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Information Management & Technology Business Case
West Midlands Control Room Reconfiguration We are currently studying the Information Management and Technology Business Case: West Midlands Control Room Reconfiguration. A cursorary glance reveals worrying inaccuracies. Much more time needs to be devoted to a detailed examination of the document. Senior Unison Representatives have raised serious concerns in letters to both the Chief Executive Director and the Head of Human Resources Department in WMAS. Please go to the feedback page to view the letter addressed to HR head. Text in black font denotes original text. Text in blue font is original text and indicates an area of concern. Text in red italicised font indicates a response from Hereford and Worcester EOC.
Information Management & Technology Business Case
West Midlands Control Room Reconfiguration
Document Change Control
Version: 1,0
Status: Draft
Date: 22nd June 2007
Related Documentation: English Ambulance Trust Control Rooms – Mason Communications Ltd
Document source location will be found in:
Distribution Record:
Date Version no. Recipient(s) Comments
19th June 2007 0.1 A C Marsh
19th June 2007 0.1 M Macgregor
19th June 2007 0.1 P Collins For review
19th June 2007 0.1 K Wood For finance information
19th June 2007 0.3 P. Collins For review
19th June 2007 0.3 A C Marsh For review
19th June 2007 0.3 M Macgregor For review
19th June 2007 0.3 K Wood Updated document – for finance information
22nd June 2007 0.4 A C Marsh/M Macgregor/P Collins/K Wood Updated document – finance still outstanding
22nd June 2007 0.5 S. Green/D Lee For review of Risk Assessment
22nd June 2007 0.6 P Collins For review
22nd June 2007 0.7 S. Green Risk update
22nd June 2007 0.8 Executive Directors/Non Executive Directors For comment
22nd June 2007 1.0 Executive Directors/Non Executive Directors/Phil Collins For Comment
Change Record:
Date Version no. Author(s) Description & Change Record
15th June 2007 0.1 Barry Thurston First Draft
19th June 2007 0.2 Barry Thurston Review B. Thurston
19th June 2007 0.3 Barry Thurston Comment from P Collins
22nd June 2007 0.4 Barry Thurston Comments from ACM
22nd June 2007 0.5 Barry Thurston Comments from P Collins
22nd June 2007 0.6 Barry Thurston Comments from P Collins
22nd June 2007 0.7 Barry Thurston Proposal changes from Sue Green
22nd June 2007 0.8 Barry Thurston Review of scope – B Thurston
22nd June 2007 1.0 Barry Thurston Finance Update Document Change Control 2
1.0 Background 5
1.1 Problem / Opportunity 5
1.2 Current Situation 6
2.0 Strategic Alignment 7
3.0 Option Appraisal 8
3.1 Control Models 8
3.2 Masons Report Control Options 8
3.3 Trust Requirements 9
3.4 Trust Options 10
3.5 Retention of all controls 12
4.0 Proposals 13
5.0 Stakeholders 13
6.0 Business & Operational Impacts 14
7.0 Implementation Risk Assessment 16
7.1 Risk Assessment associated with each potential solution (Not including Status Quo) 16
8.0 Cost / Benefit Analysis 18
8.1 Financial Cost 18
8.2 Benefits: 21
9.0 Conclusion 21
10.0 Implementation 21
10.1 Implementation Overview 21
10.2 Scope 22
10.3 Out of Scope 22
11.0 Business Case Approval Process 23
11.1 Business Case Signoff 23
1.0 Background
1.1 Problem / Opportunity
1.1.1 In July 2006, the West Midlands Ambulance Service was formed out of the merger of four county-based ambulance services located in the West Midlands region. Staffordshire Ambulance Service initially remained outside of the arrangement although retained a partnership association with the new West Midlands Trust. Recent Board decisions by both Staffordshire and West Midlands have agreed to a full merger on 1st October 2007.
1.1.2 Within the region the new Trust has five existing control rooms located at:
Millennium Point, Brierley Hill
Abbey Foregate, Shrewsbury
Stone Rd, Stafford
Bransford, Worcester
Dale St, Leamington Spa The control rooms inherited by the new Trust are generally small scale with little scope for expansion and have been designed to service the needs of the area within which they are located. The size and capacity of the controls mean that they are only able to provide limited fallback for the new regional Trust and, critically, will not be able to provide effective fallback for themselves in the medium term because of new performance requirements, new technology and the current activity growth being experienced nationally by ambulances services. In addition, the ability to manage a major incident will become increasingly challenging within the new regional service.
1.1.3 The exception to the above is the centre at Brierley Hill, which is a large-scale complex with significant resilience built into the infrastructure locally, for example, multiple telephone systems, radio systems and power supply. However, failure of the centre would have a catastrophic effect on the region as the remaining controls have neither the infrastructure nor the capacity to sustain the resulting call volumes that will be rerouted into their systems. The current fallback arrangements for Brierley Hill which involves evacuation to Falcon House is intended to provide a temporary arrangement during the reconfiguration process
1.1.4 IT and communications systems at each of the locations are now of an age where replacement is becoming critical to ensuring the Trust meets its obligations in terms of its response times. In addition, different technology is in place within each of the locations making integration expensive and complex. The result of this is that each of the areas continues to operate their systems in much the same way that they did before reconfiguration, for example, identifying the nearest resource to an incident does not take into account the opportunity of using a passing vehicle from another area.
