RIsks and Issues

1st May 09

SCR and TPP Release 4

Ref.

Type

Owner

Author

Date Raised

Project / Stream

Description

Prob-ability (Risks only)

Impact

Actions Taken

Next Steps Detail

Who

Date Due

Review Date

Status

RAG

Project

B - Business

Gemma Wade

39490

There will be a need to visit each practice and other units in order to 1. Cleanse the current set up screen to archive old roles and access no longer required. 2. Work and agree the roles and baseline functions for the end users The risk is that the bulk of our practices are TPP and therefore this is very labour intensive. In addition, the usual approach is to fit around times that the practice can see us, therefore this prolongs the time. The impact could be the deployment timescale is prolonged.

High

Do as one visit, so we will do this at the same time as defining their roles and business function, so we clean up at the same time we check access. 1. Central Cleansing with access to systems from PCT 2. DQFs to act as liaison points - Natasha to liaise with DQ

1. Central Cleansing with access to systems from PCT 2. DQFs to act as liaison points 3. Further work hs shown this to be a big piece of work, national baseline looks hardly anything like what we do locally. We need our own local baseline before we can cleanse and this had to be agreed by Info Governance group. 4. Resourcing is also an issue, see risk xx 5. BS has an action to resolve the resourcing issue, remains at red until resourcing resolved. 6. Cleansing is now understood, this has morphed into a resourcing issue (which are elsewhere in the log), so this will be closed.

Mid Sept

Closed

Green

TPP

Risk

Gemma Wade

39490

There is a work package to design workgroups (or units). There is a risk if we get the design wrong, our unit structure might be too rigid and we could stop the users working the way they do now and we could lose flexibility.

High

1. Agreed with Board that we will create a design and then review this with Information Governance Working Group, walking it through against some clinical scenarios and with input from Clinical Leads. 2. GW will speak to NE Lincs and W.Herts to see how they validated their model

1. Community project to create workgroups (these are the only ones we need). 2. Sign off by the Integrated Governance Group on Aug 12th 3. Remains open and at Green until structure signed off. 4. Add to plan for business as usual, the structure needs to be owned and managed going forward.

July 10th

Mid Aug

Open

Green

TPP

Risk

Project Manager

Gemma Wade

39672

West Herts are developing role profiles - it would be highly beneficial if these could be standardised and also shared. We need to understand whether there is any benefit in standardisation or whether there is always a need for localisation of role profiles.

High

Does not seem like they can be standardised. Role profiles very much depend on what happens locally. We will have national baseline roles though.

1. No, we must use national baseline and our own local baseline.

Closed

Green

TPP

Risk

Gemma Wade

39459

It is unclear what the permanent home is going to be for HealthSpace. Patients will not want to come out to the PCT longer term so we need to consider this.

Low

High

1. Reconsider when SCR kicks off again. 2. RAG green for now until SCR kicks off again, proximity is not close enough for any actions to be carried out..

Open

Green

SCR

Risk

Board

Gemma Wade

39637

Project (SCR)

SW Essex PCT would much prefer a consent to view model as recommended in the UCL report but we do not know as yet whether this will be recommended at SCRAG and NCRS groups and if it is, how long would it take for the SCR systems and business processes/comms to be ready.,

High

1. Await SCRAG on 16th July and NCRS end July, final decision end September. 2. Need to make a presentation to the Board anyway as they need to know level of impact and effort required. 3. Presentation to be made to Board on 8th August - risks remains at red until a decision is made 4. Await final sign off mid September, risk remains at red until sign off obtained. 5. Now signed off, we will move forward with the SCR with a permission to view model

Closed

Green

SCR

Risk

Ian Dobson

Gemma Wade

39657

Project (TPP)

W.Herts who are the early adopter for TPP Release 3 have slipped their dates to RBAC mode 2 = 10 September RBAC mode 3 = 24 September DSM = 8 October Our Mode 2 would then be a week on from theirs….and our DSM the same. This is not a recommended approach since the whole point of early adopters is to find a path through the project and provided lessons learnt. One week gives no time to understand,apply and distribute lessons learned from the early adopter. We could go with the one week inbetween W.herts Mode 3 and our Mode 2 but should give at last 3/4 weeks inbetween their DSM switch on and ours.

High

Medium

1. Explain to Board the level of risk associated with not gaining lessons learnt

Open

Green

TPP

Risk

Tracey Kalp

Gemma Wade

39490

RBAC

There are 7 SystmOne existing functions cannot be matched to RBAC roles. This is a risk as they will not be covered by a Smartcard, so users will have to enter these into System One going forward.

High

We will need a policy or guidelines to cover the use of these and to make it clear that Smartcards are the norm for system access. 1. SCRs cannot be accessed without a Smartcard. 2. We must ensure we have a strict policy that Smartcards must be used 3. We must be clear what the consequences are of not using them - no support will be provided ???. 4. Seven has turned to 11 !! 4.p.

1. To be included in the RA policy. 2. Policy awaits sign off 3. ask W,Herts how they managed these. 4. These are being set up as part of clean up, so not an issue anymore

12th Aug

Open

Green

Both

Risk

Gemma Wade

39490

Project

It is unclear whether the PCT project team can get any training or day to day support for queries or clarifications when working the processes or deploying Stage 3. This is a risk since it would be easy to misunderstand.

High

We get 4/5 days of a CsC Project Manager, and there are recommended workshops we should do to get us and the users up to speed (kick of, awareness and impacts). These need to be added to the plan and arranged. We should also use Pilot and EA lessons learnt and ask them for help.

Risk Closed

Closed

Green

TPP

Risk

Natasha Ball

G.Wade

39490

There used to be a multi-role update facility which allowed for multiple updates to roles to be done at once, saving time and resource. This is no longer available. Without this the RBAC workload will be greatly increased as job role to function has to be entered one on one. Need to clarify when or if this is coming back.

High

1. Need to chase CsC on this 2. have planned for several resources to manage this in case this does not appear. 3. Understand this is now available, will be left open byt ragged as green

Open

Green

TPP

Risk

Heather Bown

Gemma Wade

39490

It appears that NHS CRS Dissent stops data being shared being legal organisations (for example between a PCt and Trust, PCT and a Practice). Need to get this confirmed as it has implications for patients.

High

This is correct and should be covred in business change, comms and training.

Closed

Green

Both

Issue

Natasha Ball

G.Wade

39490

TPP _ There is an issue in that is is unclear whether the latest version of the national baseline for RBAC is available.This maps the baseline business functions to roles. We would not be able to proceed without having a baseline and are at risk of getting it wrong if we proceed with an older one..

