Report must ‘signal the end of the line for GPASS’

A long-awaited independent report on GPASS ‘must signal the end of the line’ for Scotland’s most commonly used GP system, BMA Scotland’s IT representative said today.

After seeing a draft version of the pending Deloitte report on ‘General Practice Information Technology Options’, Dr Stuart Scott, deputy chairman and IT lead for the BMA’s Scottish General Practitioners Committee, said: “This report bears out the concerns that Scotland’s GPs have been expressing about GPASS for a number of years – that it is not fit for purpose and is hindering GPs’ ability to deliver on the new GP contract and consequently on the [Scottish] executive’s Delivering for Health strategy.

"Criticisms of the system by GPs, which have in the past been shrugged off by civil servants, now have the backing of an independent group of experts from outwith the NHS and the health minister must take these recommendations seriously. This report must signal the end of the line for GPASS."

Around 80% of GP practices currently use GPASS, which is provided to NHS boards by the Scottish Executive free of charge, but it has attracted growing criticism both for the inadequacies of the basic system and the slow production of the more advanced version, GPASS Clinical.

E-Health Insider has seen a copy of the 65 page report, which is currently in its second draft, and has been circulated to health board chief executives and other stakeholder organisations for comment.

The report finds that the current product does not meet clinical requirements but says GPASS Clinical could provide better support if it was successfully delivered.

However, it goes on to say that requirements have moved on and there is a broadened focus on the wider primary care team and on data sharing between the health service and its partners. “These requirements are far more complex than GPASS has had to address historically, and GPASS is not well placed in terms of its current product architecture and the probable costs and risks associated with a major redevelopment of the system, when commercial alternatives are available.”

Commercial suppliers have already responded to the new requirements, the report finds, and could deliver well in advance of GPASS.

“Under these circumstances, it makes sense for Scotland to seriously consider the available commercial products. However, there remains some uncertainty regarding outcomes in the supplier market in terms of which applications will emerge as the dominant products.”

The report reasons that it would not be viable to maintain GPASS for a small residual group of users and says “A planned exit from GPASS would, therefore, be required.”

A Scottish Executive spokesperson said: "Deployment of any new systems will be the subject of competitive tendering, which will involve consultation with all key stakeholders. The procurement process should allow for the maintenance of choice, to avoid supplier lock-in.

“GPASS will not be switched off, and support (including enhancements for QOF and DES) will be maintained up to and including a managed migration to systems which support the extended primary care team

"In the meantime, no health board is to enter into a commercial agreement committing it to a primary care IT supplier for more than three years; this to maintain the eHealth strategic objective to converge to common systems within three to five years."

Dr Scott told EHI Primary Care: “GPASS simply doesn’t meet the requirements of modern medical practices. It is such a disappointment that over the last two years, there are so many things wrong with it that need to be corrected and haven’t.

“It doesn’t do things simply or well for GPs. For example, entering data involves multiple keystrokes. They have tried correcting this, with the launch of GPASS Clinical, but of the 27 pilot sites who received it in 2004, none were happy with it.”

He added that the contents of the report came as no surprise to him or GP colleagues across Scotland and they now welcome a decision from the Scottish Executive to move forward, based on the report’s conclusions.

“The report gives all practices the freedom to leave GPASS if they wish to, and migrate to another system for no longer than three years initially. If boards wish to allow GPs to exercise choice in their new systems, then they can do so, as they were given last year (http://www.ehiprimarycare.com/news/item.cfm?ID=1178). I believe that most surgeries will want to migrate from GPASS.”

In a speech to the Scottish Clinical Information Management in Practice (SCIMP) conference on 31 October, Paul Gray, director of primary and community care at the Scottish Executive Health Department, said the Scottish Executive would act on the key recommendations made in the Deloitte report. At the time, he insisted that GPASS would not be scrapped (http://www.ehiprimarycare.com/news/item.cfm?ID=2233).

BMA Scotland feel that a shift to a new supplier will require significant planning, resources and investment in order to make the transition as smooth as possible.

Dr Scott told EHIPC that the Scottish Executive would now focus on working towards creating one national system for the whole of Scotland, and BMA Scotland will offer full support to practices that stick with GPASS or choose to migrate.

“The BMA is now keen to work with the Scottish Executive not just to identify appropriate commercial suppliers but also to develop an exit strategy for GPASS that will ensure continued support for those doctors still using the system until such a time when they can transfer to an alternative.”

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