After thorough research, the execution essentials are a distillation of the attributes needed for the successful execution of a technical vision. Conversely, projects that have failed were conspicuously missing these components. A more detailed description of each element is contained in the attached appendix.

It draws on the following source materials:

• Government Design Principles
• The Government Digital Strategy
• The Power of User Research NHSX Blog by Sophie Rankin
• Making NHS UK Available Everywhere
• What we learned at NHS Hack Day by Terence Eden
• Leadership by David Marquet
• Thinking in Systems
• People Power
• Autonomy, Mastery and Purpose - Daniel H Pink
• Metacrap Blog Post
• The Government IT Self Harm Playbook
• US Digital Services Playbook

There are four key phases. These will be delivered within 24 months of the project going live.

1. Found the company
2. ESR API Wrapper and Murfin+ migration
3. Migrate SARD’s eRostering platform to the company
4. Develop a “Staff Master Index” platform within the company

In order to achieve the above deliverables we have outlined the required costing in our top level costing document. Please see Execution Plan Costing for full details

The funding for the above project is based on a 24-month delivery programme. The resource requirements have already been identified and the budget allocation in place. The 24-month period would start at project initiation and is for the time required for SARD’s actions. Timescales not included are those dependent on partners.

Existing

In 2020, there were two open-source products developed by SARD in partnership with Oxleas NHS FT and funded by NHS Improvement:

• ESR Wrapper API - an application to parse and wrap the nightly ESR CSV data from an FTP server and represent it in a modern Open API Specification aka. Swagger. This product has already been adopted by UCLH, and Torbay and South Devon, who both independently contacted SARD requiring its use in a Staff Master Index project.
• Murfin+ - an application that allows a trust to review the current job plans and compare that to the reality of direct clinical care. The core aim is to allow service managers to understand pressure points either for recruitment or redeployment of resources.

They are currently housed and maintained by SARD in their Github repositories and released under an MIT licence. The company should house these assets because they:

• become Independent of SARD
• are natural ancillary products to eRostering and the Staff Master Index
• Make it easier for non-SARD clients and her competitors to contribute

ESR Wrapper API

SARD ESR Wrapper API is an open-source product developed by SARD in partnership with Oxleas NHS FT and funded by NHS England and NHS Improvement.

Electronic Staff Record (ESR) is an incredibly important part of the NHS and holds details of all staff within the organisation. There has historically been much scope to improve the way data can be accessed from ESR to ensure it can be used in a useful way.

API stands for Application Programming Interface which is a way to define interactions between multiple software programmes. An easy way to think about an API is when you type into a search engine, once you hit enter, the search engine uses multiple APIs throughout the internet to find the answer - at an incredibly rapid speed.

Through the ESR Wrapper API, ESR data can be accessed through a user interface which is aesthetically pleasing and easy to use. This allows the user to find the information they require in a matter of minutes if not seconds.

Open-source means this facility is now available to everyone for free and all users can benefit. There is no access charge.

• Access information easily and efficiently
• Multi-level data security (only enable access to the data needed)
• Easy-to-navigate user interface, developed with the user in mind
• Community-driven and open-source project that will continue to evolve and grow

Murfin+

SARD’s Murfin+ system reviews the job plans that the trust has created and compares that to the reality of direct clinical care. This allows for a better understanding of what is happening in real time, so service managers are able to identify overload, recruitment needs and reassign efforts to improve delivery.

Why

Created in partnership with Oxleas and Nottingham University Hospitals NHS FTs, Murfin+ has been developed to create better job planning accuracy, leading to greater understanding of how work is being delivered within a trust, with the ultimate goal of improving patient experience and outcomes.

Three principles

1. Non-onerous: using existing data, Murfin+ uses what’s already available without extra administrative input.
2. Patient-centred design: aiding leadership decisions based on improving patient experience.
3. Detection: Murfin+ makes no attempt to diagnose a root cause, but displays any discrepancies in order to prompt discussion on what changes or improvements may be needed.