High

This is being revised and will not be ready until first week in May. We cannot proceed too far with RBAC without this (NE Lincs quote 100 changes need to be made as a result of this being revised after they had already completed RBAC work, Natasha says this is a high degree of change).

1. GW to speak to Phillip to get early site of revised baseline - done, only EAs and Pioneers get early site. 2. Anecdotal evdence this has slipped a week, need a specific date 3. Date is 14th May 4, email to David Waxman on 13th chasing progress 5. Date is now mid June 5. Now being told V24 can be used and that there are only minor changes only to come. 6. EoE say wait for baseline, this could delay us since it leaves only 10 weeks to get Smartcard access cleaned up. 7.Baseline will now be ready first week in July. This will impact our dates. 8. Decided not to wait for this, we will create our own local baseline 9, GP basleine signed off, left at Amber until Community baselines signed off.

12th Aug

Open

Green

TPP

Issue

Gemma Wade

G.Wade

39527

Training

There is an issue in that we do not clearly understand how SCR Sharing and TPP sharing fits together or how one might impact the other. Without this understanding we cannot realistically send letters or create communications materials.

High

1. Interaction has been worked and we now have storyboards and grids explain how both records work together.

AN/CJC

30-Apr-08

Closed

Green

Both

Risk

Tracey Kalp

Gemma Wade

39490

West Herts are planning to use implied consent for data sharing in SystmOne for when a patient is registered but not present, this seems contrary to the deafult which is private. What is our intention ?.

High

Will be worked by the Information Governance group.

Proposals made and decisions taken at 9th May Board, we want to stick to private. Please see decisions log for decisions.

9th May

Closed

Green

Both

Risk

Gemma Wade

39490

Training

There appears to be uncertainty whether there will be seperate flags for data sharing in R3 and SCR.

High

There is only one sharing flag on the spine so the CSR flag referred to is the SCR one too.

Closed 03/04

Closed

Green

Both

Risk

Natasha Ball

Gemma Wade

39490

The mechanism for monitoring access audit logs requires clarification, is this devised locally ? And do CsC have a function that can create a daily report showing who has not used their Smartcards during Mode 2..

High

No they do not have such a function and yes we do need to do something locally. Currently this looks labour intensive without a mechanism to run off all audit records ro be checked.. Could we ask the end users to take on this check so they are prompting their staff to use their Smartcard ?.

Already on the Policies List 03/04. Will be left open until policy signed off.

30-Apr-08

14th Aug

Open

Green

TPP

Risk

Heather Bown

Gemma Wade

39490

Training

Apparently, if a patient moves within SystmOne then, even if the area they move to has not been R3 enabled, the patient's record retains the new sharing model - thi means that a Practice would see the new screens but not have a clue what to do with them.

High

1. Deployment guide states that we must brief neighbouring trust on the impact of this and has some detail around this. 2. a patient that moves from release 3 keeps their sharing options, so the screens etc will pop up, Any Trust which is TPP and not on release 3 will need awareness 3. Added to Plan but need to understand Release 3 dates for all associated Trusts 4. above not quite correct because an incident has already happened with a patient coming from NE Lincs to SE Essex, probably need to get something out asap. 5. Meeting arranged between Heather and Tracye to work a breifing we can send out.

Meeting set up with Tracey Kalp and heather as to how we can communicate to neighbouring trusts. Now resolved, our neighboruing trusts do not use TPP so we do not not need to send a breifing

16th May

Closed

Green

TPP

Risk

Tracey Kalp

Gemma Wade

39490

If a parent declines to have his/her child's record shared then this may result in the child not being called for vaccs/imms. Is this correct ?.

High

1. Need a definitive statement on this. Appears to be correct and if so we must create a policy 2. This is correct 3. GW to speak to Stweart Mc Arthur to obtain current policies and give him a heads up on record sharing

1. Done. Stewart provided 2 policies which are current. These cover safeguarding children and have been passed to Tracey. Will be left as open until overall sharing policy signed off. 2. Board must see the Childs policy as well 3. Lincs have decided to share childrens records always, should we do the same ?. 4. No, this is in effect implied consent. HCPs need to plan and prepare to gain parents consent

14-Aug-08

26-Aug-09

Closed

Green

TPP

Risk

Gemma Wade

39490

Initiation

NE Lincs and West Hertford are pilot sites for R3. We need to ensure that we learn lessons from them, no not repeat their mistakes and do not create extra work for ourselves when we can work from processes which are a good fit for us as well as them.

High

Already in contact with both of them on a regular basis and at TPP Working Group meetings.

Closed

Green

TPP

Risk

Gemma Wade

39490

Conversion

TPP Deployement Guide says that errors may occurn during conversion. There is a risk that 1Conversion may throw up errors and we not have a resource or process to investigate and correct these issues. 2. End users will not understand how old privacy levels are migrated to new privacy level and what this means for them when looking at records

High

Need some explanation from CsC as to what this is all about. Risk is not close so pick up in awareness workshops.

1-Sep-08

Closed

Green

TPP

Gemma Wade

39490

Project / Stream

The TPP Deployement Guide states that all stream leads must read and understand the guides and impact analysis before the kick off workshop.. There is a risk that due to other projects, this may not be done in enough detail and we may go forward with misconceptions of what will happen on deployment.

High

1. Guides sent to stream leads with a request to read before Kick off Workshop (16th April) - Complete 2. Ensure this is coverd in the plan - Complete

Closed

Green

TPP

Risk

Ian Dobson

Gemma Wade

39490

Resources

TPP and SCR - There is a big comms exercise around this release (and SCR) and therefore PCT Comms team may be unable to resource alongside other work.

High

1. Comms resource is being interviewed, still a risk if they are not suitable. 2. Interview not suitable, does not drive 3. Further interviews needed 4. BS requested this is kept at red until resolved 5. Comms resource now recruited, remains at red until he arrives, 6. Comms resource now on Board

1. Start date 10th July 2. Need a Comms plan to be defined. 3. Riks is now manageable but will remain open until Comms plan in place.

mid Aug

Open

Green

Both

Risk

Ian Dobson

Gemma Wade

39490

Resource

SCR and TPP - There is a Training exercise around this release and therefore PCT training team may be unable to resource alongside other work.