1.1.5 The Trust has a legal obligation under the Civil Contingencies Act to ensure that it has a capability to respond to a major incident whilst ensuring their normal daily operations are unaffected. The current control room configuration of incompatible systems and variable capacity would hamper and impede the Trusts efforts to respond appropriately to any major incident in the region.
1.1.6 Each of the controls is looking to increase their call taking and dispatch capacity in the current year to address the expected growth in activity but in doing so are putting greater pressure on the infrastructure, for example electrical supply, data and voice outlets, adding to the risk of catastrophic control room failure. 1.1.7 The Department of Health has introduced ‘Call Connect’, a change to ambulance service performance measurement that from the 1st April 2008 will seek to improve the overall response times to requests for emergency assistance from the public. The performance standard realigns the start of the ambulance service emergency performance measurement from ‘establishment of chief complaint’ to the time that calls are connect to the Ambulance Control Room telephony system via the national telecommunication providers, BT and Cable & Wireless. The impact of the new clock start point has a varying effect on controls ranging from 7 or 8% on performance for some controls but as high as 15% for a significant number of others.
1.1.8 The Department of Health ‘Taking Healthcare to the Patient’ transforming NHS ambulance services, outlines an additional change to the way ambulance patient care is provided to the public as it seeks to introduce new services, quality and performance standards that shape the future development of the UK ambulance service. The changes introduce closer working relationships with local healthcare providers, the development of Unscheduled Care Networks, improvements in quality standards and the introduction of new governance standards all centred on improving patient care.
1.2 Current Situation
1.2.1 The current position for the Trust is a series of standalone controls with varying levels of resilience, capacity and fallback arrangements. The Birmingham/Black Country (BBC) control room shares its infrastructure with Shropshire and whilst this gives benefits in terms of integrated working there becomes issues around failure of critical systems, which will have an impact on both controls. Shropshire control has the capability of working autonomously but will lose access to control software, vehicle tracking and mobile data.
1.2.2 The key points around the controls are included in the table below.
Birmingham/Black Country Shropshire Coventry and Warwick Hereford and Worcester Staffordshire Total
No of Control Staff Employed 127 17 35 23 58.5 260.5
Peak Time Occupancy 30 4 9 6 9 58
Control Capacity 31 5 10 7 9 62
Other Positions (OOH, Bureau, PTS) 8 0 0 0 13 21
Triage 2 used
2 Unused 0 0 1 0 5
Demand Rates 867.7
36.2 per hr 115.3
4.8 per hr 293.0
12.2 per hr 211.9
8.8 per hr 300.0
14.0 per hr 1787.9
76.0 per hr
Correct figure is 28. This was brought to the Board's attention June 25th 2007. 14th July 2007 - this figure has now been amended in the modified proposal document of 11th July 2007. 1.2.3 The above table demonstrates a number of critical points and these are that the Trust is at capacity in terms of its seat numbers within the controls and that the BBC and Shropshire pairing account for 58% of the total seat capacity and 54% of the demand activity. Failure of the systems would mean that the remaining controls would need to more than double its activity immediately to maintain a service within the region.
1.2.4 With the current arrangements it is not possible to distribute calls from Brierley Hill should it fail in an equitable manner with the existing technology in use by the Trust. Equally the remaining controls are unlikely to sustain the volume of calls coming into the system for a sustained period of time.
1.2.5 Brierley Hill control is looking to increase its call taking and dispatch capacity by introducing more positions into the system and need to make similar provision for the room infrastructure. The room is also being configured to accept the new national radio system (ARP), which requires larger desks to be installed within the room, which will also apply to the control room at Leamington Spa.
1.2.6 All controls with the exception of Abbey Foregate have fallback control centres at nearby locations although the capacity is not at the level that would sustain a failure for a protracted period of time. In addition, the technology available is generally not appropriate, substandard or incompatible with the requirements of the control, particularly in a fallback situation. For example, vehicle tracking is not available at any fallback centre, which will impact on the controls ability to dispatch appropriate resources. In many instances the fallback control room may involve reverting to a paper-based system.
1.2.7 Technology across the sites is incompatible and in most cases is not capable of interoperability. Different levels of resilience are in place as are the maintenance arrangements creating significant risks for the Trust. Controls effectively operate in much the same that they did prior to reconfiguration.
