23 June 2014
Performance and Resources Board
14
To consider
Resourcing the Data Strategy
Issue
1
The GMC, through our Business Plan for 2014, has committed itself to
implementing a new approach to managing data across the organisation. This
paper sets out the resourcing model for the project and updates on progress in
mobilising the programme.
Recommendation
2
The Performance and Resources Board is asked to endorse the approach set
out in this paper on how the resources will be organised and the staffing and
budget managed.
2
Resourcing the Data Strategy
Issue
3
During 2013 a Working Group from across the GMC set out a new approach to
how we manage data. The Group proposed focusing on two new information
products to ensure a better understanding of the data we have. Our business
plan for 2014 commits us to taking this work forward. The details are set out in
the presentation ‘A proposal for developing a cross directorate approach to
managing data and information’, at Annex A, which provides the background to
this paper. The Group concluded that the proposed changes are mainly
organisational, relating to the way we structure our approach to dealing with
information as opposed to fundamental weaknesses in our existing technology
or systems.
4
Since we agreed to take forward the strategy the focus has been on putting
together the resources and infrastructure to support the programme. There
have been a range of workshops, one to one meetings and discussions to
develop the principles underpinning the operating model.
5
There continues to be agreement on the overall approach. But there is
recognition that the landscape has changed since the original work was
completed with increasing demands for data and information being directed to
us so that many teams, particularly within the Fitness to Practise directorate,
are now very stretched.
Organising structure
6
Rather than attempt a ‘big bang’ approach to organising a new approach to
data we are focussed on delivering two products. These products will be
developed within our existing structure rather than relying on organisational
change.
7
A small central team based around a programme manager and led by an
Assistant Director is being established. We plan to appoint a Programme
Manager by the next meeting of the Performance and Resources Board on
8 September 2014. The core team will provide: leadership to the programme;
coordinate the day-to-day execution of the workstreams; ensure each
workstream’s products are delivered on time, to budget, and to the required
quality standards. It will manage progress against budgets, risks and issues.
Getting this team in place is key to make progress on the programme.
8
There will be four workstreams overseeing the two products and one further
workstream leading on information governance issues. These workstreams will
sit within existing functions.
3
9
Our Head of Information Policy has started to lead the information governance
workstream. He has sought funding from the data strategy budget to cover an
additional staff member and legal advice, details of which are below.
10
We expect to appoint leads for the product workstreams once the Programme
Manager is in post. It is expected that they will need to give a significant
amount of time to this work, and they will be able to apply for funding to
release some of their time to support this work.
Budget
11
In establishing the data strategy it was estimated that the project would cost
£1 million over one year. There is significant uncertainty about the final cost of
the programme. This estimate will be revised and re-profiled as the project
develops with updates provide to the programme board.
12
Funding will be allocated to work steams plus a central allocation to support the
core team. Workstream leads will apply for funding to support their work and
be considered by the programme board. Once approved, the funding will be
allocated to, and managed by, workstream leads within each directorate. For
reporting purposes we will aggregate all workstream costs using Agresso
project codes to give an overall view of total expenditure on the data strategy
project.
13
As of the start of the June 2014, £100,000 has been allocated to funding a
Programme Manager for the year. The governance work stream has bid for
£95,000 to provide backfill to enable existing staff to support the project legal
advice. Ahead of the programme board meeting this funding has been approved
by the programme board chair, Paul Buckley, Director of Strategy and
Communication, and will be formally agreed at the first meeting.
14
The data strategy will run over both 2014 and 2015, therefore the budget
profile will be reflected in both year’s budget. The existing profile sees 60% of
the predicted cost spent in 2014 and 40% in 2015.
Staffing resources
15
The Working Group considered a number of different approaches for staffing
the project. It recommended a hybrid approach which saw existing staff
seconded to the project with their roles backfilled. The arguments for this
approach are set out in the Working Group’s presentation at Annex A. Where a
particular skill or knowledge is not available in-house consultants and
contractors will be used.
16
In subsequent workshops the rigidity of the secondment model has been
questioned. It was felt there should be no ‘iron wall’ between ongoing work and
the data strategy work. The key principle will be to get a commitment to
4
resourcing and supporting product development with the appropriate resourcing
mix. Therefore it is unhelpful to allocate specific individuals to a workstream,
but rather to agree a staff mix to support the programme under the leadership
of a workstream lead.
17
Feedback since the Working Group last met has suggested it might be sensible
to employ staff who are bought in to backfill on a permanent basis, rather than
for the life of the project. A view has emerged that it would be a mistake to lose
important skills which we expect to need in the future. No decision has been
taken regarding this point. The budget for the data strategy is to support one
year and therefore we will need to be clear on establishment implications
around this. We will get a better view of this when we test roles in the market
place.
18
Workstream leads will propose a staffing mix to make sure the product is
delivered. The central team will provide some core expertise, for example in
data visualisation and work with the HR team to coordinate recruitment.
5
Supporting information
How this issue relates to the corporate strategy and business plan
19
Strategic aim 1 commits us to make the best use of intelligence about doctors
and the healthcare environment to ensure good standards and identify risks to
patients. In this year’s business plan we committed to take forward the data
strategy.
What engagement approach has been used to inform the work (and what
further communication and engagement is needed)
20
The working group included staff from across the organisation. There was
external engagement with a limited number of key interest groups who had a
particular interest in our data. The group received input from external
engagement. Subsequent workshops and discussions have drawn on expertise
from across the GMC.
Other relevant background information
21
The paper should be read alongside the presentation ‘A proposal for developing
a cross directorate approach to managing data and information’ (attached at
Annex A).