High

Project may require several trainers 1.Need to work SCR and TPP plans in detail to determine exac number of resources and peaks - work started 2. ID/GW to meet and discuss Community fit and team to meet to detail the plans 3. Heather states will need 2 trainers as other 3 assigned full time to Community. 4. Heather also has other work to do besides TPP/SCR so has stated that she may struggle to create a training approach in a timely manner. 5. Action with BS to resolve resourcing 6. Training approach for TPP releaase 3 currently being proposed (SCR Screens not yet available)may mean we do not need formal Training, providing this is acceptable to the Board. Approach to be presented at next Board. 7. board signed off - 8th July

20th June

Closed

Green

Both

Risk

Gemma Wade

39490

There is a risk that we may flag a unit as Never Share without understanding the implications. Once we have set them up as Never Share, ir cannot be reversed. The impact of this would be that the unit cannot send electronic referrals via Systm One.

High

Will be covered in Workgroup planning and we will create guidelines around what this means for end users. 1. Check with TPP, what is the impact if we get this wrong and why is it difficult to undo 03/04. 2. We may not want to broadcast this type of units amonst end users as this could be perceived as a way not to share 3. Risk proximity not close, will pick up in awareness sessions 4. We do not have any never share units

17-Apr-08

Closed

Green

TPP

Risk

Gemma Wade

39490

Comms

There is a risk with patient comms on enhanced sharing that practices will get requests from patients to see their existing reocrd. The impact would be increased effort for Practices.

Low

High

Will need to make practices aware but this can happen now, patients are entitled to see their records.

This is the same as now, anyone can ask to see their data but must make the Praactices aware there may be a slight increase in these requests.

Closed

Green

Both

Risk

Heather Bown

Gemma Wade

39490

Training

There is a risk that if we do not properly train end users in how to explain patient options, security around sensitive information and the implications of dissent, the patient does not get an informed view and the Practices resist the change.

Must be included as part of the Comms and Training Plan. Must have a policy or guidelines

1. Shareing policy ready in draft 2. Plans shows awareness workshops as recommended by CsC and awareness to TPP User groups..

1-July-08

Closed

Green

Both

Risk

Tracey Kalp

Gemma Wade

39490

There is a risk that when a patient dissents then OOH cannot see their data. In a emergency situation this could put the patient at risk of not receiving the best care. We need a policy for OOH as to what they should do when this happen.

High

1. Needs a guideline or policy 2. There are already a set of reasons why this can be done, we may just need to state these ina set of guidelines so that end users feel supported - 03/04

1. Already on policy list, will be included in the Sharing policy

Aug 12th

Closed

Green

SCR

Gemma Wade

39490

Workgroups

There is a risk that if we do not understand how and who will manage workgroups in a business as usual setting (add and delete workgroups) before we start creating them, we will end up with an unworkable process and lack of testing.

High

1. Ensure we create a process before we start work on workgroup design. 2. Add to Plan 3. Likely that the management of this will stay in the Community project for some time after release 3. 4. have engaged with their project manager to raise this as a piece of work. Just need to decide which project does the handover to business as usual. 5. Process maps and high level description complete, whoever takes this over (most likely to be HR) will need training on workgroup management

End August

Open

Green

TPP

Risk

Ian Dobson

Gemma Wade

39497

Resource

TPP _ There will be a sharp increase in RA effort when we are coming up to Mode 2 and between Mode 2 and 3 as Smartcards are verified at this point and all issues with roles, business functions and workgroup must be sorted out before we reach Mode 3 (live).

High

1. Plan seeks 3 RA for the project and this risk remains at red util they are here 2. We must also now consider SCR HealthSpace registrations resource as well as these are done by Carlene (who is a current RA agent) 3. This is now becoming a serious issue in that Natasha is on maternity leave and can only do 1/2 days a week. While she is back in June, that is oly for 2 days week until Aug when it becomes 3 days a week, Natasha is never returning to 5 days a week. Overall Natasha has 35 work days between now an Mode 2 switch on. 4. BS has action to resolve resourcing. Remains at red. 5. We need these people in Mid June, happy to rag this amber now as we only need temps sho can be recruited immediately 6. Temps in place

End June

Open

Green

TPP

Risk

Board

Gemma Wade

39498

RBAC

There is currently a re-organisation underway within the PCT. It is unclear whether this raises a shift in the way services are provided and interact with each other. This needs to be considered when creating workgroups.

Low

High

Project is aware and will take into account.

organisation now announced and in place. Risk is closed

Closed

Green

TPP

Risk

Heather Bown

39507

Resource

TPP and SCR - There is a work package for business change. There is an issue in that this cannot be resourced by the current team (SCR could not be covered). The inetion is for it to become part of Training but the skills to deliver Business Change v training are different. Business change considers the impact of change delivered by the project on the end users and patients and delivers specificied benefits, training works from predefined scripts.. The project may not cover business change successfully without a business change analyst and end user may struggle to manage the change when we go live..

High

1. This def. cannot be resourced by the current team, they are assigned to community. 2. Need 2/3 BCAs. 3. Action with BS to resolve resourcing isssues, remains at red. 4. Work Package created 5. Interviews underway, 2 offers made and accepted. Remains at red until they are here. 6. 2 BCS now on board, may not bother with another....review in August.

Now ragged as Green, business change analysts on board. 1 remains to be recruited but low risk. Keep open for now.

HB/GW

Mid June

Mid Aug

Open

Green

Both

Risk

Tracey Kalp

Gemma Wade

7th March

There is a risk that a RA Sponsor may not have the right level of accountability or experiece to authorise business functions for roles. The impact would be that an end user could gain access beyond the level they need, impacting security and patient confidentiality.

High

1. Identify Sponsor as part of Stakeholder management. 2. Needs a policy and guidelines and need to engage Sponsors to explain their extended role. 3. Board of 03/04 states that we must consider Leavers in order to state how Smartcards get handed back and deactivated (believe we already have this). We may need to reassign Sponsors BS will have the final call re role to business functions (believe she as not actually at the Board when this was said, so may need to bring up on 17/4)

1. RA Policy underway 2. Training and awareness to be part of plan (already is).

End May

Open

Green

TPP

Risk

Tracey Kalp

39547

There is a risk that the CRS (Spine) sharing flag can be changed anywhere this is available and evidence that the audit trail is not robust enough to identify exactly where and who changed it. The impact if this could be confusion at the Practice as to why this has changed and the possibility of the patient denying they allowed this.

High

1. Do we need a policy that stated it can only be changed at the Practice ?. 2. Board decision for TPP detailed records this flag can only be changed at the Practice, Tracey made aware for the sharing policy

1. Sharing policy now states that the sharing flag can only be changed at the Practice.

End July

Closed

Green

TPP

Risk

Gemma Wade

39547

RBAC uploads

There is a Spine freeze during May, is this a risk to uploading any SCR data ?.

High

Plans show that this now not a risk, we wont have loaded it during this period as Rel 4a is still not BAU.