How

The system compares the expected output of direct clinical care based upon a service’s job plans with actual outcomes. The tool reports inconsistencies between the two and calls for action. This system is not designed to be a performance management tool but reduces the gap between expected and actual clinical care by improving the data quality of job plans.

Staff Master Index

The execution essential: “User led: Build The One Thing” states that we should:

“focus on a clear and unambiguously recognised problem for users”

An accurate database of the relations between staff is a common and persistent problem across the NHS. There is evidenced in the following places:

• Trusts interested in, or implementing, the ESR Wrapper API have been using it to create a Staff Master Index. Those trusts are
• UCLH
• Oxleas NHS FT
• Torbay and South Devon NHS FT
• Birmingham Community
• The lack of a core staff reference point is a common problem at The Supplier Reference Group meetings of NHSI’s Workforce Deployment System Project.
• SARD’s experience over the last 10 years has found that trusts regularly restructure their organisational data. Often this is a redefining of the hierarchy of a tree structure rather than a fundamental change in the data itself. To give a recent example, Manchester Foundation Trust have swapped Hospitals and recently restructured all their organisational groups. We are in the process of organising this for them on SARD, making sure our system reflects their new organisational structure.

At UCLH, the Staff Master Index (SMI) is designed to tackle the problem that they cannot reliably identify the same member of staff on different IT systems. This makes it very time consuming to pass important information between the systems, for example when managing new members of staff, managing the exit process for staff, or simply trying to keep a person’s details accurate. The Staff Master Index becomes the master list for all people who provide services at UCLH in a non-patient, non-carer capacity.

For each system that subscribes to the SMI a list of the following is generated:

• new members of staff that need to be added to their system;
• staff records where information is not consistent with more trusted systems.

UCLH are currently exploring how they can automatically generate default requirements for new UCLH starters for information such as Epic access, Epic training and mandatory training. This is dependent upon a fully functioning Staff Master Index.

So far UCLH have:

• Built, imported and automated matching routines that cover the following systems: ESR; Active Directory; Epic (user details); E-roster; Bank; C-CURE (door security system).
• Carried out manual matches on around 3000 records where an automated match couldn’t safely be made.
• Placed 23,000 unique records on the SMI where the record is on more than one system.
• Proposed the preferred systems for each data item when populating the SMI. ESR is the principal source of information wherever it holds a record for a person.

Key next steps for UCLH:

• Establish daily or weekly updates to the SMI from the participating systems. Aiming for this to be in place for ESR and Active Directory in early November.
• Investigate the processes and data quality for the participating systems. The outputs from the matching routines (see appendix A) show that we need to do more to understand the data and processes in each participating system.

Similar projects exist within at least four more hospitals known to SARD JV. Andy Sandford from We Are Lean and Agile - a business process improvement company - has noticed a similar need for organisational discovery tools in local government.

The company seeks to bring together the best of these projects into an open-source application. Accurate and reliable staff data is a key challenge facing public sector organisations across the globe. This project will alleviate that issue.

eRostering

SARD eRostering is a powerful, AI-driven self-rostering system that analyses the information you enter and calculates the optimum roster to most efficiently meet the needs of each individual and the workload of the trust.

eRostering is able to handle and assimilate any number of your chosen parameters, from consecutive shift restrictions, leave and sickness and Working Time Directive factors to which team members work best together and the personal preferences or prior commitments of each user.

Users can see at a glance when they’re working, and when and where their colleagues are rostered. They can also request to swap shifts with colleagues from within the system.

Our system can be used for all work groups – consultants, junior doctors, nurses and all other staff can benefit from the smarter rosters and better work-life balance SARD offers. Regardless of the job role, it can be used in any environment including both acute and community care.

Furthermore, this system goes beyond just employee rostering and can help meet other administrative needs such as locating equipment, bed allocations, theatres etc.

eRostering removes the complicated maths from the process, giving administrators time to focus on what they want their rosters to achieve, not how to make them work, saving time and money and contributing to a happier workforce with a better work-life balance.