1.2.8 The Department of Health currently have a project to replace the current analogue radios in use by all ambulance Trusts in England. The project will finish by the end of 2008 and will result in each region receiving 2 systems. In the West Midlands one system will be co-located with the Brierley Hill control and the second installed in Tollgate in Stafford. Controls not co-located with the radio equipment will rely upon a wide area network, provided by the project, to access radio functionality. Staffordshire Ambulance Trust Board have recently made a decision to relocate its headquarters and control room facility from Stone Road to Tollgate. Overall this will reduce the risk of radio failure within the new Trust by having two controls co-located with the radio systems.
2.0 Strategic Alignment
2.1 The ‘Call Connect’ initiative has forced the ambulance service to review its current method of working given the recalibration of ambulance service performance measurement to include the emergency call connect time to Ambulance Control room telephony systems. In noting the previous advantage gained by ambulance services that enabled it to establish the caller’s location, nature of complaint and triaged assessment, each organisation must now incorporate this previously unaccounted time measurement within their actual response time. This change is noted to have a significantly affect on how service provision will be performed. In implementing the ‘Call Connect’ solution, the organisation intends to operate a virtual call centre environment that will route calls received to where capacity exists in any of the Trusts control rooms. The proposed solution enables calls to be answered instantly using call taker capacity and dispatch of resources can be undertaken at specific positions within the controls purposely set up to manage the area. This sounds like a guarantee no 999 caller will ever have a call not answered immediately. Was this the intention?
2.2 ‘Taking Healthcare to the Patient’ challenges the ambulance service to improve its quality of service and governance arrangements in providing an emergency and non-emergency care provision. It suggests closer working relationships between ambulance services and local healthcare communities, improving patient the overall healthcare experience. Keeping in line with ‘Your Health, Your Care, Your Say’ strategy, the organisation seeks to implement new services within the community to help improve the service provided to the public. Virtual control room working allows the Trust to make best use of its resources by the centralisation of appropriate functions to support ‘Taking Healthcare to the Patient’, for example, category C triage. 2.3 The national deployment of the Airwave digital radio service designed by the Department of Health in conjunction with Airwave aims to provide a cost effective converged radio infrastructure that supports ambulance service communication, replacing existing analogue radio systems implemented within each Ambulance Trust. The Department of Health funding of the Airwave communication system on a per organisation basis, providing robust communication systems to support the co-ordination of its ambulance resource, has supported the national restructure of the English ambulance services into eleven new regional organisations. The equipment to be installed within the West Midlands ambulance service comprises of two systems with one being co-located at the Brierley Hill control complex with the second at Tollgate in Stafford.
2.4 A recent report, commissioned by the Department of Health, authored by Mason Communications proposes models of delivering the control room functionality within the new regional configurations. The proposal for the future delivery within the West Midlands region is entirely in keeping with the document’s aims and objectives.
2.5 This business case seeks to relocate the Stone Road control into a new expanded centre at Tollgate, to upgrade the existing facility at Brierley Hill and to retain the facility at Leamington Spa. The remaining control centres at Bransford, Abbey Foregate and Stone Rd will close along with all fallback facilities.
3.0 Option Appraisal
3.1 Control Models
3.1.1 The following are the characteristics of the control room model required by the Trust:
The control rooms in the system should form part of the whole system with each individual control playing a part in the overall model.
Calls should be routed to where the capacity is available. Any of the controls in the system should be able to handle any call from any area
All controls should have immediate and unrestricted access to all of the resources on the system including ambulances, cars, clinicians (doctors, paramedic desks), staff and calls
Standard practices, procedures and working practices should be in operation in all controls and should reflect best practice
The system should be able to absorb the loss of any one component in the system in a manner that ensures continuity of services.
If necessary each control should be able to operate in an autonomous way when appropriate.
3.1.2 The Mason report indicates that the separation of the functions of call taking and dispatch are key and do not have to reside in the same location. The Trust support this view and believe that whilst call-taking could be distributed across the control room configuration, dedicated dispatch positions for specific areas could be set up in any of the control rooms.
3.1.3 Centralisation either physically or virtually of the call taking function will significantly improve the utilisation of call taking staff and will require lower numbers of staff than multiple independent sites. The Mason report indicates that for a 100 calls of the same length (answered within a service level) a single site requires 11 staff, 2 sites would require 14, and 4 sites would require 16 staff.
3.1.4 Control rooms must have the capability and capacity to be part of the whole system. The same technology should be available at all of the locations to support cross-site working.