End April

Closed

Green

SCR

Risk

Gemma Wade

39547

Patients

There is a risk that that patients will phone up the Natipnal Care Record Line line asking about local Detailed record sharing ?, especially if we put this on any combined SCR and TPP sharing communications material. This care line wont understand TPP sharing and it is not within their remit to explain this. The impact could be that they get a big increase in calls which could be erroneously stated as SCR and the public will not understand why they cant explain both.

High

1. Raised with CfH 2 National Care Line will tell patients to speak to their doctor on Detailed record 3. Board see as a comm issue so needs to be included in Comms Plan. 4. Remains at amber until we have a Comms Plan

1. Comms Lead made aware 2. Comms plan in place.

End August

Open

Green

Both

Issue

Gemma Wade

39549

Choose and Book

There is an issue in the dissent to share at national level appears to prevent a patient using Choose and Book (CAB)

High

1. Being reported to CsC as an issue. Await reponse from Bradford PM 11/04 2. This is a TPP issue not a Spine issue, now escalated to Ian. 3. if we have 3.5 or higher out there we are ok on this, the issue only happens with lower versions. 4. There is a desktop implementation for C&b where something called Gemplus needs to be installed after C&B is updated nationally. Unclear whether we need to do this.. 5. Meeting arranged with C&B team for next week. 6. Still to be chased around the GEMPlus component but unlikely to be a widespread issue. 7. No longer an issue, we are at the higher level of CAB release.

Ongoing

Closed

Green

TPP

Risk

Natasha Ball

Gemma Wade

39549

There is anecdotal evidence from the trainers and clinical lead that existing Sponsors may no longer understand the depth and breadthe of their role and may need refesher training before embarking on work for this project. This is not covered in the plan and will be additional work if true.

Medium

High

Related to risk abovee and will be covered in Training. Business change analysts will be raising awareness around the RBAC changes and will sak if a refresher traing is needed. If so there is a course which can be amended and provided by one of Heathers team. Risk is still there but now manageable.

End August

Closed

Green

TPP

Risk

Gemma Wade

39549

DSM

Mainly SCR related - National Sharing is Implied Consent (this equates to sharing across legal orgs). However, this means that the entire contents of a patients detailed record including historical sensitive information could possibly be available to share when we go live. Legitimate relationship controls via the Smacartcard will control access but this may not be acceptable to patients and will change the nature of our Comms approach.

Medium

High

1. Cathy Cant is arrangeing a workshop for the Board to walk through the SCR and TPP sharing model so they can understand the implications. 2. When we go live providing we stick to the unit level default of Private, the detailed record wont be shared but if even one unit switches to share, then the detailed record is shared. 3. This may be covered by policy but is also a Comms, Education and training issue 4. Sharing policy will be presented to the Board on 9th May along with overview of the model.

1. Sharing model covered at the Board on 9th May, Board are satisfied they have a good level of understanding. 2. Guidelines for sharing agreed at Board on 9th May, now in the Decisions Log 3. Awareness and Comms will cover this 4. Since Evaluation report, Consent Model is likely to be reviewed and therefor may change. If so, this will no longer be an issue

CjC

9th May

Closed

Green

Both

Risk

Gemma Wade

39549

DSM

TPP - There is a risk that while Community do ask patienst about sharing choices, the share between the Practice and Community may have been decided by the Doctor not the patient. These will be migrated in release 3 as a shared record and yet the patient may have had no choice on this. We must ensure therefor that they understand and are happy with this.

Low

High

1. Ensure that rep from each Community area is invited to an awareness workshop so that they can cascade to their areas. The patient then needs to be made aware. - owned by Community 2. Ensure Board are made aware. 3. BS asked GW to make Annette aware of Board decisions on Sharing. Annette feesl this is not in her scope, as she is deploying Community unit, Practicers are already in existence. I have mailed Tracey Kalp on this one. 4. TPP release 3 working group minutes state that migration will now have choices - we can migrate as all share or all private so we wil;l need to make a choice when this is confirmed. 5. Continue to monitor risk. 6. CsC now say they cannot provide that choice, so defaults apply - existing shares stay. In Practices deafult is private, in Community it is implicitly shareable.. 7. Risk goes back to amber until we find a solution or get direction from SHA on 14th Aug.

Mid Sept

Open

Green

TPP

Risk

Ian Dobson

Gemma Wade

39603

TPP

There are messages coming from the SHA which indicate that the live dates in EoE will slip. While there is slippage on the national baseline, it is unclear if this is the reason why there might be a delay (if so this is unlikely to effect this PCT since we are not at that stage yet). CsC do not support the view that slippage is inevitable. The issue here is that there appears to be a disconnect between CsC and EoE, since on speaking to the CsC Deployemnt Lead it is clear he does not agree with this. We need a joint view of what the level of risk might be to the dates. Without this we cannot continue recruiting since it is unclear how much slippage there might be.

High

1. Speak to EJ to clairfy 2. Raise at TPP working group to see if they can issue joint statements. 3. No longer an issue, this appears to be a misunderstanding and the projects will proceed as normal.

6th June

Closed

Green

TPP

Risk

Heather Bown

Gemma Wade

39576

DSM

TPP - There is a risk that Practics are starting to ask about Release 3 when the DQ team are out and about. The team are more than happy to answer any questions and sell the project but they need some awareness of how the system works, otherwise it may look like we know very little of something where they may already see the results (patient transfers from rel 3 practice).m

Medium

High

1. Arrange meeting with Heather to see if there is a trainin environment or demo system 2. There is and we have sent a list of names for access to it 3. Now escaated to CsC as still don’t have access despite being told this would take a few days. 4. Other PCTs are now saying the same thing, SHA are escalting with CsC. 5. Training sessions underway

Mid July

Closed

Green

TPP

Risk

Natasha Ball

Gemma Wade

39576

DSm

There is evidence that some end user units have a 'fall back' card which they use for people who arrive but have not had a smart card before and possibly for people who have forgotten their card. We may be able to cover forgotten cards with a policy but we should not allow 'fallback' cards to be used for new starters. They must have a Smartcard created at the PCT + documnetation to go with it. if this is not planned for ahead of time, new joiners may not be able to work immediately. End users must be aware of this and it must be covered in Business change processes.

High

1. Ensure included in business change and business continuity 2. Discuss with Natasha 3. Board state this must not happen, Fall back cards must be removed. 3. Apparently these type of cards are not used in SW Essex, nevertheless the policy will cover it. 4. Not convinced this is true and that there are some fall back cards around.

