the MPA. Due to the complexity and unique nature of the Programme, targeted actions were implemented leading to: 1. Changes in the leadership and governance arrangements for the Programme to enhance the overall robustness by supporting the delivery and effective management of the current phase which largely involves procurement of the equipment, assurance and securing the necessary Government approvals. 2. A revamp of the Programme environment providing clarity to where accountability and responsibilities lies at the various tiers of the National Programme, for example: A. DH is providing leadership and responsible for: i. Capital Funding ii. Programme management and delivery iii. Approvals and assurance using mandatory Cabinet Office and HM Treasury processes. B. NHS England is providing leadership and responsible for: i. Commissioning ii. Clinical Services and Referrals iii. Mobilisation of PBT Services iv. Clinical Policy development v. Benefits Management and Realisation vi. Engagement with key stakeholders including the Devolved Nations and professional organisations vii. Research and Development. 3. Improvements in the resource levels including confirmation of the core Programme team and use of subject matter experts in specific areas such as the role of a National Clinical Lead for PBT, Workforce Strategy and Development, and Communications. 4. Structured and coordinated stakeholder engagement – in particular, the establishment of a National PBT Special Interest Group (SIG) with the active participation of the relevant Clinical Reference Groups (CRGs); Health Education England (HEE); professional organisations such as The Royal College of Radiologists (RCR), The Society and College of Radiographers (SCoR), Institute for Physics and Engineering in Medicine (IPEM). In addition, the Programme also has access to the expertise of specialists in the related fields relevant to developing a national PBT service in England. Work has been done to develop a national plan for the clinical management of patients who have been clinically assessed to benefit from PBT treatment. Part of this work involves the review and expansion of the clinical indications list via NHS England processes through the development of clinical policies by engaging with the relevant CRGs as a longer term strategy for the viability of a National PBT service. The culmination of these actions has put the Programme on a much improved pedestal in terms of governance, resources, communications, stakeholder engagement and the plans towards the delivery of sustainable benefits. | The MPA RAG rating was Red at Q2 2014. The key issues for the NHS Choices programme are: - splitting the transformation programme from the running of the live service (the minimum viable service); - leadership of the programme and establishing a permanent Senior Responsible Owner; and - future direction and funding for the service. Therefore the NHS Choices programme pathway to a green delivery confidence includes: - review of the current programme management and governance arrangements; - appointment of a permanent Senior Responsible Owner for the programme; - the business justification for funding of the live service for 2015/16 and initial funding of the transformation programme to be approved; and - a programme business case for 3 years (with option to extend by 2 further years) to be submitted for approval. | The MPA RAG rating was Amber at Q2 2014. The rating reflects the high risk and complex nature of the programme, as well as the high level of issues related to the NHS e-Referral Service software that still required resolution prior to implementation. The NHS e-Referral Service was not ready for go live at the time of the review; and there was an Amber status regarding achieving the previously announced target go live date of November 2014. A number of actions were underway at the time of the review, which included: • Updating the project plan to deliver NHS e-Referral Service, including ensuring a consolidated critical path (the minimum set of activities and associated durations to complete) was in place to support key decision points; • A revised test plan, to ensure all necessary testing (such as testing the service works, quickly, is secure, etc.) of the service is completed in advance of go live; and • Working with senior users, the Senior Responsible Owner and the Programme Board for the service to agree the quality criteria for acceptance of the new system, and agreement reached to de-prioritise any non essential items for go live. All MPA critical actions were completed, 3 essential actions are in progress, 2 of which require Programme Board sign off before they can be closed, which related to the refreshed vision for the service and levers to achieve it. The final action will be closed in March-15, which relates to capacity and capability of the team, with recruitment and other activities underway to close the previously identified gaps. The path to green for NHS e-Referral Service is focussed on completing go live expediently and safely. This involves reducing issues with the software, completing test, data migration and service readiness (so the service is supported after go live) activity. | The MPA RAG rating was Amber/Green at Q2 2014. Overall risk is now materially reduced as the reprocurement process has completed and the Department has appointed and entered into a contract with IBM for the delivery on ongoing services. Transition risks remain and extensive planning work is continuing to minimise these risks. | The MPA RAG rating was Amber/Red at Q2 2014. Although the project was progressing as fast as possible, it was unlikely to be completed within the scheduled timescale (July 2016) primarily due to business case approvals timescales required and the need to undertake a GDS recommended discovery phase activity ahead of the production of the SOC. In addition an MPA recommended independent risk review by Mazars LLP concluded that the proposed project schedule of July 2016 posed a significant risk of distraction to the 2015 Scheme Implementation project, a view endorsed by key stakeholders within the NHSBSA, Cabinet Office and Department of Health and direction was given to: • Extend the project schedule to July 2017, to mitigate any risk to the 2015 Scheme Implementation project. • Change the future procurement approach to a disaggregated model in line with Cabinet Office guidance to: o Undertake further discovery work to identify options for a short term tactical solution to deal with the expiry of current EP Payroll Services in July 2016 (EP Interim Extension), ahead of the production of the Interim Business Case (IBC) o Undertake further discovery work to identify options for a medium term strategic solution for the full pension re-procurement, ahead of the production of the Programme Business Case [PBC]. Even when the above are complete, both streams of procurement are likely to evolve as the final level of procurement options (disaggregation) become known. As a result the project will continue to carry a high degree of risk, reflected in the RAG status. The actions required to bring the RAG status back to green are: • IBC approval (December 2014) and completion of commercial negotiations with EP to determine the level of disaggregation for the short term solution (March 2015). • PBC approval (April 2015). • Project re-Planning and re-base lining of Project Initiation Documentation (December 2014). | The MPA RAG rating was Amber/Red at Q2 2014. The RAG status of Amber-Red reasonably reflects the Programme’s steady progress over the period since the publication of the “Better Procurement, Better Value, Better Care” report and the first year of the Programme's operation. | The MPA RAG rating was Amber at Q2 2014. Action taken by the Programme to improve delivery confidence include development of a fall-back plan in case contract refresh delayed; risk ownership assigned to project board team members; clear plan showing dependencies and critical path produced; resource plan developed and vacancies recruited; security requirements baselined; Access Policy update; and Procurement Strategy approved by the board. The path to green is through successful approval and