‘Unworkable’ smartcard rules to be re-written

NHS Connecting for Health (CfH) has been forced to scrap the rules that practices must sign up to when they receive a smartcard after it has emerged the policy is unworkable in general practice.

Thousands of GPs may have already unwittingly agreed to the Acceptable Use Policy (AUP) which includes requirements such as an agreement not to use non-NHS IT equipment as well as placing untenable information governance requirements on practices.

CfH has now agreed to rewrite the AUP with the assistance of the British Medical Association’s General Practitioner Committee.

Dr Paul Cundy, a GP in Wimbledon and chair of the IT sub-committee of the GPC, said he believed the policy had been written without getting input from general practices.

He told EHI Primary Care: “There are lots of things in there that GPs are not allowed to do which would make it impossible for them to do their day to day work.”

The issue first arose after Dr Mary Hawking, a GP in Bedfordshire, queried the RA01 form all practices are asked to sign when receiving a smartcard. The form has terms and conditions attached which includes an agreement that practices will observe the AUP for the NHS Care Records Service.

Dr Hawking asked to see the AUP and was first told that it had not yet been written and then asked the British Computer Society’s Primary Health Care Specialist group to investigate.

Ewan Davis, chair of the PHCSG, said: “After some difficulty I eventually managed to find it and the initial concern was that practices were being asked to sign a form and comply with a policy that they almost certainly would not have seen even if they had made fairly strenuous efforts to do so.”

The PHCSG then discovered that the policy was also flawed in several respects. Firstly, the AUP contained clauses such as a requirement outlawing use of equipment not supplied by the NHS; this is impractical in the majority of practices where equipment is still a mixture of practice-owned and NHS-owned items.

Secondly, Davis says the AUP contains a range of information governance requirements which he believes were initially intended for hospitals and PCTs and are impractical for practices to follow.

Davis told EHI Primary Care: “The requirements make a reasonable amount of sense for an organisation the size of a hospital or PCT but not for a general practice. It’s important that these things are done but it’s a question of working out how it is done in the best way.”

He added: “These are not just simply problems of faulty drafting because for some of the issues raised there are no easy answers.”

In the meantime it appears that GPs who already have a smartcard have either signed the RA01 form without being aware of the AUP or, Davis says, some appear not to have signed a form at all. A small number of GPs have signed the form but crossed out the items which they did not accept.

A total of 65,000 smartcards had been issued in the NHS by the end of August, including thousands to general practices as PCTs sought to earn incentive money triggered by issuing 30% of practices with smartcards by the end of June.

CfH was asked to comment but had not issued a statement as this report went to press.