1. Await sign off of the RA policy

12th August

Open

Green

TPP

Risk

Natasha Ball

Gemma Wade

39576

RBAC

There is evidence that a new release of RBAC (2008a) is coming in June. This papers to have new software (identify agent 2) and is much stricter than mode 2. Self certification is allowed with a series of checks , users also need to have a registered mobile and an NHS address registered (assume email address). In addition, forms become electronic. Need to understand more about this, is this really RBAC Mode 4 or something else, must we start using in June ?.

High

1. Speak to Cathy see if she knows anyone that can provide further detail. 2. Natasha is at an RBAC day on 16th May, should get some feedback from this. Need to catch up with her week of 19th May. 3. Related to self certification so not an immediate issue and not in scope of this project. Ragged green now but left open.

16th may 08

Open

Green

TPP

Risk

ian Dobson

Gemma Wade

39598

Policies

There is evidence that work on policies is slipping due to the number of FOI requests that the Information Governance team are having to deal with. They are currently spending up to 3 days a week managing these.

High

1. Discuss with Ian. 2. Being raised at programme level as a risk 3. Now resolved, FOI work moved to Comms

Closed

Green

Both

Risk

Gemma Wade

39619

SCR

There is a risk that if we wait for accepted recommendations from the Consent Model stream of the evaluation report teams, we have to wait further for them to be implemented, making the SCR slip further away.

Low

1. Present options to the Board 2. Options presented but PCT want to wait for Consent to View

8th Aug

Open

Green

SCR

Issue

Gemma Wade

39636

SCR Practices

The lack of progress on SCR means we have lost traction with the SCR Practices. They were expecting a date for a letter to be mailed and for a chance to discuss with other SCR practices their best practice tips. Issues etc. but may now feel it is something the PCT has not delivered (conversation with Western Road - 07/08/08).

High

1. Can we invite Practice manager in for lunch and tell them what has been happening ? 2. Should we send out a Comms every 2 - 4 weeks telling them where we are with it ? Would it sound negative if it always speak of barriers, can Comms help to turn this into a positive experience ?.. 3. Escalated to Board. Invite practices for Lunch and discussion. 4. Now arranged for 31st July 5. Meeting went very well, Practices understand why delays have occurred and are still keen to be part of the project. 6. Will keep open until we mail first letter,

31-July-08

Closed

Green

SCR

Issue

Gemma Wade

39619

Technical

There is anecdotal evidence from the TPP User Group (BBW) that the practices perceive consistent problems with the Spine being out of action, this view was directly supported by the TPP rep present. There is little evidence in the stats nationally for this to be widespread, so is it more prevalent in SW Essex ?. If this perception of Spine availability continues with the Practices, then it may result in resistance to the Smartcards, directly affecting patient security and resistance when we try to move to RBAC V4 (no more manual logins).

High

1. Can we make a comparison between what ESSA has recorded as issues and what BT has recorded as issues to determine if every problem is the Spine ?. 2. Raised at Board level, Ian Dobson has been asked to manage this issue and determine if this is a localised issue.

8th Aug

Open

Green

TPP

Issue

Gemma Wade

39629

Evidence from the TPP User groups shows that TPP rep is telling end users that it is ok to login manually and if the system is slow, they should remove their Smartcard and work without it. This is not what the PCT wants to happen, negates the value of RBAC in release 3 and is treating a symptom not the problem. Have tried to contact her to ask for her support, but no reply. Heather says that this is usual practice for them and would be difficult to change. Feel this needs escalating.

High

1. Seek further support from heather 2. Escalate to Board 3. Ian Dobson has an action to speak to the person named and stop this message being given out.

8th Aug

Open

Green

TPP

Risk

Gemma Wade

39636

Technical

There is still lots of lower level technical detail about sharing that we do not understand. We need a much clearer view of how it works technically before rolling out the sharing model otherwise we may not be able to answer questions from expert TPP users and may not be able to present a confident image to the Practices. Examples are 1. Does override dissent display the whole record including private items 2. if a patient has marked a record private at a unit1, and then a clinician at unit2 needs to look at the record from unit 1 in order to effectively treat the patient. how do they do this ?, answer seems to be they cant, they can only override dissent but we need detailed rules like this confirmed ?. 3. When marking an event private, what about all the docs related to it e.g blood tests, do these also get marked private or does the GP have to do this indvidually ?.

Medium

High

1. Heather to get access to demo system - done 2. Override Dissent does show the whole record but this is only available to GPs, so risk is lessened 2. make comparisons between current and new release if possible. - arranged for 9th July 3. Feels better risk moved to amber but more to be done. 4. Another training sessions arranged fo 13th Aug

Mid August

Open

Green

TPP

Risk

Gemma Wade

39637

Data Sharing

When DSM is switched on, defaults apply except where the record is already shared in which case it keeps its share. So….the Spine (CRS) stays at implied consent (can be shared across orgs), unit level defaults to Private (cant be shared inter org) but if a share is already present it is retained. What does this mean for the SCR record at the Practice, if the unit level is defaulted to private then despite the CRS being implied consent the SCR cant be created because the core items are private. Is that correct ?.

Low

High

1. TPP has a bug in it where even though a record is private it creates and SCR, this is believed to be incorrect and has been reported. 2. Not an immediate issue providing it is sorted out before the SCRs are created. Monitor the risk. 3. Risk already stated elsewhere, closed.

Mid July

Mid Aug

Closed

Green

SCR

There is a risk that where the clinician has decided off their own bat to share a patients record this record will retain its share in release 3. However, the patient was never asked, by rights we should not be sharing this ?.

High

1. SHA have said there will now be an option for existing shares to be migrated as private. 2. This option has now been turned down so we need to manage this issue 3. Raise at Board 4. believe this risk is stated elsewhere, so closed.

Closed

Green

TPP

Risk

Heather Bown

Training

39640

Training

Verbal evidence from W.Herts that 'Sensitive Records' are not working as specified. Unclear what these are ?. There is a risk we will roll out a system in error if we cannot identify where and how the errors occurs

Medium

High

1. Request Heather's team to test 2. Raise at working group, generally we are not getting enough evidence of issues ?/ 3. Sensitive records are part of release 4 so probably not relevant - clarify at next working group.

Open

Green

TPP

Gemma Wade

0/05/08

RBAC

RBAC OOH - There is a risk that access/Smartcard may need to be changed outside office hours, how will we manage this ?.

High

1. Question for W.herts at the next group. 2. Is there any other RA team that does work out of hours who might take this on 3. Do we need a master Smartcard 4. Do we allow manual logins - not, defeats the object 5. Workshop with Natasha and team. Suggested on call process within the team. need to work this process, agree with Ian and present to Board 6. Ian suggested we speak to SE Essex to find out what they are doing. They are at very early stages of the project and have no considered this as yet (0209). 7. SE Essex have not considered this yet. Currently they have a contractor who visits Practices and works extended hours. 8. Agree with ID that we look at further options or we do not offer an extended service.