How the issues differ across the four UK countries
22
At this stage there are no specific four country issues, however the data
strategy will provide access to greater information by each nation.
What equality and diversity considerations relate to this issue
23
The data stagy will enable us to have a much stronger evidence base to support
our equality and diversity work.
If you have any questions about this paper please contact: Luke Bruce,
Assistant Director - Strategy and Communication,
A
1
14 – Resourcing the Data Strategy
Annex A
GMC Data Strategy development
GMC Data Strategy development
A proposal for developing a cross directorate approach to
managing data and information
September 2013
Working group
A working group from across the GMC, supported by KPMG, has developed this approach to
data. The following staff have supported the production of this paper.
GMC
Andrew Ledgard
Ben Whur
David Anson
Dan Donaghy
David Darton
Jane Malcolm
John Billings
Luke Bruce
Kirsty White
Robert Loughlin
Richard Holland
Shane Carmichael
KPMG
Andrew North
Claire Warnes
Robert Bear
Yusuf Ermak
Contents
1. Executive summary
i.
What we have done overview
ii. The case for change
iii. Key messages
iv. Immediate next steps
v. Proposed structure for next steps
2. Data strategy project outline
3. Themes from stakeholder engagement
4. Two key priorities
i.
Tracking the Doctor Journey
ii. Environments Map
5. Current data/information gap and recommendations
6. Appendix
i.
Detailed themes from stakeholder engagement with GMC examples
ii.
How we have addressed stakeholders original key questions
GMC Data Strategy development
Executive summary
EXECUTIVE SUMMARY - The case for change
The feedback from stakeholders identified a
range of issues which can broadly be
categorised into the following themes. These
are explained in more detail on slides 17-18 and
within the appendix where specific GMC
examples are provided.
Two information priorities identified
1. Tracking the doctor journey
2. Understanding environments better
Key themes
1.
Adopting a more proactive and data driven
approach to regulation
2.
Connecting and integrating information
more effectively
3.
Cross-directorate insight capability
4.
Agile information product discovery
5.
Integrated work plan
6.
Sharing GMC data externally
7.
Using external data
8.
Unstructured data
9.
Common data language
These
themes
and
the
broader
stakeholder feedback all point towards a
case for change around data, driven
ultimately by three key issues, the
need to:
1. Fulfil our regulatory
responsibilities more effectively
2. Use the data we hold more
effectively and efficiently to
support our work
3. Better manage the way we
share data, including: when; why;
and how the we share data, to
enhance our reputation and
capability to influence effective
change in the system.
STAKEHOLDER
FEEDBACK TOLD US:
ADDRESSED WITH TWO
INFORMATION PRIORITIES:
1
2
THE
3
CASE FOR CHANGE:
GMC Environments map
Tracking the doctor journey
EXECUTIVE SUMMARY - Key messages
Need for a clear vision/strategic focus: with an emerging consensus that the
immediate priority should be products which assimilate information across the GMC to
facilitate an understanding of:
i.
the doctor’s professional journey
ii.
what the GMC knows about the environments doctors work in.
Proposed changes are mainly organisational: relating to the way the GMC structures
its approach to dealing with information in terms of capabilities and capacity as opposed to
fundamental weaknesses in existing technology or systems. The GMC needs more effective,
coordinated leadership and governance over data/information and how it works to identify
and address its information priorities.
Objective is to enable the GMC to make more use of the sound data platform already in
place: which includes good operational processes within directorates, a common data store with
data collected in either Siebel or LiveLink, and significant potential with the Oracle BI data
warehouse and exploratory analysis tools like Tableau.
1
2
3
4
2
Approach based on making immediate progress to address two information priorities*
now, drawing on existing structures and resources: based on the learning we will gain
from this process we can then put in place wider, permanent changes to support the long term
embedding of our strategy
EXECUTIVE SUMMARY- Information priorities
What this means
Why it matters
The GMC already has a common data store within Siebel and Live Link. These two systems capture all or most of what the GMC collects about doctors. There is a need to create a more intuitive information product layer on top of these systems which provides a more accessible means to understand doctor journeys through the health care system.
The value of GMC data held on doctors is often not fully realised until users can see information that cuts across directorates and across different parts of a doctor’s career journey. For example following a doctor from education to registration, revalidation and then to the specialty register. External stakeholders view the GMC as the sole owner of this data linked as it is to a unique identifier: the GMC number. There is a strong desire for the GMC to have a product to make this data more accessible, providing a more holistic view for exploring hypothesis, identifying trends and patterns and extracting insight.
Over time such a tool could facilitate the development of existing registers. It also facilitates addressing specific lines of enquiry for example: What is the impact of an overseas background on FtP rates? Are Locum doctors more risky as a cohort? How many doctors will qualify in 2015? What is the breakdown of specialities by location and grade and is that appropriate?
What this means
Why it matters
The GMC does not currently have an information product which provides an intuitive and accessible means to review the data it has so that it can understand what it knows about doctors training and operating environments. There have been efforts in this respect but currently there is no product which draws upon the information captured across directorates
With no single product which provides the focus for gathering, headlining key issues and providing intuitive access to the data held across the GMC on the environments the GMC has a regulatory interest in, there is a risk of not having a joined up view of the data we hold. This affects the work of liaison staff who might not be fully sighted on the information the GMC holds about the locations they are visiting. It makes it hard to respond quickly and confidently to requests for information. More broadly there is no corporate wide mechanism for capturing and presenting information obtained in the field or otherwise received.
