2018 Report details for project: NHS e-Referral Service

Project name: NHS e-Referral Service - there are 6 reports for this project: 2014, 2015, 2016, 2017, 2018, 2019
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Organisation: DHSC (D12) - see all reports for this organisation
Report year: 2018 (data is from Sept 2017)
Category: ICT - see all reports for this category
Description: Deliver NHS e-Referral Service to support paperless referrals and a paperless NHS by 2018, as a centrepiece of NHS England’s response to the Government’s Digital First and transparency initiatives. As per the scope of the original OBC, this report details the NHS e-RS Live Service project within NIB Domain F: Elective Care. The report excludes the enhancement of the service through the NIB Digital Referrals project.
DCA (RAG): Amber/Red
DCA text: Following an Assurance of Action Plan (AAP) review in September 2017, the Delivery Confidence Assessment (DCA) of Amber-Red from the May 2017 Gate 0 review remained in place. Concerns were raised by the review team about the ability to deliver paper-switch off (PSO) by September 2018, despite the technical development of the programme being to schedule. It was recommended that the programme review the hard target of September 2018 in line with provider readiness and resource requirements for paper switch-off once this is understood. However, the review team felt the programme had an exemplar approach to benefits realisation. An assessment of IPA review requirements for the next phase of delivery is underway, with an interim assessment of the Paper Switch Off (PSO) programme and a Gate 0 for the Digital Referrals Programme planned for Q1 2018. Actions being taken from Q2 2017 to address these concerns included : 1. Contractual Leverage. Enhancements to NHS England standard contracts, Quality Premium and Commissioning for Quality and Innovation to leverage use of NHS e-RS . 2. Revised Implementation Strategy to support the goal of ‘paper switch off’ by October 2018. The development of an implementation model to support the ‘hard target’ of meeting the 2018 Standard Contract requirement has necessitated a rapid change in approach and mobilisation effort. The new NHS Digital implementation function and programme team is working closely with NHS England to develop, agree and roll out a joint implementation strategy, assessing the ramp up of resources required and the challenges what will be faced. This collaborative approach to implementation will be a major step-up in both focus and resource from both organisations. 3. Non-use Research Project: to investigate non-use of the system and feed into a revised strategic roadmap. 4. System Enhancements: A clear view of the enhancements and functional changes required supporting our user needs and the rollout of the service has been developed and agreed through ERAB (Electronic Referral Advisory Board) and the NHS e-RS programme board. This strategic roadmap for the next 12 months has now been published to stakeholder groups, receiving positive feedback. 5. Change request to move to a paper switch off project target rather than a utilisation target has been accepted by DDB in September, addressing concerns around a narrow, unachievable utilisation target of 100% GP to 1st outpatients.
Start date: 2012-03-29
End date: 2018-03-31
Schedule text: The delivery of strategic change to the core e-Referral Service project is aligned with the Paperless 2020 agenda. A revised strategic programme of change for the next five years has been submitted to NIB in March 2016 and approved. Future development of the service will sit within the NIB framework. Live service is stable and Paper Switch Off (152 trusts to complete projects to transition GP to 1st outpatients referrals to e-RS) has been agreed as a ministerial target for October 2018. Future development and enhancement to the service beyond March 2018 will be delivered through the Digital Referrals PBC. This PBC will support ongoing delivery of change for a three year period. Live service costs will be managed through NHS Digital business planning processes throughout this period. An assessment of IPA review requirements for the next phase of delivery is underway, with an interim assessment of the PSO programme and a Gate 0 for the DRP planned for Q1 2018.
Baseline: £28.47m
Forecast: £22.62m
Variance: -21.00%
Variance text: The costs are actual to August 2017. The forecast programme spend to the end of the original OBC period (Mar-18) is as per the approved FBC. The underspend in revenue and capital Pre 2016/17 reflects the delay in go live for the eRS service and the agreement of the Infrastructure as a Service FBC at a lower rate than budgeted.
Whole Life Cost: £131.17m
WLCost text: At Q2 2017/18 the forecast expenditure to 2017/8 remains £21m below baseline (at £110m compared to OBC figure of £131m). £7m of these forecast savings are in revenue; these are accredited to the delay in go live, with additional savings made in the contracts for IaaS and TAL. At Q2 2017/18 Capital is forecast to be £14m under forecast to 2017/18, with the bulk of this saving to be within 2016/17 and 2017/18. This estimate is subject to decisions on the subsequent transformation of eRS and has a key dependency on wider NIB strategy work streams which are yet to be confirmed.
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Sourcefile: IPA_2018.csv

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