award of contract. | The MPA RAG rating was Green at Q2 2014. Since this return, the Trust has decided to pause the development work on the new hospital for the time being. The Trust remains totally committed to developing a new hospital to meet the future needs of the people of Hartlepool, Stockton, Easington and Sedgefield. However, the Trust feels that the complexities of the approval process are such that the Trust will be unable to get a decision before the end of the current Parliament. It is anticipated that with a general election approaching in May 2015 the Trust believe it likely that all new developments will be reviewed in light of its own priorities. As a result, there inevitably will be further delay in the completion of the new hospital. The Trust has therefore decided to pause the development work on the new hospital. The project remains only affordable subject to a capital contribution from the Department of Health. The Trust would be ready to launch the procurement process subject to confirmation of funding and approval. | The MPA RAG rating was Amber at Q2 2014. The delivery confidence was Amber as approval to launch the second round had, at that stage still not been obtained. The nursing sector and supplier community were beginning to raise concerns around the delay. Since then, negotiations with Her Majesty's Treasury resulted in endorsement of the launch with a £35M funding envelope, and the Programme remains on track to distribute the 2014/15 awards by the end of March 2015, and thus an improved delivery confidence. | The Amber/Green RAG status was assigned after a Departmental review in July 2012. Amber/Green given is based upon the point the project is in its lifecycle i.e. all key approval stages passed; preferred bidder appointed and is reflective of the last Gateway assessment. | The MPA RAG rating was Amber at Q2 2014. A recent review confirmed that all the actions to address recommendations had been completed. An Amber status was given for the Delivery Confidence Assessment. Many elements of the programme were found as exemplary or of a high standard. A total of 6 recommendations (5 critical, 1 essential) were made around the presentation of the Outline Business Case (OBC) submitted at the end of July. These were made to provide greater clarity and increased robustness. An action plan was formulated and all the critical recommendations, were completed in the following 2-3 weeks. The 6th essential recommendation concerned streamlining some elements of the business case and will be completed once a decision is made on the OBC. | The MPA RAG rating was Amber/Red at Q2 2014. This project is on hold following the Chief Medical Officer's request review the feasibility and appropriateness of maintaining such a stockpile in the light of the emergence of new viruses with pandemic potential. This includes reviewing new and emerging technologies for flu vaccine and taking scientific advice from scientific and subject matter experts, including the New and Emerging Respiratory Virus Threats Advisory Group (NERVTAG). The current vaccine stockpile will undergo regular potency testing from this summer. | The MPA RAG rating was Red at Q2 2014. The Cabinet Office's MPA rated the delivery confidence as Red. Agreeing the Programme Business Case is the key to improved delivery confidence and the Programme will continue to report a Red delivery confidence whilst the Programme Business Case is progressing through the approvals process and the discovery phase has still to complete. Action taken by the Programme includes a new Senior Responsible Owner and Programme Director joining the team changing the focus of delivery; Health and Social Care Network has been confirmed as a Programme, and is to be a pathfinder for the new Agile Business Case Approach; a Business Case team has been recruited including a financial modeller; there has been an emphasis on joining the current N3 service team with the Health and Social Care Network Teams to ensure continuity of service for customers; Terms of Reference have been approved and the Programme Board commenced; procurement of managed services and specialist resource to ensure that the resource is suitable; risk and issue log created and a process to update and review developed fortnightly. Furthermore, communications to users of the current network solution have been made and stakeholder engagement has accelerated. | The MPA RAG rating was Green at Q2 2014. The delivery confidence assessment has been set at Green as rotavirus immunisation was successfully introduced on schedule on 1 July 2013. Vaccine uptake is in line with expectations at about 93% for one dose, and about 88% for the full course of two doses. The burden of rotavirus disease has reduced significantly following the introduction of the immunisation programme. Laboratory reports of confirmed instances of rotavirus for the period July 2013 to June 2014 were about 70% lower than the ten-season average for the same period in the seasons 2003/2004 to 2012/2013. This is an early indication, which needs to be confirmed by further investigation, that rotavirus immunisation is having an effect on the level of disease. A GMPP Exit Review was carried out in November 2014 and the Major Projects Authority has decided that this programme should be removed from the GMPP. | The MPA RAG rating was Green at Q2 2014. Following Financial Close in December 2013, construction commenced as planned in early February 2014. The construction programme has been delayed due to the discovery of asbestos on the site. However, the PFI Consortium has developed remedial measures and a revised programme shows a steady recovery of lost time so that the contractual completion date remains unchanged at March 2017. The Trust continues to closely monitor the construction programme. Construction delay and asbestos removal are both Consortium risks - the Trust holds no risk. The project has continued to receive high or significant assurance from the project's external auditors. | The MPA RAG rating was Green at Q2 2014. The Trust confidence assessment was originally well founded as its OBC was agreed by the DH and HMT. It has subsequently had issues to resolve regarding affordability due to externally driven financial pressures e.g. tariff reviews and increasing Quality Innovation Productivity and Prevention (QIPP) demands. This led, in conjunction and agreement with the NHS Trust Development Authority (TDA), to the project being appropriately downsized to help mitigate the affordability position. | The MPA RAG rating was Amber/Green at Q2 2014. The RAG rating reflects the authorisation of the OBC by DH/HMT and a successful commencement of the procurement. Since Q2 2014 one bidder has withdrawn and one failed to submit a bid at interim submission. The Trust has received a compliant interim bid from one bidder. The programme may change as a result . | The MPA RAG rating was Green at Q2 2014. The delivery confidence assessment has been set at Green as shingles immunisation was successfully introduced on schedule on 1 September 2013. Vaccine uptake in the first full year of the programme was 62% for 70 year olds and 60% for 79 year olds. A GMPP Exit Review was carried out in November 2014 and the Major Projects Authority has decided that this programme should be removed from the GMPP. | The MPA RAG rating was Amber/Green at Q2 2014. The programme achieved an Amber/Green rating due primarily to the lack of clear governance arrangements at that time. In response to the recommendations the programme team have established a robust programme governance model and, as such, five of the six recommendations have now been closed. The remaining recommendation, for Trusts to create clear benefits realisation plans, is currently being addressed by Trusts with support from the programme team, as they prepare their Full Business Cases and prepare for deployment. Completion of this would help support a path to a Green delivery confidence. | The MPA RAG rating was Amber at Q2 2014. The Amber assessment reflects a delivery confidence that Care Identity Service delivery in February 2015 appears feasible. As with all major deliveries of this scale there are a number of significant