Tracking the doctor journey
Environments map
EXECUTIVE SUMMARY - Immediate next steps
This virtual model could serve as an
effective means to test new ways
of working so that the GMC can make
the most effective decision about a
more longer term strategic operating
model. In the longer term a broader
and more comprehensive Programme of
Work may be required to address more
complex organisational challenges (for
example how directorates effectively
collaborate to act upon new insights)
and to embed developing capability and
capacity more effectively.
Immediate next steps To build from the momentum of the data strategy work and address
the demands for change the GMC should :
2. Establish a project to begin addressing the two information priorities. This should begin by producing a more detailed specification and mock up of what products in these areas might look like, defining their data and technical requirements
1. Establish interim
leadershipto take responsibility for implementing the above project and begin to apply in shadow form measures to build capacity and capability to deliver the initial products.
3. Expand the scope of the data strategy working group to operate as a cross GMC information governance board which can more effectively engage the wider GMC to ensure a strategic, joined up and controlled approach to sharing data.
3
2
1
What’s next?We should work to deliver the information priorities:
1. Tracking doctor journeys;
2. Understanding what the GMC knows about environments
To achieve this we are not proposing significant organisational change in the first instance. Rather we progress with a ‘virtual’
team drawn from across the
organisation. The working group which
developed this strategy could act as the project board. There will be a significant resource requirement (up to 15 FTE) which could include a senior project leader, and back filling of staff time which is diverted to this project and project management support
EXECUTIVE SUMMARY – Next steps ‘virtual’ model
Programme Board
Executive
Steering
Project
Lead/Programme
Manager
Exec Sponsor
Strategy &
Policy Board
Doctor
Journey
Environments
Map
Data map and
Governance
development
Capability
Design, build and test a product to capture and provide insight around doctor journeys and doctor/trainee environments
Steering
Ŷ
Provide top level sponsorship.
Ŷ
Remove barriers to progress.
Ŷ
Identify resources and priorities.
Ŷ
Challenge options.
Ŷ
Make decisions.
Project management
Ŷ
Deliver goals and objectives.
ŶDevelop and execute project plan.
ŶSecure resources and manage team
ŶEnsure ‘buy-in’ and manage risk.
ŶEnsure consistent approach.
Ŷ
Ensure effective communications.
Workstream teams
Ŷ
Develop and execute project
plans.
Ŷ
Define requirements
Ŷ
Identify dependencies/constraints
ŶAnalyse data and produce solution
output mock ups.
Ŷ
Identify solutions and
improvements.
Ŷ
Own outputs.
Ŷ
Deliver changes / skills transfer
Programme
management
Key workstreams
RESPONSIBILITIES
LAYER
Building on the data
strategy group
Developing a GMC data map to capture what data sits where including how it is capture and processed.
Information governance and data security support and scrutiny that the development of new products will demand.
Capability development work stream to ensure effective skills transfer and embedding capability into the GMC
EXECUTIVE SUMMARY – The next year
Key aims:
•
Establish a ‘virtual’ working model
for data strategy implementation
•
Recruit required resource &
backfill staff
•
Produce detailed product
specification around the two
information priorities
Key outputs:
•
Established ‘virtual’ operating
model
•
Dr Journey and Environment map
product specifications along with
visual mock ups
Phase ONE
ESTABLISH
Months 2-3
Key aims:
•
Develop complete product prototypes for
iterative testing and development
•
Refine final design to reflect user
preferences and desired user interface
•
Reflect information governance and data
security needs
•
Test with selected internal / external
stakeholders and approve for build
•
Build approved products
Key outputs:
•
Dr Journey product
•
Environment Map product
•
Functioning data strategy group
Months 4 - 10
BUILD
Phase TWO
Key aims:
•
Establish user testing group and
complete user testing including
external product users
•
Complete train the trainer activity
•
Comprehensive skills transfer
•
Refine finalised products for
circulation / publication
•
GMC product approval
•
Robust user testing
Key outputs:
•
Approved products ready for
publication
•
Skills transfer covering product
maintenance and usage
Months 11 - 12
Phase THREE
TEST & RUN
Implementation of the two suggested products is likely to take over 12 months. This programme will demand
significant capacity and capability investment over this period.
EXECUTIVE SUMMARY – Resourcing options
Option
Advantages
Disadvantages
1. GMC led and delivered
3
Lower cost
3
Easier to secure internal buy-in
3
No external dependency
3
Develops internal capacity and
capability for long term
x
Must stop BAU (not a viable option)
x
Likely to make slower if any progress
given capacity constraints
x
Potential to wither on the vine
2. Consultant led and delivered
3
Rapid mobilisation
3
Quicker progress
3
More flexible approach
3
Delivery focus
x
Tender required
x
Higher cost
x
Harder to secure organisational buy-in,
x
Could create dependency
x
Does not build GMC capacity and
capability
3. Hybrid GMC led, consultant
supported, with backfill leading
to handover and skills transfer
(preferred option)
3
Moderate cost for expected value
3
More rapid progress with buy in
3
Rapid mobilisation
3
No long term dependency
3
Benefit from skill transfer to build
capability and capacity over time
x
Tender required and backfilling of staff
resource diverted to the project.
x
Must have some significant GMC
commitment
x
Initial consultancy dependency with
potential longer term risk if internal
GMC capacity and capability in house is
not developed
There are obvious resourcing implications to delivering a programme of this scope. Without stopping some current BAU the
capacity does not exist within the GMC to deliver this work. We could seek an external provider to solely deliver the
programme but this could result in external/consultancy dependency which would hamper our long term progress. An
external provider will require significant input from GMC staff to define requirements and to refine outputs as they develop.