• Facility to build, edit and approve rosters before they are made live to all users
• The right people in the right place, with the right skills at the right time
• Smart self-rostering that can outperform any manual analysis and calculation
• Safe staffing levels
• Reduced sickness and unauthorised absence
• Minimised agency and locum cover

The licence type

Our current open-source products operate on a MIT license. The MIT license is a short and simple permissive license with conditions only requiring preservation of copyright and license notices. Licensed works, modifications, and larger works may be distributed under different terms and without source code.

Other licenses under consideration are the AGPL v3 license. Permissions of this strongest copyleft license are conditioned on making available complete source code of licensed works and modifications, which include larger works using a licensed work, under the same license. Copyright and license notices must be preserved. Contributors provide an express grant of patent rights. When a modified version is used to provide a service over a network, the complete source code of the modified version must be made available.

Upon funding agreement, Public Money, Public Code will establish its constitution, board structure and membership structures. The remaining funding will rest within the company for the system migration phases outlined above. The executive board will allocate the development budgets and oversee the project plan and completion. A membership structure will be set up to ensure future self-sustainability of the company, without any further funding requirements. Public Money Public Code is not predicated on SARD JV’s long term involvement and must be an independent body with the constitution at its centre.

Constitution

currently in draft by commercial lawyers

It is imperative that an agreed and definitive constitution is set out in the memorandum of association, as well as the rules to govern the company via its articles of association. The constitution will underpin the goals and objectives of the company and all the members that it serves.

Executive board responsibilities

The executive board will have overall responsibility for ensuring that the company meets its statutory and other obligations, and that the company is run in such a way that it will continue to satisfy the community interest test. They would act to make collective decisions and will be limited in the number of members and length of term. There will be a criteria for nomination and selection in place. During the initial establishment of the company a list of nominated board members are already presented.

Founding executive board member

Criteria for initial nomination

• Advocate for open-source
• Experience in the field
• Technically literate
• Proposed Board Members - Executive

Board members will be subject to a term limit and will need to be nominated for a place on the board. During the creation of the company, this proposal will act as the nomination process for board members to serve the first term. It is also proposed that the annual remuneration for a board member is £12,000 per annum. The initial list of board nominations are:

• Kevin Monk (Managing Director)
• Prof Joe McDonald
• Rob Dyke
• Marcus Baw

If you wish to be a founding board memeber, we will shortly be giving details of how to put yourself forward.

Leadership and direction

The company should be led by a managing director. The managing director should be appointed by the executive board members. Their primary responsibility must be to be a driving force for engaging with stakeholders and articulating the vision. As a metric of accountability and suitability for leadership, it should be non-ambiguous to any employee, contractor, board member or client who the leader is and the wider vision of the company.

Steering Group - Membership

Chair - Tim Donohoe NHSX

The steering group will be made up of membership representatives. The steering group will act as an advisory group to the executive board members. The membership will also be able make nominations to the executive board.

Membership Structure

Membership will be set up in the following way:

Code Maintenance

Once the initial four systems are migrated to the company the maintenance of the code and documentation and the roles within that would need to be devised and established. The company would need to define how to incorporate regular project contributions into the workflow and how to resolve any community debates. Many open-source projects opt for the following roles:

• Maintainer - Responsibility for the overall direction of the project and is committed to improving it.
• Contributor - This role can cover a multitude of different areas including commenting on issues or pull requests, people who add value to the project and those who submit code.
• Commiter - This is a more specific responsibility and is used to distinguish commit access.

This is drawn from the following source material: https://opensource.guide/leadership-and-governance/

Open-source Implementation

The code,documentation and APIs for each system will be available on GITHub and can be readily accessed. If a Trust already has the IT infrastructure available then the systems can be implemented internally. For those Trusts that require implementation, maintenance and support, external companies can quote for the opportunity based on the level or required assistance.

For example if a Trust wished to implement the eRostering system, SARD would be able to quote for the initial implementation of the system within the Trust as well as quote for the maintenance and support required within a time limited period, subject to contractual agreements. Should a tender be required, existing frameworks including the HSSF could be used to select the right supplier.