risks that are being managed to mitigate the impact to the programme. Hence, our pathway to a Green assessment is based upon the following actions being underway: • There have been a number of rehearsals, working closely with BT Health, to validate the approach to a complex transition; • There has been considerable stakeholder engagement, the develop of a national e-learning tool and considerable Registration Authority training; • The non-functional assurance (volumes and performance testing) is underway and is a significant element that must pass the technical assurance activities, this remains a significant risk until the assurance activities conclude in mid February; and • A 24/7 end to end service and IT operational management capacity has been established and will adopt the current spine service 1st and 2nd line support mechanism. | The MPA RAG rating was Amber at Q2 2014. There has been significant progress: • As of January 2015 almost 50 million records have been created, over 86% of the population of England. • Use of Summary Care Record has increased with over 30,000 views of records per week (equating to one record viewed every 20 seconds) and rising. • The ministerial commitment to enable a third of all A&Es, Ambulance Trusts and 111 with Summary Care Record has been successfully delivered. • A total of 130 Community Pharmacies are live with Summary Care Record, with positive initial findings from the proof of concept exercise. • First of Type testing for improved delivery of additional information within TPP SystmOne GP system (Summary Care Record v2.1) has commenced. • The programme is current on track to achieve a Value for Money ratio of 3.86 (net present value), with additional benefits to be quantified. • Summary Care Record is referenced in the National Information Board’s framework, recognising that the solution has further potential. Actions taken to improve delivery confidence include: The Programme has undertaken a stocktake to ensure that it structured in the optimal way for the next phase of delivery; the Senior Responsible Owner role has been reviewed and clarity provided to the Programme; a review of the Stakeholder Management process has been completed and improvements implemented; the Programme has developed a more robust process for managing changes supported by an Expert Advisory Committee which has been established to provide lay input, governance and greater patient voice to Programme. Remaining actions underway to progress the Programme towards a Green delivery confidence include: Plans and processes in development to move completed constituents parts of the programme into Business As Usual live service; improvements to communication approach and marketing of Summary Care Record, involving a digital media campaign, targeted messages at specific groups and increased patient engagement, underpinned by a Communications Plan; Programme Board members reviewed and new members co-opted as required to bolster expertise and governance. | The MPA RAG rating was Amber/Red at Q2 2014. The Programme is progressing towards a positon where there will be confidence in going live by completing the required testing of the solution, progressing contracts for the support of the live service with suppliers to conclusion by mid-February and ensuring the required documentation and processes are in place prior to go-live through the use of Service Acceptance Criteria. These are the key areas where progress is required to enable the service to move into a live environment and the Programme Team is prioritising these actions to ensure go-live is achieved. The MPA noted the improvement in the quality and quantity of the resource available to the Programme. Work has also been undertaken over this period to strengthen the governance, planning and commercial aspects of the project. The Amber/Red rating was primarily due to the level of activity still required to enable the February go-live date to be achieved. In particular there was concern around the Service Contracts being completed in time to support the live system. The two HIGH recommendations of the review relate to a critical path and to contingency arrangements. Work has been undertaken to enhance the programme plan following the revised go-live date, highlighting the revised critical path. In terms of contingency planning options have been reviewed to enable SUS to go-live in the absence of Care Identity Service system going live. Proposals on both these issues have been accepted by the Programme Board and will be key to increased delivery confidence. The two MEDIUM recommendations on programme board composition and on benefits planning are to be addressed in coming months, following transition go-live. |
| Project - Start Date (Latest approved start date) | 07/07/2014 | 27/01/2012 | 10/07/2012 | 18/12/2003 | 26/01/2004 | 01/09/2012 | 04/06/2013 | 16/09/2013 | 23/06/2003 | 24/07/2007 | 04/08/2011 | 01/01/2003 | 01/03/2013 | 26/01/2012 | 10/04/2013 | 31/10/2010 | 01/04/2011 | 16/09/2011 | 19/03/2012 | 01/01/2012 | 02/09/2013 | 26/07/2012 | 10/06/2013 | 05/07/2013 | 01/09/2013 | 29/03/2012 | 01/04/2013 | 01/11/2013 | 01/12/2003 | 09/08/2013 | 01/10/2011 | 29/03/2012 | 05/03/2009 | 01/06/2010 | 15/01/2011 | 01/10/2008 | 11/12/2012 | 01/11/2011 | 10/05/2010 | 01/04/2006 | 20/08/2013 |
| Project - End Date (Latest approved end date) | 31/03/2015 | 24/12/2021 | 11/02/2020 | 30/10/2015 | 31/10/2015 | No end date | 01/12/2016 | 01/09/2018 | 31/07/2016 | No end date | 17/03/2014 | 31/12/2016 | 01/03/2018 | 31/03/2015 | 31/12/2017 | 31/12/2015 | 01/04/2014 | 20/01/2015 | 01/12/2015 | 31/12/2018 | No end date | 31/03/2018 | 30/11/2015 | 31/07/2017 | 31/03/2016 | 30/06/2016 | 30/06/2017 | No end date | 01/11/2017 | 30/03/2021 | 01/07/2014 | 10/10/2014 | 01/04/2014 | 01/11/2016 | 28/11/2016 | 15/10/2018 | 01/11/2013 | 27/06/2017 | 30/03/2018 | 31/03/2016 | 05/12/2014 |
| Departmental narrative on schedule, including any deviation from planned schedule (if necessary) | The planned schedule from Q2 has been kept, with additional milestones added as Phase 2 has progressed. Key milestones achieved have been putting in place remedial arrangements and support for areas unable to sign off a plan of sufficient quality/ambition, reviews undertaken for area plans in October and the majority of plans reaching approved status by January 2015. Phase 2 of the Taskforce was an extension not initially planned for when the TaskForce was first set up. The extension developed in order to allow the TaskForce to fulfil its objectives and coordinate continuing support required by a number of areas facing challenges in submitting plans of the required detail and quality, as well as to ensure that the appropriate implementation support and planning was in place in the run up to April 2015. | The Trust had an approved OBC from HMT in May 2014. This was two years later than originally planned. This delay was due to several factors, the main one being the requirement to secure planning permission prior to submission. Planning consent was achieved in January 2012. The OBC was subsequently re-approved by NHS SEC after which the DH/MT approval process was set in motion. Following the OBC approval the Trust completed the FBC which was approved by the Trust Board in September 2014 and then submitted to the TDA in October. Market testing continued throughout this period in order for the GMP to be ready as stated in the summer of 2015. The decant programme also continued and is due to be completed at the end of 2015. FBC approval by the TDA is pending following the recent Board meeting . | As at 30th September 2014 all activities were on programme - the site generator had been relocated; the old PMVA building and the boiler house chimneys had been demolished; the top soil had been stripped; the foundations had been removed. During the period 1st October 2014 - 31st March 2015 the following (will) have taken place - water main for new Hospital; cut and fill continues; foundation piling (1 x ward block, central building and new entrance building); pre-cast concrete frame installation; off-site construction (concrete and windows); delivery of off site manufactured service riser modules to serve the bedrooms; further