Below we’ve outlined in broad terms available options. A more formal options analysis and selection of a preferred approach
is required. An indication of the sort of resourcing that might be required is provided in the following slide.
EXECUTIVE SUMMARY – indicative resourcing
1 Doctor Journey
2 Environments Map
3&4 Data map and
Governance
Skill sets
Programme Lead GMC
senior lead responsible for driving progress and reporting to programme lead.
Business Analyst
understands the business context and can capture and define technical requirements
Data Analyst comfortable
with extracting, cleaning and analysing data to extract insight
Prototyping a mixed skill
set more effectively delivered by a team with graphic, data visualisation and application / report development experience and expertise
Database Administrator
(DBA) responsible for installation, configuration, upgrade, admin and maintenance of GMC database / warehouse
Information Governance and Data Security SME – a
subject matter expert in these areas
Shared prototyping resource
1 x Graphics /
Report designer
1 x Tableau/data
visualisation expertise
1 x App/report
developer
External GMC Illustrates hybrid approach to resourcing. See slide 40 for assumptions
Key
1 x Business Analyst
1 x Data Analyst
1 x Business Analyst
1 x Data Analyst
1 x Business Sponsor
1 x Data Analyst
1 x Business Sponsor
1 x Data Analyst
0.5 x DBA
There are GMC capacity constraints that suggest external support will be required to backfill current BAU so that GMC staff can effectively contribute. This will be necessary as they represent the critical path to success
1 x
Programme
Manager
0.25 x IG
SME
1 x
consultant
Strategy and policy board
Executive sponsor
Programme board (building on the data strategy group)
GMC Data Strategy development
Work to date
WORK TO DATE - what we have done
Academics Dr / Trainee reps Education reps Healthwatch Royal Colleges Regional representatives NHS employers System Regulators GMC Directorate representatives Education IS FtP Registration and revalidation RLS and ELS Devolved offices Strategy and Communications Issue Example Issue 1 e.g. 1 Issue 2 e.g. 2 Issue 3 e.g. 3 Theme 1 Issue 1 Issue 2 Theme 2 Issue 1
Environment Map
STAGES OF WORK
1. Stakeholder engagement: We conducted targeted stakeholder engagement with key stakeholders across the GMC and a selected set of external stakeholders.
2. Long-list of issues: Notes from over 20 meetings were captured into a long list of issues.
3. Issues grouped into themes: These issues where grouped into themes to identify information priorities
4. Two immediate information priorities identified: Representing a near consensual view of the areas the GMC has to focus on in terms of developing information products
1
STAKEHOLDER
ENGAGEMENT
2
LONG-LIST
OF ISSUES
3
GROUPED
INTO THEMES
4
TWO IMMEDIATE
INFORMATION PRIORITIES
WORK TO DATE - what we have done
Enabler Theme
STAGES OF WORK
5. Developing each theme: To address each theme, using our stakeholder feedback and analysis of information priorities, we conducted a more in depth analysis of associated issues and the challenges that would need to be overcome to address them (for example understanding current data processing and governance arrangements or people and capability constraints).
6. Mapping themes to organisational enablers: Each theme has been mapped to five organisational enablers that the GMC could act against: 1. Governance and organisational structure; 2. People and capabilities; 3. Processes and data analysis; 4. Technology; and 5. Data capture.
7. Identified gaps against each by enabler: To identify where to focus change, gaps against each of the five enablers were identified. These are areas the GMC needs to focus activity over the medium to long term in order to effectively implement its data strategy.
8. Develop high level product specs: To guarantee a focus on identified information priorities we have developed high level products specifications (see 7) that the GMC needs to further develop and build.
8
DEVELOPED
EACH THEME
6
MAPPED THEMES TO
ORGANISATIONAL ENABLERS
7
RECOMMENDATIONS
BY ENABLER
Theme Explanation e.g. Theme / Enabler 1 2 3 4
1 3
2 3
3 3
4 3
DEVELOP HIGH LEVEL
PRODUCT SPECS
5
GMC Data Strategy development
Themes from stakeholder feedback
Themes emerging from stakeholder feedback
Two information priorities were identified which suggest the development of at least
two information products
Tracking the doctor journey:
Using the GMC number to bring together datasets and enable
following of a doctor throughout their career through the use of an intuitive and accessible tool.
Understanding environments better:
Enabling data held by the GMC to be visible at an
environment level; thereby mitigating the risk that trends involving more than a single doctor
may be missed.
The following is a summary of the key themes from stakeholder feedback
1.
Adopting a more proactive and data driven approach to regulation:
applying
information (like that to be captured in the products above) to communicate across
directorates and capture external data more effectively enabling the planning and co-ordination
of activity in a more intelligent risk focused way.
2.
Connecting information more effectively:
Developing mechanism to connect and
integrate data held about doctors and their environments, internal and external data, and
centrally held GMC data and that acquired through regional/field/liaison activity.
3.
Cross-directorate insight capability:
A hub and spoke capability which cuts across
directorates is required to coordinate the delivery against the integrated work plan (see 6
below). This crucially needs to involve the analysts working within directorates to ensure there
is knowledge transfer between central and directorate teams but also across directorates.
1
2
Themes emerging from stakeholder feedback
Key themes from stakeholder feedback (continued)
4.
Agile information product discovery:
Capability across directorates to define the
requirements for future information products and tools. Helping directorates work through
what data they have, what is of value, what can be joined with other things and what is
missing and how to prioritise this.
