System maintenance services

Tender description

Coordinate My Care (CMC) is a 24/7 NHS clinical service hosted by the Royal Marsden NHS Foundation Trust and currently implemented by the 32 London Clinical Commissioning Groups (CCG). The service is underpinned by a highly scalable, digital, multidisciplinary advance care planning solution provided by a hosted, managed service. The solution is used collaboratively across care settings and organisations. Patients are able to initiate their own care plans, and view and request changes to their clinically approved care plans. Care professionals are able to create, maintain, clinically approve and view care plans. The CMC service is a catalyst for clinical transformation and includes: — managing a robust information governance model; — training in clinical processes and system use, including a comprehensive set of eLearning modules; — information reporting; — clinical governance and risk management; — system administration, including organisation and user maintenance; — help desk and first line support. CMC currently has Information Sharing Agreements (ISAs) with approximately 1 700 organisations and approximately 25 000 users with CMC system logins. The digital solution, including the hosting and managed service is currently provided by InterSystems is due to expire on the 23 November 2020 and needs to be extended till 31 March 2022. The current contract is underwritten by the Office of London CCGs. The CMC digital solution comprises multiple components including: the patient portal, myCMC; the care professional system, the CMC system; Provider Directory, used by CMC back office staff to maintain care organisations, individuals and CMC system users; it also includes a comprehensive set of eLearning modules, which cover both use of the system and clinical processes. The CMC digital solution data sets, functionality and user interfaces have all been developed by InterSystems to CMC’s specification of the service’s unique requirements. All aspects of the solution have been delivered via a jointly resourced development life cycle involving CMC specification of requirements, InterSystems technical design with CMC review and sign off, InterSystems development and testing, CMC user acceptance testing and sign off and InterSystems release to the live and training environments. The IT solution in its current form has involved on-going system development and multiple such releases over a 4 year period. The associated eLearning modules have also gone through similar joint development involving gathering CMC specifications, agreeing and reviewing content and presentation, with development by InterSystems and final review and approval by CMC. In addition to base deliverables, the Trust’s contract with InterSystems has allowed for the development of Additional Functionality via the contract change control note process. Several CMC specific additional functionalities have been added to the IT solution, including a generic ‘in-context link’ facility, which has enabled the CMC system to be linked with multiple GP practice, acute, community and urgent care systems across London, impacting several 100s of organisations. Due to the highly CMC specific nature of the CMC digital solution it would not be possible to replace this with an off-the-shelf solution. Based on the experience of developing the current solution it is estimated that it would take a minimum of 4 years to develop a replacement system from scratch with the associated CMC resource time and effort required to support such a development. Clearly any such replacement would also have implementation and training implications and associated disruption to CMC service users, both patients and care professionals, across the capital’s care landscape, including the additional third party system supplier time, effort and cost of replacing the ‘in-context links’. A CMC strategic objective is to expand geographically, ideally to provide a national solution and to support other care pathways. If CMC were to be commissioned to provide a national solution, this would trigger a tender process for the CMC digital solution.