PAC report reveals postcode lottery on GP systems

Connecting for Health has treated contracts for GP systems differently in its five clusters with local service providers contracted to supply GP systems to all practices in three clusters while there is no such agreement in the other two clusters.

The different contractual arrangements around the country are revealed in print for the first time in the Public Accounts Committee’s highly critical report on the National Programme for IT published today.

PAC member Richard Bacon MP asked the Department of Health (DH) to disclose the total number of GP systems that each local service provider (LSP) will be supplying under the terms of its LSP contract.

The DH response was that in the North East, East and East Midlands and London clusters the contracts cover all GP practices, a total of 1265 in the North East, 1632 in the East and East Midlands and 1661 in London.

However in the North West and West Midlands cluster and the Southern cluster there is no similar agreement. In the NWWM cluster the DH said: “CSC is required to make a GP system available but no volumes are currently committed.”

An even less strongly worded agreement exists in the Southern cluster where the DH said there is “an option to require the LSP to provide GP systems to all GP practices” but no volumes are currently committed.

In its 188 page report the PAC raises concerns that the programme is now dependent on only two major software suppliers, iSoft and Cerner and states that one issue causing concern among GPs is the future of their IT systems.

It says that although LSPs were required to offer GP practices a choice of system under the nGMS contract LSPs had only been contracted to provide two systems and it quickly became apparent that one of these was not being delivered. The report acknowledges that the DH is trying to resolve the problem with the introduction of GP Systems of Choice (GPSoC) although in a separate section it also raises concerns about the future of iSOFT’s Lorenzo system, the reference solution for the three northern clusters.

It states: “We are concerned in particular that iSOFT’s flagship software product, ‘Lorenzo’- on which three fifths of the Programme depends – is not yet available despite statements by the company in its 2005 Annual report that the product was available from early 2004.”

Problems with clinical engagement are highlighted as one of four key areas in the PAC report which says the DH still has much to do to win hearts and minds in the NHS, especially among clinicians.

The report added: “It [the DH] needs to show that it can deliver on its promises, supply solutions that are fit for purpose, learn from its mistakes, respond constructively to feedback from users in the NHS and win the respect of a highly skilled and independently minded workforce.”

The report, which focuses most of its attention on secondary care, calls for the Department of Health to take urgent action on the £12.4 billion NPfIT which they say is already running two years late while there remains much uncertainty about the cost of the programme and the value of the benefits it should achieve.

Edward Leigh, PAC chairman, said a question mark hangs over NPfIT and that the DH needed to get a grip on what it and the NHS are spending.

He added: “Urgent remedial action is needed at the highest level if the long-term interests of NHS patients and taxpayers are to be protected.”

The committee report says the DH has been deploying patient administration systems to trusts but says these are not a substitute for the vision of a shared electronic patient clinical record and that no firm plans have been published for deploying software to achieve this vision.

The PAC makes nine recommendations on how it believes the DH must act to salvage the programme. These include developing a robust timetable with suppliers which they are capable of delivering, publishing an annual statement of NPfIT costs and benefits, brining in additional suppliers where necessary, improving communication with staff and especially clinicians and clarify responsibility and accountability for the local implementation of the programme.

Link

PAC report

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