GP systems market shake-out predicted by Granger

The numbers of GP system suppliers and local pharmacies could be reduced within five years as the NHS IT programme transforms their markets, Richard Granger, chief executive of NHS Connecting for Health, has predicted.

Granger described the primary care systems market as "immature" and based on a business model unlikely to be sustainable. He said: "I don’t think that most of the GPs’ system suppliers are going to exist in five years’ time, as I don’t think it’s a sustainable business model."

New systems might not be popular but they will be safer, added Granger. Existing user interfaces were liked but, he argued, in many ways they were dangerous, because they can allow free and unstructured text to be entered as records. "A better structured system is actually less usable," commented Granger.

He went on to state that existing primary care suppliers have deliberately covered up "significant" data corruption of electronic patient records.

Granger said that large numbers of records were sat on decade-old technology and that "significant data corruption" had occurred, some of which had been covered up by suppliers.

Asked about system choice, Granger said that it "makes life more complicated" for technical implementation, but at least made it easier to persuade GPs to adopt the new systems.

Turning to the community pharmacy sector the NHS director general said the implementation of electronic transfer of prescriptions will cause bricks-and-mortar pharmacies to suffer financially and may result in closures: "Making things available electronically means moving to virtual pharmacies, with all the social and economic impact that will cause."

Comparing the pharmacies’ situation to sub post offices that have had to close due to benefits being paid into accounts electronically, he said: "Unless we get services into these industries, you are going to get [reduced] footfall, no cash flow and the whole business model will fall apart. I don’t think those things have been thought through fully yet."

The NHS IT director general’s candid remarks came in a speech and question and answer session at last week’s Health and Social Care Exchange conference in London, as Granger spoke of the wider implications of NHS IT modernisation programme.

Turning to Choose and Book Granger asked GPs who did not want to spend consultation time doing electronic referrals for some give and take.

"In a GP’s practice, a lot of things are electronic, but the discharge summary isn’t… GPs frequently tell me they want discharge summaries fired into their systems but they don’t want to do the referral. If you don’t do the first bit, how can you expect your clinical colleagues to give you the other bit back?"

"As we move to longitudinal healthcare records there will have to be some give and take in the allocations of professionals’ time," he added.