New deal on system choice for GPs

GPs will be able to choose from a wider range of IT system suppliers under the terms of a new deal outlined by Connecting for Health.

The agreement, which is subject to Treasury approval, means eligible systems will be funded centrally by the Department of Health, removing the financial pressure on primary care trusts.

Existing funding arrangements under which local service provider systems are effectively free to PCTs have been heavily criticised by GPs who have complained that it denies practices’ system choice. Among the profession’s complaints have been that practices have been forced to move systems because it is cheaper for PCTs than paying to maintain a practice’s existing system from the PCT’s own budgets.

The initiative, known as GP Systems of Choice (GPSoC), is broken down into two parts. Capital funding will be provided to PCTs from 5 April to enable practices’ hardware to be upgraded to meet and continue to minimum standards for infrastructure to set by Connecting for Health.

In addition ongoing revenue costs for existing systems will be met directly by Connecting for Health. This element of the agreement is still subject to Treasury approval.

Kemi Adenubi, programme director for GPSoC, said the business case still needed approval but it was hoped the deal would be ready to be rolled out by the fourth quarter of this year.

Dr Gillian Braunold, Connecting for Health’s GP clinical lead and a GP in London, said: “I don’t have any qualms in saying we have done a deal that will deliver for GPs this year.”

GPs will also be able to switch to any of the 12 suppliers with which the DH is negotiating an agreement. However practices will have to have their business case approved by their PCT and the costs of data migration, around £1500 for a 7,500 patient practice, will have to be met locally. The cost of data migration for GPs moving to an LSP system will be covered within the LSP contract.

Systems will be offered to GPs providing they meet specified standards in a “maturity model” or “ladder of interoperability” designed to ensure than systems will work with the new NHS systems installed by Connecting for Health.

The model starts at level 0, which involves RFA99 accreditation, QMAS and Quality and Outcomes Framework compliance and compliance with information governance standards. Levels 1-5 add additional elements of the National Programme for IT. Level 1 EPS, level 3 compliance with GP2GP, level 4 requires provision of a data centre hosted system and level five requires the ability to access and update the summary patient record on the spine.

System providers will be paid a tariff, individually negotiated with CfH, dependent upon which level of the maturity model they have reached.

Eventually practices will still be expected to move to a level 6 system which is described as a system fully integrated with the LSP care record service system across all care settings.

Twelve system suppliers are working with the DH to develop the scheme and Adenubi said she hoped agreements would be in place by June. The 12 suppliers are: Accenture, Ascribe, Capital care Alliance, CSC Alliance, EMIS, Fujitsu Alliance, Healthy Software, In Practice Systems, iSOFT, Microtest, Seetec and The Phoenix Partnership.

The choice initiative does not affect systems for community health staff which will continue to be provided under LSP contracts.

The deal was welcomed by Dr Manpreet Pujara, a GP in Rochester, Kent, and chairman of the EMIS National User Group, although he said he remained concerned about how arrangements to approve practice business cases to move systems would work at local level.

Dr Braunold said the arrangements for PCT approval and for an appeals process had yet to be agreed. But she added: “I prefer to call it a ‘justification’ rather than a ‘business case’. It doesn’t need to be a financial business case. You just need to be able to justify why you want to move.”

Dr Braunold said she and Professor Mike Pringle, her co-GP clinical lead at CfH, would soon be writing to GPs outlining the scheme as well as covering other CfH issues.

An initial announcement to widen GP system choice was made at the Healthcare Computing conference 12 months ago. However Dr Braunold revealed that the scheme outlined then, which involved GPs being able to access any systems so long as it had a contract with a LSP in the country, was scrapped because it could not be made to work and would not offer and the NHS value for money.

Links

Connecting for Health: GP Systems of Choice