5.
Integrated work plan:
A 6–12 month detailed plan and a 3 year strategy to reflect key
priorities and horizon scanning.
6.
Sharing GMC data externally:
Proactively agreeing what information the GMC should share,
how and for what purpose to more effectively engage the outside world and contribute to the
wider patient safety regulatory agenda.
7.
Using external data:
Determining what data the GMC should collect and why. The initial
basis for this could be identifying any gaps that need to be addressed in producing the two
products above, then developing to consider what additional valuable data to capture.
8.
Unstructured data:
Integrating unstructured data (e.g. ELS, RLS & Devolved Offices meeting
notes) to improve GMC insight.
9.
Common data language:
Maintaining the data dictionary, standards and a taxonomy for
core datasets.
Education and Academia
System Regulators
EXTERNAL STAKEHOLDER FEEDBACK – snapshot
•
GMC should be the ‘owner’ of the data relating
to the Doctor Journey ideally from
undergraduate level through to removal from the
register. The ability to track these journeys even
at a cohort level could yield valuable insights
regarding predictors of success or failure.
•
GMC needs to consider the burden it places
upon educational organisations when requesting
data, the purpose and value of such collection
needs to be clearly articulated and tangible
outputs shared.
•
There seems to be a degree of difficulty in
extracting consistent datasets for selected
cohorts which is dependant upon the knowledge
of key personnel as opposed to an intuitive and
accessible system
•
Can the GMC offer a service to students (like the
EPortfolio) that will facilitate the capture,
playback and tracking of educational data?
•
Interested in analysis or products the GMC may
develop that may provide an indicator of a
higher level of systemic risk. For example the
triangulation of data collected around doctor
training, FtP, revalidation responses that might
suggest potential organisational weaknesses.
•
Keen to build upon good existing working
relationships with the GMC by committing to
formal agreements and protocols around ways of
working and data sharing.
•
Interested in tools that would make the
following datasets more accessible for partners:
FtP data by organisation and type, Education
Quality assessments, Revalidation statistics.
•
GMC perceived to have good systems which it
can more effectively leverage if it adopts a more
joined up approach internally.
Doctor and Patient Representatives
All or others
(e.g. HSCIC, HEE, regional bodies)
EXTERNAL STAKEHOLDER FEEDBACK – snapshot
•
Would like the GMC to adopt a more positive and
engaging approach to the way it collects and
shares data. Doctors and trainees don’t want to
feel like this is being done to them. The GMC
needs to clearly understand the benefits of its
activities and communicate this clearly.
•
What can the GMC offer doctors and trainees?
One suggestion was a means for doctors to track
their own performance (against selected metrics
e.g. Standardised mortality data) by being able
to access their own data potentially
benchmarked, within a secure portal. This would
encourage self-reflection, greater ownership of
the data and an improved sense of inclusiveness
and engagement.
•
Patients reps and patients would be keen to
have intuitive access to data around the nature
and number of complaints by environment.
•
Any analysis, data collection or sharing activity
the GMC conducts must be contained to its remit
as the regulator of doctors and their training
environments and need not go beyond that.
•
The GMC needs to communicate a clear and
consistent message regarding what data it
collects and why and present a consistent image
when any data is shared or analysed. There is a
perception of mixed messages and a feeling the
GMC is sometimes not joined up.
•
There are concerns regarding who holds GMC
data, with some strong voices suggesting that
this data storage and processing activity must be
retained within the GMC and not outsourced.
•
Data regarding the number of doctors by
locations and specialty, whether they leave the
profession, why and to what would be very
valuable for workforce planning but also
academic research.
GMC Data Strategy development
Two information priorities
1.
Tracking the doctor journey
2.
Environments map
Registration Data of registration Registering org. Specialty registration FP FP training Org/s ARCP ARCP resultsFtP Any FtP proceedings Date of complaint Type of complaint FtP Stage Speciality training Selected speciality GP St 1 – 3 Run Through ST 1 – 7 Core CT 1- 3 Demographics Gender Ethnic category English as foreign language etc.. Revalidation Scheduled for reval Status deferred Status revalidated
GMC doctor journeys – outline
Quickly see information we hold about an individual doctor for core data sets applying an intuitive and accessible journey pathway.
Create a flat file to conduct analysis upon a selected cohort of Doctor’s. Crucially using the GMC number to trace the journey with number pseudonymised. Run a report that tells me what we know about doctors in a selected environment of care or training, released in line with Information Governance approved data at a facts and figures level only (i.e. Strictly non identifiable). Org FtP S1 S2 NTS concerns Org 1 15 2 7 None Org 2 10 3 5 None Org 3 5 4 5 5 Org 4 15 2 7 5 Org 5 10 3 5 10 Org 6 5 4 5 1
!
BME GMC No Reg. FTP BME 12345 25/06/83 BME 12346 26/08/91GMC GN: xxxx
Reg FP ARCP
Speciality / GP trainingInternal
& Doctors
Internal
&
External
External:
Applying robust information governanceUG
!
FtP
DemographicsI WANT TO...
PRODUCT LAYER
AUDIENCE
WHAT IS THE
CORE DATASET?
COMPONENTS
INDIVIDUAL DOCTORS
COHORTS ANALYSIS FLAT FILE
BY ENVIRONMENT (example)
Additional data sources will also need to be
identified and included on an iterative basis,
like for example why Doctor’s leave the
profession.