development of operational commissioning and transition planning programme (separate from construction programme) has been ramped up and is progressing well. All activities are on or slightly ahead of programme. | The remaining NHS Acute Trust IT upgrade activity is progressing to plan. The locally managed NHS Trust activities to exit the BT Local Service Provider contract and transition to new locally sourced arrangements are on track. The Health and Social Care Information Centre programme team are working closely with all impacted NHS Trusts to de-risk their plans and to ensure that they are adequately supported to exit the BT Local Service Provider contract. | The remaining NHS Acute Trust IT upgrade activity is progressing to plan. The locally managed NHS Trust activities to exit the BT Local Service Provider contract and transition to new locally sourced arrangements are on track. The Health and Social Care Information Centre programme team are working closely with all impacted NHS Trusts to de-risk their plans and to ensure that they are adequately supported to exit the BT Local Service Provider contract. | The ‘pathfinder stage’ has been established as a discovery stage within the care.data programme, it will provide key information from which the programme team can learn from and assess the impact before approval and progression onto a “wider roll-out”. | Phase 1 delivery is on track for 1 April 2015. A LGA / ADASS stocktake survey completed in September 2014 (prior to delivery of key support products and funding) identified that 97% of councils are very or fairly confident that they will be able to deliver the Care Act reforms from April 2015 and confidence increasing on most measures of progress. Delivery of Phase 2 remains on time for introduction of reforms from 1 April 2016. Whilst the consultation on the 16/17 reforms has been put back from December 2014, a focused and effective consultation early in 2015 will allow the timetable for Phase 2 to stay on track. | The cohorts of children to be immunised in each year of the roll out of this programme are not yet finalised as planning is based on the previous years and dependant on confidence around workforce capacity and vaccine supply. | There are no significant deviations from the plan, however exit from contract remains a challenge. | We will publish shortly a report from the interim National Medical Examiner setting out the lessons learned from the pilot sites. The MPA have advised that Death Certification Reforms Programme should cease GMPP reporting and that reporting can be reinstated at a future point when there is a steer on the reforms from the new government. | Acute services consolidation occurred on 1 October 2014 and the emergency department scheme operational on 15 October 2014 as planned there was no deviation from timetable | Planning is underway to determine whether Phase 4 can be implemented by April 2016. | N/A | Programme on track. | On schedule. Over 2000 pilot samples sequenced by December 2014 | The programme is on-track with no significant changes to dates of deliverables and key milestones. Workforce expansion: at the time of preparing this report, the most recent management information (November 2014) published by NHS England estimates an indicative count of 11,290 FTE health visitors; 3,198 more than the May 2010 baseline, representing an increase of 40%. At the time of preparing this report, the latest official figures (September 2014) show there were 10,800 full time equivalent health visitors; 2,708 more than in May 2010. Since 2010 around 7,500 health visitor training places have been commissioned, with the annual total growing from around 550 to around 2,700 in 2013, representing a five-fold increase in the number of health visitor trainees starting their training. This investment in training has delivered most of the expansion in health visitor workforce we are now seeing. In addition, there are a further 1,200 training places being commissioned in 2014/15 - this will ensure that the workforce growth is sustained beyond the end of the programme. Service transformation: at the time of preparing this report, the new service model has been tested in early implementer sites and case study material published. These sites saw increases in the numbers of children receiving the 2-2½ year review almost double. We have six published priorities for demonstrating success and building sustainable services. Data collection and reporting is in place so that delivery of service transformation can be demonstrated. Transfer of health visitor commissioning to Local Authorities: at the time of preparing this report, the Baseline Agreement Exercise has been issued to support the issuing of allocations to Local Authorities in February 2015 and the draft regulations to mandate key checks have been published. | Since the programme was re-configured in July 2013, the schedule has remained stable. At that time, a plan was agreed that Liaison and Diversion services would be rolled-out in increments each year until full coverage in England could be achieved, by April 2017. This remains the plan, and to this end, the first wave of services went live in April 2014, with a further wave of services due to go live in April 2015. Together, these first two waves will provide population coverage of Liaison and Diversion services to over 50% of the population of England. All of these services will conform to the national commissioning specification for Liaison and Diversion services that was first agreed in September 2013. Planning commenced in January 2015 for the commissioning of the final waves of Liaison and Diversion service rollout, at the same time that drafting of the Full Business Case commenced. | The Clock View element of the Project is now complete. The Edge Lane/Old Swan scheme is currently being re-scheduled. | Approval for an extension for the current contract up to 30th November 2015 is being sought. | The National PBT Programme remains on schedule to treat first patients in the Spring of 2018. The PBT equipment procurement is at an advanced stage as it is on the critical path of the Programme. In addition, the mandatory assurance and approvals processes have been accelerated by about 6 months - this also provides added assurance to the service commencement date in 2018. | On-going discussions between the Department of Health, Cabinet Office, NHS England and the Health and Social Care Information Centre seek to secure agreement on the production of a revised funding model & business case approach, taking account of the latest Cabinet Office and Department of Health spend control guidance. NHS England is responsible for the production of the full 5 year business case, and this will be created alongside the business justification to ensure funding for the current live service (including transformation activities) is secured for the next financial year. | Testing across all required test streams is progressing, however NHS e-Referral Service software defect levels remain higher than expected at this stage of project. Defect fix and release remains on track for e-Referral Service go live by Spring 2015. Future development activity is ongoing but being impacted by focus on go live. | None | Following stakeholder direction, the project schedule was extended to July 2017 and project progress is on track | Savings of £307.8 million have been achieved by the Programme at September 2014. It is worth noting that the Programme is currently scheduled to complete its work by the end of March 2016. However, if the innovative work on metrics identifies further potential efficiencies, then an implementation phase with Trusts beyond the current life of the Programme may be required. | The NHSmail 2 Outline Business Case outlined that the service would be procured from the Crown Commercial Service Managed Email framework that was under procurement. The award of the framework was delayed, resulting in a critical path delay to the NHSmail 2 project. As of January 2015, the Managed Email framework has been awarded and contains 5 suppliers. The NHSmail 2 project is in its final stages of procurement. The impact of the delay has been to delay the contract award and