Planning

Once ready to proceed, contact the NHS England live services team  to get a copy of the on-boarding checklist and the NRL NEMS Stakeholder and End User Rollout Form.   

The on-boarding checklist and rollout forms must be completed and submitted to [email protected] once you are ready to implement NEMs. The forms must be submitted a minimum of 10 days prior to your proposed go-live date or earlier if you have a go-live date that cannot be moved for commercial reasons. This allows for any delays.

During peak times, there may also be a pipeline of organisations implementing NEMS. The NHS England implementation team will be able to advise on any lead-in times.

To ensure you meet your go-live date, it is advisable to start the following on-boarding activities

• share your supplier’s NEMS clinical safety case and the NHS Digital clinical hazard log with your clinical safety lead
• share the Data Sharing Arrangement (DSA) with your IG lead as they will need to sign this document prior to implementation
• read the technical specification/user guide/release notes for NEMS and understand how the product you will be using meets your requirements for interoperability
• read the End User AUP from your supplier (Appendix 1 in supplier’s Connection Agreement with NHS Digital) and ensure you comply with the requirements
• check whether your organisation has ‘standards met’ (or higher) for the Data Security Protection Toolkit (DSPT) or find out what the work-off plan is to meet the requirement  see https://www.dsptoolkit.nhs.uk/  If it isn’t ‘standards met’ or higher, please contact [email protected] and seek advice on your work-off plan now
• work with your supplier to understand what NEMS subscriptions need to be implemented to enable the correct data flows for your patient cohort. This information should be included within the NRL NEMS Stakeholder and End User Rollout Form and submitted a minimum of 10 working days prior to your NEMs implementation date

You will have to change some of the ways you work to make best use of interoperability. This area of work is about understanding what your current processes are and ensuring that the introduction of new processes is as smooth as possible. It also supports the identification of any existing problems and potential improvements (benefits).

If you haven’t already got your current processes in each setting mapped out, it might be worth doing it. This will help you to see what changes are needed further down the line and who needs to be told about them. Decide where you want to see benefits and take a baseline measure of the things you expect to improve. If your project is in Child Health Information Services or Health Visiting guides are available to help you. Additional support is available in Appendix C.

Once an organisation has decided to use NEMs for birth notifications, they may wish to stop their HL7 feed as part of the cutover plan, assuming they have one (opting to use the BNA or BNA email as a means of checking the births happening in their maternity unit instead as their back-up process). Any organisation wanting to do this will need to send an email to the National Service Desk at least 10 working days in advance of the go-live and the exact date and time of the stoppage needs to be coordinated with the organisation’s cutover plan.

When carrying out User Acceptance Testing (UAT), it is advised to test several different scenarios and process flows so you can test your proposed processes and ensure that the correct people in the process are notified and take the appropriate action.

If your supplier has detailed user guidance for NEMs, they may not facilitate user testing and instead rely on screen shots within their documentation to inform you of the changes NEMs will deliver.

Identify who needs to be trained in the new processes, how this training can best be delivered, and the materials you will need to ensure the training is delivered effectively. Your Standard Operating Procedures will also need to be amended.

Don’t forget to ensure the changes are reflected in your business continuity and disaster recovery plans.  It is important to ensure that you have effective contingency processes in place should the NEMs service be unavailable for any period (either nationally or locally).  Any local issues or outages should be reported to your local service desk and system supplier. Your system supplier will escalate to NHS Digital if necessary.

Engage with your organisational IG lead or Caldicott Guardian to identify the existing IG policies, procedures and training materials that need to be updated. You can verify which organisations are also using NEMs and for which exchange of information by checking the NEMS Controller Catalogue

A risk assessment in line with the existing clinical hazard log and processes should also be factored into your planning. 

You should speak to your system supplier to ask about whether any upgrades to your existing system is required or whether it is part of your current contractual arrangement.  Any upgrades should be factored into your project plan. You should also ask to read their technical specification/Release notes for NEMS, so you are familiar with what the product offers.

Some suppliers will enable access to NHS Digital’s Deployment Environment (DEP) for carrying out User Acceptance Testing (UAT). Learn more about connecting to the path to live environments. If so, your users will require smartcards configured to the DEP environment rather than Live (check with your local RA and supplier around configuration and provision of cards).  In some cases, a ‘switch’ set-up can be created on local devices meaning the same device can be used for both testing and in Live You may need to use separate devices configured solely for testing purposes.  You should speak to your local IT lead for clarity on this. You should allow a week for configuration issues to be resolved once you have your smartcards locally.

To request additional smartcards for the DEP environment, requests must be made by the Path to Live service requests must state which ‘R’ and ‘B’ codes are required. The turnaround time is approximately 1 week but please bear in mind with remote working these will then have to be distributed locally.

The minimum child health and community services (0-25) requirement for ‘R’ and ‘B’ codes for smartcards are:

Base role

R5110 demographic administrator

Activities required

B0056 Complete Work Item

B0057 National Demographics Supervision and Reporting

B0059 National Demographics Management

B0062 Local System Administration

B0089 Access DSA

B0091 Manage Violent Patient Indicator

B0092 Access Service Dependant Data

B0093 Create Work Item

B0094 Amend Work Item

B0096 Amend Patient Demographics (National Back Office)

B0098 Perform Extended Person Trace

B0111 Create Work Item for CBO

B0264 Access SCR Application (perform patient trace)

B0320 View Patient Demographics (primary care)

B0330 Amend Patient Demographics (primary care)

B0620 Track Physical Health Records

B0625 Create Physical Health Records

B0825 Amend Patient Demographics

B1610 Allocate NHS Number

B1611 Access Sensitive(S) Flagged Records

B1680 Manage Patient Duplicate Records

B8009 Register Patient with Primary Care Provider on PDS

Your team should support PDF as a minimum for unstructured retrieval.  No additional licenses are required for NEMS implementation. Learn more about UAT and using the NEMS test tool.

In some cases, there may be additional costs to uplift your commercial arrangements with your supplier and you will need to think about the benefits NEMS will provide for you to offset the costs.

It is important to provide communications to all identified stakeholders explaining what is proposed as part of the child health interoperability implementation, who will be impacted, what is changing locally, why the changes are taking place and when it is planned to take place. This will help identify any impacts that have not yet been captured as well as ensure everyone is working towards common objectives. Think about how you will receive and deal with any queries off the back of these messages and keep your communications in a regular cycle.