3.2 Masons Report Control Options
3.2.1 Within the report prepared for the Department of Health, Mason identify 14 different control room configurations that could be used by the new regional Trusts, broadly breaking down into national solutions, new Trust solutions and the status quo. These models were then assessed against the Department of Health eight nominated criteria, which were:
Clinical safety and governance
Business Continuity, disaster recovery and resilience
Opportunities for improvement of operation
Organisational development requirements
Service delivery requirements
Integration to the NHS and other agencies
Support of patient choice and care provision
Change management and continuity
3.2.2 The risk evaluation found that the status quo (do nothing or minimal change) represented the greatest risk to Trusts and whilst the national approach offered advantages such as costs, economies of scales, management etc they also represented a larger risk in terms of likelihood and impact. Therefore, we are left with regional Trust options summarised as follows:
A single Trust hub
Trust hubs networked for load balancing calls
Two (or more) independent sites per Trust large enough to provide mutual fallback
Two (or more) sites per Trust paired for call handling
Two (or more) sites per Trust with call handling maintained at a single site
Two (or more) sites per Trust for dispatchers, call handling at one Trust and one other Trust site
Two (or more) main sites per Trust plus a local dispatch site for rural area
3.2.3 Options a and b are based around a single hub with either local standby or reliance upon a neighbouring Trust to provide fallback. Using neighbouring Trusts is unlikely to be effective due to the size of the West Midlands Trust – it is unlikely that the capacity could be accommodated for a long period of time. The Trust would, therefore, need to provide its own fallback arrangements to ensure that adequate arrangements were in place.
3.2.4 The remaining options, c through g, are variations on two or more larger controls able to offer mutual support. The main differences between the options relate to the level of integrated working they are capable of offering.
3.3 Trust Requirements
3.3.1 The Trust would want to ensure that all controls within the configuration were able to provide seamless, mutual support.
3.3.2 The Trust, like every other Trust are reviewing their call-taking and dispatch process to ensure that it is making best use of its resources in its attempt to achieve the targets being set by the Department of Health. In order to do this the Trust are proposing to implement virtual control room working which allows calls from anywhere in the region to be directed to where call-taking capacity is available. This requirement is fundamental regardless of the number of controls retained within the system – the new performance standards, “Call Connect”, indicate that the Trust will need to “pack” all call centres to respond to what calls might come into the system unless we pool the call taking resource across the region. The configuration must be able to support this requirement.
3.3.3 The Trust would not wish to retain any “cold” standby facilities. The Trusts experience of relying upon these sites indicates that reliance upon an unmanned, untested facility at a critical point is an extremely risky strategy. The Mason report supports this view and states “the problem with unmanned fallback is that nobody works there”
3.3.4 The control configuration must provide sufficient seats to address the needs of “Call Connect” and the current expansion of 4% currently being experienced with the region. The system should cater for growth for the next 5 years and provide the infrastructure to expand beyond that period when growth may be more predictable.
3.3.5 Within the existing control configuration the Trust has approximately 62 call-taking and dispatch positions. The requirements of fallback arrangements, expansion and call connect will have a significant impact on those numbers. The following table demonstrates that the number of controls has an effect on the seats required. A balance needs to be established between the technology and number of control rooms required. Whilst more controls require fewer seats the technical solution becomes more complex and therefore more expensive and carries a greater risk of failure. The table allows for the fact that larger controls are able to absorb growth within its existing infrastructure far easier than a smaller one. To achieve the “Call Connect” target more staff are required, achieving a lower utilisation but are critical in achieving the call-answering targets.
Control Rooms Baseline Call Connect Fallback Total per Control
4 22 9 8 39
3 30 7 12 49
2 45 5 25 75
3.3.6 The solution required by the Trust must address a number of issues in order for the Trust to achieve its obligations under the Civil Contingencies Act, its responsibility to meet the Department of Health performance standards and to ensure that it continues to make best use of its available resources. Those requirements are listed as follows:
The selected solution will address the issue of providing an appropriate fallback arrangement for the Brierley Hill facility by providing a control of equal size.
The configuration will address the requirements of the national ambulance radio programme (ARP) for the West Midlands region.
Meet the aims and objectives of the Trusts strategies to achieve “Call Connect”, Standards for Better Health and Taking Healthcare to the Patient in terms of expansion, functionality and capability. 3.4 Trust Options
3.4.1 The available options for the Trust are as follows:
· Single Control Room.
· Multiple control room configurations (2 or more).
· Do nothing and retain the existing control rooms.
3.4.2 The single control room would carry too much risk for the Trust and would rely on robust arrangements with neighbouring Trusts to provide resilience in the event of a catastrophic failure. If the reconfiguration process had been well established then this could have been an option. However, most Trusts around the country are in a similar position to the West Midlands and would not be in any position to guarantee mutual aid. The single control room can, therefore, be dismissed at this stage. Would employees be moved to the Stafford site for example only to discover perhaps 2 years down the line, that when the reconfiguration process had become established, Stafford control room was scheduled for closure and go through the whole process again? Is this best use of tax-payers money? It would be un-nerving for the public who could be forgiven for thinking West Midlands Ambulance Service can't decide what it wants. Most of all, it would be DANGEROUS.
3.4.3 Equally the “do nothing” option would carry too much risk for the Trust, as the configuration has not been designed with a regionally based service in mind. The Mason report states “….we assess significant risk in “do nothing” and minimal change. This is because the current network fails to fully address the requirements of the new Trust”. For this reason the Trust will not opt for no change.