GMC doctor journey – detailed description
Layer
What this means
Why it matters
Overall
The GMC already has a common data store
within Siebel and Live Link. These two systems
capture all or most of what the GMC collects
about doctors. There is a need to create a more
intuitive information product layer on top of
these systems which provides a more accessible
means to understand doctors journeys through
the system.
The value of the GMC data held on doctors is often not fully
realised until users can see information that cuts across
directorates and across different parts of doctors journeys for
example following a doctor from education through to
registration, revalidation and then subsequent addition to the
specialty register. This provides a more holistic view for
testing/validating hypothesis.
Internal
-individual doctor
level
Having an intuitive ‘Journey Path’ which visually
presents a means to view the core dataset held
on an individual doctor and allows users to click
and review information held at each point on the
journey path
Some parties like individual doctors are interested in having
easy access to the data held on them. Within the GMC
stakeholders would like to have similar access to data around a
single doctor or a selected set or doctors for a core dataset
which enables them to see more then their current functional
access might allow (whilst according to IG demands).
Internal and
selected external
partners
The ability to provide bespoke flat files with
anonymised data allows user to conduct their
own cohort analysis.
The academic community for example could analyse whether
there is a link between trainees from selected cohorts
presenting more commonly in FtP cases.
GMC partners could request an ongoing data feed in relation to
their particular needs (take for example relevant data to
Regional Quality and Risk Summits).
External (general)
To support the GMC’s brand and assuage some
of the FoI pressures the GMC faces, this layer is
geared towards presenting the data the GMC
holds and can share with the external world in
an intuitive and accessible way
A lack of transparency over core datasets that the GMC can
share per information governance restrictions will only increase
the level of scrutiny and pressure upon the GMC to share more
of it’s information. To retain control over sharing information
about the doctors, the GMC should set the agenda by
publishing doctor data by environment. The GMC has already
has plans to do this by sharing FtP statistics by Trust
GMC environments map
Environment master
table/list • ODR listing CQC inspection reports • CQC data interface
Deanery reports • Concerns raised (by
Domain & Org)
• Progression statistics NTS • NTS Sites outlier table FtP by trust • FtP cases by category by trust ELS, RLS & devolved offices
concerns •• ELS feedbackRLS feedback by
level
• Devolved Offices • Best practice
Revalidation • Referred for reval • Status Deferred • Status Revalidated
Have a strategic/overview
of what we know regarding
environments for selected
areas (e.g., FtPs, Education
concerns, RLS concerns,
Best practice) providing a
mechanism for field staff to
feed information to the
centre of the GMC.
Run selected reports using
simple tick and select,
drag and drop down
functionality, enabling field
staff to extract insight to
guide their activity so that
it is more intelligence led.
Provide our partners with
an accessible and
controlled tool to see what
we know about
environments, and
generate reports for their
analysis purposes
SE England Org 1 9 FtP 9 Edu. Concerns Revalidation stats 100 Enquiries 25 Stream One 15 Stream Two FTP 9 Registered 9 Concerns 9 Best practice 9Please select a region to see environments
What do you want to know?
Internal
Internal
&
External
(selected
partners)
External:
Applying robust information governanceSTRATEGIC OVERVIEW
SELECTED REPORTS
I WANT TO...
PRODUCT LAYER
AUDIENCE
WHAT IS THE
CORE DATASET?
COMPONENTS
GMC environments map – detailed description
Layer
What this means
Why it matters
Overall
The GMC does not currently have an information product
which provides an intuitive and accessible means to review
the data it has so that it can understand what it knows about
doctors training and operating environments. There have
been efforts in this respect but currently no product which
draws upon the information captured across directorates
With no single product which represents the focus
for gathering data, headlining key issues and
providing intuitive access to the data held on
environments the GMC runs the risk of not having
a joined up view of what it knows.
Strategic overview
This should be the top layer of the environments map. In the
future one could envision an algorithm that could rate
environments according to whether they raise concerns or
are examples of best practice. Initially however this should
just present the intuitive portal to access headline facts and
figures or issues related to environments.
For example whether any education concerns are raised, any
FtP cases, RLS concerns or instances of best practice. This
will be for internal use only.
This can make it easier for GMC staff to
understand what they know about environments
but also to add information that they collect when
conducting their day-to-day work. This is
effectively the tool that should allow the ‘centre’ to
communicate what it knows about and with
directorates and vice versa.
Selected reports
This layers provides a means of rationalising the increasing
requests the GMC is receiving from its partners. Developing a
tool to allow the production of selected reports or at least to
manage the demand of selected reports.
The GMC needs to take a proactive approach to
triangulating the data it holds about environments
and providing an intuitive and accessible means
for staff and external partners to engage with its
information to promote more proactive and
effective intervention, to highlight areas of best or
better practice, and to better manage the current
burden of ad hoc requests.
Published tool
This layer should represent the portal for sharing the most
relevant and useful data the GMC holds for the external
world. Such a tool is critical to protecting the GMC’s
reputation by proactively sharing useful data and analysis.
This helps the GMC to more effectively govern
what it shares, meet the transparency agenda and
also potentially benefit from the insight capabilities
from the external world.
GMC Data Strategy – a new approach to data
KPMG analysis of the gaps to be bridged over the period of
the corporate strategy
Current gaps to implementing the data strategy
Coordinated activity to address strategic information priorities requires addressing some gaps in five key
areas, being;
27
1. Governance and Organisational Structure
2. People and Capabilities
3. Processes and Data Analysis & Interpretation
4. Technology
5. Data Capture
Tracking
the doctor
journey
GMC
Environments
map
The two identified products can become the focal point to adopting a strategic and coordinated approach to
addressing broader GMC information priorities. In working towards these there will be a number of gaps in our
resources and way of working which are likely to need to be addressed. The following represents a KPMG
assessment of existing gaps.