subsequent delivery of NHSmail 2. During the delay period the NHSmail 1 service has continued and has provided benefits, meaning that whilst this is a time delay benefits have not been lost. | The Trust has decided to pause the development work on the new hospital for the time being. Due to the complexities of the approval process, it is expected that the Trust will be unable to get a decision to proceed before the end of the current Parliament. It is anticipated that with a general election approaching in May 2015 the Trust believe it likely that all new developments will be reviewed in light of its own priorities. As a result, there inevitably will be further delay in the completion of the new hospital and to this end, the key milestones outlined highlighted above are anticipated to change, namely: start date (DH / Monitor approval) to 25.9.2015 and the end of project (Mobilisation to the operational phase of PFI2) until 30.8.2019. | Approval to launch was received in November, resulting in a closing date for applications in December and approval of awards in January. The Programme remains on track to distribute the 2014/15 awards by the end of March 2015. A change in the funding profile was negotiated, meaning some awards will be distributed in 2015/16. | The project is expected to reach Financial Close in February 2015. | The programme schedule for the year was dependent on a procurement contract which in the end was more complex and took longer than anticipated to reach an acceptable agreement. This delayed the start of the design work but once commenced remained on schedule over this period - completing the design work by the end of June 2014, and submitting the Outline Business Case (OBC) by the end of July 2014. An ambitious target of a decision on the OBC by the end of September 2014 has been set. Any delay beyond this will push back any subsequent milestones although opportunities to bring milestones forward will obviously be sought. | Currently on hold. | A plan was not published in Q2 2014/2015. The Programme has reset its strategic direction and as such the plan is to no longer relevant. The Programme has started to develop a Blueprint out of which agreement on the exit, transition and procurement plans will be developed. The programme end date is the 31st March 2017 when the current contract with N3SP comes to an end. | There have been no deviations from the planned schedule. | Although construction of the new hospital is behind the programme established at Financial Close, the Trust has received significant assurance from the PFI Consortium that the planned completion date will be achieved. Monthly Progress Meetings are held with the PFI Consortium and the Construction Contractor, with the Independent Tester and Technical Advisor to the project funders also present. The PFI contract places all risk of delay and cost overrun with the PFI Consortium. | There has been a change in the schedule timetable since the Q2 2013/14 return, primarily because the scheme has been on hold whilst affordability was reviewed. This has led to the procurement route being altered from PFI to non-PFI, with a revised OBC currently being prepared for issue to the TDA by end January 2015. Currently, the contract is scheduled for financial close July 2015, compared to November 2014 reflected in the Q2 2013/14 return. Construction completion is now scheduled for March 2017, compared to previous milestone of Sept 2016. | The procurement proceeded according to programme through to evaluation of interim submission. As noted above the Trust is now in a single bidder situation and this may necessitate some changes to future programme. | There have been no deviations from the planned schedule. | The programme is progressing broadly as planned and the programme team is working closely with all collaborative groups in order to ensure that they submit and gain approval for their Full Business Cases in line with their expectations for signing contracts. There has been a delay to the original programme timescales due primarily to the approvals process for the Outline Business Case taking longer than anticipated, and Trusts taking longer than anticipated to launch their procurements. | The delivery of Spine 2 is broadly made up of two parts: Core Spine, and Care Identity Service. Core Spine went live 25th August 2014, and Care Identity Service is expected to be live in February 2015. | All actions are on track. | The Programme Plan has been subject to a number of revisions since with the transition (Go-Live) now agreed to commence on 20th February 2015. Changes to this planned date have been mainly due to the reliance on the Care Identity Service system to go-live prior to Secondary Uses Systems Transition as this is required to provide secure access to the system. The original date for Care Identity Service Go-Live was in Mid November 2014 but due to technical issues this has now been rescheduled for the 20th February with the SUS Transition System going live simultaneously. |
| 2014/2015 Budget (£million) | £5.38m | £28.13m | £42.11m | £97.50m | £40.11m | Data not provided by department | £62.90m | £59.83m | £213.76m | £0.00m | £0.00m | £4.28m | £2.50m | £79.64m | £50.00m | £242.05m | £50.00m | £1.74m | Data exempt under Section 43 (2) of the Freedom of Information Act (2000) | £9.40m | Data not provided by department | £35.41m | £7.75m | £1.70m | £21.76m | £27.39m | £0.00m | £70.00m | £18.00m | £29.68m | Data exempt under Section 43 (2) of the Freedom of Information Act (2000) | £177.46m | £25.50m | £19.50m | £0.00m | £0.00m | £67.34m | £40.91m | £65.86m | £7.77m | £30.67m |
| 2014/2015 Forecast (£million) | £5.38m | £33.75m | £25.92m | £121.00m | £68.77m | Data not provided by department | £0.40m | £59.83m | £134.11m | £0.00m | £21.56m | £4.55m | £2.16m | £90.34m | £19.20m | £242.05m | £25.40m | £0.69m | Data exempt under Section 43 (2) of the Freedom of Information Act (2000) | £9.40m | Data not provided by department | £33.98m | £12.80m | £1.70m | £7.76m | £19.09m | £0.00m | £70.35m | £18.00m | £15.67m | Data exempt under Section 43 (2) of the Freedom of Information Act (2000) | £1.89m | £25.50m | £19.50m | £0.00m | £0.00m | £67.34m | £11.05m | £73.68m | £10.95m | £30.67m |
| 2014/2015 Variance (£million) | £0.00m | £5.62m | -£16.19m | £23.50m | £28.66m | Data not provided by department | -£62.50m | £0.00m | -£79.65m | £0.00m | £21.56m | £0.27m | -£0.34m | £10.70m | -£30.80m | £0.00m | -£24.60m | -£1.05m | Data exempt under Section 43 (2) of the Freedom of Information Act (2000) | £0.00m | Data not provided by department | -£1.44m | £5.05m | £0.00m | -£14.00m | -£8.30m | £0.00m | £0.35m | £0.00m | -£14.01m | Data exempt under Section 43 (2) of the Freedom of Information Act (2000) | -£175.57m | £0.00m | £0.00m | £0.00m | £0.00m | £0.00m | -£29.86m | £7.82m | £3.19m | £0.00m |
| 2014/2015 Variance %age | 0% | 20% | -38% | 24% | 71% | Data not provided by department | -99% | 0% | -37% | 0% | >1000% | 6% | -14% | 13% | -62% | 0% | -49% | -60% | Data exempt under Section 43 (2) of the Freedom of Information Act (2000) | 0% | Data not provided by department | -4% | 65% | 0% | -64% | -30% | 0% | 0% | 0% | -47% | Data exempt under Section 43 (2) of the Freedom of Information Act (2000) | -99% | 0% | 0% | 0% | 0% | 0% | -73% | 12% | 41% | 0% |
| Total budgeted whole life costs (£million) (including non-government costs) | £5.38m | £445.76m | £287.42m | £1,108.97m | £634.06m | Data not provided by department | £1,682.40m | £436.09m | £2,294.07m | £411.61m | £212.03m | £77.74m | £14.55m | £309.42m | £160.00m | £653.15m | £213.17m | £208.80m | Data exempt under Section 43 (2) of the Freedom of Information Act (2000) | £1,295.53m | Data not provided by department | £131.16m | £425.38m | £1.90m | £39.44m | £168.09m | £975.83m | £100.00m | £697.50m | £10,447.57m | Data exempt under Section 43 (2) of the Freedom of Information Act (2000) | £748.16m | £70.20m | £828.00m | £53.54m | £1,036.30m | £171.53m | £189.06m | £205.71m | £51.10m | £53.61m |