3.4.4 The multiple control room configuration could comprise of 2 or more control rooms. The greatest risk to the Trust in the current configuration is the potential failure of the Brierley Hill control as it currently provides over 50% of the total call-taking capacity for the region. Currently failure is addressed by evacuation to a “cold” centre at Falcon House but this is not ideal for the following reasons:
· Technology is periodically tested but cannot be guaranteed to work at the time it is required.
· Insufficient positions. The fallback is not intended to provide fallback for an extended period of time as it has a limited number of seats.
· Technology is generally of an older generation and is not all accessible, for example, tracking and mobile data
Currently the technology is not in place to load balance calls across the remaining controls either internally or externally through BT. Therefore the Trust will need to make a significant investment in IT and communications systems to provide a “hot” standby for a failed control. The system will need to know where the capacity is available and direct calls appropriately, without this in place there is a real risk of overwhelming a control room causing further failures in the system.
3.4.5 The clear choice for the Trust is to either reduce the size of Brierley Hill into two controls to allow them to provide each other with fallback or to develop a further control of a similar size to Brierley Hill that can absorb a failure of what is currently the largest centre in the system. Reducing the size of the controls will reduce the risks around the failure of Brierley Hill but will significantly add to the costs and to the risk for the whole system, for example, another control that is not co-located with a radio system and relying on external network providers to access radio functionality and is, therefore, unacceptable.
3.4.6 A second control room of a similar size to Brierley Hill also requires it to be staffed to similar levels to ensure that it is a “hot” standby and able to assume control of calls within the region immediately. Ideally the second control room would be co-located with the proposed data centre at Tollgate thus reducing risk of wide area network failure of the system having an impact on the Trusts ability to respond to emergency calls.
3.4.7 With Brierley Hill and Tollgate providing approximately 100 of the total seating capacity (Brierley Hill already has 40+ seats but would look to expand to approximately 50 seats – the proposal is for Tollgate to replicate the capacity) for the region the Trust would not require all of the capacity provided by the remaining controls at Dale Street, Bransford and Abbey Foregate although a certain amount of additional capacity would need to be retained for the following reasons:
· Closure of too many controls over a short period of time could have a destabilising effect on the Trust
· The exact impact of “Call Connect” has not been fully established and can’t be until the Trust have begun to adapt systems to address the new response time targets. Some further seating capacity may be required.
· A failure in the system of the larger controls will necessarily affect the Trusts ability to respond to emergencies – having a “buffer” in the system would be beneficial in the event of a medium and long-term failure of either of the larger controls.
The Trust plan to introduce significant technology changes over the next 18 months and a stable platform (existing controls) are required to test the systems
Greater likelihood of failures developing with new control in its infancy and therefore diverse fallback (2 alternative sites) are a distinct advantage.
3.4.8 The two controls at Tollgate and Brierley Hill deliver the major part of the Trusts projected requirements, e.g. 100 seats. The remaining controls at Dale St, Bransford and Abbey Foregate provide 10, 10 and 4 seats respectively. The following table identifies the strengths and weaknesses of each of the controls.
Advantages Disadvantages
Bransford 1. Space available 1. Costly for radio programme diverse routing (150k)
2. Technology is significantly different to other controls and would require investment e.g. telephone system, vehicle tracking (approx 100k) An omission of vital and relevant information here. And some information that's downright misleading. There is a whole 1st floor currently consisting of 8 offices divided only by stud-walling and only partly utilised. The EOC currently operates from 1 room taking up at most, 1/4 of the ground floor. Bransford has a functional space area (m2) of 473. of which 157 in on
the first floor. We have been repeatedly assured finance is not the issue, so let's see that £150k invested in Bransford. As Mr Marsh stated recently, right decisions are sometimes hard decisions; equally, right decisions are sometimes not the cheapest ones. £150k divided by the 722,500 population of herefordshire and Worcestershire , rounded up to the nearest whole penny, equates to 21p her head. Pretty good value for money. Will gain confirmation asap but believe MIS can work in conjunction with ARP. Vehicle tracking would have to be installed whether the Bransford site closes or not. Leamington Spa 1. Cost-effective to provide radio resilience
2. Modern technology already in place with resilience already in place and compatible with Staffordshire control.
3. High performance control currently delivering “Call Connect” performance.
4. Building is leased from Fire Brigade at a competitive rate It should be noted Fire Brigade is vacating the builing in 2 years time.
5. Technology in use is similar to that in place throughout the region e.g. telephony, AVLS and mobile data 1. Very little space to develop further positions
2. Building not owned by the Trust
Abbey Foregate 1. Space available
2. Already linked to the BBC control and share the same infrastructure 1. Too small currently and requires significant expansion to accommodate the additional seats required.
2. Building requires a significant investment to meet Health and Safety requirements
3. Expensive to provide radio diverse routing
From the above list of advantages it can be seen that whilst the control room at Leamington Spa has little room for expansion it has numerous other advantages in terms of costs and infrastructure that are beneficial to the Trust at this stage of the development of the West Midlands system.