1. RA Teams hours have been extended s changes are more likely to happen firt thing in the morning espexially for Locums. There is still an opportunity to manually login for a short period, this should cover any issues lat evening. 2. Risk is noe green but will not be closed until we publish details of RA service.

Mid July

Mid Sept

Open

Green

Both

Risk

Gemma Wade

39278

RBAC

There are a seriesof RBAC risks which need to be resolved before Mode 2 is switched on. These are all detailed in the problem/requirements list under Business Change in the directory.

High

..\..\..\TPP Release 3 Project\Execution\Business Change\RBAC and Sharing - Problems Requirements for Board.xls all RBAC issues held in this document

Spreadsheet updated, feels green now.

Green

Risk

Gemma Wade

39644

RBAC

RBAC - Locums tend to turn up with no notice so will not have a Smartcard, ideally they need one before they get to the Practice but the current process is to have forms of ID and come to the PCT t get registered and be issued with a Smartcard. This may not be the most effective process once we go to RBAC 3 is Practices will need a quick turnaround

High

Medium

1. Could they be one of the exceptions for manual login with a weeks grace until they get their Smartcard. 2. Could agencies issue Smartcards ?. How can we persuade them to make this happen ?. 3. Can each Practice have their own RA agent for emergency Smartcards with a reporting line thru to the the PCT ?. 4. See what Pam Lumsden from W.herts says on the 14th as she has the same issue,

14th Aug

Open

Green

Both

Risk

Gemma Wade

39644

RBAC

There are occasions where a Practice may have a Doctor off sick and will phone another Practice for help to cover that days. The new Doctor will need immediate access to their system first thing in the morning before the PCT has staff available, how will they get this ?

High

1. Could each Practice be allowed to give that access ?. Can they be their own workgroup administrator so to speak ?. 2. Are they an exceptional circumstance for manual login 3. master Smartcard ?. 4. Again ask Pam on 14th

14th Aug

Open

Green

Both

Gemma Wade

39644

RBAC

Currently in some Practices, new members of staff are on a 3 month probation period, during which time they are not issue with a Smartcard. Can this continue as an exceptional circumstance or must they have a Smartcard from day one. If so, this also needs a fast turnaround.

High

1. Can this continue as an exceptional circumstance 2. 3 months seems a long time ?, sounds like they must have one ?. 3. Ask Pam on 14th.,

14th Aug

Open

Green

Both

Risk

Gemma Wade

39644

RBAC

The Practices have a concern that where a member of staff is working on Choose and Book and they have to remove their card to work on another PC, they lose all the C&B info and have to start again. Should we monitor the issue where users have 2 roles on their Smartcard to see if this is delaying their ways of working and if so, merge them into one role ?.

Medium

High

1. This happens now but will be compounded when only Smartcards can be used. 2. We should gauge reaction after some weeks and see whether some roles need combining into one 3. Why do they have to work on another PC instead of the one they are on ?. business change analysts to find ot more on this one.

Mid Aug

Green

TPP

RBAC

How do we manage Smartcards for non NHS staff ?. For instance, Hereath, Colby and Dipple Practices all have fitness professionals/lifestyle advisors who have signed a confidentiality agreement nut unclear on who with (Practice ?, patient ?). Need more info.

1. Check with Natasha and raise at Board 3. Business change analysts need to find ot more about these questions, list of required nformation sent to the, await comeback - 06/08. 2. Check also with Pam on the 14th, have they needed to manage this.

Mid August

Open

Green

TPP

How will the Practices get permission to share from home based patients ?. These are the ones most likely to benefit from sharing records. Assume by law the consent must be given by the patients but can this be over the phone ?.

1. This is probably ok at Spine level as default is Implied consent 2. How would this work - seek clinical help on this one. 3. Check current policies. 4. This is fine now, they should follow current procedures, explain in simple terms or best interest.

Mid August

Open

Green

TPP

Gemma Wade

39644

RBAC

Practices have raised a concern that they will need a much faster turnaround time for Smartcard, roles and functions. Currently they feel the process is slow and there is not always someone there to answer the phone, however, as they can login manually it's not an immediate issue However, when they re not allowed to do this anymore....a much faster and slicker process is required and the working hours need to be more than 9-5.

High

1. Pretty much related to all the other RBAC issues which require resolution. 2. Bring to Board for direction

Mid Aug

Open

Green

Both

Risk

Gemma Wade

39644

RBAC

There is a risk that someone will forget their Smartcard (at home or leave at the Practice when going to another Practice). Right now this is not an issue as they can login manually. In release 3 they cant, but this is a natural human error and will happen with frequent to start with so we must cater for it.

High

1. Could be an exceptional circumstance but may turn into normal practice if not managed ?. 2. probably not an exception, need to manage as other RA issues

Mid Aug

Open

Green

TPP

Gemma Wade

39644

DSM

Where inappropriate access has been made to a patients record in release 2, a tasks is generated. The Practice Manager check this list and if such a task is found will then escalate to the Practice Caldicott Guardian, who again will escalate to the PCT for investigation and resolution. We need to check whether this is the same in release 3 and also create a clear process and SLAs for the response.

Low

Medium

1. Need to understand a bit more about the audit process 2. We need a formal process, escalation procedure and SLA. May also need to look at roles and resps (who does what). 3. On Policy list but remains at amber until signed off (will be in the sharing policy)

1. Access process underway 2. Privacy Officer JD created and to be agreed with Ian 3.Need to find out a bit more about how to report access from Community units. 4. Privacy Officer now called IG Compliance Officer, JD created, agreed with Tracey and has gone for grading.

Mid Aug

Open

Green

TPP

Risk

Gemma Wade

39843

Technical

There is a risk that because we are unclear what support is needed from the project team during the bulk upload of SCRs per TPP Practice (tasks, skills or level of effort) we cannot produce a detailed plan. The impact of this would be that we would not be ready to support the upload of SCRs for Wave 1 at end of March (8 weeks away).

Medium

High

1. Have requested from CfH/CsC what is involved and a date for when this information will be with us. Fintan will come back on this.

Open

Green

SCR

Risk

Gemma Wade

39843

Technical

There is a risk that we do not yet understand what needs to be done to implement TPP Release 4 ( SCR enrichment) or its relationship to the upload. The impact of this would be that we would not roll the SCR functionlaity out immediately following the upload. NB This is not a high risk since there will only be 15000 records on the Spine for Wave 1 so it is unlikely enrichment will start to happen straight away in SW Essex. Initial records with meds.alleries and reactions can still be created for new patients without the new release

Low

1. GW is working with CsC and SHA to arrange a workshop to drive the PID. Conference call arranged 11/02 2. We do now understand a lot more abou release 4 operates and therefore this risk will mvoe to green and seaparate risks will be opened for the detailed risks around release 4.