| Departmental narrative on budget/forecast variance for 2014/15 (if variance is more than 5%) | Budget variance less than 5% | Variance of 20% is mainly caused by CDEL (24% variance) which is a result of comparing different programmes (budgeted programme vs forecast programme). Programmes will be different due to delays in approval of business cases and approval of Trust loans. The underlying cashflows follow the programmes and in the GMPP return it can be seen that other years will have similar and opposite variances eg 2015/16 is -67%, 2016/17 -20%, 2017/18 is +61% etc. It can also be seen in the Q2 GMPP return that the outturn forecast is equal to budget based on the approved OBC. | Although the variance for 2014/15 appears to be more than 5%, the true variance should be measured against the projected figure for 2014/15 in the approved full business case (FBC), i.e. £25.391m. That being the case, the variance to 30th September 2014 was an overspend of 2% because of a change in the spend profile for the year once works actually started; the projected variance to 31st March 2015 is 1% underspend. The total projected spend remains within the approved cost of £242.4m. | Increase in 2014/15 forecast against Budget is due to IT deployments being deferred from earlier years and Administration costs now being included in the Budget as it was previously funded by the local NHS Strategic Health Authority. | Increase in 2014/15 forecast against Budget is due to IT deployments being deferred from earlier years and Administration costs now being included in the Budget as it was previously funded by the local NHS Strategic Health Authority. | Baselined of the financial figures took place in January 2015. 2014/2015 Budgets include all care.data and technology spend. Technical costs are to be met by the Health and Social Care Information Centre (£1.2 million). Programme and communications costs are to be met by NHS England (£4.08 million). All costs are in relation to the pathfinder stage that preludes the Programme. The projected overspend is expected to be brought in on budget by March 2015. | Q2 forecast return reports actual spend at this point. Profile of spend such that most commitments and spend occur towards the end of the financial year. We anticipate the forecast / actual spend reported in Q4 will be within 1% variance of budget. This variance is due to the fact that it does not reflect the funding to local authorities to support them in implementing the Care Act which accounts for approximately a third of the variance. The majority of grant payments to delivery partners are scheduled for the latter 2 quarters of the year. Business cases for implementation support products were largely approved between October and December thus this significant area of spend will show in the last quarter. Additional implementation support to Local Authorities has been approved since Q2 and Phase 1 of the public awareness campaign has been approved but will not reflect in the figures until the final quarter. | Budget variance less than 5% | The underspend is due to a slower uptake of the Lorenzo product than anticipated and also as a result of amending the scope of the Programme. The budget also included estimated Trust incurred costs these are not now forecast. | Budget variance less than 5% | Total costs have remained the same, the changes are a result of slippage on the programme caused by the delay in DH and Treasury approval. | The revenue costs for 2014/15 are ahead of forecast, partly due to the higher than predicted take up of the Electronic Prescription Service Release 2 by GP practices in year and partly due to an anticipated increased spend on central staff. | The variance is due to a declared forecast underspend being declared for the programme budget. It was agreed that the underspend would be used for the Freedom To Speak Up review. | 2014/15 budget figures were taken from the approved General Practice System of Choice Replacement Appointment Business Case v2.4. Whilst the approvals were in progress the procurement negotiations were ongoing which resulted in changes to the unit pricing and annual profile of charges. Furthermore one of the principal suppliers was not able to sign the contract in March 2014 which increased the forecast for 2014/15 and the forecast therefore includes the decision to procure new GP services from The Phoenix Partnership via General Practice System of Choice instead of through the North Midlands and East Local Service Provider contract. | Currently the estimated spend in 2015/16 is forecast to be under budget with additional finances moved to later years of the project | Budget variance less than 5% | The original financial plan for the rollout of Liaison and Diversion services was developed in 2011, prior to the creation of NHS England or the definition of the Mandate funding formula. The Liaison and Diversion programme was originally expected to rollout services by 2014. However, the requirement for a Full Business Case to be presented to HM Treasury, and the lack of a suitable evidence base to support it, led to the re-configuration of the programme in early 2013. This included a re-baselined plan for expenditure on services, with incremental rollout from 2014/15 to 2017/18. The new plan is for incremental growth in the expenditure on Liaison and Diversion services over that period. | The Budget figure assumed a September 2011 Financial Close (Actual February 2012) and a Summer 2014 Completion (Actual December 2014) resulting in the Unitary Charge applying to only the Final Quarter of 2014/15 instead of from Quarter 2. | Data exempt under Section 43 (2) of the Freedom of Information Act (2000) | Budget variance less than 5% | The costs reflect the budget for the current live service. There has been a strategic shift in the operating model between delivering the NHS Choices programme as a live service and the transformation activities. This split is still subject to ongoing discussions with between the Department of Health, Health and Social Care Information Centre, NHS England and the Cabinet Office. | Budget variance less than 5% | Current in-year costs including the bringing forward of costs originally expected to be incurred in subsequent financial years (predominantly hardware refresh). There has also been an increase in overall capital costs which is leading to a committed reduction in ongoing revenue costs. | Budget variance less than 5% | The Programme is now forecasting an underspend in 2014-15 of circa £16m. This underspend is a result of a pause in certain Programme activities and the new focus on wider hospital efficiency metrics to help deliver savings. | The procurement of the NHSmail 2 service was delayed as the Crown Commercial Service Managed Email framework was not available. This has delayed the closure of the NHSmail service and the transition costs associated with it into FY15/16. For absolute clarity, the whole life costs have not materially changed, the amount in 2014/15 has been reduced and in 2015/16 has been increased by a commensurate amount. | Budget variance less than 5% | Budget variance less than 5% | Budget variance less than 5% | The forecast for 2014/15 is for an underspend due to the delayed commencement of the design work which constitutes the major spend for the programme over this period. Delays on an OBC decision will delay the recommencement of design and lead to further underspend. | Data exempt under Section 43 (2) of the Freedom of Information Act (2000) | The budget was allocated according to the original plan which expected contract exit and transition to be taking place 2014/ 2015. The programme has been delayed while its strategic direction is reviewed and therefore this budget allocation is no longer relevant. The budget figure is as per the Strategic Outline Business Case and envisaged a completed transition to the Public Service Network for Health (as was) and does not include any spend on the current N3 service. | Budget variance less than 5% | Budget variance less than 5% | Budget variance less than 5% | Budget variance less than 5% | Budget variance less than 5% | The variation between the budget and forecast figures for 2014/15 are attributable to delays since the approval of the Outline Business Case, from which the figures above are taken. Forecast costs have been re-profiled in line with current plans for Full Business Case approval, contract signature and implementation. | The Spine 2 Outline Business Case / Full Business Case estimated a total cost of £205M commencing 2013/14 through to 2017/18. Delay in approving the business case meant that key activities could not be initiated in line with plan, there was some shift in spend from year to year. A change request had been approved to address this, which showed a reduced spend in 2013/14 and an increase in 2014/15. For the purposes of the Government Major Projects Plan return on which this report is based, it was thought best to reflect the original spend profile for 2014/15 in the budget, whilst showing the correct spend under forecast. The variance reported is therefore notional. | The spend profile has moved to the right as local NHS organisations delayed implementation in 2013.This resulted in Years up to 2013/14 showing an underspend with a corresponding overspend in year 2014/15 and 2015/16, this is predominantly local NHS costs. The overall spend remains within the business case. | Budget variance less than 5% |