3.4.9 The radio system will impose certain methods of working on Trusts (by providing only two systems) and will play a part in determining Trust IT strategy. For example, the two planned centres at Tollgate and Brierley Hill will be expanded into data centres to make best use of the network technology, reduce the risk of failure by protecting larger centralised and resilient systems and also reduce the cost of ownership, maintenance and management of the systems.
3.5 Retention of all controls
3.5.1 The Trust recognise the issues around the closure of control rooms within the region but believe the benefits of the Trusts proposals will benefit all patients within the region. The system is intended to provide a virtual call centre that identifies where the capacity exists within the system and directs the calls appropriately. To achieve this seamlessly and safely the system will rely heavily on computer and communications technology. The simplest approach to the problem is to provide 2 large call-taking environments, as this requires a single network link. However, for the reasons described in the previous section, the process will place a number of risks on the Trust and therefore retention of a second existing control reduces the risk considerably.
3.5.2 To retain controls within the system the following areas of technical cost needs to be considered:
· Each of the sites will require diverse routing for the radio and telecommunications systems. Current costs of provision are in excess of 150k for Bransford and Abbey Foregate. Costs of the routing are in the region of 15k for the sites being retained
· The Trust currently uses 4 different control systems and a plan is already in place to implement a Trust wide standard but increased sites will increase the license cost.
· The Trusts strategy for a virtual control system means that the Trust will need to provide data connectivity across all of the sites at a cost of 150k implementation and approximately 300k for rental. This figure is substantially reduced with less control rooms in the system
· The need for a virtual control room also requires standardisation of telephone system and to ensure that they are able to work autonomously (in the event of a system failure) a local system is also required. The system at Bransford control is different to the Meridian technology used across the other control centres and would need to be replaced at a cost of approximately 100k.
· Voice recording will provide the Trust with a number of technical challenges as provision of remote recording will be required as access to the radio system will be through wide area network links provided by the ambulance radio programme.
· Much of the back office support equipment employed at the control centres in Leamington Spa, Bransford and Stone Rd is near or past replacement or has no resilience. The Trust strategy is to centralise all back office functionality to the two data centres and deliver the functionality using thin client technology. This approach will require further investment from the Trust.
· IT support, both locally and externally through maintenance agreements, are expensive. Centralisation of the role to the data centres will prove more cost effective and allow the Trust to direct funds into front line services. 4.0 Proposals
4.1 Proposal 1. To expand Tollgate to 50 seats
4.1.1 To provide sufficient furniture to support 50 positions
4.1.2 To provide sufficient call taking and dispatch positions for the new centre
4.2 Proposal 2. To expand Brierley Hill to 50 seats
4.2.1 To provide sufficient furniture to support 50 positions
4.2.2 To provide sufficient call taking and dispatch positions for the new centre
4.3 Proposal 3. To upgrade the facility at Leamington Spa to accommodate the requirements of the national radio project.
4.4 Proposal 4. To close the current facilities at Stone Rd, Abbey Foregate and Bransford.
5.0 Stakeholders
5.1 In implementing the proposed solution, the following stakeholders have been identified as being involved in the within the desired implementation.
Stakeholders: Overview of Business Requirements
Primary – Internal IM&T Department
Staffordshire control
Estates Department
HR Department
Finance Department
External Building supplier
Cabling Suppliers 6.0 Business & Operational Impacts
6.1 The business and operational impact in deploying the proposed solutions are noted below:
Impact & Description Proposal 1 -
To expand Tollgate to a 50 seats Call Centre
Proposal 2 –
To expand Brierley to a 50 seat Call Centre
Proposal 3 –
To upgrade Leamington Spa to receive the new radio system
Proposal 4 -
To close the controls at Bransford, Abbey Foregate and Stone Rd
Stakeholder: IM&T Department
·1 Impact 1 -
Additional training required to support the proposed solution
Impact – None/Positive
No impact
Impact – Low /Positive
Familiarisation with desk and cable management Impact – Low /Positive
Familiarisation with PC and application configuration Impact – Low/Positive
Familiarisation with building layout
·2 Impact 2 –
Resource commitment to achieve proposed solution
Impact – Medium/Negative
Potential reduction in performance during planned Control Room migration Impact – Low/Positive
Resource will be required to route power and data requirements between desk and floor sockets
Furniture specification to include IT hardware requirements
Impact – Medium/Negative
Potential reduction in performance during planned Back-Office server migration Impact – None/Positive
No impact
·3 Impact 3 –
Impact on Data Centre strategy.