There is a need to address current gaps by adopting:
x
A data strategy implementation board
reporting to the GMC
Performance and Resources board, with reps from each directorate and IT,
to agree work plans.
x
A central insight team
engaging with directorate analysts with
responsibility for:
A. Horizon scanning:
Identifying emerging trends and prompting
analysis and relevant data capture in advance.
B. Delivering cross GMC insight
against the two key priorities (doctor
journey and environments) as proposed and identified in work plans.
C. Agile insight development and delivery capability
that helps to
work through and identify insight opportunities, test ideas with the
business, develop requirements, and deliver proof of concepts for the
overall work plan.
D. Portfolio management and delivery
of the work plans across GMC
and provision of a simple secretariat function to the above data
strategy implementation board.
E. Additional information governance/policy capacity
to ensure
there is a GMC wide approach to the approval for publication / sharing
of information.
A key question to address here will be to what extent the GMC operates a ‘hub
and spoke’ versus a centralised model to create the required information sharing
community and culture critical to an insight led organisation.
1. Governance and organisational structure
IDENTIFIED
CURRENT GAPS
2. People and capabilities
Over the medium term there is likely to be a recruitment need to address the
issues identified and prevent consultancy dependency. Potential full time roles
include:
x
A Lead (AD or Director level)
of suitable experience, expertise and
seniority, and the remit to establish and make a success of the proposed
central team and governance structures.
x
Data Scientists
with the capability and experience to support critical
business requirements by mining the data for patterns that can be turned
into regulatory value
x
Business Analysts
who have the skills and experience to define
applications and reports that address key organisational needs and
requirements as defined by the organisation and/or identify innovation
areas worthy of consideration by the organisation
x
Report and application developers
who can develop and provide
reports, dashboards, and data visualisations in Tableau and applications
With established virtual roles and engagement from:
x
Directorate analysts, IT roles including DBAs, MDM lead etc...
IDENTIFIED
MEDIUM TERM
GAPS
IDENTIFIED
CURRENT GAPS
Given existing capacity constraints there is a definite and immediate recruitment
need to address the issues identified. A transitory ‘virtual’ model to address this
has been proposed in the executive summary. Over time however a more stable
longer term model is required to allow for skills transfer and GMC self sufficiency.
3. Processes and data analysis & interpretation
Define and agree GMC relevant processes for:
x
Publication approval
– to govern what and how information is published /
shared particularly externally.
x
Demand management (Integrated work plan)
– to determine how
demand for data products and projects are defined, agreed, funded,
prioritised and re-prioritised.
x
Customer engagement / management
– the processes to ensure that
the central team are engaged closely with both the corporate, directorate and
external users / customers of GMC data.
x
Specification, design, test and challenge cycle
– analysis and the
development of insight is a heuristic task. There must be effective processes
to allow for a: specification, design (at a mock up level), and test and
challenge cycle; that ensures ideas are developed iteratively and
appropriately tested for validity and appropriateness before any significant
investment in resources and time in wholesale solution development.
When developing the two information priorities, the above areas and best ways
to approach them can be tested and developed appropriately in line with the
GMC context.
IDENTIFIED
CURRENT GAPS
4. Technology
x
Little to no change in the short to medium term. The basic core
products can be developed with existing technology and the transitory model
proposed in the executive summary.
x
Over the longer term the GMC will likely need to consider wider
changes to current technology to keep in line with developments and
emerging needs.
x
Emphasis in the short term is to capitalise on investments already made, and
ensure governance is in place so that discovery/prototype products do not
lead to dilution of the enterprise information architecture.
x
Potential areas for consideration could be technology-lead proof-of-concepts
for:
a)
Unstructured data analysis technology
– to allow teams to search
through meeting/contact notes or FtP evidence files.
b) Education assessments portal
– web based form (ideally an
adaptation within GMC Connect) to collect the results of various Deanery
education submissions (currently collected as MS Excel / Word forms).
IDENTIFIED
CURRENT GAPS
5. Data capture
Areas to be managed by the data strategy implementation board include:
x
Determining the core GMC datasets
– determine the core datasets that
are required for tracking the doctor journey and understanding
environments this may require
both
internal and external datasets.
x
Conducting a core data gap assessment
– that is current data vs. the
core GMC dataset identified above
x
Maintain robust data standards (common language)
– the above
dataset should apply agreed GMC-wide conventions (e.g. Key Interest
Groups refers to defined organisations and the validation list is as follows…)
x
Conduct ongoing quality audits
of this core dataset. This should be
conducted against the demands of the emerging two information products
(Dr Journey and Environments Map) – it may arise that there are significant
data quality issues which require projects themselves to for them to be
addressed.
x
Refine data quality dashboards and other playback mechanisms
that reflect above points to data providers/collectors for validation
purposes.
IDENTIFIED
CURRENT GAPS
Developing the GMC Data Strategy
Appendices
Background information to support the key themes
Opportunity/theme Explanation GMC Examples• Tracking the
doctor journey:
Using a unique identifier to bring together disparate datasets and enable following of a doctor throughout their career.
The GMC through the GMC unique identifier is ideally suited to tracking the doctor journey both for individual doctors and cohorts, from medical school through to removal from the register,. There is a strong desire for a tool which provides cohort (aggregated) analysis externally and individual level analysis internally to reflect the doctor’s path from training through to removal. Whilst this may not provide an immediate operational benefit internal and external stakeholders have identified this as the fundamental anchor against which insight can be developed and contextualised.