| Departmental narrative on budgeted whole life costs | The BCF Taskforce Phase 1 ran from the 7th of July 2014 to the 31st of October 2014. It was forecast a cost of work done in Phase 1 of £3.5m, which included: costs of employing a Programme Director and support; professional PMO support; admin support; delivery of the Nationally Consistent Assurance Process and validation of this process; assessment of Fast Track plans; support to 6 Fast Track plans; meta-analysis of data; plan improvement support; local government networks. The actual cost of Phase 1 was £3.86m. The scope for Phase 2, running from 31st October to 31st March, was still being developed in detail in Q2 and dependent on 1) An understanding of the number of areas whose plans are approved with conditions, approved with support or not approved in September as this will impact the shape and size of any Task Force provided support in Phase 2 2) The feedback from Programme Board and Stakeholders over the coming weeks as the scope for Phase 2 is socialised with them. The costs included all those for Phase 1 less the local government networks and also including Better Care Advisors and events. The Taskforce was forecast a final cost of work done for Phase 1 and Phase 2 of £5.38m at the end of March 2015 in Q2. The current forecast in Q4 is £6.13m: an additional budget amount of £778,197.00 was repurposed from identified SCLGCP savings in October and the updated budget situation was noted by the BCF Programme Board on the 14th October 2014. It was agreed at the Programme Board on the 14th of October that Plan Implementation Support would be procured to support areas with the implementation of their plans, this support is being funded (approx £1.2m) and procured via NHS England and is not included in the Taskforce's full life costs. | This remain based on Q2 2014/15 which reflect approved OBC. These may be amended upon approval of Full Business Case depending on prevailing market conditions. | On 17th December 2013, the Department of Health approved the FBC on the basis of a capital sum which included the tender figure plus an amount for costs directly attributable to the delay in approving the FBC (beyond the original anticipated date of 25th April 2013). The build cost is significantly lower than anticipated at the outline business case (OBC) and Enabling Works FBC stage because the contractor is using off-site construction for many of the elements of the new hospital buildings. | The whole life costs reflect the figures in the current Business Case. | The whole life costs reflect the figures in the current Business Case. | To be confirmed through the business case, which is in the progress of being developed. Discussions are taking place between the Health and Social Care Information Centre and NHS England to agree funding for 2015/16. Note data is not provided: There is no approved financial information available, although the business case assurance and approval is in progress. The figures for Financial Year 2014/15 have been agreed and reported as above (correct April - December 2014). The business planning and financial position for Financial Year 2015/16 is also in progress. Variance in forecast versus actual spend is due mostly to the intention to now print patient facing materials for use in pathfinder areas in the next Financial Year. | The costs of the reforms are captured within the impact assessments supporting the White Paper and the draft regulations and guidance published in June 2013 for consultation and in the Funding Reform Impact Assessment published with the draft Care Bill in April 2013. These costs and benefits have been updated to reflect the approved changes in the impact assessment published alongside the regulations and guidance for part 1 of the Care Act that come into effect from 1 April 2015. Figures also capture planned departmental programme spending agreed as part of 2014/15 business planning and projections for future years - which are subject to approval. The costs are quoted in 15/16 prices to be consistent with these impact assessments. | The whole life cost includes the costs for: vaccine, administration of the vaccine, IT, comms, surveillance and training. The whole life cost is subject to the number of cohorts immunised each year and therefore there may be some variation in the figure as the programme rolls out. | The CSC Local Service Provider contract was re-negotiated with the supplier in 2012 and this resulted in a reduction in contractual commitment. The budgeted whole life costs assumes a maximum of 22 Lorenzo IT service deployments after August 2012. | Pre 2014/15 Spending totals £2.7m, this is primarily the costs of running the pilots, stakeholder management and consultancy/professional support. 2015/16 costs are zero as HMT have advised that there should be no spending in 2015/16. 2016/17 costs are £11.8m + DH running costs Oct 2016-Apr 2017 + the cost of lower process efficiency for the first 6 months. This figure covers LA set-up costs + the costs of running the Sheffield and Gloucester pilots for 2014/15 and 2015/16 + cost of GRO and E-learning. After implementation in Oct 2016 (assumption), 2017/18 costs are estimated to be £33.6m, these are borne by DH 18 months after implementation (April 2018) there will be an assessment of the impact on coroners following the policy and a decision as to whether DH will fund the cost of the additional burden. This will result in the costs in the region of £40.8m thereafter. | Comprises the capital cost over the lifetime of the scheme. | The Electronic Prescription Service Release 2 expenditure was approved in two separate business cases. The business case budget to the end of 2013/14 included costs for NHS Business Service Authority redundancies, Department of Health payments to pharmacies for adopting Electronic Prescription Service Release 2, NHS Primary Care Trust costs for GP practice training and NHS Connecting for Health / Health and Social Care Information Centre costs for staff and supplier Change Control Notices. The business case budget for the period from 14/15 onwards includes Clinical Commissioning Group costs for GP practice training and Health and Social Care Information Centre costs for staff and Spine Change Control Notices. The rollout of Electronic Prescription Services Release 2 to prescribing sites has been slower than anticipated and the NHS Business Service Authority redundancies were not realised, hence the significant shortfall in costs expended and benefits realised to date. | Based on a 3 year programme with budget profiles of: (Pre 2014/15) £9.55m + (2014/15) £2.5m + (2015/16) £2.5m = £14.55m | No change to budgeted Whole Life Costs which are as per the approved General Practice System of Choice Replacement Appointment Business Case v2.4. | The £160million WLC of the 100k genomics programme covers the government investment. Genomics England have also identified additional grants to fund the project and anticipate some income from commercial investment. | The costs of the programme are associated with: • The incremental and cumulative costs of employing additional health visitors in each year of the programme until April 2015 in line with the