Impact – Low/Positive
Implementation complies with Data Centre strategy
Impact – Low/Positive
Implementation complies with future Data Centre strategy
Impact – None/Positive
No impact
Impact – None/Positive
No impact
Stakeholder: Staffordshire Control
·4 Impact 4 -
Additional training required to use the proposed solution
·5 Impact 5 -
Resource commitment to achieve proposed solution
Stakeholder:
Estates Department
·6 Impact 6 –
Resource commitment to achieve proposed solution
Stakeholder:
Network Supplier
·7 Impact 7 -
Resource commitment to achieve proposed solution
Impact – None/Positive
No impact
Impact – None/Positive
No impact
Impact – None/Positive
No impact
Impact – Medium/Positive
Installation of data cabling within office area
Stakeholder:
Building Supplier
·8 Impact 8 -
Resource commitment to achieve proposed solution
Impact – None/Positive
No impact
Impact – None/Positive
No impact
Impact – None/Positive
No impact
Impact – Medium/Positive
Commitment to renovate building/office space in line with Trust requirements
·9 Impact 9 -
Resource commitment to achieve proposed solution
Impact – None/Positive
No impact
Impact – None/Positive
No impact
Impact – Low/Positive
Provision of Triage software
Impact – None/Positive
No impact
Positive impact - indicates that it will help to achieve the stated goal
Negative impact - indicates that it will hinder the achievement of that goal
High impact - indicates significant impact to stakeholder
Medium impact - indicates manageable impact to stakeholder
Low impact - indicates minor impact to the stakeholder
None - indicates no impact to stakeholder
7.0 Implementation Risk Assessment
7.1 Risk Assessment associated with each potential solution (Not including Status Quo)
7.1.1 The following information was noted in performing a risk assessment of the proposed solutions:
Impact & Description Proposal 1 -
To expand Tollgate to a 50 seats Call Centre
Proposal 2 –
To expand Brierley to a 50 seat Call Centre
Proposal 3 –
To upgrade Leamington Spa to receive the new radio system
Proposal 4 -
To close the controls at Bransford, Abbey Foregate and Stone Rd
Probability Impact Probability Impact Probability Impact Probability Impact
Risk 1 - Lack of Executive support to implement the proposed solution
2
(Unlikely to occur) 3
(Objectives / Projects) 2
(Unlikely to occur) 5
(Objectives / Projects) 2
(Unlikely to occur) 3
(Objectives / Projects) 2
(Unlikely to occur) 3
(Objectives / Projects)
Risk 1 - Risk mitigation Produce business case to support requirement Produce business case to support requirement Produce business case to support requirement Produce business case to support requirement
Risk 2 - Lack of additional funding to support the implementation of the proposed solution 5
(Almost certain) 4
(Staffing/ Capacity) 5
(Almost certain) 4
(Staffing/ Capacity) 5
(Almost certain) 4
(Staffing/ Capacity) 5
(Almost certain) 4
(Staffing/ Capacity)
Risk 2 - Risk mitigation Produce business case to support requirement
Produce business case to support requirement Produce business case to support requirement Produce business case to support requirement
Risk 3 - Potential reduction in IM&T service delivery performance during proposed implementation
2
(Unlikely to occur) 1
(Staffing/ Capacity) N/A N/A 2
(Unlikely to occur) 1
(Staffing/ Capacity) N/A N/A
Risk 3 - Risk mitigation Resource staff to ensure requirement is achieved Resource staff to ensure requirement is achieved
Risk 4 – Proposed solution does not meet Operational, Airwave or IM&T requirements
2
(Unlikely to occur) 3
(Service/ Business Continuity)
2
(Unlikely to occur) 3
(Objectives/ Projects) 2
(Unlikely to occur) 3
(Objectives/ Projects) 2
(Unlikely to occur) 3
(Objectives/ Projects)
Risk 4 - Risk mitigation Resource project with appropriate Stakeholder
Resource project with appropriate Stakeholders Resource project with appropriate Stakeholders Resource project with appropriate Stakeholders
Risk 5 - Risk mitigation Ensure appropriate IM&T Stakeholder is part of project team Ensure appropriate IM&T Stakeholder is part of project team
Risk 6 - Proposed solution results in loss of Control Room performance / effectiveness
3
(Reasonable Chance of occurring) 1
(Service / Business interruption) N/A N/A 2
(Unlikely to occur) 1
(Service / Business interruption) 2
(Unlikely to occur) 3
(Objectives/ Projects)
Risk 6 - Risk mitigation Ensure appropriate staffing levels during implementation Ensure appropriate IM&T Stakeholder is part of project team Ensure appropriate staff /Operational present within Project team
Risk 7 - Lack of Supplier commitment or quality within proposed solution
2
(Unlikely to occur) 3
(Objectives/ Projects) 2
(Unlikely to occur) 3
(Objectives/ Projects) 2
(Unlikely to occur) 3
(Objectives/ Projects) 2
(Unlikely to occur) 3
(Objectives/ Projects)
Risk 7 - Risk mitigation Gain written commitment from Supplier to assist in migration as part of contract negotiations Gain written commitment from Supplier to complete renovation as part of contract negotiations Gain written commitment from Supplier to complete renovation as part of contract negotiations Gain written commitment from Supplier to complete work as part of contract negotiations
Risk 8 – Proposal requirements does not meet Trust requirements
N/A N/A 2
(Unlikely to occur) 3
(Objectives/ Projects) 2
(Unlikely to occur) 3
(Objectives/ Projects) 2
(Unlikely to occur) 3
(Objectives/ Projects)
Risk 8 - Risk mitigation Employ a specific team leader to monitor migration. Employ a specific team leader to monitor renovation work. Employ a specific team leader to monitor Machine room build. Employ a specific team leader to monitor selection of furniture
8.0 Cost / Benefit Analysis
8.1 Financial Cost
8.1.1 The following costs highlight the various elements of the proposed expenditure:
2007/08 2008/09
Revenue Capital Non Recurrent Revenue Revenue Capital Charges Total Revenue Capital Revenue Capital Charges Total Revenue
Tollgate Works 400 50 0 9 59 0 (100) 34 (66)
Brierley Hill/Leamington upgrades 400 0 0 9 9 0 0 34 34
Resilient Hardware 250 0 0 14 14 0 0 58 58
Dispatch Software 900 250 20 40 310 0 80 160 160
Voice Recording 120 0 5 1 26 0 20 6 6
Telephony 350 0 8 20 28 0 30 80 80
Networking 120 0 25 6 31 0 100 26 26
Disposals 0 0 0 0 0 (2950) 0 (177) (177)
Sub-Total Costs 2540 300 58 99 457 (2950) 130 221 351
All Values include VAT and Capital charges/depreciation.
