London Ambulance Service NHS Trust

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Information Management and Technology in the LAS

As a leading Ambulance Service committed to improving standards of patient care and operational performance, The London Ambulance Service requires robust and up to date IM&T services to support operational responses to over a million Emergency calls, and numerous high profile incidents and events each year.

The LAS is moving into an exciting new era with the implementation of new information and technology services including a new Computer Aided Dispatch System, the Airwave digital radio network, IP Telephony across the Trust, new server and data warehouse architectures, updated office IT services and many more new facilities. Making sure that these, and all existing IM&T services, run smoothly, and constantly evolve, is a critical responsibility. Consequently, the Trust is re-organising and expanding the IM&T Directorate to ensure our customers receive the highly effective, professional and clinically focussed standards of IM&T service which their environment demands.

The IM&T Directorate is now structured to provide customer focussed IM&T service delivery and support, based on ITIL service management frameworks, to approximately 4,000 internal customers across around 100 sites including:

• Operational users (Emergency Service, Urgent Care and Patient Transport) at Emergency and Urgent Operations Centres, operational Ambulance Stations, Hospitals, at other sites and in operational vehicles.
• Operational support and corporate users spread across the organisation.

The technologies and techniques supported are relatively complex. This is due to the size of and the quantity of sites served by the infrastructure, the resilience required to ensure business and operational continuity and the degree of availability and flexibility required by a large Emergency Service.

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IM&T Directorate Overview

The directorate is organised as follows

Service Delivery:

This area provides management of security and service provision and high level delivery of specialist information services, comprising two departments:

• Security and Service Delivery Department:
  The main remit of this department is to proactively manage security and service provision. This brings together information security, service level management, change management, service desk, finance and administration, continuity, availability and capacity process management.
• Management Information Department:
  This Department provides an information service covering production and analysis of information, development of MI systems and web-based tools and to provide a patient records archive function.

Service Support:

This area provides day to day operational support and provision of all IM&T service functions, with specific emphasis on the mission critical operational environment of taking and responding to 999 emergency calls, comprising two departments:-

• Software Development and Support Department:
  This area provides specific focus on the management of the Computer Aided Dispatch (CAD) system, its overall performance and the resilience of all integrated CAD functions (including Mobile Data Terminals and Graphical Information Systems). The Department provides the technical leadership and management for the replacement CAD system, particularly in relation to migration and ensuring support arrangements for the new system.
• Infrastructure Department:
  This Department is responsible for provision and support of all technical services and systems. This includes Airwave, voice and data networks, all non-CAD systems and desktop support. There is very close liaison and inter-working with the Service Desk.

The following are more detailed descriptions of each Department.

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IM&T Security AND Service Delivery Department

This Department brings together all the functions that oversee the effective delivery of services. In many ways it is seen as the customer champion and gatekeeper for the Directorate. It is different from other departments in that it comprises a number of discreet functions, some possibly with only one or two members of staff, but ensuring overall delivery of service from a customer perspective. Reporting directly to the Head of Security and Service Delivery is Information Security, Continuity, Service Level Management, Configuration, Change and Release Management, Service Desk, Finance and Administration. A brief description of each follows:

• Information Security:
  Information Security Manager, a key role within the department, responsible for information security processes, policies, procedures, physical security and investigations. This role is supported by two Information Security Officers.
• Continuity Manager:
  Responsible for overall BC planning and testing and IM&T service availability and capacity management processes. This role works directly with system managers across the Directorate, providing Trust wide BC planning, ensuring appropriate measures are in place and that regular testing is undertaken and to proactively manage the availability and capacity management processes. There is a clear link between the availability and capacity management processes and service Level management, ensuring the continuity of all IM&T services.
• Service Level Management:
  ‘The customer champion’ establishing clear levels of (realistic) service with defined users and reviewing directorate performance against them. This role, however, does not simply monitor performance but actively engages IM&T support and managers to ensure delivery.
• Configuration, Change and Release:
  The Configuration, Change and Release Manager, is supported by a Configuration, Change and Release Officer. This function is responsible for these three ITIL processes across the Directorate. It is core to ensuring stability in a changing environment.
• Service Desk:
  Service Desk Manager is responsible for the day to day management and development of the Service Desk, supported by five permanent Service Desk staff committed to operating an efficient, customer focussed IM&T service. Currently this provides office hours support, although extended hours may be considered in the future.
• Finance and Administration:
  A finance and administration manager providing finance and administrative services across the Directorate, with a professional responsibility to the Finance Department. This role is supported by two administrative assistants.