trajectory. • Annual MPET (Multi-Professional Education and Training) allocations for the service to cover costs of health visitor expansion, including covering salary and training costs and expected costs of training nurses to replace those moving onto the health visitor programme. • Specific recruitment, retention and training initiatives in addition to MPET-funded activity to support workforce expansion and service transformation. • Delivering the marketing strategy. The total budgeted whole life costs have remained stable and are thought to be accurate at this point. It should be noted that the total budgeted whole life cost stated in the previous Transparency Report did not include the cumulative costs of expanding the health visitor workforce and was therefore lower than the costs stated in this report. This solely represents a change in the way costs are reported (to increase transparency) and not a change in the costs themselves. | Budgeted whole-life costs for the Liaison and Diversion programme will be finally confirmed during Summer 2015 when the Full Business Case is developed and as the outcomes of the Spending Review negotiation for the NHS England are confirmed. The slippage in budgeted expenditure in 2014/15 could be offset by increased expenditure in the final two years of the programme, depending on the full rollout costs agreed with HM Treasury. | Budgeted whole life costs are not expected to change. | Data exempt under Section 43 (2) of the Freedom of Information Act (2000) | Estimated Whole Life Costs have not changed significantly. Slight changes arise from a later Service Commencement date assumed in the final Trust OBCs (ramp up commences one Quarter later) and this re-phasing reduces some costs and benefits in the twenty year window of the Project life. | The programme will be subject to a split between 'Live Service' and 'Transformation' the detail of this split is still subject to ongoing discussions between the Department of Health, Health and Social Care Information Centre, NHS England and the Cabinet Office. Note data is not provided: The Strategic Outline Case received DH approval in Feb 2014, although it was not approved by HMT. There are on-going discussions with DH, MPA, CO, NHS England and the HSCIC to secure agreement on the production of a revised funding model & business case, taking account of the latest spending control guidance. Until discussions have concluded, a revised business case is unavailable. | The Budgeted costs are based on the latest Outline Business Case, with the latest forecast costs being taken from the IaaS Full Business Case, the TAL Full Business Case (funding agreed to 2015/16) and the extension of the Choose and Book Service to March 2015. This Choose and Book extension represents an additional £1.95m forecast revenue expenditure in 2014/15. The impact of these changes is to reduce overall forecast expenditure by £16.02m compared to budgeted Whole Life Cost. | The contract secured enables delivery of the solution within the budgeted whole life costs. Future returns are expected to demonstrate lower whole life costs. | The costs above are derived from the original Project Verdi until further work is completed to prepare the Interim Business Case (IBC) and Programme Business Case (PBC). It is expected these will vary from those quoted above as the these take shape. No budget has been approved in future years pending submission of these. It is expected that the IBC will be available by December 2014 and the Programme Business by April 2015. Elements of the overall re-procurement project may be undertaken this financial year and these will be subject to separate business cases if the IBC & PBC are approved. Operating costs (circa £24m) for the current project are not included as they are part of the Pensions 2015 Implementation scheme. | The whole life costs of the Programme are estimated at £39.44mn between August 2013 and end March 2016. These costs, and/or the timing of expenditure, is subject to change in light of programme outcomes, experiences and stakeholder feedback. | Budgeted whole life costs remain on target as per the Transition Full Business Case. | No change | The funding for the second round was reduced from £70M to £35M. This means the projected whole-life costs are now £65.3M, consisting of £65M for distribution to health and care providers, with £300K for programme administration. | The whole life costs include: - the purchase of the land at the Cambridge Biomedical Campus - a capital contribution towards the capital cost of the new hospital - transition costs - the estimated annual cost of the Unitary Payment (as known Q2 2014/15) | The whole life costs associated with the programmes are significant because the business case analysis has to cover an appraisal period of 60 years, plus 8 years of development and transition. This includes all staff and running costs associated with the functions included in the scope of the programme | Data exempt under Section 43 (2) of the Freedom of Information Act (2000) | The budget whole life costs are currently under review due to the quick wins and Blueprint work being undertaken. This will be updated in the uplifted Programme Business Case. | The budgeted whole life costs (WLC) set out in the Q2 2014/15 GMPP return are estimates from the Full Business Case to implement the programme as a whole, including vaccine purchase costs borne by PHE and vaccine administration costs borne by NHS England. The business case was approved by HM Treasury on 13 August 2012. At that time the programme was planned to start in September 2013. Subsequently it was decided to commence the programme from July 2013, a decision which was agreed with DH Finance. The WLC figure has not changed since the equivalent transparency report in 2013/14. | The budgeted whole life cost includes project development costs, enabling schemes, the Authority's capital contribution and the PFI Unitary Payment for the thirty-year concession period. Following Financial Close for the PFI element of the development, these costs are fixed subject only to inflation on one part of the Unitary Payment. | i) The current whole life scheme costs of £53.54m include upfront capital costs of £40.5m, along with £13m relating to a Hard FM service provision over a 30 year period; ii) The costs have been calculated by the Trusts' Quantity Surveyors and are confirmed as accurate; iii) There has been a change in the figures since the Q2 2013/14 return, primarily because as at Q2 2013/14, the scheme was still a PFI procurement based on a £55m capital cost. The overall costs of the scheme at that stage were recorded as £208.79m and included the cumulative total of the PFI Annual Unitary Payment (AUP) over a 30 year period, with the AUP including elements covering debt repayment, interest payments, Hard FM, lifecycle, insurance, bid costs and management/administration costs. | The budgeted whole life costs of the project represent the anticipated value of the unitary payment over the contract life . | The budgeted whole life costs (WLC) set out in the Q2 2014/15 GMPP return are estimates from the Full Business Case to implement the programme as a whole, including vaccine purchase costs borne by PHE and vaccine administration costs borne by NHS England. The business case was approved by HM Treasury on 3 November 2012. The WLC figure has not changed since the equivalent transparency report in 2013/14. | The budgeted Whole Life Costs are based on the Outline Business Case. The Whole Life Costs will be refined when all collaborative Full Business Cases have been approved, and all costs are known. The programme is funded by a mixture of central funding (including NHS England programme revenue and Health and Social Care Information Centre programme admin costs) and local funding (NHS Trust costs). | Whole Life Cost listed is inclusive of optimum bias, inflation, irrecoverable VAT and contingency, and is taken from the approved business case. | The whole life costs of the business case are on track. | The whole life project includes the development costs, capital costs and operational costs until June 2016 when the new National Tariff System is due to replace the existing SUS System. |