8.2 Benefits:
8.2.1 The following key benefits are output in implementing the Control Room reconfiguration:
The Trust is able to make best use of technology to support the requirements of the “Call Connect” performance indicators and Taking Healthcare to the Patient.
The issues around the business continuity of the Trusts largest call centre in Brierley Hill are addressed by the implementation of a second control room of equal size
The Trust achieve inter-operability across the region, allowing each area to make best use of resources
The Trust have sufficient strategic capacity to respond to peaks and troughs of demand by centralising core functions such as call-taking and dispatch
The Trust have increased capacity in responding to major incidents both from its ability to control the incident and in its ability to identify resource across the region
9.0 Conclusion
9.1 The proposed control room reconfiguration business case provides the most cost effective, safe and resilient method of delivering control room technology to the region of the West Midlands and supports the aims and objectives of the Trust Board.
9.2 The proposed Control room forms part of the organisation Virtual Control Room implementation to meet the NHS ‘Call Connect’ and ‘Taking Healthcare to the Patient Strategy. The configuration addresses the requirements of the Trusts obligations under the Civil Contingencies Act and ensures that the Trust makes best use of its available resources.
9.3 Proposed expenditure (£thousands)
Implementation costs 2007/8 2008/9 2009/10 2010/11 2011/12
Capital 2540 (2950) 0 0 0
Non-recurrent revenue 300 0 0 0 0
Revenue 58 130 130 130 130
Capital Charges 99 221 221 221 221
Total Revenue 457 351 351 351 351
10.0 Implementation
10.1 Implementation Overview
10.1.1 The business case seeks to implement a Control Room configuration that supports the ‘Call to Connect’ performance standard, ‘Taking Healthcare to the Patient’ and the proposed Airwave implementation that forms part of the organisations overall strategy. To achieve this aim, the following objectives are outlined:
To implement a 50 seat call centre in tollgate in Stafford
To expand the seating requirements in Brierley Hill to 50 seats
To provide furniture at the new centre in Tollgate
To provide call taking/dispatching systems in Tollgate
To upgrade facilities in Leamington Spa to accommodate the requirements of the new radio system
To close the facilities at Stone Rd, Bransford and Abbey Foregate.
10.1.2 The timing around the ambulance radio project is critical in terms of its impact on the control room reconfiguration. The implementation must be programmed to work in conjunction with the dates provided by the Department of Health radio project team.
Approve business case Week 1
Implement 50 Seat Centre
Expand Brierley Hill
Upgrade Leamington
Close Stone Rd, Bransford and Abbey Foregate
10.2 Scope
10.2.1 The scope of the implementation is to include:
To provide up to 50 positions within the Tollgate facility
To expand the capacity at the Brierley Hill control to accommodate up to 50 positions
To upgrade the facility at Leamington Spa to accommodate the requirements of the new radio system.
To close the controls located at Stone Rd, Bransford and Abbey Foregate
10.3 Out of Scope
10.3.1 The activities not included within the business case:
The implementation of the Virtual Call Centre Telephony solution
The implementation of the Virtual Call Centre CAD solution
The implementation of the West Midlands Wide Area Network
The Ambulance Radio Programme
11.0 Business Case Approval Process
11.1 Business Case Signoff
Director of Finance: …………………………..……… Date:…………………………….
Director of IM&T: …………………………………..… Date:…………………………….
Chief Executive: ……………………………………..… Date:…………………………….
Chairman: ……………………………………………..… Date:…………………………….
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