•Both internal and external stakeholders are of the view
that great value could be achieved through an integrated view of the data sources for the doctor journey, particularly around the various reports related to training and education.
•Use of the GMC number as a unique identifier throughout
would enable these datasets to be brought together in some form, even if not by the GMC
•The general expectation is the GMC is best placed to do
the linking and so it should.
• Understanding
environments better:
Enabling data held by the GMC to be visible at an environment level, thereby mitigating the risk that trends involving more than a single doctor may be missed.
Whilst the GMC is not duty bound to regulate the providers of care, it has both an actual responsibility as the regulator of doctors’ training environments and a constructive responsibility to understand or otherwise share what it knows about the environments in which they work. A product which brings together both the structured and, crucially, the unstructured data the GMC collects relating to environments would be valuable for addressing this responsibility and rationalising a number of information demands.
Given the emerging and developing context post Mid Staffs, The Francis Enquiry and now the recently published Sir Bruce Keogh review – the need for coordinated and strategic action in this area will only increase.
•Data is currently held and structured around either
individual doctors or organisations. An ability to view data in relation to specific environments would add value in being able to analyse at department / trust level, thereby spotting systemic risks / issues – e.g. If a specifc department in a particular hospital has 4-5 doctors, each with minor complaints against them that don’t individually raise great concern but could highlight a cultural problem that warrants further investigation.
Background information to support the key themes
Opportunity/theme Explanation GMC Examples1. Adopting a more proactive and data driven approach to regulation
There is a pressing need to agree across directorates what data the GMC will share, how it will share it and why. There is currently a siloed approach to determining what information to share externally which is not governed by GMC- wide information policy. The current approach to sharing data is reactive and may result in a position which is not sustainable for example increasingly unwieldy FoI requests. The GMC runs the risk of appearing disjointed, not efficiently leveraging all the data it holds and failing to put in place the most effective platforms and information governance mechanisms available to maximise impact while managing risk.
There is recognition of the opportunity to rationalise and structure how the GMC proactively shares data externally. One such example of an initiative is the plan to share FtP data by trust – applying such an initiative should rationalise current FoI demands. A similar approach could be adopted with a GMC portal which shares the information the GMC holds about doctors with doctors and trainees and in a sensitised way and with wider audiences where the situation merits it.
A proactive and structured approach to using and sharing of GMC data could help to reduce the following pressures/issues:
The failure to identify malpractice or areas of risk to the public when the information is available to do so
The increasingly unwieldy burden of FoI requests.
The risk the GMC receive a data inflow that is not identified and acted upon appropriately.
There is not currently a standard route for external parties to access core GMC datasets around the journeys of doctors through the systems and GMC knowledge about environments.
2. Connecting and integrating information more effectively
This theme is composed of three key areas:
i. Collection – over time fully embedding, wherever possible, automated systems to replace current semi-automated processes for the collection and capture of data, particularly within Education, ELS and RLS.
ii. Data capture & categorisation – ensuring that data for core datasets is validated to ensure correctness and consistency, in addition to being categorised in a manner which is internally consistent and agreed at a cross-directorate level for core datasets.
iii. Ownership to improve quality – it is expected that creating a sense of ownership with the providers of data (e.g. doctors, deans, RO’s, employers etc.) potentially can improve the quality of GMC data and mitigate concerns regarding what data is held by the GMC.
•Inevitably current data collection / capture
infrastructure does not accommodate some desired requirements for example being able to input Key Interest Groups, multiple meeting topics, addresses / postcodes.
•The resulting bespoke workarounds results in highly manual processes, thereby increasing the time spent on categorisation and maintaining high data quality.
•The responsible officer for revalidation could be used
as a basis to connect data relating to doctors to that relating to organisations to identify correlations, patterns or potential casual links around best practice or areas of concern among both doctors and their environments
Background information to support the key themes
Opportunity/theme Explanation GMC Examples3. Cross-directorate insight capability:
A capability which cuts across directorates is required to coordinate delivery against the integrated work plan.
The Insight and Intelligence team which currently sits within the Strategy and Communications directorate needs to adopt a clear mandate to operate across directorates. It will have the responsibility of coordinating efforts conducted at the directorate level (governing the creation, adaptation and implementation of the work plan above).
Besides coordinating activity across directorates, the team should also have the responsibility for practically managing the prioritisation of insight development activity.
•In order to improve integration there is strong consensus
that a greater cross-directorate capability than is currently in place is required. The current situation means teams are developing their own solutions such an offline trackers or databases to fulfil their requirements, where a cross directorate approach would yield more value.
4. Agile information product discovery: Capability within Directorates to define the requirements insight and to develop future information products and tools.
Analysis and the extraction of insight is by its nature a heuristic task. It is difficult for the directorates to appreciate fully what sort of ongoing information product they require until an issue is adequately explored. Linked to this however, the suppliers of information services/products do not have the capacity to adapt current strategic or core business systems to explore all potential lines of enquiry. Prototyping or information product discovery capability should help to manage the conflict between this limited capacity and ongoing/emerging analysis needs.
This would work by developing proofs of concept that are then presented for approval and inclusion into the integrated work plan for full development (see 4 below)
•Teams currently have development needs that require
sporadic analysis of data which requires increased flexibility in the ability of the GMC to develop agile insight development and delivery capability to enable the identification of emerging concerns before they become critical events.
•There is also an aspiration to identify areas of best
practice so that such practices can be highlighted and learned from.