Open

Green

SCR

Risk

Gemma Wade

39843

Project

There is a risk that Practices many not sign up to future waves, If this happened, we could not have enough records on the Spine to make it viable for unsheduled care to use the system.Currently Wave 3 and 4 are big, although Practices can drop out at the last minute.

Low

High

1. Continue to engage Practices into Wave 3 and 4. 2. Bill to do a newsletter re positive reactions from Wave 1 3. Wave 3 has gone well, sign up was positive 4. Risk moved to green for now

Open

Green

SCR

Risk

Gemma Wade

39636

Policy

What is the process for patients who are no competent or capable to understand the process of sharing detailed records?. If we are not clear on this, patients records may be shared inappropriately or keep private when ideally they should be shared.

Medium

High

1. Check current competency policy 2. This now been clarified and is in the sharing policy.

Mid Aug

Closed

Green

TPP

Risk

Gemma Wade

39644

TPP Service

During a presentation to ESSA, they asked if the SLA and priority for Smartcard kit would need to change with the advent of Mandatory Smartcards?. Right now it is not that high since users have a fallback to login manually. If Smartcards become mandatory, then they cannot work if their kit is broken.

Medium

High

1. Find out how this works ?. 2. May just need to provide few bits of extra kit in Practices.

Open

Green

TPP

Risk

Gemma Wade

39644

There is a risk that where a patient is referred to a PCT unit from A*E for example, the Practice record could become visible when the patient registers at that unit. The reason is because the organisational level has a default of implied consent e.g it can be shared across organisations. Normally when referral happens from the GP this wont be an issue because the GO will ask the patient if they want to share and if they don't, it can be set to private. This is not the case where referral happens from A&E because the practice does not know this referral has happened..

Medium

High

1. Find out if this is really a scenario. 2. It's not, a Practice is a unit as well so the private default applies. The referral can come from A&e without the Doctor being aware but they wont see the patients record.

Open

Green

TPP

Risk

Gemma Wade

39652

RBAC

At least one practice uses a self arrival screen where patients click on their appointment to say they have arrived. The Smartcard cant be left in this as it in the waiting room but it has no access to clinical data just a tick box. This sounds like an ideal case for manual login. Check with Board.

Low

High

1. This seems highly likely it will be an exceptional circumstance (manual login), but needs sign off by the Board.

8th Aug

Open

Green

TPP

Risk

Ian Dobson

Gemma Wade

39598

TPP Release 4a

Testing for this release which uploads the SCR is slipping each time dates are reported. This is a continuing issue. We would need to ensure that this functionality is in place before the end of the 16 week PIP.

Medium

High

1. is now Mid August 2. Now mid September 3. keep in touch with CfH and Bradford for progress updates 3. latest dates are October/November 4. Now likely to be Jan 09 5. Changed to amber, this will be in plenty of time for our first upload 6. SCR Upload has worked first time in another EA, now at Green

Open

Green

SCR

Risk

SHA

Risk

Tracey Kalp

Gemma Wade

39926

Data Quaity

There are potentially some Practices that do not have accrediation (IM&T Des) but may have data that is be good enough (either within a short while or by the end of the 12 weeks) for them to sign up to the SCR. However, as accreditation hads always been a pre requisite to the SCR, they will need to go through the same process. If they are not willing to do this, then up to 80,000 would not gain great benefit from the SCR .

Low

High

1. Not close proximity, but will need to consider towards end of Wave 4 2. We should contact these now anyway for intial engagement and to explain what the precursors are for SCR

Engagement with these Practices is ongoing, theere does not appear to be an issue with requesting them to fo quality work.

Open

Amber

SCR

Risk

SHA

Gemma Wade

39926

TPP Release 4a

There is a risk that we cannot get deployment dates for release 4 in a timely manner from CsC. Since there must be a 45 day contractual gap between Wave 1 deployment and Wave 2.....this impacts on our ability to realise benefits and may damage our credibility with the Wace 2 Practices when we cannot get an upload close after the end of their PIP.

Medium

High

1. keeping in touch with CsC and CfH to ensure they understand our requirements and to chase for dates. 2. Dates are now agreed although Acorns nd Khans still have slipped due to external factors.

Product epert to be on site to help us with uploads, date tba. CsC are working on ew dates for Khans and Acorns

Open

Amber

SCR

Gemma Wade

39926

Project

There is a risk that while CsC offer extra support during Wave 1, we are unclear what the process will be when we get to Wave 2. This could delay further deployments or cause communication issues within and external to the project.

Medium

High

1. We have agreed with SHA that the process for Wave 2 onwards will be documented in the PID as a deliverable by the end of the project. If we do not have the process by then, we will not sign off Wave 1 deployment. 2. Now covered in the PID

Open

Amber

SCR

Risk

Gemma Wade

39895

TPP Release 4a

TPP Release 4 (PDS component) offers the ability to allocate an NHS number. However, this is a risk since if a Practice staff do not do enough searches or are under pressure of work, patienst could end up with duplicate NHS numbers

High

1. recommendations at Board to cover policy on this. It will not be allowed.

Risk

Tracey Kalp

Gemma Wade

39926

Policy

TPP Release 4 (PDS) offers the ability for a Practice to allocate an NHS number. This is a risk since if the Practce does not do enough searches, a patient could end up with duplicate NHS numbers. In addition we are unclear how to control this. This is recognised as a national risk. Humber and Yorks who were the FOT for TPP Release 4 (PDS) have created a policy that states that a Practice are not allowed to use this.

High

1. discuss with Tracey and Ian what our own policy will be. 2. Our policy is that we will not allocate this access right but will continue to operate as is.

Practices made aware, and Training will exclude allocation of NHS numbers.

Open

Amber

SCR

Risk

Gemma Wade

39844

Unscheduled Care

Information is nor proactively made avilable as to what Adastras roll out plan looks like and how this is progressing. The site following FOT was to be South Birmingham in mid Feb and Apprently Adastra want to do a fast roll out of PDS (this enables SCR integration to be the flick of a switch). Plans are a bit fuzzy around what is happening or what is planned. We need to understand this in order to be fully prepared when we engage OOH.