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IM&T Management Information Department

The Management information Department has evolved over many years and now provides an information service across the Trust. Over the last few years, systems have changed considerably and access to data has improved massively. The department’s role has changed from providing a traditional information reporting and analytical service, to encompassing a wider development role in response to demands for bespoke information and IT tools which aid the performance management of the service. Development of MI systems and web-based solutions are now a core function within the department. The structure ensures that staff specialise and focus either on development of systems or on information provision and analytical work and that the department meets the challenges of the future and is able to continue to provide an efficient, customer-focussed service which meets the demands of the Service.

The Management Information Department encompasses three main areas; Information Development Services, Information Analytical Services and Operational Information and Archives.

• Information Development Services:
  This team is managed by a Deputy Head of MI responsible for Information Development, this is a key function, responsible for the technical development of all Management Information systems across the Trust. This Deputy head is supported by a team of developers who focus on the support and development of new MI systems and enhancements to specific systems. The team is also responsible for the development and support of Trust wide web-based solutions.
• Information Analytical Services:
  Managed by an Information Analytical Services Manager, reporting direct to the Head of Management Information, this team of analysts is responsible for information provision across all Management Information systems. The Information Analytical Services Manager is specifically responsible for ensuring that MI is meeting customer requirements and works closely with the Deputy Head of Management Information. The analysts are supported by a team of Management Information assistants and Management Information clerks.
• Operational Information and Archives:
  This team is responsible for the management, storage and retrieval of operational and patient information. New developments across the Trust are likely to have an impact in the way that this information is stored and accessed.

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IM&T Software Development and Support Department

The Service Support Department is currently focussed on replacing the existing CAD system under a project named CAD 2010. In parallel, there is focus on maintaining the current CAD system and, where necessary, enhancing it to ensure business functionality and stability. The Department has three areas:

• CAD 2010 Project:
  Project Manager and staff with this single focus to replace the existing CAD in the shortest safe timeframe possible.
• CAD System Management:
  CAD Systems Manager and staff are responsible for maintaining stability of existing CAD system and associated interfaces (e.g. Mobile Data Termianls). The team supports the overall CAD service including system hardware, operating systems, applications and database environment. The team also works closely with the CAD 2010 Project to assist with migration and preparation to take over system management of the new CAD once live.
• CAD Enhancements:
  Lead on a part-time basis by a Consultant Project Manager, who is also the Airwave implementation Project Manager. The team work closely with the existing CAD team to complete outstanding enhancement work and assist with maintenance upgrades.
• London Ambulance Radio Projects (the Airwave implementation Project):
  Responsible for implementing the Airwave radio services provided through the DH, including the Integrated Communications Control Systems (ICCS) in the Trust’s control rooms, mobile and hand-portable radios, and associated systems

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IM&T Infrastrucuture Department

This department has end to end responsibility for the IM&T technical infrastructure and systems.

The term Infrastructure refers to a wide variety of facilities and services such as telephone and data networks, mobile voice and data systems, radio networks and systems, information systems, host server systems, host applications and the desktop and mobile office environments.

The Department comprises:

• Support Specialists teams
  These teams are responsible for desktop services which refers to the IM&T environment provided directly to customers’ workplace (whether fixed or mobile). This includes desktop, personal, and mobile computer and telephone equipment, client software including office automation services (Microsoft Outlook, Office etc.) and access to specialist information systems.
• The Systems team
  The Systems team supports the IM&T information systems. The term “information systems” relates to the hardware, operating systems, software, utility software and administration associated with Trust servers, including the management of Data Centres and network services such as Active Directory, Dynamic Host Configuration Protocol (DHCP) & Domain Name System (DNS)
• The Networks team
  This team supports the IM&T voice & data services, including the provision and maintenance of Trust wide, high availability, telephone services, data networks, and support of the mobile data networks and equipment.
• The Airwave team
  The Airwave Team supports the Airwave radio services provided through the DH, including the Integrated Communications Control Systems (ICCS) in the Trust’s control rooms, mobile and handportable radios, and associated systems.
• The IM&T Infrastructure Project Teams
  These teams are responsible for co-ordinating and implementing enhancements and new facilities in the IM&T Infrastructure.
• Technical Support & Maintenance Contractor
  This is an integrated, third party, outsourced IM&T Contractor, for the maintenance and support of critical front line equipment.

All of these teams to a greater or lesser degree provide support of critical operational services in the Emergency Operations Centre, the Mobile Data Terminal infrastructure and other services and equipment used by frontline ambulance crews in order to provide a fast response in delivering emergency patient care.

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