Low

High

1. Speak to Mark Leonard 2. Have since had a meeting with Adastra and Esssex Ambulance which has clarified the position. We await further news

None, await Adastra

Open

Amber

SCR

Risk

Gemma Wade

39844

Unscheduled Care

There is a risk that we may not engage Unscheduled care (OOH, MIU, Basildon) at at the right time either because we assume the 60% rule applies in SW Essex or because implementation of Adastra/Summary care record tke longer than we think. It may be that (a.) OOH or MIU could work with less than this or with 60% of a specific area, or that implementation takes a lot longer than we perceive. The impact of this is that we benefit to patients is not delivered in a timely manner.

Low

High

1.Suggest we engage OOH, MIU and Basildon for a very initial discussion and share our plans. 2. Decide when we want to invite someone from Unscheduled Care onto our Board and who this should be 3. Difficult to determine who to contact 3. Now have a name for OOH, Jon Tuppen will help with this by arranging an inviet to a meeting

GW/ID

Amber

SCR

Risk

Gemma Wade

39850

Finance

Generally there seems to be an issue with getting a Purchase order number and the length of time this takes. The risk here is that the mailhouse will not mail without the number. If that happens, we would have to change all the Practice documentation, possibly reextract all the names and addresses and re communicate dates. In addition, it could cause all the other waves to slip.

Medium

High

1. Understand what the process is, who is responsible for each step and how much lead time is safe. 2. Ensure plan has the appopriate dependent dates. 3. This has now been clarified and risk si closed. 30/04

GW/BW

Closed

Green

SCR

Risk

Ian Dobson

Gemma Wade

39965

Resources

Due to family illness there is a risk that our Trainer may not be available when the new release is switched on for some of the wave 1 Practices. As SHA expect an accredited trainer to conduct training, this could mean we have no resource available when the release is switched on.

Medium

High

1. Have agreed that PM will conduct intial training around registrations only ro cover this situation. The remainder will be delivered on the trainers return.

need to srpead the expertise around the other trainers when their current projects finish the core work.

Amber

SCR

Risk

Barbara Stuttle

Gemma Wade

39644

Resource

Our current clinical lead is moving on to another role. We need to find a replacement quickly since we need clinical advice and engagement on both SCR and TPP. Lack of a clinical lead mayl slow both projects, although in Wave 1 of SCR, it is small enough to manage with help from TK and JT..

Low

High

1. Flyer updated with new request for clinical lead and passed to Hayley for distribution. 2. No responses to this flyer. Spoke to Bradford who said they had similair problems, so they extended the search and did a small poster to attract others who may have a clinical background. Suggest at Board we try again and follow Bradford example.. 3. BS will discuss with JT where there are any likely candicates that could be approached. We have access to Teresa and Jon in the interim. 4, Suggestion has been made for someone from SHA but not felt to be suitable 5. Suggest we try Wave 1 6.Now have an interim clinical lead.

Amber

SCR

Risk

Board

Gemma Wade

39644

RBAC

There is some discussion over what rights should be provided to particular roles. This is under discussion and a solution is being looked for but depending on the result, if this is not resol-ved by Septh 5th it could delay Mode 2 switch on dates. Board made aware.

Medium

High

1. Speak to CfH and Clinical Lead for responses. 2. BS to raise at Clinical exec meeting for direction (board action 26/09) 3. Resolved for interim but believe discussion continue, project dates not impacted by this risk but remains at amber for now. 4. Now with BS to follow up.

Open

Green

TPP

Issue

Board

Bill

39723

Comms

Cannot get hold of an up to date Stakeholder list which includes Community units. Since the Comms Strategy is to drive the SCR message via Community units, this is making it difficult to implement the strategy in a timely manner.

High

1. Invite to manager's forum on 5th November, we will ask this team to provide details of who we need to cascade SCR messages to. 2. We have had some invites and where we are meeting people through other forums, we are seeking invites. Still feels amberish and long term Comms need a process for stakeholder database management

Open

Amber

Both

Issue

CsC

Gemma Wade

DSM

DSM has been delayed due to an issue with imms and vacs. In the current solution if a parent descents to sharing their childs medical record, information relating to their childs imms and vacs is still shared with other units such as the Child Health unit. Current legislation suggests that this shouldn't be the case and if a parent dissents to share their childs record then the childs imms and vacs history should also be included in that descent which results in no other units being able to view the childs imms and vacs record. Prior to CSC/TPP changing the solution to comply with the legislation we wanted to highlight the obvious risks of this approach and TPP therefore wrote to Maureen Baker to ask for her opinion. This has now been passed to David Low who is currently working on a paper assessing the risks and we're expecting this shortly. Following receipt of the paper from David we will take appropriate action.

Low

High

1. Following receipt of the paper from David Low, TPP will take appropriate action. 2. Chasing via SHA for when this paper might be ready. 3. Likely Safety sign off is end September 4. Date for sign off is not clear and a change request has now been submitted from CfH to CsC to change TPP to permission to view. 5. Need to decide what our strategy is - go ahead with release 3 sharing as is or wait for permission to view. No longer appears to be red as no drive to implement coming from SHA and W.Herts (early adopter) are very relaxed about when they will do this.. 6. For now we will hold off on release 3 since release 4 is coming shortly.

Open

Green

TPP

Risk

Gemma Wade

40051

DSM

Senior User (BS) is not happy with having two different consent models for SCR (permission to View) and TPP ( consent to share). Ideally sje wants both to work the same otherwise she will not feel able to support the deployment one both. This is high risk since SHA have already stated we must go with the current TPP consent model as the architecture does not lend it self to permission.

High

1. We need to present evidence and options of what could be done with permission to view in TPP and the level of risk. To be presented at next Board on 18/09 2. Remains ar Red until resolved as we cannot communicate anything until we are sure what we intend to deliver. 3. Moved to Green for now as release 4 not rolled out.

Open

Green

Risk

Gemma Wade

39644

TPP Release 4a

The default migration to release 3 for GP records is private. A GP record which is private will stop an SCR being generated (because SCR core items are then also private). However, Patients may genuinely want an SCR due to the wider implications for it's use and the fact it is limited to fairly innocuous items but may not want to share their full detailed record to other organisations. The risk here is that if many records are migrated as Private, then for patients who want an SCR, the detailed practice record cant be kept wholely private.

High

1. This is an assumption, we need to wait for comeback from CfH, to confirm status.

Update fom CfH is : 1If a patient makes their who record private (or if it is left as the default) then a complete SCR will be created regardless of whether there are core items included or not. If a patient makes their record shareable but markds individual items within their record as private, then those items can't be uploaded to the SCR. If one of these items is a core item it will stop an SCR being created, as it is deemed unsafe to not include a complete list of core items. Green for now but may move back to amber once we kick off SCR again.

Open

Green

SCR